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PROFESSOR  PHILIP  HANSON  HISS 

1868-1913 

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Mrs.  Philip  Hanson  Hiss 


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A    MANUAL 


OF 


PRACTICAL  HYGIENE 


BY 

EDMUND   A.   PARKES,   M.D.,  F.R.S. 

LATE   PEOFESSOE   OP   MILITARY  HYGIENE   IN   THE   ARMY   MEDICAL   SCHOOL  ;    MEMBER   OP  THE    GENERAL 

COUNCIL   OF   MEDICAL   EDUCATION  ;    FELLOW   OF   THE   SENATE    OF   THE    UNIVEESITT   OF   LONDON ; 

EMEBITUS  PKOFESSOE  OF  CLINICAL  MEDICINE  IN   UNIVERSITY  COLLEGE,   LONDON 


EDITED   BY 

F.  S.  B.  FRANgOIS  DE   CHAUMONT,   M.D.,  F.R.S. 

FELLOW  OF  THE   ROYAL  COLLEGE   OF   SURGEONS   OP   EDINBURGH  ;    FELLOW   AND   CHAIRMAN   OF   COUNCIL 

OF   THE   SANITARY   INSTITUTE    OF    GREAT   BRITAIN  ;    PROFESSOR   OP   MILITARY 

HYGIENE  IN  THE  ARMY  MEDICAL  SCHOOL 

FROM   THE    LAST   LONDON    EDITION 

WITH  AN   APPENDIX 
Giving  the  American  Peactice  in  Mattees  KELATma  to  Htgiene 

PBBPARED  BY  AND   UNDER   THE    SUPERVISION   OF 

FREDERICK    N.   OWEN 

CIVIL  AND  SANITARY  ENGINEER 

TWO     VOLUMES    11^    ONE 

Volume  I. 

NEW  YORK 
WILLIAM    WOOD    &    COMPANY 

56  &  58  Lapatette  Place 
1884 


/ 


OOPTBIOHT 
WILLIAM    WOOD  &  COMPANY 

1863 


'Tl 


TROW'9 

PRINTING  AND  BOOKBINDING  COMPANY^ 

K£W  TORK« 


PEEFACE  TO  THE  SIXTH  EDITION. 


In  presenting  the  Sixth  Edition  of  the  "  Manual  of  Practical 
Hygiene,"  I  have  endeavored  to  keep  within  much  the  same  limits 
as  in  the  previous  edition,  by  omitting  matter  which  had  either 
become  out  of  date  or  was  no  longer  necessary.  In  this  way  space 
has  been  obtained  for  matter  which  the  progress  of  science  and  the 
results  of  experience  rendered  it  desirable  to  add.  Some  slight 
changes  have  been  made,  such  as  putting  all  the  directions  for  making 
chemical  solutions  in  one  appendix  at  the  end  of  Volume  II.,  and 
uniting  all  the  questions  of  disinfection  and  deodorization  in  one 
chapter.  The  prefaces  to  former  editions  have  been  omitted,  as 
being  no  longer  required.     The  index  is  as  full  as  on  the  last  occasion. 

F.  DE  CHAUMONT. 
WooLSTON  Lawn, 
Southampton,  March^  1883. 


CONTENTS. 


PAGE 

INTRODUCTION ix 

BOOK   I. 

CHAPTER  I. 

Water •  •  1 

Section       I. — Quantity  and  supply 2 

Quantity  for  healthy  men  and  animals ^ 

sick  men 7 

Collection 8 

Storage 11 

Distribution 14 

Action  on  lead  pipes 17 

Section     II.— Quality 19 

Composition  of  drinking-water 19 

Characters  and  classification  of  drinking-water 24 

Origin  of  the  impurities  in  drinking- wMer 24 

Impurities  of  source . .  24 

transit 27 

storage 28 

distribution . , • .  29 

Section    III. — Purification  of  water 30 

Without  filtration 30 

With  filtration ...  32 

Section    IV. — Effects  of  an  insufficient  or  impure  supply 39 

Insufficient    supply 39 

Impure  supply 40 

Section      V.  — Examination  of  water  for  hygienic  purposes 65 

Collection 66 

Coarser  physical  examination 67 

Examination  of  suspended  matters 69 

Microscopical 69 

Chemical 74 

of  dissolved  matters 74 

Qualitative 76 

Quantitative 81 

Section    VL — Search  after  water 107 

Supply  of  water  to  soldiers 107 


VI 


CONTENTS. 


CHAPTER   II. 

PAOB 

AIR 113 

Section       I. — Impurities  in  air 114 

Suspended  matters 115 

Gaseous  matters 121 

Impurities  in  certain  special  cases = 122 

Section     II.— Diseases  produced  by  impurities  in  air 133 

supended  impurities 133 

gaseous  impurities 138 

co-existing  impurities 143 

CHAPTER   III. 

Ventilation 157 

Section       I. — Quantity  of  air  required 157 

Section      II. — Mode  in  which  it  should  be  given 164 

Section    III. — Means  by  which  air  is  set  in  motion 168 

Natural  ventilation 168 

Artificial  ventilation   183 

Extraction 183 

Propulsion 188 

Section    IV. — Relative  value  of  natural  and  artificial  ventUation 190 

CHAPTER  IV. 

Examination  of  Am 191 

Section       I. — Measurement  of  cubic  space 191 

Section      II. — Movement  of  air  in  the  room 193 

Section    III.  — Examination  of  the  air 195 

Section    IV. — Application  of  foregoing  rules 201 

CHAPTER  V. 

Food 203 

Section       I. — General  principles  of  diet 203 

Quantity  of  food  209 

On  the  energy  obtainable  from  food  210 

On  the  relative  value  of  food 217 

The  digestibility  of  food 219 

Section     II. — Diseases  connected  with  food 221 

CHAPTER  VI. 

Quality,  Choice,  and  Cookino  op  Food 225 

Section       I.— Meat  225 

Section     II.— Wheat 241 

Section    III.  —Barley 268 

Section    IV.— Oats 268 

Section      V.— Maize  and  Rye 269 

Section    VI.— Rice 269 

Section  VII.— Millet,  Buckwheat,  etc , 270 


CONTENTS. 


Vll 


PAGE 

Section  VIII. — Leguminosse 371 

Section      IX. — Starches  and  Sugar 273 

Arrowroots 373 

Tapioca 273 

Sago 273 

Sugar 274 

Section       X. — Succulent  vegetables 275 

Section     XI.— Milk 277 

Section     XII  —Butter 285 

Section  XIII.— Cheese 289 

Section  XIV.— Eggs o 289 

Section     XV. — Concentrated  and  Preserved  Food 290 

CHAPTER  VII. 

Bevekages  and  Condiments 294 

Section         I. — Alcoholic  beverages 294 

Beer ,  <,   294 

Wine 301 

Spirits 306 

Alcohol  as  an  article  of  diet 307 

Section       II. — Non-alcoholic  beverages 327 

Coffee 327 

Tea 333 

Cocoa 336 

Section      III. — Condiments  338 

Vinegar 338 

Mustard  339 

Pepper 341 

Salt  . 343 

Section      IV. — Lemon  and  lime  juice  343 

CHAPTER  VIII. 

Soils 346 

Section         I. — Condition  of  soil  affecting  health 346 

Air  in  soil 346 

Water  in  soil 348 

Solid  constituents 355 

Malarious  soils 362 

Section       II. — Examination  of  soil 364 

Section     III. — Method  of  examining  a  locality 367 

Section      IV. — Preparation  of  site 368 


TNTRODUCTIOJSr. 


HTGiEisrE  is  the  art  of  preserving  health ;  that  is,  of  obtaining  the 
most  perfect  action  of  body  and  mind  during  as  long  a  period  as  is 
consistent  with  the  laws  of  life.  In  other  words,  it  aims  at  rendering 
growth  more  perfect,  decay  less  rapid,  life  more  vigorous,  death  more 
remote. 

This  art  has  been  practised  from  the  earliest  times.  Before  Hip- 
pocrates there  were  treatises  on  hygiene,  which  that  great  master  evi- 
dently embodied  in  his  incomparable  works.  It  was  then  based  on 
what  we  should  now  call  empirical  rules — viz.,  simply  on  observations 
of  what  seemed  good  or  bad  for  health.  Yery  early,  indeed,  the  effects 
of  diet  and  of  exercise  were  carefully  noticed,  and  were  considered  the 
basis  of  hygiene.'  Hippocrates,  indeed,  appears  to  have  had  a  clear 
conception  of  the  relation  between  the  amount  of  food  taken  and  of 
the  mechanical  energy  produced  by  it ;  at  least,  he  is  extremely  care- 
ful in  pointing  out  that  there  must  be  an  exact  balance  between  food 
and  exercise,  and  that  disease  results  from  excess  either  way. 

The  effects  on  health  of  different  kinds  of  air,  of  water,  and  to 
some  extent  of  soils,  were  also  considered  at  a  very  early  date ;  though 
naturally  the  ignorance  of  chemistry  prevented  any  great  advance  in 
this  direction.  Hippocrates  summed  up  the  existing  knowledge  of  his 
time  on  the  six  articles,  which  in  after-days  received  the  absurd  name 

'  Herodicus,  one  of  the  preceptors  of  Hippocrates,  was  the  first  to  introduce  medi- 
cinal gymnastics  for  the  improvement  of  health  and  the  cure  of  disease  ;  though  gym- 
nastics in  training  for  war  had  been  used  long  before.  Plutarch  says  of  him,  that 
laboring  under  a  decay  which  he  knew  could  not  be  perfectly  cured,  he  was  the  first 
who  blended  the  gymnastic  art  with  physic,  in  such  a  manner  as  protected  to  old  age 
his  own  life,  and  the  lives  of  others  afflicted  with  the  same  disease.  He  was  censured 
bj  Plato  for  keeping  alive  persons  with  crazy  constitutions. — Mackenzie  on  Health. 


X  INTRODUCTION. 

of  the  "  Non-naturals." '  The  six  articles,  whose  regulation  was  con- 
sidered indispensably  necessary  to  the  life  of  man,  were — air,  aliment, 
exercise  and  rest,  sleep  and  wakefulness,  repletion  and  evacuation,  the 
passions  and  affections  of  the  mind. 

I  With  the  exception  of  the  attempts  of  the  alchemists,  and  of  the 
chemical  physicians,  to  discover  some  agent  or  drug  which  might  in- 
crease or  strengthen  the  principle  of  life,"  the  practice  of  hygiene 
remained  within  the  same  limits  until  physiology  (the  knowledge  of 
the  laws  of  life)  began  to  be  studied.  Hygiene  then  began  to  acquire 
a  scientific  basis.  Still  retaining  its  empirical  foundation  drawn  from 
observation,  it  has  now  commenced  to  apply  the  discoveries  of  physi- 

'  Tliis  title  originated  in  a  sentence  of  Galen,  and  was  introduced  into  use  by  the 
jargon  of  the  Peripatetic  school.  It  was  employed  in  all  treatises  on  hygiene  for  prob- 
ably nearly  1,500  years. 

*  It  was  when  chemistry  was  being  rudely  studied  by  the  alchemists  that  an  entirely 
different  school  of  hygiene  arose.  The  discovery  of  chemical  agents,  and  the  great 
eflFect  they  produce  on  the  body,  led  to  the  notion  that  they  could  in  some  way  aid  the 
forces  of  life,  and  insure  a  prolonged,  if  not  an  eternal  youth,  and  a  life  of  ages  instead 
of  one  of  years.  This  belief,  the  natural  result  of  the  discovery  of  new  powers,  has 
not  yet  entirely  died  out ;  and  while  there  are  some  who  still  look  to  every  fresh  agent 
as  possibly  containing  "  the  balsam  of  life,"  there  are  also  still  enthusiasts  who  search 
the  mystic  tomes  of  the  alchemists  or  the  Rosicrucians,  in  the  faith  that,  after  all,  the 
great  secret  was  really  found.  It  may  be  worth  while  to  consider  the  idea  which  under- 
laid the  dreams  of  the  alchemists.  Life  was  looked  on  as  an  entity  or  principle  liable 
to  constant  waste,  and  to  eventual  expenditure.  If  some  agent  could  be  found  to  arrest 
the  waste,  to  crystallize,  as  it  were,  the  tissues  in  their  full  growth  and  vigor,  decay,  it 
was  conceived,  would  be  impossible,  and  youth  would  be  eternal.  In  other  cases,  it 
was  supposed  that  the  agent  would  itself  contain  the  principle  of  life,  and  therefore 
would  at  once  restore  destroyed  health,  and  recall  again  departed  youth.  We  now  know 
this  idea  to  be  wrong  in  every  point.  The  constant  decay  the  alchemists  sought  to 
check  is  life  itself,  for  life  is  but  incessant  change,  and  what  we  call  decay  is  only  a 
metamorphosis  of  energy.  To  arrest  the  changes  in  the  body  for  one  single  moment 
would  be  death,  or,  short  of  death,  it  would  be  lessening  of  the  energy  which  is  the 
expression  of  life.  Nor  is  there  any  hope  that  the  extension  of  the  period  of  vital 
energy  can  ever  be  accomplished  except  by  improving  the  nutrition  of  the  tissues. 
Here,  indeed,  it  is  just  possible  that,  in  time  to  come,  drugs  will  aid  Hygiene,  either 
by  better  preparing  food  for  the  purposes  of  nutrition,  or  by  removing  or  preventing 
those  chemical  changes  in  the  tissues  which  we  call  decay.  But  at  present,  certainly, 
no  rules  can  be  laid  down  for  the  use  of  drugs  in  hygiene,  except  in  that  debatable 
land  which  lies  between  hygiene  and  the  practice  of  medicine,  that  is,  in  that  uncer- 
tain region  which  we  do  not  like  to  call  disease,  and  yet  which  is  not  health. 


ITfTRODUCTIOIir.  XI 

ology  to  the  improvement  of  health,  and  to  test  the  value  of  its  own 
rules  by  this  new  light.  It  is  now  gradually  becoming  an  art  based  on 
the  science  of  physiology,  with  whose  progress  its  future  is  identified. 

But  the  art  of  hygiene  has  at  present  still  another  object.  If  we 
had  a  perfect  knowledge  of  the  laws  of  life,  and  could  practically 
apply  this  knowledge  in  a  perfect  system  of  hygienic  rules,  disease 
would  be  impossible.  But  at  present  disease  exists  in  a  thousand 
forms,  and  the  human  race  languishes,  and  at  times  almost  perishes, 
under  the  grievous  yoke.  The  study  of  the  causes  of  disease  is  strictly 
a  part  of  physiology,'  but  it  can  only  be  carried  out  by  the  practical 
physician,  since  an  accurate  identification  of  the  diseases  is  the  first 
necessary  step  in  the  investigation  of  causes. 

The  causes  being  investigated,  the  art  of  hygiene  then  comes  in  to 
form  rules  which  may  prevent  the  causes  or  render  the  frame  more 
fitted  to  bear  them  ;  and  as  in  the  former  case  it  was  the  exponent  o£ 
physiology,  in  this  case  it  becomes  the  servant  of  the  pathologist. 

Taking  the  word  hygiene  in  the  largest  sense,  it  signifies  rules  for 
perfect  culture  of  mind  and  body.  It  is  impossible  to  dissociate  the 
two.  The  body  is  affected  by  every  mental  and  moral  action ;  the 
mind  is  profoundly  influenced  by  bodily  conditions.  For  a  perfect 
system  of  hygiene  we  must  train  the  body,  the  intellect,  and  the  moral 
faculties  in  a  perfect  and  balanced  order. 

But  is  such  a  system  possible  ? 

Is  there,  or  will  there  ever  be,  such  an  art,  or  is  the  belief  that 
there  will  be,  one  of  those  dreams  which  breathe  a  blind  hope  into  us, 
a  hope  born  only  of  our  longings,  and  destined  to  die  of  our  experi- 
ence ?  And,  indeed,  when  we  look  around  us  and  consider  the  con- 
dition of  the  world — the  abundance  of  life,  its  appalling  waste ;  the 
wonderful  contrivances  of  the  animal  kingdom,  the  apparent  indiffer- 
ence v^ith  wdiich  they  are  trampled  under  foot ;  the  gift  of  mind,  its 
awful  perversion  and  alienations  ;  and  when,  especially,  we  note  the 


'  Physiology  and  pathology  are,  in  fact,  one  ;  normal  and  abnormal  life,  regular  and 
irregular  growth  and  decay,  must  be  studied  together,  just  as,  in  fact,  human  physi" 
ology  is  imperfect  without  the  study  of  all  the  other  forms  of  life,  animal  and  vegeta- 
ble, which  are  in  the  world.  Separated  for  convenience,  these  various  studies  will 
finally  converge. 


Xii  INTRODUCTION. 

condition  of  the  human  race,  and  consider  what  it  apparently  might 
be,  and  what  it  is;  its  marvellous  endowments  and  lofty  powers;  its 
terrible  sufferings  and  abasement ;  its  capacity  for  happiness,  and  its 
cup  of  sorrow ;  the  boon  of  glowing  health,  and  the  thousand  diseases 
and  painful  deaths, — he  must  indeed  be  gifted  with  sublime  endurance 
or  undying  faith  wlio  can  still  believe  that  out  of  this  chaos  order  can 
come,  or  out  of  this  suffering  happiness  and  health. 

Whether  the  world  is  ever  to  see  such  a  consummation  no  man 
can  say ;  but  as  ages  roll  on,  hope  does  in  some  measure  grow.  In  the 
midst  of  all  our  weaknesses,  and  all  our  many  errors,  we  are  certainly 
gaining  knowledge,  and  that  knowledge  tells  us,  in  no  doubtful  terms, 
that  the  fate  of  man  is  in  his  own  hands. 

It  is  undoubtedly  true  that  we  can,  even  now,  literally  choose  be- 
tween health  or  disease  ;  not,  perhaps,  always  individually,  for  the  sins 
of  our  fathers  may  be  visited  upon  us,  or  the  customs  of  our  life  and 
the  chains  of  our  civilization  and  social  customs  may  gall  us,  or  even 
our  fellow-men  may  deny  us  health,  or  the  knowledge  which  leads  to 
health.  But  as  a  race,  man  holds  his  own  destiny,  and  can  choose  be- 
tween good  and  evil ;  and  as  time  unrolls  the  scheme  of  the  world,  it 
is  not  too  much  to  hope  that  the  choice  will  be  for  good. 

Looking  only  to  the  part  of  hygiene  which  concerns  the  physician,  a 
perfect  system  of  rules  of  health  would  be  best  arranged  in  an  orderly 
series  of  this  kind. 

The  rules  would  commence  with  the  regulation  of  the  mother's 
health  while  bearing  her  child,  so  that  the  growth  of  the  new  being 
should  be  as  perfect  as  possible.  Then,  after  birth,  the  rules  (different 
for  each  sex  at  certain  times)  would  embrace  three  epochs;'  of  growth 
(including  infancy  and  youth) ;  of  maturity,  when  for  many  years  the 
body  remains  apparently  stationary ;  or  decay,  when,  without  actual 
disease,  though,  doubtless,  in  consequence  of  some  chemical  changes, 
molecular  feebleness  and  death  commence  in  some  part  or  other,  fore- 
running general  decay  and  death. 

In  these  several  epochs  of  his  life,  the  human  being  would  have  to 
be  considered — 


*  First  expressly  noted  by  Galen. 


INTEODUCTIOTT.  Xlll 

1st,  In  relation  to  the  natnral  conditions  which,  surround  him,  and 
which  are  essential  for  life,  such  as  the  air  he  breathes ;  the  water  he 
drinks ;  his  food,  the  source  of  all  bodilv  and  mental  acts ;  the  soil 
which  he  moves  on,  and  the  sun  which  warms  and  lights  him,  etc. ;  in 
fact,  in  relation  to  nature  at  large. 

2d,  In  his  social  and  corporate  relations,  as  a  member  of  a  commu- 
nity with  certain  customs,  trades,  conditions  of  dwellings,  clothing, 
etc. ;  subjected  to  social  and  political  mfluences,  sexual  relations,  etc. 

3d,  In  his  capacity  as  an  independent  being,  having  within  himself 
sources  of  action,  in  thoughts,  feelings,  desires,  personal  habits,  all  of 
which  affect  health,  and  which  require  self -regulation  and  control. 

Even  now,  incomplete  as  hygiene  necessarily  is,  such  a  work  would, 
if  followed,  almost  change  the  face  of  the  world.  But  would  it  be  fol- 
lowed ? 

In  some  cases  the  rules  of  hygiene  could  not  be  followed,  however 
much  the  individual  might  desire  to  do  so.  For  example,  pure  air  is 
a  necessity  for  health  ;  but  an  individual  may  have  little  control  over 
the  air  which  surrounds  him,  and  which  he  must  draw  into  his  lungs. 
He  may  be  powerless  to  prevent  other  persons  fi-om  contaminating  his 
air,  and  thereby  striking  at  the  very  foundation  of  his  health  and  hap- 
piness. Here,  as  in  so  many  other  cases  which  demand  regulation  of 
tlie  conduct  of  the  individuals  toward  each  other,  the  State  steps  in  for 
the  protection  of  its  citizens,  and  enacts  rules  which  shall  be  binding 
upon  all.  Hence  arises  what  is  now  termed  "  State  Medicine,"  a  mat- 
ter of  the  greatest  importance.  The  fact  of  "  State  Medicine  "  being 
possible,  marks  an  epoch  in  which  some  sanitary  rules  receive  a  gen- 
eral consent,  and  indicates  an  advancing  civilization.  Fear  has  been 
expressed  lest  State  Medicine  should  press  too  much  on  the  individual, 
and  should  too  much  lessen  the  freedom  of  personal  action.  This, 
however,  is  not  likely,  as  long  as  the  State  acts  cautiously,  and  only 
on  well-assured  scientific  grounds,  and  as  long  as  an  unshackled  Press 
discusses  with  freedom  every  step.^ 

^  A  -n-atcliiul  care  over  the  liealtli  of  the  people,  and  a  due  regulation  of  matters 
■wMcIl  concern  their  liealth,  is  certainly  one  of  tlie  most  important  functions  of  Govern- 
ment. The  fact  that,  in  modern  times,  the  subject  of  hygiene  generally,  and  State 
Medicine  in  particular,  has  commenced  to  attract  so  much  the  public  attention,  is  un- 


xiv  INTRODUCTION^. 

There  are,  however,  some  cases  in  which  the  State  cannot  easily 
interfere,  though  the  individual  may  be  placed  under  unfavorable 
hygienic  conditions  by  the  action  of  others.  For  example,  in  many 
trades,  the  employed  are  subjected  to  danger  from  the  carelessness,  or 
avarice,  or  ignorance  of  the  employers.  Every  year  the  State  is,  how- 
ever, very  properly  more  and  more  interposing  and  shielding  the  work- 
man against  the  dangers  which  an  ignorant  or  careless  master  brings 
on  him. 

But  in  other  cases  the  State  can  hardly  interpose  with  effect ;  and 
the  growth  of  sanitary  knowledge,  and  the  pressure  of  public  opinion, 
alone  can  work  a  cure,  as,  for  example,  in  the  case  of  the  dwellings  of 
our  poorer  classes.     In  many  parts  of  the  country  the  cottages  are 

doubtedly  owing  to  the  application  of  statistics  to  public  health.  It  is  impossible  for 
any  nation,  or  for  any  Government,  to  remain  indifferent  when,  in  figures  which  admit 
of  no  denial,  the  national  amount  of  health  and  happiness,  or  disease  and  suffering,  is 
determined.  The  early  Statistical  Reports  of  the  Army  by  Tulloch,  Marshall,  and  Bal- 
four, directed  attention  to  the  importance  of  this  matter.  The  establishment  of  the 
Registrar-General's  office  in  1838,  and  the  commencement  of  the  system  of  accurately 
recording  births  and  deaths,  will  hereafter  be  found  to  be,  as  far  as  the  happiness  of 
the  people  is  concerned,  one  of  the  most  important  events  of  our  time.  We  owe  a  na- 
tion's gratitude  especially  to  him  to  whose  sagacity  the  chief  fruits  of  the  inquiry  are 
due,  to  William  Farr. 

Another  action  of  the  Government  in  our  day  was  scarcely  less  important.  It  is 
impossible  to  overrate  the  value  of  the  Government  Inquiry  into  the  Health  of  Towns, 
and  of  the  country  generally,  which  was  commenced  forty  years  ago  by  Edwin  Chad- 
wick,  Southwood  Smith,  Neil  Arnott,  Sutherland,  Guy,  Toynbee,  and  others,  and  has, 
in  fact,  been  continued  ever  since  by  the  official  successors  of  these  pioneers,  the  former 
medical  officer  to  the  Privy  Council,  Mr.  Simon,  the  late  Dr.  Seaton,  and  the  present 
medical  officer  of  the  Local  Government  Board,  Dr.  Buchanan.  Consequent  on  this 
movement  came  the  appointment  of  medical  officers  of  health  to  the  different  towns  and 
parishes.  The  reports  published  by  many  of  these  gentlemen  have  greatly  advanced 
the  subject,  and  have  done  much  to  diffuse  a  knowledge  of  hygiene  among  th^  people, 
and  at  the  same  time  to  extend  and  render  precise  our  knowledge  of  the  conditions  of 
^  national  health.  When  the  effect  of  all  these  researches  and  measures  develops  itself, 
it  will  be  seen  that  even  great  wars  and  political  earthquakes  are  really  nothing  in 
comparison  with  these  silent  social  changes.  Even  now  legislation,  sucli  as  the  Public 
Health  Act,  1875,  and  the  various  measures  since  passed,  is  beginning  to  exert  a  deep 
influence.  Legislation,  and  action  baaed  on  legislation,  can  only  proceed  slowly,  and 
we  must  be  satisfied  if  there  be  a  continual  advance,  though  it  may  not  be  so  rapid  as 
some  desire. 


INTRODUCTIOIT.  XV 

unfit  for  human  beings ;  in  many  of  our  towns,  the  cupidity  of  builders 
runs  np  houses  of  the  most  miserable  structure,  for  which  there  is  un- 
]iappily  no  lack  of  applicants  ;  or  masters  oblige  their  men  to  work  in 
rooms,  or  to  follow  plans  which  are  most  detrimental  to  health. 

But  even  in  such  cases  it  will  be  always  found  that  self-interest 
would  really  indicate  that  the  best  course  is  that  we  should  do  for  our 
neighbors  as  for  ourselves.  Analyze  also  the  effect  of  such  selfishness 
and  carelessness  as  has  been  referred  to  on  the  nation  at  large,  and  we 
shall  find  that  the  partial  gain  to  the  individual  is  far  more  than  coun- 
terbalanced by  the  injury  to  the  State,  by  the  discontent,  recklessness, 
and  indifference  produced  in  the  persons  who  suffer,  and  which  may 
liave  a  disastrous  national  result.  It  is  but  too  commonly  forgotten 
that  the  whole  nation  is  interested  in  the  proper  treatment  of  every 
one  of  its  members,  and  in  its  own  interest  has  a  right  to  see  that  the 
relations  between  individuals  are  not  such  as  in  any  way  to  injure  the 
well-being  of  the  community  at  large. 

In  many  cases,  again,  the  employer  of  labor  finds  that,  by  proper 
sanitary  care  of  his  men,  he  reaps  at  once  an  advantage  in  better  and 
more  zealous  work,  in  fewer  interruptions  from  ill-health,  etc.,  so  that 
his  apparent  outlay  is  more  than  compensated. 

This  is  shown  in  the  strongest  light  by  the  army.  The  State  em- 
ploys a  large  number  of  men,  whom  it  places  under  its  own  social  and 
sanitary  conditions.  It  removes  from  them  much  of  the  self-control 
with  regard  to  hygienic  rules  which  other  men  possess,  and  is  there- 
fore bound  by  every  principle  of  honest  and  fair  contract  to  see  that 
these  men  are  in  no  way  injured  by  its  system.  But  more  than  this: 
it  is  as  much  bound  by  its  self-interest.  It  has  been  proved  over  and 
over  again  that  nothing  is  so  costly  in  all  ways  as  disease,  and  that 
nothing  is  so  remunerative  as  the  outlay  which  augments  health,  and 
in  doing  so,  augments  the  amount  and  value  of  the  work  done. 

It  was  the  moral  argument  as  well  as  the  financial  one  which  led 
Lord  Herbert  to  devote  his  life  to  the  task  of  doing  justice  to  the  sol- 
dier, of  increasing  the  amount  of  his  health,  and  moral  and  mental 
training,  and,  in  so  doing,  of  augmenting  not  only  his  happiness,  but 
the  value  of  his  services  to  the  country. 


PRACTICAL  HYGIENE. 


^oaU  |. 


CHAPTER    I. 

WATER. 


The  supply  of  wholesome  water  in  sufficient  quantity  is  a  fundamental 
sanitary  necessity.  Without  it  injury  to  health  inevitably  arises,  either 
simply  from  deficiency  of  quantity,  or  more  fi-equently  from  the  presence 
of  impurities.  In  aU  sanitary  investigations,  the  question  of  the  water 
supply  is  one  of  the  first  points  of  inquhy,  and  of  late  years  quite  unex- 
pected evidence  has  been  obtained  of  the  frequency  with  which  diseases 
are  introduced  by  the  agency  of  water.  In  such  an  investigation,  if  the 
headings  of  the  sub-sections  of  this  chapter  ai-e  followed,  and  the  facts  ai'e. 
noted  under  each  heading  in  order,  it  will  be  hardly  possible  to  overlook 
any  condition  which  may  have  affected  health.  The  order  of  investigation 
would  be  as  follows  : — Quantity  of  water  per  head  ;  how  is  it  collected  ; 
stored ;  distributed  ;  what  is  its  composition  ;  is  it  wholesome  water  at  its 
source  and  throughout,  or  has  it  been  contaminated  at  any  point  of  its  dis- 
tribution ;  what  are  the  effects  presumed  to  arise  from  it  ?  ' 

^  Anni/  Regulations  on  t7ie  Subject  of  Water.— The  Regulations  for  the  Medical  De- 
partment of  Her  Majesty's  Army  frequently  refer  to  the  supply  of  water.  In  Part  I., 
Section  iii.,  paragraph  81  (o,  the  Surgeon-General  and  Deputy  Surgeons-General  are 
directed  to  ''  ascertain  that  the  water-supply  is  good  and  abuudant.  and  perfectly 
protected  from  pollution."  Also  paragraph' 21  (b),  '•  that  the  means  of  ablution  and 
cleanliness  are  sufficient,  and  made  use  of  by  the  men."  As  regards  hospitals  they 
are  also  to  ascertain  (paragraph  25).  "  that  the  water-supply  is  pure,  pnd  abundant 
and  sufiicieuc  for  all  the  requirements  of  a  hospital,  .  .  .  and  that  the  lava- 
tories, bath-rooms,  and  water-closets  are  kept  in  proper  order."  In  the  Sanitary  Reg- 
ulatioas,  Part  V.,  Section  ii. ,  paragraph  618,  the  medical  officer  in  charare  of  troops  is 
ordered  to  examine,  from  time  to  time,  •'  the  quality  and  amount  of -drinking-water," 
and  to  ascertain  that  there  is  "no  soakage  from  latrines,  cesspools,  drains,  or  other 
sources  of  impurity."  He  is  also  ordered  to  inspect  the  lavatories  and  baths.  In 
Sections  vi.  and  vii.  the  same  supervision  over  the  water-supply  of  camps  and  garri- 
sons and  transport  ships  is  enjoined. 

When  an  army  takes  the  field  a  Sanitary  Officer  is  appointed,  and  he  examines 
into  all  sanitary  points,  including  the  wcter-supply.     (Section  viii.,  paragraph  (179.) 

In  the  quarterly  and  annual  reports  the  water-supply  has   to  be  considered,  in 


3  PRACTICAL    HYGIENE. 

SECTION  L 
ON  THE   QUANTITY  AND   SUPPLY  OF  WATER. 

Sub-Section  I. — 1,  Quaittity  of  Water  for  Healthy  INIen. 

In  estimating  the  quantity  of  water  required  daily  for  each  person,  it  is 
necessary'  to  allow  a  liberal  supply.  There  should  be  economy  and  avoid- 
ance of  waste  ;  but  still,  any  error  in  supply  had  far  better  be  on  the  side 
of  excess.  In  England  many  poor  families,  either  fi'om  the  difficulty  of 
obtaining  water,  or  of  getting  lid  of  it,  or  fi-om  the  habits  of  uucleaiiliness 
thus  handed  down  from  father  to  son,  use  an  extremely  small  amount.  It 
would  be  quite  incon-ect  to  take  this  amount  as  the  standard  for  the  com- 
munity at  large,  or  even  to  fix  the  smallest  quantity  which  will  just  suffice 
for  moderate  cleanliness.  It  is  almost  impossible  to  give  a  definition  of 
cleanliness,  nor  perhaps  is  it  necessary,  since  there  is  a  general  understand- 
ing of  what  is  meant. 

It  must  be  clearly  understood  for  what  pui-jDOses  water  is  supj^lied.  It 
may  be  required  for  di'inking,  cooking,  and  ablution  of  persons,  clothes, 
utensils,  and  houses ;  for  cleansing  of  closets,  sewers,  and  streets  ;  for  the 
di-inking  and  washing  of  animals,  washing  of  cai'riages  and  stables  ;  for 
trade  purjioses  ;  for  extinguishing  fires  ;  for  public  fountains  or  baths,  etc. 

In  towns  supphed  by  water  companies,  the  usual  mode  of  reckoning  is 
to  diA^ide  the  total  daily  supply  in  gallons  by  the  total  pojDulation,  and  to 
express  the  amount  per  head  per  diem. 

The  following  are  some  of  the  gross  amounts  used  at  the  present  time 
for  all  the  above  purposes,  as  judged  of  in  this  way  : — 

Gallons  per  head  of  popu- 
lation daily. 

New  River  Company  in  London,  1879 ' 28.7 

East  London  Water- Work  Company,  1879 342 


Kent 

Chelsea  " 

West  Middlesex       " 

Grand  Junction       ' " 

South wark  and  Vauxhall 

Lambeth 


29.1 
36.5 
26.5 
32.9 
40.9 
3L5 


Average  of  London  Districts 32.7 


common  with  other  sanitary  conditions,  including'  "  the  sources,  quality,  and  quan- 
tity of  the  water-supply,  and  whether  it  is  wholesome,  and  what  means  of  purifica- 
tion are  in  use,  if  such  be  necessary.  Also,  "  Baths  and  lavatories,  their  couditions, 
and  if  sufficient  for  cleanliness  for  troops  and  sick  ;  whether  there  are  bathing  pa- 
rades, and  how  often  a  week."     (Appendix  No.  15.) 

In  the  Instructions  in  Case  of  an  Invasion  of  Cholera  (Appendix  No.  14.  paragraph 
7),  special  attention  is  directed  to  the  water-supply.  Provision  is  also  made  for  the 
chemical  examination  of  water  when  required,  PartV.,  Section  vi. .  paragraph  607. 

'  These  and  other  London  amounts  are  taken  from  the  Report  of  the  Select  Com- 
mittee of  the  House  of  Commons  on  London  Water-Supply,  1880.  p.  308.  With  the 
exception  of  the  three  first  on  the  list  the  London  supply  is  from  the  Thames.  The 
Edinburgh  amount  is  taken  from  the  same  work. 


WATER.  3 

Gallons  per  head  of  popu- 
lation daily. 

Southampton  Water- Work  Company,  1879 35 

Glasgow  Water- Work  Company,  1879 50 

Edinburgh 35 

Liverpool 30  ' 

Sheffield 20 

Paris 31 

Calcutta  (for  Europeans),''  amount  originally  intended .  30? 

"        (for  Natives),  amount  originally  intended ....  15  ? 

New  York' 83 

In  1857  the  average  supply  to  fourteen  EngHsh  towns,  of  second-rate 
magnitude,  was  24  gallons.  The  average  of  72  English  and  Scotch  towns, 
supplied  on  the  constant  system,  is  131.4  gallons  per  house  (but  this  in- 
cludes the  sujDply  to  factories,  of  which  there  were  16,087  to  889,028 
houses),  or  (at  5  persons  to  each  house),  26.7  per  head;  of  23  towns,  sup- 
pHed  on  the  intermittent  system,  127  per  house,  25.4  head,  including  1,367 
factories  to  137,414  houses  ;  and  of  London,  also  on  the  intermittent  sys- 
tem, 204,  or  41  per  head,  including  5,340  factories  to  499,582  houses." 
The  range  in  indi^ddual  cases  is,  however,  very  great,  from  25  gallons  per 
house  (5  per  head)  in  one  small  town  to  700  at  IVliddlesborough  ( 140  per 
head).  ]\Ir.  Bateman  states  that  in  the  manufacturing  towns  of  Lancashke 
and  Yorkshire,  the  present  amount  is  from  16  to  21  gallons  ;  in  some 
cases  less.  ° 

At  Norwich  about  14|  gallons  daily  per  head  are  supplied  on  the  con- 
stant system,  of  which  10. 5  are  taken  for  domestic  purposes,  3  for  trade, 
and  .7  gallons  for  public  and  sanitary  pm-poses."  In  Manchester  the  sup- 
ply is  also  constant,  and  is  14  gallons  per  head  for  domestic,  and  7  for 
trade  purposes.  In  1878  in  fifteen  American  cities  the  supply  was  on  the 
average  55  gallons  per  head. ' 

By  decision  of  the  Secretary  of  State  for  War,  a  soldier  receives  15  gal- 
lons daily  ;  no  extra  allowance  is  made  for  the  wives  and  children  in  a 
regiment. 

The  gross  amount  thus  taken  is  used  for  different  pui-poses,  which  must 
be  now  considered. 

Amount  for  Domestic  Purposes,  excluding  Water- Closets. 

This  item  includes  drinking,  cooking,  washing  the  person,  the  clothes, 
the  house  utensils,  and  the  house. 

'  See  pag-e  15. 

^  The  daily  supply  in  Calcutta  was,  in  1871,  5,000,000  gallons  of  filtered  water;  in 
1879  it  was  7^  millions  and  1,000.000  gallons  unfiltered  for  watering  roads.  This, 
however,  after  all  deductions,  only  left  o  gallons  per  head  for  domestic  purposes.  A 
new  scheme  is  in  progress,  which  will  provide  8,000,OUO  more  daily,  thus  securing  12 
gallons  per  head. 

^  In  former  editions  this  was  stated  at  300,  but  it  is  given  as  100  (?)  in  Buck's  Hy- 
giene and  Public  Health.  These  are,  however,  U.  S.  gallons,  equal  to  83  imperial 
gallons. 

^  Sixth  Report  of  the  Rivers  Pollution  Commissioners,  pp.  232,  233. 

^  See  table  in  the  Sixth  Report  of  the  Rivers  Pollution  Commissioners 

*  Report  by  Dr.  Pole,  F.R.S.  Enormous  saving  was  accomplished  by  taking  steps 
to  prevent  waste. 

'  Dr.  P.  H.  Brown,  in  Buck's  Hygiene,  vol.  i.,  p.  180.  A  table  is  also  given  by 
Prof.  W.  R.  Nichols  (p.  212)  showing  the  supply  to  eighteen  cities,  ranging  from  20 
imperial  gallons  in  Louisville  to  116  in  Washington. 


4  PRACTICAL    HYGIENE. 

An  adult  reqmres  daily  about  70  to  100  ounces  (S^  to  5  pints)  of  water 
for  nutrition  ;  but  about  20  to  30  ounces  of  this  are  contained  in  the  bread, 
meat,  etc.,  of  his  food,  and  the  remainder  is  taken  in  some  form  of  liquid. 
There  are,  however,  wide  ranges  from  the  average.  Women  drink  rather 
less  than  men  ;  children  drink,  of  com'se,  absolutely  less,  but  more  in  pro- 
portion to  their  biilk  than  adults.  The  i-ules  for  transport  vessels  aUow  8 
pints  in,  and  6  out  of  the  tropics  for  cooking  and  drinking.  During  hot 
weather  and  great  exertion  a  man  will,  of  course,  drink  much  more. 

In  some  experiments  made  for  the  "War  OfMce  in  1866,  at  the  Kichmond 
Barracks  in  Dublin  and  the  Anglesea  Barracks  in  Portsmouth,  the  amount 
of  the  different  items  of  the  domestic  suj^jDly  (excluding  latrines,  which 
take  5  gallons  per  head)  is  thus  given  : — 

Gallons  per  soldier  daily. 

Cook-house 1 

Ablution  rooms  and  baths 4 

Cleaning  barracks 2.25 

Wash-house  and  married  people 2.5 

9.75 

Dr.  Parkes  measured  the  water  expended  in  several  cases  ;  the  followmg 
was  the  amount  iised  by  a  man  in  the  middle  class,  who  may  be  taken  as 
a  fair  type  of  a  cleanly  man  belonging  to  a  faiidy  clean  household  : — 

Gallons  daily 
per  one  person. 

Cooking 75 

Fluids  as  cliink  (water,  tea,  coffee) 33 

Ablution,  including  a  daily  sponge-bath,  which  took  2-^  to  3  gaUs.     5 

Share  of  utensil  and  house-washing 3 

Share  of  clothes  (laundi-y)  washing  estimated 3 

12 

These  results  are  tolerably  accordant  with  the  Dublin  experiments,  if  we 
remember  that  with  a  large  household  there  is  economy  of  water  in  wash- 
ing utensils  and  clothes,  and  that  the  number  of  wives  and  chilch-en  in  a 
regiment  is  not  gi-eat.  In  poor  families,  who  draw  water  from  wells,  the 
amount  has  been  found  to  varj'  from  2  to  4  gallons  j)er  head,  but  then 
thei'e  was  certainly  not  perfect  cleanhness. 

Mr.  Bateman  '  states  that  in  a  group  of  cottages  with  82  inmates,  the 
daily  average  amount  was  7^  gallons  per  head,  and  in  another  group  5 
gallons  per  head.  Dr.  Letheby  found  in  the  poor  houses  in  the  city  of 
London  the  amount  to  be  5  gallons.''  In  experiments  in  model  lodging- 
houses,  Mr.  Muir  states  that  7  gallons  daily  were  used."  Mr.  Easton,  in 
his  own  house  in  London,  found  he  used  about  12  gallons  per  head,  of 
which  about  5  were  for  closets,  leaving  7  for  other  uses  ;  but  probably 
the  laundry  washing  was  not  included.  In  the  conrict  prison  at  Ports- 
mouth, where  there  are  water-closets,  and  each  j^risoner  has  a  general  bath 
once  a  week,  the  amount  is  11  gallons  (Wilson). 

'  On  Constant  Water  Supply,  by  Messrs   Bateman.  Beggs,  and  Rendle.     1867. 
'^  Report  of  the  East  London  Water  Bill  Committee,  1867.     Questions  234(5  and 
2347.  ^  Ibid.,  p.  5. 


WATEE.  0 

In  several  of  tlie  instances  just  referred  to,  it  may  be  questioned,  whether 
the  amount  of  cleanliness  was  equal  to  what  would  be  expected  in  the 
hio'her  ranks.  In  most  instances  c[uoted  no  general  baths  were  used  ;  but 
it  is  now  becoming  so  common  in  England  to  have  bath-rooms,  that  it  is 
said  they  are  often  jDut  even  in  eight-roomed  houses.  A  general  bath  for 
an  adult  requii-es,  with  the  smallest  adult  bath  {i.e.,  only  4  feet  long  and  1 
foot  9  inches  wide),  38  gallons,  and  many  baths  will  contain  50  to  60  gal- 
lons. A  good  shower-bath  will  dehver  3  to  6  gallons.  General  baths  used 
only  once  a  week  will  add  5  or  6  gallons  -per  head  to  the  daily  consump- 
tion. 

We  may  safely  estimate  that  for  personal  and  domestic  use,  "without 
baths,  12  gallons  per  head  daily  should  be  given  as  a  usual  minimum  sup- 
ply ;  and  with  baths  and  perfect  cleanliness,  16  gallons  should  be  allowed. 
This  makes  no  allowance  for  water-closets  or  for  unavoidable  waste.  If 
from  want  of  supply  the  amount  of  water  must  be  hmited,  4  gallons  daily 
per  head  for  adults  is  jDrobably  the  least  amount  which  ought  to  be  used, 
and  in  this  case  there  could  not  be  daily  washing  of  the  whole  body,  and 
there  must  be  insufficient  change  of  underclothing. 

If  jDubhc  baths  are  used  the  amount  must  be  greatly  increased.  The 
largest  baths  the  world  has  seen,  those  of  Ancient  Eome,  demanded  a  sup- 
ply of  water  so  gTeat  as,  according  to  Leshe's  calculations,  to  raise  the  daily 
average  per  head  to  at  least  300  gallons. 

Amount  for   Water- Closets. 

The  common  aiTangements  with  cisterns  allow  any  quantity  of  water  to 
be  poui-ed  down,  and  many  engineers  consider  that  the  chief  waste  of 
water  is  owing  to  water-closets.  In  some  distiicts,  by  attention  to  this 
point,  the  consumption  has  been  gTeatly  reduced  ;  in  one  case  fi'om  30  to 
18,  and  in  another  from  20  to  12  gallons  per  head.  It  has  not  yet  been 
precisely  determined  what  quantity  should  be  allowed  for  water-closets. 
Small  cisterns,  tenned  water-waste  preventers,  are  usually  put  up  in  towns 
with  constant  water-sujDply,  which  give  only  a  certain  hmited  amount  each 
time  the  closet  is  used.  The  usual  size  now  in  use  holds  about  two  gal- 
lons ;  but  even  two  gallons  ai-e  often  insufficient  to  keep  the  pan  and  soil-pij)e 
perfectly  clean.  This  depends  a  good  deal  upon  the  kind  of  closet  used. 
The  water-waste  j)reventer  must  be  sometimes  allowed  to  fill  again,  and  be 
again  emptied.  Considering  also  that  some  persons  "^-ill  use  the  closet  twice 
daily  and  sometimes  oftener,  and  that  occasionally  more  water  must  be 
used  for  thoroughly  flushing  the  pan  and  soil-pipe,  six  gallons  a  day  per 
head  should  probably  be  allowed  for  closets.  In  this  i^articular  instance  a 
false  economy  in  the  use  of  water  is  most  undesii'able.  Water  latrines  re- 
quire less  ;  the  amount  is  not  precisely  known  ;  the  experiments  of  the 
Eoyal  Engineers  at  Dubhn  give  an  average  of  five  gallons  per  head,  but  it 
is  considered  this  might  be  reduced. 

In  fixing  the  above  Cjuantities,  viz.,  12  gallons  per  head  for  all  domestic 
purposes  except  general  baths  and  closets,  4  gallons  additional  for  general 
baths,  and  6  for  water-closets,  endeavors  have  been  made  to  base  them  upon 
facts,  and  they  are  probably  not  much  in  en-or.  It  is,  however,  necessary 
to  make  some  allowance  for  unavoidable  waste  within  the  premises,  and  for 
exti-a  supply  to  closets,  and  it  ^t11  be  a  moderate  estimate  to  allow  3  gallons 
daily  per  head  for  this  pui-pose.      This  will  make  25  gallons. 

There  is  another  reason  for  beheving  that  an  amormt  of  about  25  gallons 
per  head  should  pass  fi'om  eveiy  house  daily  into  sewers,  if  sewers  ai-e  used. 


6  PRACTICAL    HYGIENE. 

It  is  that  in  most  cases  this  quantity  seems  necessary  to  keep  the  sewers 
perfectly  clear,  though  in  some  cases,  no  doubt,  with  a  well-aiTanged  and 
constnicted  sewei-age,  a  less  amount  may  suiiice.  But  the  complete  clear- 
age  of  sewers  is  a  matter  of  such  fundamental  importance  that  it  is  neces- 
sary to  take  the  safest  course.  Hitherto  much  w^ater  has  run  merely  to 
waste. 

Amount  for  Animals. 

From  expeiiments  conducted  in  some  cavahy  stables  in  1866,  by  the 
Eoyal  Engineers,  the  ^Yar  Office  authorities  have  fixed  the  daily  supply  for 
cavahy  horses  at  8  gallons,  and  for  artillery  horses  at  10  gallons  per  horse. 
This  is  to  include  washing  hoi-ses  and  caii-iages.  The  amount  seems  i-ather 
small  Of  course  the  amount  that  hoi"ses  diiiik  vaiies  as  much  as  in  the 
case  of  men,  and  depends  on  food,  weather,  and  exertion  ;  but  if  a  horse  is 
allowed  free  access  to  water  at  all  times,  and  thLs  should  be  the  case,  he  will 
diTnk  on  an  average  6  to  10  gallons,  and  at  times  more.  In  the  month  of 
October,  with  cool  weather,  a  hoi-se  16  hands  high,  doing  8  miles  a  day  car- 
riage work,  and  fed  on  com  and  hay,  was  foimd  to  di'ink  1^  gallons.  An- 
other caniage  horse  drank  nearly  the  same  amount.  In  a  stable  of  cavahy 
horses,  doing  veiy  Httle  work,  and  at  a  cool  time  of  the  year,  the  amount 
per  horse  was  found  to  be  Q-^^  gallons.  The  amount  used  for  washing  was 
3  gallons  daily.  Li  hot  and  du'ty  weather  the  quantity  for  both  piu-jDoses 
would  be  lai"gei\  For  washing  a  horse  requii'es  at  least  1-^  gaUon,  and 
twice  this  amount  if  he  is  washed  twice  a  day.  There  is  a  saving,  however,  if 
gi'ooms  wash  several  horses  in  the  same  water.  It  is  difficult  to  say  how  much 
is  used  for  caniage  washing.  On  the  whole,  including  carriage  washing,  etc., 
16  gallons  per  horse  is  not  an  excessive  amount.  A  cow  or  an  ox,  on  dry 
food,  will  drink  6  or  8  gallons  ;  a  sheep  or  pig,  ^^  to  1  gallon.  In  the  Abys- 
sinian expedition,  the  following  was  the  calculation  for  the  daily  expendi- 
tm-e  of  water  per  head  on  shipboaixl : — 

Gallons. 

Elephants 25 

Camels 10 

Oxen  (large  draught) 6 

Oxen  (small  pack  animals) 5 

Horses 6 

Mules  and  ponies 5 

For  20  elephants  and  100  men,  50,000  gallons  were  put  on  board  for  a 
voyage  of  60  days.' 

Amounts  required  for  Municipal  and  Trade  Purposes. 

For  municipal  purposes  water  is  taken  for  washing  and  watering  streets, 
for  fountains,  for  extinguishing  fii*es,  etc.  The  amount  for  these  and  for 
trade  pui-j^oses  will  vaiy  gi-eatly.  Professor  Rankine,^  who  gives  an  aver- 
age allowance  of  10  gallons  per  head  for  domestic  pm-jDOses,  proposes  10 
more  for  trade  and  town  use  in  non-manufacturing  towns,  and  another  10 
gallons  in  manufacturing  to^vns.  Considering,  however,  the  comparatively 
small  number  of  horses  and  cows  in  towns  as  compared  Avith  the  human 

'  This  information  was  derived  from  Major  Holland,  Assistant  Quartermaster-Gen- 
eral, Abyssinian  Army. 

»  Civil  Engineering,  1863,  p.  731. 


WATER,  7 

population,  and  tlie  frequent  rains  in  this  country  which,  lessen  watering 
of  sti'eets,  the  two  latter  quantities  might,  perhaps,  in  most  cases  be  halved. 
If,  now,  the  total  daily  amount  for  all  purposes  be  stated  per  head  of 
jDopulation,  it  will  be  as  follows  :  — 

Gallons. 

Domestic  supply  (without  baths  or  closets) 12 

Add  for  general  baths 4 

Water-closets 6 

Unavoidable   waste , , 3' 

Total  house  supply 25 

Town  and  trade  purposes,   animals  in  non-manufac-  )  ^j 

taring  town | 

Add  for  exceptional  manuf acturiag  towns 5 


In  India  and  hot  countries  generally,  the  amounts  now  laid  down  would 
have  to  be  altered.  Much  more  must  be  allowed  for  bathing  and  for  wash- 
ing generally,  while  a  fresh  demand  would  arise  for  water  to  cool  mats, 
punkahs,  or  air-passages  by  evaporation.  In  Calcutta  it  was  intended  to 
supply  to  Europeans  30  gallons  per  head,  and  to  natives  15  gallons  daily,  ^ 
but  the  amount  has  been  reaUy  much  less  up  to  the  present  time. 

In  Madras  it  was  assumed  that  the  ultimate  amount  used  would  be  20 
gallons  per  head,  including  all  residents.*  At  present  (in  1879)  the  total 
sapply  is  about  2^  millions  daily ;  this  in  a  population  of  about  400,000 
would  give  6^  gallons  per  head.  As  yet,  however,  all  the  population  do 
not  use  it. 

2.  Amount  Required  for  Sick  Men. 

In  hospitals  a  much  larger  quantity  must  be  provided,  as  there  is  so 
much  more  washing  and  bathing.  From  40  to  50  gallons  per  head  are  often 
used.  There  are  no  good  experiments  as  to  the  items  of  the  consumption, 
but  the  following  is  probably  near  the  truth : — 

Gallons  daily. 

For  drinking  and  cooking,  washing  kitchen  and  utensils  . .  2  to  4 

For  personal  Avashing  and  general  baths 18  to  20 

For  laundry  washing 5  to  6 

Washing  hospital,  utensils,  etc 3  to  6 

Water-closets 10 


38  to  46 
It  would  be  very  desirable  to  have  more  precise  data  ;  j^ossibly  the 
amount  for  closets  is  put  too  high,  but  not  greatly  so  when  all  cases  are 
taken  into  account. 

'  Most  engineers  reckon  the  waste  much  hijjher  than  this  ;  there  is  no  doubt  much 
room  for  economy  in  this  naatter.  The  greatest  waste  appears  to  be  in  transit  before 
reaching  the  houses. 

■^  This  allowance  will  vary  in  every  case,  and  must  be  verv  uncertain.  In  the  Lou- 
don district  18  per  cent,  is  reckoned  for  trade  purposes. 

^  Gordon's  Army  Hygiene,  p.  4?0. 

*  Captain  TuUoch's  Keport  on  the  Drainage  of  Madras,  1865,  p.  9S. 


PRACTICAL    HYGIENE. 


Sub-Section  II. — Collection,  Storage,  and  Distribution  of  Water. 

The  daily  necessary  quantity  of  water  per  head  being  determined,  the 
next  points  are  to  collect,  store,  and  distribute  it. 

1.  Collection. 

In  many  cases  collections  of  water  occur  naturally  in  the  depressions  of 
the  surface,  or  the  commingling  of  small  streams  forms  rivers.  The  col- 
lection by  men  consists  almost  entirely  in  imitating  these  natural  pro- 
cesses, and  in  directing  to,  antl  finally  arresting  at  some  point,  the  rain  or 
the  streamlets  formed  by  the  rain.  The  arrangements  necessarily  differ  in 
each  case.  Eain-water  is  collected  from  roofs,  or  occasionally  from  pave- 
ments and  flags,  or  cemented  grovmd  ;  in  hilly  countries,  with  deep 
ra^dnes,  a  resen'oir  is  sometimes  formed  by  canning  a  wall  across  a  valley, 
which  is  well  placed  for  receiving  the  tributary  waters  of  the  adjacent 
hills,  or  on  a  flatter  surface  trenches  may  be  arranged,  leading  finally  to 
an  excavated  tank. 

The  collection  of  the  surface  water  which  has  not  penetrated  is  usually 
aimed  at,  but  it  has  been  proposed  by  Mr.  Bailey-Denton  '  to  collect  the 
sub-soil  water  by  drainage-jjipes,  and  thus  to  accomplish  two  objects^ — to 
dry  the  land,  and  to  use  the  water  taken  out  of  it.  Eelow  the  surface  the 
water  is  collected  by  wells,  shallow,  deep,  and  Artesian,  or  by  boring. 

"With  resjDcct  to  wells,  if  they  are  situated  near  a  river,  and  do  not  pro- 
duce sufficient  water,  it  has  been  recommended  to  lay  perforated  earthen- 
ware pipes  parallel  to  the  river,  and  below  its  fine-weather  level,  in 
trenches  not  less  than  six  feet  deep,  and  filled  up  above  the  pipes  with  fine 
gravel.  The  jjipes  end  in  the  well,  and  water  jjassing  from  the  river  and 
filtered  through  the  gravel  passes  into  them.  The  American  tube-well 
(Norton's  patent)  is  a  very  useful  invention.  It  is  merely  a  ^mall  iron 
pipe  driven  into  the  ground  in  lengths  by  means  of  a  "monkey";  the 
water  passes  through  small  holes  in  the  lowest  part  of  the  pijDe,  and 
is  drawn  up  by  a  common  or  double-action  pump  according  to  the 
depth.' 

All  these  matters  fall  within  tl\e  j^rovince  of  the  engineer,  and  the  med- 
ical part  of  the  question  is  chiefly  restricted  to  the  consideration  of  the 
purity  of  the  water.  The  cleanliness  and  natiu'e  of  the  surface  (lead,  zinc, 
coi^per,  etc.)  on  which  rain  falls  ;  the  kind  of  gTOund  ;  and  of  cultivation  ; 
the  amount  of  manuring  ;  the  nature  of  the  subsoil  if  drainage  water  is 
used,  and  points  of  the  like  kind,  have  to  be  considered  and  sujjplemented 
by  a  chemical  examination. 

Plain. — The  amount  of  water  given  by  rain  can  be  easily  calculated,  if 
two  points  are  known,  viz.,  the  amount  of  rainfall,  and  the  area  of  the 
receiving  sm-face.  The  rainfall  can  only  be  determined  by  a  rain-gauge 
(the  mode  of  constructing  which  is  given  in  the  chapter  oil  Peacticai, 
Meteorology)  ;  the  area  of  the  recei\dng  surface  must  be  measured. 

Supposing  that  it  be  known  that  the  rainfall  amounts  to  twenty-four, 
inches  per  annum,  and  the  area  of  the  recei^dng  surface  (say  the  roof  of  a 
house)  is  five  hundred  sc[uare  feet : 


'  On  the  Supply  of  Water  to  Yillajres  and  Farms,  by  Mr.  Bailey-Denton.  C.E. 
^  In  the  Ashantee  Expedition  tlie  lube-well  did  not  succeed,  as  it  got  clogged  with 
sand.     See  Sir  A.  D.  Home's  Report,  Army  Medical  Reports,  vol.  xv.,  p.  247. 


WATER.  -  9 

MultijDly  the  area  by  144  (number  of  squai-e  inches  in  one  square  foot), 
to  bring  it  into  square  inches,  and  multiply  this  by  the  rainiaU.  The  pro- 
duct gives  the  number  of  cubic  inches  of  rain  "svhich  fall  on  the  "house-top 
in  a  year,  or  in  any  time  the  rainfall  of  which  is  known.  This  number,  if 
divided  by  277.274,  or  multiphed  by  .003607,  -will  give  the  number  of  gallons 
which  the  roof  of  the  house  will  receive  in  a  year  (viz.,  in  this  case  6.232 
gaUons) ;  or,  if  it  is  wished  to  express  it  in  cubic  feet,  the  number  of  cubic 
inches  must  be  divided  bv  1728  (number  of  cubic  inches  in  a  cubic  footj, 
or  multiphed  by  .00058. 

To  calculate  the  receiving  stu-face  of  the  roof  of  a  house,  we  must  not 
take  into  account  the  slope  of  the  roof,  but  merely  ascertain  the  area  of  the 
flat  space  actually  covered  by  the  roof.  The  joint  ai^eas  of  the  gTound-floor 
rooms  will  be  something  less  than  the  area  of  the  roof,  which  also  covers 
the  thickness  of  the  walLs  and  the  eaves. 

In  most  English  towns  the  amount  of  roof  space  for  each  pei'son  cannot 
je  estimated  higher  than  60  sc[uai-e  feet,  and  in  some  poor  districts  is 
much  less.  Taking  the  rainfall  in  all  England  at  80  inches,  and  assuming 
that  all  is  saved,  and  that  there  is  no  loss  fi'om  evaporation,  the  receiving 
sui-face  for  each  person  would  give  935  gallons,  or  2^  gallons  a  day.  But 
as  few  town  houses  have  any  reservoirs,  this  quantity  xnins  in  great  part  to 
waste  in  ui-ban  districts.  In  the  countiy  it  is  an  important  soui'ce  of  sup- 
ply, being  stored  in  cisterns  or  water-butts.  If,  instead  of  the  roof  of  a 
house,  the  receiving  surface  be  a  piece  of  land,  the  amount  may  be  calcu- 
lated in  the  same  way.  It  must  be  understood,  however,  that  this  is  the 
total  amount  reaching  the  gTound  ;  all  of  this  viill  not  be  available  ;  some 
will  sink  into  the  gi'ound,  and  some  will  evaporate  ;  the  C[uantity  lost  in 
this  way  will  vaiy  with  the  soil  and  the  season  fi'om  the  one-half  to  seven- 
eighths.  To  facilitate  these  calculations,  tables  have  been  constructed  by 
engineers.  ^ 

One  inch  of  rain  dehvers  4.673  gallons  on  eveiy  squaj-e  yard,  or  22,617 
gallons  (101  tons  by  weight)  on  each  square  acre.' 

In  estimating  the  annual  yield  of  water  from  rainfall,  and  the  ^ield  at 
any  one  time,  we  ought  to  know  the  gTeatest  annual  rainfaU.,  the  least,  the 
average,  the  period  of  the  year  when  it  falls,  and  the  length  of  the  rainless 
season.  It  must  also  be  remembered  that  the  amount  of  rainfall  differs 
very  greatly  even  in  j^laces  near  together. 

Springs,  Fdvers. — ^It  win  often  be  a  matter  of  gi-eat  importance  to  de- 
termine the  yield  of  springs  and  small  livers,  as  a  body  of  men  may  have 
to  be  placed  for  some  time  in  a  paiiiculai-  spot,  and  no  engineeiing  opinion, 
perhaps,  can  be  obtained. 

A  spring  is  measured  most  easily  by  receiving  the  water  into  a  vessel 
of  kno'^Ti  capacity,  and  timing  the  rate  of  filhng.  The  spring  should  be 
opened  up  if  necessaiy,  and  the  vessel  stould  be  of  large  size.  The  vessel 
may  be  measured  either  by  filhng  it  first  by  means  of  a  known  (pint  or 
gaUon)  measure,  or  by  gauging  it.  If  it  be  round  or  squai'e,  its  capacity 
can  be  at  once  known  by  measming  it,  and  using  the  rules  laid  down  in 
the  chapter  for  measuring  the  cubic  amount  of  air  in  rooms.  The  ca- 
pacity of  the  vessel  in  cubic  feet  may  be  brought  into  gallons  if  desirable, 
by  multiplying  by  6.23.  If  a  tub  or  cask  only  be  procurable,  and  if  there 
is  no  pint  or  gallon  measure  at  hand,  the  following  rule  may  be  useful : — 

'  Beardmore's  Mannal  of  Hydrology,  p-  61  ;  see  also  table  in  Appendix  E,  Vol.  II. 
^  To  bring  cubic  inches  into  gallons,  multiply  by  -iO  and  divide  by  11,091,  or  mul- 
tiply at  once  by  .0036u7. 


10 


PRACTICAL    HYGIENE. 


Take  the  bung  diameter  in  inches,  by  measuring  the  circumference  ai 
the  bung,  di\T.ding  by  3.1416,  and  making  an  allowance  for  the  thickness 
of  the  staves  ;  square  the  bung  diameter,  and  multiply  by  39.  Take  the 
head  diameter  in  inches  by  du-ect  measurement,  and  square  it,  and  multi- 
jjly  by  25.  Multiply  one  diameter  by  the  other,  and  the  product  by  26. 
Add  the  sums,  and  multiply  by  the  length  of  the  cask  in  inches  ;  then 
mvdtiply  by  .000031473,  and  the  result  is  given  in  gallons.' 

"When  it  is  required  to  ascertain  the  yield  of  any  small  watercoui-se 
with  some  nicety,  it  is  the  practice  of  engineers  to  dam  up  the  whole 
stream,  and  convey  the  water  by  some  artificial  channel  of  known  dimen- 
sions. 

1.  A  wooden  trough  of  a  certain  length,  in  which  the  depth  of  water 
and  the  time  which  a  float  takes  to  pass  from  one  end  to  the  other  is 
measxu-ed. 

2.  A  sluice  of  known  size,  in  which  the  difference  of  level  of  the  water 
above  and  below  the  sluice  is  measui-ed.'^ 

8.  A  weu-  formed  by  a  plank  set  on  edge,  in  which  a  rectangular  notch 
is  cvit,  usually  one  foot  in  width  ;  over  this  the  water  flows  in  a  thin  sheet, 
and  the  difference  of  level  is  measured  by  the  depth  of  the  water  as  it  flows 
over  the  notch.  Then  by  means  of  a  table  the  amovmt  of  water  dehvered 
per  minute  is  read  off.  The  weii-  must  be  formed  of  very  thin  board  and 
be  perfectly  level  ;  a  plumb-hne  has  generally  to  be  used.'  This  jDlan 
of  measuring  the  jdeld  of  water-cotu-ses  is  the  one  now  most  generally 
adopted  by  engineers. 

The  same  object  may,  however,  be  attained  with  sufl&cient  accuracy  for 
the  pui-jDOses  of  the  medical  officer  by  selecting  a  portion  of  the  stream 
where  the  channel  is  pretty  uniform,  for  the  length  of,  say  not  less  than 
twelve  or  fifteen  yards,  and  in  the  coui'se  of  which  there  are  no  eddies. 
Take  the  breadth  and  the  average  depth  in  thi-ee  or  four  places,  to  obtain 
the  sectional  area.  Then,  dropping  in  a  chij^  of  wood,  or  other  hght  oli- 
ject,  notice  how  long  it  takes  to  float  a  certain  distance  over  the  portion  of 
channel  chosen.  From  this  can  be  got  the  svu-face  velocity  per  second, 
which  is  greater  of  course  than  the  bottom  or  the  mean  velocity.     Take 


'  Nesbit's  Practical  Mensuration,  1859,  p.  309.  Another  rule,  applicable  to  com- 
mon forms  of  casks,  is  to  multiply  the  culie  of  the  diagonal  by  0.U(j3o  ;  the  cube  of 
the  diagonal  is  got  by  adding  the  square  of  half  the  sum  of  the  diameters  in  inches  to 
the  square  of  half  the  length  ;  then  this  sum  multiplied  by  its  square  root  gives  the 
cube  of  the  diagonal.  This  and  many  other  useful  calculations  can  be  very  conven- 
iently done  by  means  of  the  common,  or  carpenter's  slide-rule. 

■■^  Diacharge  of  water  through  a  sluice. — Multijily  breadth  of  opening  by  the  height; 
this  gives  the  area  of  the  sluice. 

Disdiarge  —  area,  multiplied  by  five  times  the  sqvnre  root  of  head  of  water  in  feet. — 
The  head  of  water  is  the  difference  of  level  of  the  water  above  and  below  the  dam,  if 
the  sluice  be  entirely  under  the  lower  level;  or  the  height  of  the  upper  level  above 
the  centre  of  the  opening,  if  the  sluice  be  aVo.e  the  lower  level. 

^  Discharge  of  water  over  a  weir  one  foot  i)b  length. — If  the  weir  is  more  or  less  than 
a  foot,  multiply  the  quantity  in  the  table  opposite  the  given  depth  by  the  length  of 
the  weir  in  feet,  or  decimals  of  a  foot. 


Depth  falling 
over,  inches. 

Discharge  per 
minute. 

Depth  falling 
over,  inches. 

Discharge  per 
minute. 

1 

H 
2 

; 

1.70  cubic  feet. 

4.83  "       " 

8.84  "       " 
13.63       "       " 

2i        . 

3 

3*        . 

4 

19.70  cubic  feet 
2.162       "       " 
33.23       "       " 

40.71  "       «' 

Thus,  if  the  weir  measure  1  foot,  and  the  depth  of  water  falling  over  be  3  inches,  the 
delivery  is  read  at  once,  viz.,  13.63  cubic  feet,  or  84.9  gallons  per  minute. 


TTATER,  11 

foui'-fiitlis  of  the  surfaee-velocitr  (being  nearly  the  proportion  of  mean  to 
smiace  Telocity),  and  multiply  by  the  sectional  area.  The  resiolt  vrill  be 
the  yield  of  the  stream  per  second. 

it  may  sometimes  be  worth  "svhile,  if  labor  be  at  hand,  to  remove  some 
of  the  uregularities  of  the  channel,  or  even  to  dig  a  new  one  across  the 
neck  of  a  bend  in  the  coui'se  of  the  sti'eam. 

The  yield  of  a  spiing  or  small  river  should  be  determined  several  times, 
and  at  difterent  periods  of  the  day. 

Wells. — The  jield  of  wells  can  only  be  known  by  pumping  out  the 
water  to  a  certain  level  and  noticing  the  length  of  time  requii'ed  for  refill- 
ing. In  cases  of  cojiious  flow  of  water,  a  steam-engine  is  necessary  to 
make  any  impression  ;  but,  -in  other  cases,  pumjoing  by  hand  or  horse 
labor  may  be  sufficient  j^erceptibly  to  depress  the  water,  and  then,  if  the 
c[uantity  taken  out  be  measvu'ed,  and  the  time  taken  for  reiilhng  the  well 
be  noted,  an  apx^roximate  estimate  can  be  formed  of  the  yield. 

Permanence  of  Supply. — ^It  is  obvious  that  the  permanence  of  the  sup- 
ply of  a  spring  or  small  stream  may  often  be  of  the  gTeatest  moment  in  the 
case  of  an  encampment,  or  in  the  estabhshment  of  a  permanent  si:ation. 

In  the  fii'st  place,  evidence  should,  when  available,  be  obtained.  If  no 
evidence  can  be  got,  and  if  the  amount  and  period  of  rain  be  not  known, 
it  is  almost  impossible  to  amve  at  any  safe  conclusion.  The  country 
which  foiTQis  the  gatheiing  gi'ound  for  the  springs  or  rivers  should  be  con- 
sidered. If  there  be  an  extensive  backgTOimd  of  hills,  the  springs  toward 
the  foot  of  the  hills  "s\ill  probably  be  pennanent.  In  a  flat  countiy  the 
permanency  is  doubtful,  unless  there  be  some  evidence  from  the  tempera- 
tui'e  of  the  spring  that  the  water  comes  fi-om  some  depth.  In  limestone 
regions  spiings  ai-e  often  fed  from  subten-anean  reservou's,  caused  by  the 
gTadual  solution  of  the  rocks  by  the  water  charged  with  cai'bonic  acid  ; 
and  such  springs  are  very  permanent.  In  the  chalk  districts  there  ai-e  few 
springs  or  streams,  on  account  of  the  porosity  of  the  soil,  unless  at  the 
point  the  level  be  considerably  below  that  of  the  country  generally.  The 
same  may  be  said  of  the  sandstone  formations,  both  old  and  new  ;  but  deep 
weUs  in  the  sandstone  often  yield  largely,  as  the  peiTaeable  rocks  form  a 
vast  resers-oii-.  In  the  granitic  and  trap  districts,  small  sti*eams  ai'e  liable 
to  great  variations,  unless  fed  from  lakes  ;  spiings  are  more  pennanent 
when  they  exist,  being  j^erhaps  fed  from  large  collections  or  lochs. 

2.  Storage. 

The  amount  of  storage  requii-ed  will  depend  on  circumstances,  viz.,  the 
amount  used,  and  the  ease  of  replenishing.  It  is,  of  coui'se,  easy  to  calcu- 
late the  space  recjuired  when  these  conditions  are  knn-um,  in  this  way  : — 
The  number  of  gallons  required  daily  for  the  whole  population  must  be 
divided  by  6.23  to  bring  into  cubic  feet,  and  multiphed  by  the  number  of 
days  which  the  storage  must  last ;  the  product  is  the  necessary  size  of  the 
reservoir  in  cubic  feet. 

Many  waters,  particularly  rain  water,  must  be  filtered  thi'ough  sand 
b  }f ore  they  pass  into  small  cisterns,  and  the  filter  should  be  cleaned  eveiy 
three  or  four  months.  Fig.  1  is  a  single  filter  recommended  by  the  Bar- 
rack Commission. ' 

A  double  filter  can  be  made  by  haring  a  second  chamber. 

Whatever  be  the  size  of  the  reservon,  it  should  be  kept  carefully  clean, 

■  Report  on  the  Mediterranean  Stations,  1883. 


12 


PRACTICAL    HYGIENE. 


and  no  possible  source  of  contamination  should  be  permitted.  In  the 
large  reservoirs  for  town  supply,  the  Avater  is  sometimes  rendered  impure 
by  lloods  washing  surface  refuse  into  them,  or  by  substances  being  thrown 
in.  In  fact,  in  some  cases,  water  pure  at  its  soui'ce  becomes  imi^ure  in  the 
reservou's. 

Some  large  cities  are  still  supplied  principally  by  rain-water,  as  Con- 
stantinople,— where  under  the  houses  are  enormous  cisterns, — Venice,  and 
other  places.     Gibraltar  and  Malta  are  in  part  suj^plied  in  this  way. 

As  far  as  possible,  all  reservoirs,  tanks,  etc.,  should  be  covered  in  and 
ventilated ;  in  form  they  should  be  deep  rather  than  extended,  so  as  to 
lessen  evaporation,  and  secure  coolness.  Though  they  should  be  periodi- 
cally and  carefully  cleaned,  it  would  appear  ihat  it  is  not  always  wise  to 
disturb  water-plants  which  may  be  growing  in  them  ;  some  plants,  as  the 
Protococcus,  the  Chara,  and  others,  give  out  a  very  large  amount  of  oxygen, 
and  thus  oltidize  and  render  innocuous  the  organic  matter  which  may  be 
dissolved  in  the  water  or  volatilized  from  the  surface. '     Dr.  Chevers  men- 

jnomalhcoveT^if  stone  PavvntJ  Level  of  Ground 


^ 


Pia.  1. 

tions  that  the  water  of  some  tanks  which  were  ordered  to  be  cleared  of 
water-plants  by  Sir  Charles  Napier,  deteriorated  in  quality.  Other  plants, 
however,  as  some  species  of  duckweed  (Levma  at  home,  Pistia  in  the  tropics), 
are  said  to  contam  an  acrid  matter  which  they  give  off  to  the  water.  It 
would  be  well  to  remove  some  of  the  plant,  place  it  in  pure  water  in  a  glass 
vessel,  and  try  by  exi^eriment  whether  the  amount  of  organic  matter  in  the 
water  is  increased,  or  whether  any  taste  is  given  to  the  water.  The  presence 
of  some  of  the  Nostoc  family  gives  rise  to  an  offensive  pig-pen  odor  when 
decaying.'  Dead  vegetable  matter  should  never  find  its  way  into,  or  at  any 
rate  remain  in,  the  reservoir. 

Whenever  a  reservoir  is  so  large  that  it  cannot  be  covered  in,  a  second 
smaller  covered  tank,  capable  of  holding  a  few  days'  supply,  might  be  pro- 
vided, and  this  might  be  fitted  with  a  filtei',  through  which  the  water  of  the 
large  reservoir  might  be  led  as  required. 


'  Clemens,  in  Archiv.  fiir  Physiol.  Heilk..  1853. 

^  Farlow.   Supplement  to  First  Annual  Report  of  State  Board  of  Health,   etc.,  of 
Massachusetts,  1877,  p.  143. 


WATER.  13 

When  tanks  are  large  they  are  made  of  earth,  stones,  or  masonry  ;  if 
mortar  be  used,  it  should,  as  in  the  case  of  the  smaller  reservoirs,  be  hy- 
drauhc,  so  that  it  may  not  be  acted  on  by  the  water. 

The  materials  of  small  reservoirs  and  cisterns  are  stone,  cement,  brick, 
slate,  tiles,  lead,  zinc,  and  iron.  Glass-lined  wooden  cisterns  have  also  been 
proposed.  Of  these  slate  is  the  best,  but  it  is  rather  liable  to  leakage,  and 
must  be  set  in  good  cement  or  in  Spence's  metal ;  common  mortar  must 
not  be  used  for  stone  or  cement,  as  hme  is  taken  up  and  the  water  becomes 
hard.^  Leaden  cisterns,  as  in  the  case  of  leaden  pipes,  often  yield  lead  to 
water,  and  should  be  used  as  little  as  possible,  or  should  be  protected. 
Lead  cisterns  are  corroded  by  mud  or  mortar,  even  when  no  lead  is  dis- 
solved in  the  water.  Iron  cisterns  and  pijDes  are  often  rapidly  eaten  away  ; 
they  are  now  sometimes  protected  by  being  covered  inside  with  Portland 
cement  or  with  a  vitreous  glaze.  Crease's  patent  cement  is  a  very  useful 
covering.  Birff' s  process  of  producing  the  magnetic  oxide  on  the  surface 
of  iron  is  coming  into  use.  Glalvanized  iron  tanks  are  also  very  much  used. 
They  must  be  covered,  and  in  India  be  protected  from  the  sun.  Zinc  has 
been  recommended,  but  water  passing  through  zinc  pipes,  or  kept  in  zinc 
pails,  or  in  so-called  galvanized  iron  vessels,  may  produce  symptoms  of 
metallic  poisoning,'^  and  even  taste  strongly  of  zinc  salts,  especially  if  the 
water  is  rich  in  nitrates.  It  would  certainly  be  best  to  abandon  lead,  zinc, 
and  galvanized  iron  as  materials  for  cisterns,  as  much  as  possible ;  iron 
coated  by  the  Barff  process  is  much  to  be  preferred. 

Cisterns  should  always  be  well  covered,  protected  as  much  as  possible 
from  both  heat  and  hght,  and  thoroughly  ventilated,  if  they  are  of  any  size. 
Care  should  always  be  taken  that  there  is  no  chance  of  leakage  of  pipes 
into  them.  A  common  source  of  contamination  is  an  overflow  pipe  passing 
direct  into  a  sewer,  so  that  the  sewer  gases  pass  up,  and  being  confined  by 
the  cover  of  the  cistern,  are  absorbed  by  the  water ;  to  prevent  this,  the 
overflow  pipe  is  curved  so  as  to  retain  a  -little  water  and  form  a  trap,  but 
the  water  often  evaporates,  or  the  gases  force  their  way  through  it ;  no  over- 
flow pipe  should  therefore  open  into  a  sewer,  but  should  end  above  ground 
over  a  trapped  grating.^  A  cistern  supplying  a  water-closet  should  not  be 
used  to  supply  cooking  and  drinking  water,  as  the  pipes  leading  to  the 
closet  often  conduct  closet  air  to  the  cistern.  Hence,  a  small  cistern  (water- 
waste  preventer)  should  be  used  for  each  closet.  Cisterns  should  be 
periodically  and  carefully  inspected  ;  and  in  every  new  building,  if  they 
are  placed  at  the  top  of  the  house,  convenient  means  of  access  should  be 
provided. 

Tanks  to  hold  rain-water  require  constant  inspection. 

WeUs  (which  are  really  reservoirs)  are  very  hable  to  contamination  from 
surface  washings  during  rains.  A  good  coping  will  often  prevent  this  ;  but 
if  there  is  much  subsoil  soaking,  lining  with  iron  to  a  certain  depth,  or 
covering  with  brickwork  set  in  cement  for  a  sufficient  depth  to  arrest  the 
flow,  is  desirable. 

'  In  two  cases  in  Ireland  (at  Belturbet  and  Monaghan)  so  much  lime  was  taken  up 
from  the  lining-  of  the  tanks  that  the  water  was  strongly  alkaline  and  tasted  caustic. 
See  Eeport  on  Hygiene,  Army  Medical  Reports,  vol.  six.,  p.  170. — [F.  de  C] 

^  Dr.  Orsborn,  formerly  of  Bitterne,  has  seen  several  cases  of  this  kind.  See  also 
Downes,  Sanitary  Record,  vol.  ix.,  p.  333. 

^  For  an  instance  of  typhoid  fever  produced  by  this  cause,  see  Lectures  on  State 
Medicine,  by  F.  de  Chaumont,  pp.  76,  77.  See  also  Dr.  Blaxall's  Report  on  Enteric 
Fever  at  Ilkeston  in  1880. 


14  PRACTICAL    HYGIENE. 


3.  Distribution. 

When  houses  are  removed  from  sources  of  water  the  supply  should  be 
by  aqueducts  and  pipes.  The  distribution  by  hand  is  rude  and  objection- 
able, for  it  is  impossible  to  supply  the  proper  quantity,  and  the  risks  of 
contamination  are  increased.  Some  of  the  most  extraordinary^  of  the  Ro- 
man Avorks  in  both  the  Eastern  and  Western  Empires  were  undertaken  for 
the  supply  of  water — works  whose  ruins  excite  the  astonishment  and  should 
rouse  the  emulation  of  modern  nations. 

The  plans  for  the  distribution  of  water  should  include  arrangements 
for  the  easy  and  immediate  removal  of  dirty  water.  This  is  an  essential 
point,  for  in  many  towns  where  1  ouses  are  not  properly  arranged  for  small 
families,  there  are  no  means  of  getting  rid  of  water  from  the  upper  rooms, 
and  this  inconvenience  actually  limits  the  use  of  water,  even  when  its  supply 
is  ample. 

The  supply  of  water  to  houses  may  be  on  one  of  two  systems,  intermit- 
tent or  constant.  The  difference  between  the  two  plans  is,  that  in  the  first 
case  there  is  storage  in  the  houses  for  from  one  to  three  days  ;  while  in  the 
latter  case  there  is  either  no  storage,  or  it  is  only  on  a  very  small  scale  for 
two  pui^DOses,  viz.,  for  water-closets  and  for  the  sujiply  of  kitchen  boilers.' 
It  should,  however,  l^e  understood  that  the  constant  supply  has  not  always 
meant  in  jiractice  an  unlimited  supply,  nor  has  it  been  the  case  that  the 
water  in  the  house  pipes  was  always  in  direct  communication  with  the 
water  in  the  reservoirs.  On  the  contrary,  the  water  to  the  houses  has  often 
been  cut  off,  jjarticidarly  in  places  where  the  supply  was  limited,  and  the 
fittings  not  good,  and  where  there  was  great  waste. 

The  great  arguments  against  storage  on  the  premises  (except  on  a 
limited  scale  for  closets  and  boilers)  are  the  chances  of  contamination  in 
cisterns,  and  the  very  imperfect  means  of  storage.  In  poor  houses  wooden 
casks  or  barrels  ai*e  often  used,  and  may  be  placed  in  the  worst  situations. 
Although  the  arguments  against  the  storage  system  are  directed  in  part 
against  removable  failures,  it  must,  howevei",  be  admitted  that,  especiallj' 
in  poor  houses,  the  inspection  and  cleansing  even  of  a  well-placed  cistern 
will  never  be  properly  done,  and  that  with  all  precautious  the  chances  of 
contamination  of  the  water  dvu-ing  storage  ai-e  very  great.  As  regards  this 
point,  the  constant  system  has  a  very  great  superiority,  for  there  is  no 
chance  for  contamination  except  in  the  resei'\'oir  or  in  the  pipes.  So  gi-eat 
an  advantage  is  this  in  a  sanitary  point  of  view,  that  almost  all  those  who 
have  paid  most  attention  to  sanitary  affairs  have  advocated  the  constant 
system.  It  is,  however,  quite  necessary  that  it  should  be  understood  what 
the  constant  system  sometimes  has  been  in  practice.  When  there  is  an 
abundance  of  water,  as  at  Glasgow,  the  stoppages  of  water  may  have  been 
few,  but  when  water  has  had  to  be  economized,  the  water  has  been  from 
time  to  time  shut  off  from  the  house  pipes,  and  then  no  water  has  been 
procurable  for  hours.  This,  however,  is  avoided  as  much  as  possible  in 
the  day  time,  so  that  the  inconvenience  is  reduced  to  a  minimum.  In  some 
cases,  again,  in  order  to  economize  water,  a  throttle  or  ferrule  has  been  in- 

'  Much  valuable  evidence  on  the  constant  supply  may  be  found  in  the  Report  of 
the  Hovise  of  Commons  Committee  on  the  East  London  Water  Bills,  1 8f)7.  It  is  curious 
to  see  how  difficult  the  definition  of  a  con.«;tant  supply  was  found  to  be.  The  differ- 
ence of  opinion  between  engineers  on  the  desirability  of  a  con.stant  supply  is  shown  to 
be  considerable.  The  statements  in  the  text  are  drawn  from  a  collation  of  this  evi- 
dence, and  from  a  consideration  of  Mr.  Bateman's  pamphlet,  and  many  other  works. 


"WATER.  1 5 

troduced  into  the  communication  or  house  pipe,'  lessening  the  diameter 
to  |th  or  even  to  Jgth  of  an  inch,  or  smaller,  so  that  if  the  head  of  pressure 
be  small  the  water  flows  very  slowly,  and  sometimes  merely  dribbles.  In 
other  cases,  a  meter  is  put  on  a  pipe  communicating  with  several  houses ; 
and  the  owner  of  the  houses  is  charged  for  the  watei-,  and  this  leads  him  to 
enforce  a  very  sparing  use  of  it.  In  all  these  ways  the  constant  system 
may  tell  against  the  consumer,  while,  on  the  other  hand,  great  waste,  leak- 
ing fittings,  and  fraudulent  abstraction  of  water  (to  avoid  which  there  are 
several  ingenious  contrivances)  tell  against  the  company,  and  lead  to  a  de- 
preciation of  their  proj)erty. 

In  spite  of  all  these  difficulties  the  system  of  constant  supply,  in  some 
shape  or  other,  has  bcsen  carried  out  in  about  150  towns  in  England  ;''  and 
the  Metropolis  Water  Act  of  1871  ordered  constant  sujDply  for  London,  if 
demanded  by  the  ratepayers,  and  if  proper  fittings  are  provided. 

In  providing  a  constant  supply,  certain  precautions  are  necessary.  The 
fittings  must  be  as  perfect  as  possible.  In  some  cases,  when  the  system 
has  been  changed  from  the  intermittent  to  the  constant  system,  as  in  Ches- 
ter, the  waste  of  water  has  been  so  great  that  the  old  plan  has  been  re- 
curred to.  But  when  the  fittings  are  good  there  is  real  economy  in  the 
constant  system, — as  shown  by  the  comparison  between  Lincoln  and 
Oxford,  and  by  Hawksley's  evidence  with  reference  to  Norwich.^  Common 
taps  do  not  answer,  and  the  best  screw  taps  and  fittings  must  be  used.* 
To  prevent  theft,  it  has  been  proposed  to  make  the  removal  of  fittings  a 
specific  offence,  punished  summarily  by  imprisonment,  and  to  place  the 
sale  of  such  property  under  the  same  restrictions  as  in  the  case  of  Crown 
proj)erty. 

One  important  sanitary  advantage  of  the  constant  system  is  that,  in 
order  to  facilitate  inspection  and  detection  of  waste,  no  waste-pipe  is  al- 
lowed to  open  into  a  sewer,  but  it  is  always  so  placed  that  any  escape  of 
water  can  be  easily  seen  (the  so-caUed  warning  pipe).  The  great  evil  of 
sewer  gases  being  conducted  back  into  houses  through  overflow  pipes  is 
thus  avoided.  Carefiol  inspection  and  good  fittings  so  far  lessen  the  waste 
of  the  constant  system,  that  in  some  cases  less  water  is  used  than  under 
the  ijfctermittent  plan.  ^ 

iSh:  G.  Deacon,  in  a  very  interesting  and  instructive  paper,"  has  shown 
that  the  loss  on  the  constant  system  is  due  to  cau.ses  over  which  the  con- 
sumer has  generally  little  or  no  control,  and  that  it  occurs  for  the  most 
part  before  the  water  reaches  him.  It  arises  chiefly  from  leaks  in  pipes, 
drawn  joints,  and  so  on,  and  up  to  lately  there  was  no  means  of  detecting 
this  in  a  way  practically  useful.  By  the  introduction  of  his  water-waste 
meter  this  is  now  done  with  the  utmost  precision  and  accuracy,  so  that  now 
in  Liverpool  the_  expenditure  of  water  has  been  reduced  from  33.5  gallons 
per  head  per  diem  to  13.3,     This  does  not  mean  any  restriction  to  the  con- 

'  The  terms  used  to  describe  the  pipes  differ  a  little  apparently ;  the  mains  and 
district  or  sub-maius  are  the  large  pipes,  which  are  always 'full  of  water,  the  latter 
being  of  course  the  smaller ;  the  service -pipe  is  another  terra  for  a  district  main.  The 
communication-pipe  is  that  which  runs  from  the  service-pipe  to  the  house,  and  in  the 
house  it  takes  the  name  of  house-pipe. 

-  Mr.  Beggs'  Pamphlet,  op.  cit. ,  p.  20. 

^  See  Report  of  Rivers  Pollution  Commission,  vol.  vi.,  p.  233. 

*  A  bad  ball-cock  has  been  known  to  drop  12  gallons  a  day. 

^  Evidence  of  Mr.  Easton  in  the  Report  of  Committee  on  the  East  London  Water 
Bills,  1867. 

«  The  Constant  Supply  and  Waste  of  Water,  by  George  F.  Deacon,  M.  Inst.  C.  E., 
Journal  of  the  Society  of  Arts,  vol.  sxx.,  p.  738,  1882. 


16  PRACTICAL    HYGIENE. 

sumer  ;  tlae  supply  is  now  absolutely  constant  and  the  use  unlimited.  But 
it  means  that  formerly  the  consumer  used  only  13  gallons  at  the  outside, 
whilst  20  gallons  went  to  pure  waste.  Mr.  Louttit '  stated  that  the  Lam- 
beth Water  Company  was  able  by  this  means  to  reduce  the  expenditure 
from  35.09  to  15.28  per  head.  The  general  waste  in  London  appears  to  be 
about  15  gallons  per  head  out  of  a  total  of  about  35.  "With  such  a  system 
of  checking,  the  main  difficulties  of  a  constant  supply  seem  to  be  solved, 
even  if  every  consumer  used  the  full  25  gallons  laid  down  in  this  work. 

Some  engineers  have  proposed  what  may  be  called  a  compromise  be- 
tween the  intermittent  and  constant  systems.  The  objection  to  this  plan 
is  that  cisterns  are  reintroduced,  and  their  lessened  size  does  not  remove 
the  objections  to  them. 

If  the  constant  system  is  used,  a  good  screw  stop-cock,  available  to  the 
tenant,  should  be  placed  at  the  point  of  the  entrance  of  the  pipe  into  the 
house,  so  that  the  water  may  be  tiu-ned  off  if  pipes  biu'st,  or  to  allow  the 
pij)es  to  be  empty,  as  diuing  frost.  Eveiy  precaution  must  be  taken  that 
impure  water  is  not  di-a^Ti  into  the  pipes  by  a  pipe  being  emptied  and 
sucking  up  water  from  a  distance.^ 

For  the  sujDply  of  a  very  lai'ge  city,  it  might  be  desu'able  to  divide  the 
city  into  sections,  and  to  estabhsh  a  resersoir  for  each  district,  holding 
thi'ee  or  four  days'  supply.  In  this  way  the  waste  of  one  section  would  not 
take  away  the  water  from  another.  In  some  instances,  people  in  one  pai-t 
of  a  town,  supphed  on  the  constant  system,  have  used  so  much  water  for 
gardens  that  other  paris  have  been  altogether  deprived  of  supply.  The 
system  of  secondary  reservou's  would  not  only  lessen  this  chance,  but  would 
make  it  possible  to  ascertain  that  every  pai-t  of  the  town  was  getting  its 
supply.  The  number  of  water  companies  in  London  has  in  fact  somewhat 
this  effect,  but  the  subdirision  is  not  earned  fai*  enough. 

There  is  no  doubt  that  the  constant  system  is  the  safer,  especially  for 
poor  houses,  as  it  leaves  no  loophole  for  inattention  in  the  cleansing  of 
cisterns.     Only,  it  recjuires  that  the  constant  system  should  reaUy  fuMl  the 

'  Discus-ion  on  Mr.  Deacon's  paper.  /^ 

'  The  Board  of  Trade  issued  a  Minute  in  1872,  laying  down  regulations  an«3eiin- 
ing  the  kind  of  fittings  and  arrangements  for  London.  The  following  are  the  princi- 
pal points  :  lead  pipes  to  be  of  certain  strength  (if  internal  diameter  is  f  in.,  -i  in., 
I  in.,  f  in.,  1  in.,  1^  in. ,  the  respective  weights  per  lineal  yard  are  to  be  .5  Iti,  6  JT),  7^  It), 
9  ft,  12  ft),  16  ft)).  Every  pipe  in  contact  with  the  ground  to  be  of  lead  ;  each  house 
to  have  a  communication  pipe,  but  only  one,  unless  an  owner  has  it  for  a  block  of 
houses  ;  connection  of  every  communication  pipe  to  be  by  a  brass  screwed  ferule  or 
Btop-cock  witii  a  clear  area  of  water-way  equal  to  cne-half  inch,  every  joint  to  be  a 
"  plumbing  "  or  *' wipe  "  joint.  No  pipe  to  pass  through  an  ash-pit.  manure  heap, 
drain,  unless  it  cannot  be  avoided,  and  then  the  pipe  is  to  be  laid  in  an  exterior  cast- 
iron  pipe  or  jacket ;  each  pipe  in  the  ground  to  be  thirty  inches  below  surface  ;  each 
communication  pipe  to  have  near  the  entrance  into  the  house  a  screwdown  stop-valve: 
if  in  the  ground  such  valve  to  be  protected  by  proper  cover  and  guard  box  ;  every 
cistern  to  be  water-tight,  to  have  a  good  '"  ball-tap  ;  "  no  waste-pipe  except  a  ''  warn- 
ing pipe,"  and  such  warning  pipe  to  be  so  placed  as  to  be  easily  inspected.  Xo  cistern 
buried  in  ground  to  be  used  ;  wooden  cisterns  to  have  metallic  linings ;  every  water- 
closet,  urinal,  or  boiler  shall  be  served  only  from  a  cistern,  and  shall  not  be  in  direct 
communication  with  the  water-pipes  ;  closets  and  urinals  to  have  water-waste  pre- 
venters ;  every  •'  down  pipe  "'  into  a  water-closet  to  have  an  internal  diameter  of  not 
less  than  '[i  inch,  and  to  weigh  not  less  than  9  ft)  per  lineal  yard.  Xo  bath  to  have 
an  overflow  pipe  except  of  the  '•warning"  kind;  the  outlet  must  be  di.stinct  from 
the  inlet,  and  the  inlet  shall  be  higher  than  the  highest  .«tand  of  the  water.  Lead 
warning  pipes  of  which  the  ends  are  open,  and  which  cannot  remain  charged  with 
water,  may  have  the  following  minimum  weight  :  ^  inch  in  diameter  to  have  a  weight 
3  ftj  per  yard  ;  f  in.,  5  ft) ;  1  in. ,  7  lb. 


WATER.  1 7 

conditions  laid  down  for  it,  viz.,  it  should  deliver  sufficient  water  at  all 
times,  and  not  merely  delude  us  with  a  j)lu-ase. 

In  both  plans  the  water  is  conducted  from  the  reservoii's  in  pipes.  The 
pipes  are  comj^osed  of  u'on,  masonry,  or  earthenware,  for  the  larger  pijDes 
or  mains,  the  ii'on  being  sometimes  tinned  or  galvanized,  or  lined  with  con- 
crete, or  pitched,  or  covered  with  a  vitreous  glaze,  such  as  that  patented 
by  De  Lavenant ;  for  the  smaller  pipes,  ii'on,  lead,  tin,  zinc,  tiimed  copper, 
earthenware,  gutta  percha,  etc.,  ai'e  used. 

Pipes  of  artificial  stone  are  now  made.  Iron  is  the  best  material  for 
the  larger  pipes,  and  iron  or  non-metalhc  substances  for  the  smaller  pipes. 

Water  should  be  distributed  not  only  to  eveiy  house,  but  to  every  iioor 
in  a  house.  If  this  is  not  done,  if  labor  is  scarce  in  the  houses  of  poor 
peojjle,  the  water  is  used  several  times  ;  it  becomes  a  question  of  labor  and 
trouble  versus  cleanliness  and  health,  and  the  latter  too  often  give  way. 
Means  must  also  be  devised  for  the  speedy  removal  of  dii'ty  water  fi'om 
houses  for  the  same  reasons.  In  fact,  houses  let  out  in  lodgings  should  be 
looked  upon,  not  as  single  houses,  but  as  a  collection  of  dwellings,  as  they 
really  are. 

ACTIOX    OF    WATER    OX    LE.AD    PIPES. 

There  are  more  discrepancies  of  opinion  on  this  subject  than  might 
have  been  anticipated. 

From  an  analj^sis  of  most  of  the  works,  the  following  points  appear  to 
be  the  most  certain  : — 

1.  The  waters  which  act  most  on  lead  are  the  purest  and  most  highly 
oxygenated  ;  also  those  containing  organic  matter,  nitrites  (Medlock),' 
niti-ates,^  and  according  to  several  obseiwers,  chlorides.^  Besides  the  por- 
tion dissolved,  a  film  or  cnist  is  often  formed,  especially  at  the  time  of 
contact  of  water  and  au' ;  this  crust  consists  usually  of  two  parts  of  lead 
carbonate  and  one  part  of  hydi-ated  oxide.  The  mud  of  several  rivers, 
even  the  Thames,  will  coiTode  lead,  probably  fi-om  the  organic  matter  it 
contains,  but  it  does  not  necessaiily  follow  that  any  lead  has  been  dissolved 
in  the  water.     Bits  of  mortar  'will  also  corrode  lead. 

2.  The  waters  which  act  least  on  lead  are  those  containing  carbonic 
acid,^  calcium  carbonate,  calcium  phosphate  (which  has  been  found  by 
Frankland  to  have  a  gi-eat  protective  power),  and  in  a  less  degree  calcium 
sulphate,  and  perhajDs,  in  a  still  less  degree,  magnesian  salts,  and  the  alka- 
line phosphates  ;  ^  but  it  has  been  said  that  perfectly  pure  water,  contain- 
ing no  gases,  has  no  action  on  lead.  This,  however,  is  not  strictly  coiTect, 
as  pure  distilled  water  has  been  known  at  Netley  to  take  up  lead  from  a 
leaden  pipe.     The  deposit  which  fi-equently  coats  the  lead  consists  of  car- 

^  Medlock  attributes  the  greatest  influence  to  ammonium  nitrite  formed  from  or- 
ganic matter  ;  lead  nitrite  is  rapidly  formed,  and  carbonate  is  then  produced  ;  the 
nitrous  acid  bsing  set  free  to  act  on  another  portion  of  lead.  The  ammonium  nitrite 
exists  in  most  distilled  -vvater. 

"^  Pattison  Muir  attributes  very  powerful  action  to  nitrates,  but  says  that  it  is  modi- 
fied or  even  arrested  by  the  presence  of  carbonates,  sulphate«,  and  chlorides,  but  there 
is  some  discrepancy  of  opinion  as  to  the  action  of  the  chlorides. 

"  Pattison  Muir  found  that  a  solution  of  sulphate  or  chloride  of  ammonium  of  0.04 
per  cent,  took  up  3.2  grains  per  gallon  after  exposure  to  lead  for  505  hours. 

■•  M.  Langlois  (Uec.  de  Mem.  deMed.  Mill,  1865,  p.  412'  attributes  a  great  action  on 
lead  to  the  carbonic  acid,  but  states  that  the  carbonate  of  lime  entirely  protects  lead, 
apparently  by  rendering  the  carbonic  acid  inactive. 

^  Report  of  the  Government  Commission,  1851,  p.  7. 
2 


18  PRACTICAL    IIYGIEXE. 

bonate,  phosphate,  and  stilphate  of  lead,  calcium,  and  magnesium,  if  the 
■water  have  contained  these  salts,  and  lead  chloiide.' 

3.  From  the  obsei-vations  of  Graham,  Hofmann,  and  jMiller,  the  protec- 
tive influence  of  carbonic  acid  gas  appears  to  be  very  great  ;  a  difficultly 
soluble  lead  cai-bonate  is  foi-med.  JHowever,  a  veiy  gi-eat  excess  of  free 
carbonic  acid  may  dissolve  this.  This  has  perhaps  led  to  the  statement 
that  carbonic  acid  countei'acts  the  preservative  effects  of  the  salts.  Water 
chai'ged  with  carbonic  acid  under  pressui'e  has  a  very  mai-ked  solvent  action 
on  lead  (Pattison  Muh'). 

Other  substances  may  find  their  way  into  "water  which  may  act  on  lead 
— as  vegetable  and  fatty  acids,  ai-ising  from  fruits,  vegetables,  etc.,  or  sour 
milt  or  cider,  etc. 

4  The  lead  itself  is  more  easUy  acted  upon  if  other  metals,  as  iron, 
zinc,  or  tin,  are  in  juxtaposition  ;  galvanic  action  is  produced.  Bending  lead 
pipes  against  the  grain,  and  thus  exposing  the  structiu-e  of  the  metal,  also 
increases  the  risk  of  solution  ;  zinc  pipes,  into  the  comi:)osition  of  which 
lead  often  enters,  yield  lead  in  large  quantities  to  water,  and  this  has  been 
especially  the  case  -with  the  distilled  water  on  board  shii:)S. 

AMOX."XT    OF   DISSOL'S'ED    L.EAD    WHICH    WELL   PEOCrCE    SYMPTOIIS    OF   POISOXIXG. 

Dr.  Angus  Smith  refers  to  cases  of  lead  paralysis  in  which  as  little  as 
-j-Kth  of  a  gi-ain  per  gallon  was  in  the  water.  Adams  ^  also  speaks  of  ^^^Tyth 
of  a  gi-ain  causing  poisoning.  Graham  speaks  of  J-th  of  a  grain  per  gallon 
as  l>eing  innocuous.  Angus  Smith  says  that  J^jth  of  a  gi-ain  per  gallon 
may  affect  some  persons,  while  ^V^^  ^^  ^  grain  per  gallon  may  be  requii-ed 
for  others.^  But  it  is  difficult  to  prove  it  may  not  at  some  time  have  been 
more  than  this.  Ciilvert  found  that  water  which  had  been  decidedly  injuri- 
ous in  Manchester  contained  from  ^V^^^  ^o  j^o^^^  *^^  ^  grain  jDcrgallon. 

In  the  celebrated  case  of  the  poisoning  of  Louis  Phihppe's  family  at 
Claremont,  the  amount  of  lead  was  -i\ths  of  a  gi-ain  per  gallon  ;  this  quan- 
tity affected  3-4  per  cent,  of  those  who  di'ank  the  water. 

The  water  of  Edinbiu-gh  is  said  to  contain  only  yj^r^^  ^^  ^  grain  per 
gallon,  which  is  not  hurtfvil* 

On  the  whole,  it  seems  probable  that  any  quantity  over  ^V^^  ^^  ^  grain 
per  gallon  should  be  considered  dangerous,  and  that  some  persons  may 
even  be  affected  by  less  quantities.^  • 

PBOTECTION    OF   LEAD   PIPES. 

The  chief  means  which  have  been  proposed  are  : — 

[a)  Lining  with  tin.  Calvert's  expeiiments  "^  show  that  extra  tinned  and 
ordinaiy  tinned  lead  piping  both  gave  up  lead  to  the  piu-e  water  now  used 
at  Manchester. 

(b)  A  much  better  j^lan  is  by  having  a  good  block-tin  pipe  enclosed  in  a 
lead  pipe,  as  in  Haines'  patent.  If  the  tin  is  good,  it  is  httle  acted  on,  and 
the  strength  of  the  pipe  is  increased,  while  bends  and  junctions  can  be 

'  Lauder  Lindsay,  Action  of  Hard  Water  on  Lend,  p.  7. 

*  Trans   of  the  American  Medical  Society.  1852,  p.  10.3. 

'  Wanklyn  adopts  i\,th  of  a  g'l  ain  per  gallon  as  justifying  rejection  of  a  water ; 
^^fth  would  probably  be  a  safer  limit. 

*  Chemical  News.  September  28,  1861. 

*  See  also  Taylor's  Med.  Jurisp..  1865,  p.  242  ;  and  opinions  of  Penny,  ibid  ,  p.  241. 

*  Chemical  News,  September  28   1861. 


■^ATER.  19 

made  TvitJbout  clestroving  tiie  continuity  of  the  tin.  The  composite  j^ipes 
of  this  kind  made  by  Messi-s.  '\\'alk:er,  Parker  &  Co.  are  said  to  -withstand 
any  amount  of  torsion.  On  the  authoiity  of  Professor  J.  Emerson  Rey- 
nolds, F.E.S.,  it  is  said  that  lead  alloyed  with  3  per  cent,  of  tin  is  not  acted 
upon  by  Tvater ; "  pipes  of  this  kind  appear  to  be  used  in  Dublin  and  in 
Glasgow.  Later  experience  with  this  alloy,  however,  seems  to  have  modi-' 
tied  the  good  opinion  first  held  of  it ;  it  is  ceriainly  inapphcable  to  cisterns, 
or  for  any  purpose  where  it  is  more  or  less  exposed  to  the  aii'. 

(c)  Fusible  metal,  \iz.,  lead,  bism.uth,  and  tiru  This  is  certainly  objec- 
tionable. 

(d)  Bituminous  cqating  (M'Dougall's  patent).  This  is  said  to  be  effec- 
tual, but  no  exact  experiments  have  been  recorded. 

(e)  Various  gums,  resins,  g"utta-percha,  and  india-rubber.  These  would 
probably  be  efficacious,  but  there  does  not  seem  to  be  any  evidence  to  show 
how  long  they  will  adhere. 

(/)  Coating  interior  of  pipes  with  lead  sulphide  by  boiling  the  j^ipes  in 
sodium  stdphide  for  fifteen  minutes.  The  sodium  sulphide  may  be  made 
by  boiling  suljDhur  in  hquor  sodte.      (Schwai'tzs  patent. j 

(g)  Tarnish  of  coal  tar.' 

SUBSTITTTES    FOE    LEAD    PIPES, 

Cast  and  wi'ought  u'on  j)ipes  can  be  used,  and  ^Ir.  Piawlinson  now 
orders  no  others.  The  u'on  can  be  glazed  internally.  ^  Copper  tinned  and 
block-tin  are  also  employed,  and  both  are  excellent,  but  are  rather  expen- 
sive.    In  some  cases  the  tin  is  eaten  thi'ough,  but  this  is  not  common." 


SECTION  n. 

QUALITY  OF  DEIXKIXG  WATER. 
Scb-Sectiox  I. — Coixposinox. 

The  composition  of  water  is  of  importance  for  several  economic  pur- 
poses ;  for  certain  trades  which  requii'e  careful  pi-ocesses  of  washing  and 
dyeing  ;  for  the  supply  of  engines,  etc.  But  these  subjects  are  too  techni- 
cal to  be  discussed  here,  and  this  chapter  is  therefore  restricted  to  the 
Cjuahty  of  water  as  used  for  drinking  pui-poses.  The  only  domestic  matter 
of  imj)ortance  connected  with  quality,  apaii-  fi'om  drinking  and  cooking,  is 
the  relative  amount  of  soap  used  by  hard  and  soft  water  in  washing.  But 
this  is  so  obrious  a  matter  that  it  only  requires  to  be  alluded  to. 

0^ving  to  many  of  the  domestic  uses  of  water,  such  as  the  washing  of 

'  Manual  of  Hygiene  for  Ireland,  p.  218.  Professor  Cameron,  of  Dublin,  corrobo- 
rates this  statement,  Manual  of  Hygiene,  p.  86. 

-  Lauder  Lindsay,  Action  of  Hard  Water  on  Lead,  p.  21. 

^  Iron  pipes  coated  inside  with  Angus  Smith's  bituminous  varnish  are  a  good 
deal  used.  In  experiments  made  at  Xetley  these  %Yere  found  to  yield  a  distinct  taste 
of  tar  to  the  water  for  a  considerable  time  ;  after  a  time,  however,  this  action  was 
much  diminished,  but  did  not  entirely  cease.  Probably  Barff's  process  of  producing  a 
surface  of  magnetic  oxide  on  iron  will  come  into  use.  For  joining  pijDes  Spence's 
metal  will  probably  prove  useful. 

*  I  have  seen  block-tin  pipes  eaten  through  by  water  at  Woolsten,  apparently  in 
consequence  of  the  presence  of  nitrates.  Zinc  pipes,  which  have  been  recommended, 
are  objectionable  as  likely  to  yield  poisonous  sales  to  such  waters. — [F.  de  C] 


20  Pii ACTIO AL    HYGIENE. 

utensils,  the  supply  for  closets,  etc.,  not  requiring  a  very  pure  water,  it  lias 
been  proposed  in  some  cases  to  supply  water  from  two  sources — one  pure 
for  drinking  and  cooking,  the  other  impure.  This  requires,  however,  two 
sets  of  pipes,  and  involves  the  chance  of  mistake  between  two  waters  ;  and 
it  is  only  likely  to  be  of  use  under  exceptional  circumstances. 

Drinking  water  is  supplied  from  shallov\r,  deep,  and  Ai-tesian  weU  sources : 
rain,  rivers,  weUs,  springs,  etc. 

Rain  Water. — As  it  falls  through  the  air,  rain  becomes  highly  aerated 
(average,  25  cubic  centimetres  per  litre),  the  oxygen  being  in  larger  pro- 
portion than  in  atmospheric  air  (32  per  cent.,  or  a  little  more)  ;  carbon 
dioxide  constitutes  2^  or  3  per  cent,  of  the  gas.  It  carries  down  from  the 
air  ammoniacal  salts  (carbonate,  nitrite,  and  nitrate),  and  nitrous  and  nitric 
acids  in  small  amount.  The  total  quantity  of  nitrogen  in  ammoniacal  salts, 
nitrous  and  nitric  acid,  is  .0985  parts  per  100,000.  Frankland  puts  the 
average  at  .032.  At  Montsoui-is, '  mean  of  seven  years,  the  ammonia 
amounted  to  .193  per  100,000,  or  9.135  gi-s.  per  gallon  ;  the  nitric  acid 
(NOg),  mean  of  six  years,  to  .354  per  100,000,  or  .248  per  gallon.  This 
gives  a  total  nitrogen,  from  ammonia  and  nitric  acid,  of  .239  per  100,000. 
Tn  towns  with  coal-fires  it  takes  up  sulphiu'ous  and  sulphuric  acids,  and 
sometimes  hydrogen  sulphide.  The  sulphates  in  rain  increase,  according 
to  Dr.  Angus  Smith, '^  as  we  pass  inland,  and  before  large  towns  are  reached  ; 
they  are,  according  to  this  author,  "  the  measure  of  the  sewage  in  air " 
when  the  sulphur  derived  from  the  combustion  of  coal  can  be  excluded, 
but  in  this  country  the  exclusion  could  never  be  made.  Free  acids  are  not 
found  with  certainty,  according  to  Smith,  when  combustion  and  manufac- 
tures are  not  the  cause.  The  acidity  taken  as  sulphuric  anhydride  was 
equal  to  .0097  grain  per  gallon  of  rain  in  a  country  place  in  Scotland, 
and  1.0589  grain  in  Glasgow  ;  in  Manchester  in  1870  it  was  .8416,  and  in 
London,  .2713  gi-ain.  The  nitric  acid 'in  Glasgow  was  as  much  as  .1705 
grain  per  gallon,  and  in  London  only  .06188.  Albuminoid  ammonia  was 
no  less  than  .326  part  in  a  million  in  London  rain.^  Rain  also  carries 
dowTQ  many  solid  substances,  as  sodium  chloride,  in  sea  air  ;  calcium  car- 
bonate, sulphate,  and  phosphate  ;  ferric  oxide  ;  carbon.''  It  almost  always 
contains  also  a  httle  nitrogenous  organic  matter,  amounting  in  extreme 
cases  to  as  much  as  .35  grain  per  gallon.  The  total  amount  of  solids  from 
five  analyses  quoted  by  Moleschott,  was  0.032  gramme  per  htre,  or  224 
grains  per  gallon,  and  from  63  samples  bv  Frankland,  3.86  per  100,000,  or 
2.701  per  gaUon.' 

'  Annuaire  de  I'observatoire  de  Montsouris  pour  I'au  1882. 

2  Air  and  Rain,  1873,  p.  245. 

^  Angus  Smith,  op.  cit  ,  p.  363. 

*  An  ingenious  plan  for  removing  suspended  matter  from  rain-water  is  supplied  by 
Buck's  "  Patent  Percolator,"  which  may  be  attached  to  the  pipe  supplying  a  rain-water 
tank.  It  works  automatically  and  produces  good  results,  although  at  the  expense  of 
considerable  waste  of  the  water. 

'-  In  rain-water  collected  at  St.  Albans,  in  the  middle  of  an  arable  field,  two  feet 
from  the  ground,  Frankland  found  as  much  as  8.58  parts  in  lOO.OCO  or  6.006  grains 
per  gallon  ;  from  the  roof  of  the  Land^  End  Hotel  (Cornwall)  42.8  per  1(10,000,  of  which 
one-half  was  chlorides. 

In  a  sample  from  supply  tank  in  officers'  quarters  at  Portland  I  found  47.05  gr.  per 
gallon  of  solids,  of  which  about  10  were  chlorides  ;'*'ohe  organic  constituents  were  also 
very  large.  In  another  sample,  gathered  as  collected,  o2. 55  total"s^Uds  and  14  chlo- 
rides; .Tud  in  one  from  a  pipe  leading  to  the  cookhouse.  59.25  total  solids  and  15.2 
chlorides.  In  a  ^sample  collected  through  funnels  direct  into  glass  bottles,  the  solids 
were  6.65  per  gallon,  of  which  4.9  were  volatile,  chiefly  ammonium  chloride,  etc. — 
[F.  de  C] 


WATEE.  21 

Occasionally  microscopic  plants  of  the  lowest  order  (as  Protococcus 
j:)luvialis  and  others)  are  present,  and  in  towns  the  debris  arising  from 
street  dust. 

With  regard  to  Rain  as  a  Source  of  Supjoly. — The  uncertainty  of  the  rain- 
fall from  year  to  year,  the  length  of  the  dry  season  in  many  coimtries,  and 
the  large  size  of  the  reservoirs  which  are  then  required,  are  disadvantages. 
On  the  other  hand,  its  general  purity  and  its  great  aeration  make  it  both 
healthy  and  pleasant.  The  gTeatest  benefits  have  resulted  in  many  cases 
(especially  in  some  of  the  West  Indian  Islands)  from  the  use  of  rain  instead 
of  spring  or  well  water,  which  is  often  largely  impregnated  with  earthy 
salts.  In  all  places  where  the  spring  or  well  water  is  thus  bad,  as  in  the 
neutral  ground  at  Gibraltar,  rain-water  should  be  substituted.  So  also  it 
has  been  suggested  that  in  outbreaks  of  cholera  anywhere,  the  rain-water 
is  less  likely  to  become  contaminated  with  sewage  matters  than  wells  or 
springs,  into  which  organic  matters  often  find  their  way  in  an  unaccounta- 
ble manner. 

Ice  and  Snoio  Water. — In  freezing,  water  becomes  purer,  losing  a  large 
portion  of  its  saline  contents.  Even  calcium  carbonate  and  sulphate  are 
partially  got  rid  of.  The  air  is  at  the  same  time  expelled.  Ice-water  may 
thus  be  tolerably  pure,  but  heavy  and  non-aerated.  Snow-water  contains 
the  salts  of  rain-water  with  the  exception  of  rather  less  ammonia.  The 
amounts  of  carbonic  acid  and  air  are  very  smaU. 

There  has  long  been  an  opinion  that  snow-water  is  unwholesome,  but 
this,  if  it  be  true,  is  probably  due  to  impurities.  Ice  and  snow  often  con- 
tain a  good  deal  of  suspended  organic  matter.  Dr.  Baker  Edwards  of 
Montreal  found  2  grains  per  gallon  in  the  shore  ice  and  1  grain  per  gallon 
in  the  river  ice.'  In  Northern  Europe,  the  poor  classes  have  the  habit  of 
taking  the  snow  lying  about  their  dwellings,  and  as  this  is  often  highly 
impure  with  substances  thrown  out  from  the  house,  this  water  may  be  un- 
wholesome. It  has  been  conjectured  that  the  spread  of  the  cholera  in  the 
Russian  wiiiter  in  1832  was  owing  to  the  use  of  such  snow-water  cont.ami- 
nated  by  excretions.  Ice  and  snow  may  also  be  the  means  of  conveying 
malarious  poison  to  places  at  a  distance.^ 

Dew  has  occasionally  been  a  source  of  supply  to  travellers  in  sterile 
regions  in  South  Africa  and  Australia,  on  board  ship. 

Spring,  Well,  and  River  Water. — The  rain  falhng  on  the  ground  partly 
evaporates,  partly  runs  off,  and  partly  sinks  in.  The  relative  amounts 
vary  with  configuration  and  density  of  the  ground,  and  with  the  ch'cum- 
stances  impeding  or  favoring  evaporation,  such  as  temperature,  movement 
of  air,  etc.  In  the  magnesian  Hmestone  districts,  about  20  per  cent,  pene- 
trates ;  in  the  new  red  sandstone  (Triassic),  25  per  cent.  ;  in  the  chalk,  12  ; 
in  the  loose  Tertiary  sand,  90  to  96. 

Penetrating  into  the  groimd,  the  water  absorbs  a  large  proportion  of  car- 
bonic acid  from  the  air  in  the  interstices  of  the  soil,  which  is  much  licher 
(250  times)  in  CO^  than  the  air  above.  It  then  passes  more  or  less  deeply 
into  the  earth,  and  dissolves  everything  it  meets  with  which  can  be  taken 
up  in  the  time,  at  the  temperature,  and  by  the  aid  of  carbonic  acid.  In 
some  sandy  soils  there  is  a  deficiency  of  C0„,  and  then  the  water  is  also 
wanting  in  this  gas,  and  is  not  fresh  and  sparkhng. 

^  Further  evidence  of  the  impurity  to  be  sometimes  met  with  in  ice  will  be  found 
in  the  Reports  of  the  State  Board  of  Health  of  Massachusetts,  vols.  vii.  and  x. 

'•^  See  paper  by  C.  Smart,  M.B..  CM.,  Captain  and  Assistant- Surgeon,  United  States 
Army,  "  On  Mountain  Fever  and  Malarious  Water,"  American  Journal  of  the  Medical 
Sciences,  Jan.,  1878.     See  also  Report  on  Hygiene,  A.M.D.  Reports,  vol.  six. 


22  PRACTICAL    HYGIEXE. 

^Tlie  cliemical  changes  and  decompositions  wliich  occur  in  the  soil  by 
the  action  of  cai-bonic  acid,  and  which  are  probably  influenced  bv  diffusion, 
and  perhaps  pressui-e,  as  vrell  as  bv  temperatui-e,  are  extremely  curious, ' 
but  cannot  be  entered  upon  here.  The  most  common  and  simple  ai-e  the 
solution  of  calcium  carbonate,  and  the  decomposition  of  calcium  and  sodium 
sihcate  by  carbonic  acid,  or  alkaline  cai'bonates.  Salts  of  ammonia,  also, 
when  they  exist,  appear  fi-om  Dietrich's  observations  to  have  a  consider- 
able dissolving  effect  on  the  sihcates. 

Fed  from  a  variety  of  soui'ces,  river-water  is  even  more  complex  in  its 
constitution  than  spidng-water ;  it  is  also  more  influenced  by  the  season, 
and  by  cii'cmnstances  connected  with  season,  such  as  the  melting  of  snow 
or  ice,  rains  and  floods,  etc.  The  water  taken  on  opposite  sides  of  the 
same  river  has  been  found  to  drffer  shghtly  in  composition. 

The  general  result  of  solution  and  decomposition  is,  that  the  water  of 
spi-ings  and  rivers  often  contains  a  great  number  of  constituents — some  in 
very  small,  others  in  gi'eat  amount.  Some  waters  are  so  highly  charged  as 
to  be  termed  mineral  watei-s,  and  to  be  unfit  for  diinking,  except  as  medi- 
cines. The  impiuities  of  water  are  not  so  much  influenced  by  the  depth 
of  the  spiing  as  by  the  strata  it  passes  thi-ough.  The  water  of  a  surface 
sj)ring,  or  of  the  deepest  Ai-tesian  well,  may  be  piu-e  or  imjiiu-e.  The  tem- 
peratui'e  of  the  water  also  varies,  and  is  chiefly  regulated  by  the  dej)th. 
The  temperatui'e  of  shallow  springs  altera  with  the  season  ;  that  of  deeper 
spiings  is  often  that  of  the  yeai'ly  mean.  In  veiw  deep  sjjiings,  or  in  some 
Aiiesian  wells,  the  temperatui-e  of  the  water  is  high. 

The  substances  which  are  contained  in  sj^ring,  river,  and  well  waters 
ai'e  noted  more  fully  under  the  head  of  "exa^iixation  of  water."  There 
may  be  susjDended  matters,  mineral,  vegetable,  or  animal ;  dissolved  gases, 
viz.,  niti'ogen,  oxygen,  cai'bon  dioxide,  and  in  some  cases  hydi-ogen  sul- 
phide, and  carbiu'etted  hydi-ogen  ;  and  dissolved  sohd  matters,'  consisting 
of  hme,  magnesia,  soda,  potassa,  ammonia,  ii-on,  alumina,  combined  with 
chloiine,  and  sulphiuic,  carbonic,  phosj)horic,  nitiic,  nitrous,  and  sihcic 
acids.  More  infrequently,  or  in  special  cases,  certain  metals,  as  arsenic, 
manganese,  lead,  zinc,  and  copper,  may  be  present. 

The  mode  of  combination  of  these  substances  is  yet  uncertain  ;  it  may 
be  that  the  acids  and  bases  are  equally  distributed  among  each  other,  or 
some  other  modes  of  combination  may  be  in  play.  The  mode  of  combina^ 
tion  may  usually  be  assumed  to  be  as  follows.  The  chemist  determines 
the  amount  of  each  sejDai'ate  substance,  and  then  calculates  the  combina- 
tion as  follows.  The  chloiine  is  combined  with  sodium  ;  if  there  is  an 
excess,  it  is  combined  with  potassium  or  calcium  ;  if  there  is  an  excess  of 
soda,  it  is  combined  with  suli^huric  acid,  or  if  still  in  excess,  with  carbonic 
acid.  Lime  is  combined  with  excess  of  chloiine,  or  sulphiuic  acid,  or  if 
there  be  no  sulphuiic  acid,  or  an  excess  of  hme,  with  cai'bonic  acid.  Mag- 
nesia is  combined  with  carbonic  acid.  So  that  the  most  usual  combina- 
tions are  sodium  chloride,  sodium  sulphate,  sodium  carbonate,  calcium 
carbonate  (held  in  solution  by  cai'bonic  acid),  calcium  sulphate,  calcium 
chloride  and  sihcate,  and  magnesium  carbonate  ;  but  the  results  of  the 
analysis  may  render  other  combinations  necessaiy. 

Distilled  Water. — Distillation  is  now  veiy  largely  used  at  sea,  and  af- 
fords an  easy  way  of  getting  good  water  from  sea  or  brackish  water.     Almost 

'  These  are  given  in  detail  by  G  Bischof,  Chemical  and  Phj'sical  Geology  (Caven- 
di>h  Society's  edit. ),  18o4.  vol  i.,  p.  2  et  seq.  ;  and  in  Watt's  Dictionary  of  Chemistry, 
Article  '•  Chemistry  of  Geology,"  by  Dr.  FauL 


WATER.  23 

any  form  of  apparatus  will  suffice,  if  fuel  can  be  procured,  to  obtain  enough 
water  to  support  life  ;  and  if  even  the  simplest  apphances  are  not  attainable, 
the  mere  susjjension  of  clean  woollen  clothing  over  boihng  water  will  enable 
a  large  quantity  to  be  collected.  At  sea,  salt  water  is  sometimes  mixed 
with  it  from  the  priming  of  the  boilers,  and  occasionaUy  from  decomposi- 
tion of  magnesium  chloride  (probably),  a  httlefree  hydi'ochloric  acid  passes 
off.     This  can,  if  necessary,  be  neutralized  by  sodium  carbonate. 

As  distnied  water  is  nearly  free  from  au",  and  is,  therefore,  unpalatable 
to  some  persons,  and  is  supposed  indigestible,^  it  may  be  aerated  by  allow- 
ing it  to  run  through  a  cask,  the  bottom  of  which  is  pierced  with  fine  holes, 
so  as  to  expos3  the  water  to  the  ah-.  Plans  for  aerating  the  water  distiUed 
from  sea-water  have  been  proposed  by  Normandy  and  others,  and  are  used 
in  many  steamers.  Organic  matter,  at  first  offensive  to  taste  and  smell  in 
distnied  water,  can  be  got  rid  of  by  passing  through  a  good  filter,  or  by 
keeping  three  or  four  days,  or  by  the  addition  of  a  httle  permanganate 
solution. 

Care  should  be  taken  that  no  lead,  zinc,  or  copper  finds  its  way  into 
the  distnied  water.  Many  cases  of  lead  poisoning  have  occuiTcd  on  board 
ships,  partly  from  the  use  of  minium  in  the  apparatus,  and  partly  from  the 
use  of  zinc  pipes  containing  lead  in  their  composition.  If  possible,  block 
tin  should  always  be  used. 

Comparative  Value  of  Spring,  Paver,  and  Well  Water  as  Sources  of  Supply. 

This  depends  on  many  circumstances.  Spring- water  is  both  pure  and 
impure  in  different  cases  ;  and  the  mere  fact  of  its  being  a  spring  is  not, 
as  sometimes  imagined,  a  test  of  goodness.  Frequently,  indeed,  river- 
water  is  purer  than  spring- water,  especially  from  the  deposit  of  calcium 
carbonate  ;  organic  matter  is,  however,  generaUy  in  greater  quantity,  as  so 
much  more  vegetable  matter  and  animal  excreta  find  theu'  way  into  it.  The 
water  of  a  river  may  have  a  very  different  constitution  from  that  of  the 
springs  near  its  banks.  A  good  example  is  given  by  the  Ouse,  at  York : 
the  water  of  this  river  is  derived  chiefly  from  the  millstone  gTit  which  feeds 
the  Swale,  the  Ure,  and  the  Nid,  tributaries  of  the  Ouse  ;  the  water  contains 
only  9  gTains  per  gallon  of  salts  of  calcium,  magnesium,  sodium,  and  a  lit- 
tle u'on.  The  weUs  in  the  neighborhood  pass  down  into  the  soft  red  sand- 
stone (Yore  dale  series)  which  hes  below  the  millstone  grit ;  the  water  con- 
tains as  much  as  64.96  grains,  and  even,  in  one  case,  96  grains  per  gaUon ; 
in  addition  to  the  usual  salts,  there  is  much  calcium  chloride  and  calcium, 
sodium,  and  magnesium  nitrates.  Shallow  well-water  is  always  to  be  viewed 
with  suspicion  ;  it  is  the  natural  point  to  which  the  drainage  of  a  good  deal 
of  surrounding  land  tends,  and  heavy  rains  will  often  wash  many  sub- 
stances into  it.^  The  cjuestion  may  arise  as  to  what  should  be  considered 
a  shallow,  and  what  a  deep  weU.  In  the  Pdvers  Pollution  Commissioners' 
Sixth  Report  all  the  shallow  weUs  examined  are  less  that  50  feet  deep  ;  most 
of  the  deep  wells  more  than  100  feet  deep.  Any  well  less  than  50  feet  deep 
that  does  not  pass  through  an  impermeable  stratum,  such  as  stiff  clay  or 

'  By  some  even  dangerous  (Gerardin). 

^  Dr.  Cameron  (Dublin  Journal  of  Medical  Science)  cites  a  case  where  good  and  bad 
water  were  obtained  from  different  levels  in  the  same  well.  Similar  results  have  been 
observed  elsewhere ;  see  analysis  of  water  from  a  well  at  Fareham,  Report  on  Hygiene, 
A.M.D.  Reijoris,  vol.  xxi.  In  these  cases  both  samples  were  impure,  but  the  water 
from  the  bottom  of  the  well  contained  a  great  excess  of  salts,  due  probably  to  infil- 
tration from  the  tidal  waters  of  the  neighboring  river. 


24  PRACTICAL    HTGIEi^E. 

hard  rock,  must  be  classed  as  a  shallow  welL     The  following  table  is  given 
by  the  Rivers  Pollution  Commissioners  : — ' 

Wholesome  -|  2.  Deep  well-water,         .  \       ^  1 '  ' 

3.  Upland  sm-face-water,  Moderately  palatable. 

Q       .  .  j  4.  btored  ram-water,      .  \  ■   -^ 

auspicious    -j  g  Surface-water  from  cultivated  land,     .         .  ) 

■p.  \  6.  River-water,  to  which  sewage  gains  access,  >-  palatable. 

IJangerous    -j  ^^  Shallow  weH-water, ) 

Sub-Section  II. — Ch-\r.\cteks  and  Classitication  of  Dkinking  Watees. 

The  general  characters  of  good  water  are  easily  enumerated.  Perfect 
clearness ;  freedom  from  odor  or  taste  ;  coolness  ;  good  aeration  ;  and  a 
certain  degTce  of  softness,  so  that  cooking  operations,  and  especially  of 
vegetables,  can  be  properly  performed,  ai'e  ob^dous  properties.  But  when 
we  attempt  a  more  complete  description,  and  assign  the  amounts  of  the 
dissolved  matters  which  it  is  desu-able  should  not  be  exceeded,  we  find  con- 
siderable difference  of  opiuion,  and  also  a  real  want  of  evidence  on  which 
to  base  a  satisfactory  judgTaent. 

Still  an  hygienic  classification  or  enumeration  of  potable  waters,  based 
on  such  facts  as  are  generally  admitted,  will  be  useful.  A  di\-ision  of  waters 
used  for  diinking  into  four  classes  has  been  adopted  in  this  work  : — 

1.  Pui'e  and  wholesome  water. 

2.  Usable 

3.  Suspicious  " 

4.  Impure  " 

The  waters  belonging  to  the  first  and  second  class  may  be  used  ;  those 
of  the  third,  or  suspicious  class,  should  be  well  filtered  before  distribution, 
and,  if  possible,  should  be  again  filtered  in  the  house.  A  jDui-er  source 
should  also  be  obtained  if  possible,  and  soui'ces  of  sewage  contamination 
ascertained  and  prevented. 

The  waters  of  the  foiu'th  class  should  be  enth-ely  disused,  or  only  be 
used  when  a  better  source  is  not  procurable,  and  means  of  pui'ification 
should  then  be  systematically  resorted  to. 

Sub-Section  IH. — Origin  of  the  Impurities  in  Drinking  Water. 

The  origin  of  the  impurities  in  water  may  be  conveniently  refen-ed  to 
four  heads,  ^iz.  : — (1)  Substances  derived  from  the  som-ce  ;  (2)  Substances 
added  duiing  the  flow  of  the  waters  in  rivers,  canals,  aqueducts,  or  other 
conduits  ;  (3)  Impui'ities  caused  by  storage  in  resei'\'oirs  or  tanks  ;  and  (4) 
Substances  added  during  distribution  from  resei-voii's  either  in  pipes  or 
water  baiTels,  or  in  house  cisterns. 

1.  Impurities  of  Source. 

The  geological  formation  of  a  district  necessarily  influences  the  com- 
position of  the  water  running  thi-ough  it,  though  it  is  impossible  to  teU 
\rith  absolute  certaiaty  what  the  constituents  of  the  water  may  be.  For- 
mations vary  greatly,  and  the  broad  features  laid  down  by  geologists  do 

»  Sixth  Report,  p.  129. 


WATER.  25 

not  always  suffice  for  our  purpose.  In  the  middle  of  a  sandy  distiict, 
;^-ielding  usually  a  soft  water,  a  liard  selenitic  "svater  may  be  found  ;  and 
instead  of  the  pure  calcium  cai'bonate  water,  a  chalk  well  may  jield  a  water 
hard  fi-om  calcium  sulxohate  and  iron.  Still  it  may  be  useful  to  give  a 
short  sununaiy  of  the  best  known  facts. 

1.  The  Granitic,  2Ietamorphic,  Trap-Rock,  and  Clay-Slate  Waters.— 
Generally  the  gi-anitic  water  is  very  pure,  often  not  containing  more  than 
2  to  6  gTains  -^ev  gallon  of  sohds,  viz.,  sodium  carbonate  and  chloride,  and 
a  httle  lime  and  magnesia.  The  organic  matter  is  in  very  small  amount. 
The  clay-slate  water  is  generally  very  pure,  often  not  containing  more  than 
from  3"^  to  4  gTains  per  gallon.  The  water  fi-om  hai'd  trap-rocks  is  pm-e, 
but  if  the  trap  be  disintegi-ated  the  shallow  wells  sunk  in  it  ai-e  of  course 
hable  to  be  fouled  by  surface  washings  or  soakage. 

2.  The  Water  from  JTillstone  Grit  and  Hard  Oolite. — Like  the  granitic 
water  this  is  very  pure,  often  not  containing  more  than  4  to  8  gTains  per 
gallon  of  mineral  matters,  which  consist  of  a  httle  calcium  and  mag-nesium 
sulphate  and  cai-bonate  ;  a  trace  of  u'on. 

3.  Soft  Sand-Rock  Waters. — These  ai'e  of  vaiiable  composition,  but  as 
a  rule  are  impure,  containing  much  sodium  chloride,  sodiiun  carbonate, 
sodium  sulphate,  h'on,  and  a  httle  hme  and  magTiesia,  amounting  alto- 
gether to  from  30  to  80  grains  x^er  gallon.  The  organic  matter  may  be 
in  large  amount — 4  to  8  gTains  j)er  gallon,  or  even  more.  Sometimes  these 
waters  are  pure  and  soft,  but  in  other  cases  wells  or  springs,  within  a 
short  distance,  may  vary  considerably  in  composition. 

4.  The  Loose  Sand  and  Gravel  Wate7\'-. — In  this  case  there  is  also  a 
great  variety  of  composition.  Sometimes  the  water  is  very  pure,  as  in  the 
case  of  the  Famham  waters,  and  in  some  of  the  waters  from  the  green 
sand,  where  the  total  solids  ai'e  not  more  than  fi-om  4  to  8  grains  per 
gahon,  and  consist  of  a  httle  calcium  carbonate,  sulphate,  and  sihcate  ; 
magnesium  carbonate  ;  sodium  and  potassium  chloride ;  sodium  and  po- 
tassium sulphate  ;  iron,  and  organic  matter.  The  last  is  sometimes  in 
some  amount,  viz.,  .8  to  1.8  grain  per  gallon.  In  tolerably  pm-e  gTavels, 
not  near  towns,  the  water  is  often  very  fi-ee  from  impuiity.  In  the  case  of 
many  sands,  however,  which  are  rich  in  salts,  the  water  is  unpiu-e,  the  sohd 
contents  amounting  sometimes  to  50  or  70  gTains  per  gallon,  or  more,  and 
consisting  of  sodium  chloride,  sodium  carbonate,  sodium  sulphate,  with 
calcium  and  magTiesium  salts.'  These  waters  are  often  alkaline,  and  con- 
tain a  good  deal  of  organic  matter.  The  water  fi'om  the  sands  in  the 
"  Landes  "  (Southern  France)  contains  enough  organic  matter  to  give  agTie. 

5.  Watei's  from  the  Lias  Clays  vai-y  in  composition,  but  are  often 
impure  ;  even  217  gi-ains  per  gallon  of  mineral  matters  have  been  found. 
No  less  a  quantity  than  88  gTains  of  calcium  sulphate,  and  41.8  of  magne- 
sium sulphate,  existed  in  a  water  examined  by  Yoelcker." 

6.  The  Chalk  Waters. — The  pui-e,  typical,  calcium  carbonate  water 
from  the  chalk  is  very  spai'khng  and  clear,  highly  charged  with  carbonic 
acid,  and  contains  from  7  to  20  gTains  per  gallon  of  calcium  carbonate,  a 
Httle  magnesium  carbonate  and  sodium  chloride — small  and  immaterial 
quantities  of  u-on,  sihca,  potassa,  nitric,  and  phosphoric  acids.     Sulphuric 

'In  a  shallow  vvell  (20  feet  deep)  in  the  gravel,  near  Netley  Abbey,  the  water 
yielded  total  solids  148.75,  of  which  were  chlorides  86.80  grains  per  gallon;  after 
de-epening  it  to  '60  feet,  and  passing  through  a  stratum  of  stifE  blae  clay,  it  gave 
only  16.8  total  solids,  and  6.5  of  chlorides.  —  [P.  de  C] 

'■^  In  a  well  from  Weedon  Barracks,  109  feet  deep,  sunk  in  blue  lias,  I  found  91  grains 
per  gallon  of  solids,  but  very  little  organic  matter. — [F.  de  C  J 


26  PE ACTIO AL    HYGIENE. 

acid  in  combination  is  sometimes  jiresent  in  variable  amount ;  organic 
matter  is  usually  in  small  amount.  This  is  a  good,  wholesome,  and  pleas- 
ant water.     It  is  hard,  but  softens  gTeatly  by  boiling. ' 

7.  The  Limestone  and  Magnesian  Limestone  Wate7\s. — These  are  also 
clear  spai-kHng  waters  of  agreeable  taste.  They  differ  from  the  chalk  in 
containing  usually  more  ctdcium  sulphate  (4  to  12  grains,  or  even  more) 
and  less  carbonate,  and,  in  the  case  of  the  dolomitic  districts,  much  mag- 
nesium sulphate  and  carbonate.  Organic  matter  is  usually  in  small 
amount.  They  are  not  so  wholesome  as  the  chalk  waters.  They  are  hai'd, 
and  soften  less  on  boihng. 

8.  The  Selenitic  Waters. — Water  charged  with  calcium  sulphate  (6  to 
20  grains,  or  even  more)  may  occur  in  a  variety  of  cases,  but  it  may  some- 
times come  from  selenitic  rocks.  It  is  an  unwholesome  water,  and  in 
many  persons  produces  dyspepsia  and  constipation,  alternating  with  diar- 
rhoea. It  is  hard,  softens  little  on  boihng,  and  is  not  good  for  cooking  or 
washing. 

9.  Clay  Waters. — Very  few  springs  exist  in  the  stiff  claj' ;  the  water  is 
chiefly  surface,  and  falls  soon  into  rivers  ;  it  varies  gTeatly  in  composition, 
and  it  often  contains  much  suspended  matter,  but  few  dissolved  constitu- 
ents, chiefl}'  calcium  and  sodium  salts. 

10.  Alluvial  Waters. — (Alluriimi  is  usually  a  mixtiu-e  of  sand  and  clay.) 
Generall}^  impure,  with  calcium  carbonate  and  sulphate,  magnesium  sul- 
phate, sodium  chloride  and  carbonate,  ii-on,  sihca,  and  often  much  organic 
matter.  Occasionally  the  organic  matter  oxidizes  rapidly  into  nitrites,  and 
if  the  amount  of  sodium  chloride  is  large,  it  might  be  supjDosed  that  the 
water  had  been  contaminated  "with  sewage.  The  amount  of  solids  per  gal- 
lon varies  from  20  to  120  grains,  or  even  more. 

11.  Surface  and  Subsoil  Water. — Very  variable  in  composition,  but 
often  very  imj^ure,  and  always  to  be  regai'ded  with  suspicion.  Heaths  and 
moors,  on  primitive  rocks,  or  hard  mUlstone  gi'it,  may  suj^ply  a  pure 
water,  which  may,  however,  be  sometimes  shghtly  colored  with  vegetable 
matter.  Cultivated  lands,  with  rich  manvu-ed  soils,  give  a  water  containing 
often  both  organic  matter  and  salts  in  large  quantity.  Some  soils  contain 
potassium,  sodium,  and  magnesium  nitrates,  and  give  up  these  salts  in 
large  quantity  to  water.  This  is  the  case  in  several  parts  of  India,  at  Aden, 
and  at  Nassick  in  the  Deccan  (Haines).  In  towns  and  among  the  habita- 
tions of  men,  the  sui'face-water  and  the  shallow  well-water  often  contain 
large  quantities  of  calcium  and  sodium  nitrites,  nitrates,  sulphates,  jDhos- 
phates,  and  chlorides.  The  nitrates  in  tliis  case  probably  arise  from 
ammonia,  ammonium  nitrite  being  first  formed,  which  dissolves  large 
quantities  of  Hme.  Organic  matter  exists  often  in  large  amount,  and  slowly 
oxidizes,  forming  nitric  acid  and  ammonia.  In  some  cases  butyric  acid, 
which  often  unites  with  lime,  is  also  formed. 

12.  Marsh  Water. — This  always  contains  a  large  amount  of  vegetable 
organic  matter  ;  it  is  not  vmusual  to  find  from  12  to  40  gi-ains,  and  in  some 
cases  even  more.  Suspended  organic  matter  is  also  common.  The  salts 
are  variable.  A.  little  calcium  and  sodium  in  combination  with  cai*bonic 
and  sulphuric  acids  and  chlorine  are  the  most  usual.  Of  course,  if  the 
marsh  is  a  salt  one,  the  mineral  constituents  of  sear-water  are  jDresent  in 
var\'ing  proportions. 

_^_ » ^____^ 

'  Sometimes  the  water  drawn  from  the  upper  part  of  the  chalk  is  really  derived 
from  tertiary  sand  lying-  above  the  chalk.  The  water  contains  less  calcium  carbonate, 
and  more  sodium  carbonate  and  chloride,  and  may  be  alkaline. 


WATER.  27 

13.  Water  from  Graveyards. — Ammonium  and  calcium  nitrites  and 
nitrates,  and  sometimes  fatty  acids,  and  much  organic  matter.  Lefort 
found  a  well  of  water  at  St.  Didier,  more  than  330  feet  from  a  cemetery,  to 
be  largely  contaminated  with  ammoniacal  salts  and  an  organic  matter  which 
was  left  on  evaporation.  The  water  was  clear  at  first,  but  had  a  vapid  taste, 
ajid  speedily  became  putrid. 

14.  Artesian  Well- Water. — The  composition  varies  gTeatly.  In  some 
cases  the  water  is  so  highly  charged  with  sahne  matter  as  to  be  undrink- 
able ;  the  water  of  the  Artesian  well  at  Grenelle  contains  enough  sodium 
and  potassium  carbonates  to  make  it  alkaline  ;  there  is  also  often  a  con- 
siderable amount  of '  free  or  sahne  ammonia.  In  some  cases  the  water 
contains  an  appreciable  amount  of  iron  ;  in  other  cases,  especially  when 
drawn  from  the  lower  part  of  the  chalk,  or  the  green  sand  below  it,  it  is 
tolerably  pure.  Its  temperature  is  usually  high  in  proportion  to  the  def)th 
of  the  well.  The  aeration  of  the  water  is  often  moderate,  sometimes  nil. 
These  last  two  points  sometimes  mihtate  against  the  employment  of  water 
from  very  deej)  wells. 

15.  Water  from  Wells  near  the  Sea.'' — This  frequently  contains  so  much 
saline  matter  as  to  taste  quite  brackish,  although  the  organic  matter  may 
not  be  very  large.  In  some  samples  from  Shoeburyness  (analyzed  at  Netley) 
the  total  solids  ranged  from  104  to  218  grains  per  gallon  of  total  solids,  the 
chlorides  being  from  22  to  65  :  mean  of  six  samples — 165  total  solids,  and 
35  of  chlorides.  In  one  sample,  however,  the  albuminoid  ammonia  was 
only  0.07  per  million,  and  in  five  the  oxygen  required  for  organic  matter 
was  under  0. 75  per  million.  At  Landgaiard  Fort,  water  from  a  boring  150 
feet  deep  yielded  more  than  500  grains  of  solids  and  380  grains  of 
chlorides. 

16.  Rain-Water  may  be  contaminated  by  washing  the  air  it  falls  through, 
but  more  by  the  STU-face  on  which  it  faUs,  such  as  decaying  leaves,  bu-d 
droppings,  soot,  or  other  matter  on  the  roofs  of  houses  ;  it  also  takes  lead 
from  lead  coatings  and  pipes,  and  zinc  from  zinc  roofs. 

2.  Impurities  of  Transit  teom  Source  to  Reservoirs. 

Open  conduits  are  liable  to  be  contaminated  by  surface  washings  carry- 
ing in  finely  divided  clay,  sand,  chalk,  and  animal  matters  from  cultivated 
land  ;  and  the  leaves  and  branches  of  trees  and  their  contingent  of  vege- 
table matters.  These  impurities  may  occur  in  most  cases,  but  in  addition 
the  refuse  of  houses,  trades,  and  factones  is  often  poured  into  rivers,  and 
all  sorts  of  matters  are  thus  added. 

These  impurities  are  broadly  divided  by  the  Rivers  Pollution  Commis- 
sioners into  "sewage "and  "manufacturing:"  under  the  former  term  all 
solid  and  liqiiid  excreta,  house  and  waste  water,  and  in  fact  aU  impurities 
coming  from  dwelhng's  are  included  ;  under  the  latter  term  are  placed  all 
manufacturing  refuse,  such  as  from  dye  and  bleach  works,  tanneries,  paper- 
making,  woollen,  silk,  and  metal  works,  etc.^ 

The  very  numerous  animal  and  vegetable  substances  derived  from  habi- 
tations are  usually  classed  imder  the  vague,  but  convenient  term  of  "  organic 

'  For  a  good  example  of  the  iDfluence  of  a  tidal  river  on  neighboring  wells,  see  my 
Lectures  on  State  Medicine,  Table  x.,  p.  91.  — [F.  de  C]  On  the  other  hand,  springs 
situated  near  the  sea  have  been  found  very  pure. 

^  For  a  full  account  of  all  these  impurities,  and  the  best  mode  of  dealing  with  them, 
the  six  Reports  of  the  Hiver  Pollution  Commissioners  must  be  referred  to. 


28  PRACTICAL   HYGIENE. 

matter,"  as  the  separation  of  the  individual  substances  is  impossible.  The 
organic  matter  is  usually  nitrogenous,  and  Frankland  has  proposed  to  ex- 
press its  amoxmt  in  terms  of  its  nitrogen  (organic  nitrogen),  but  this  view 
is  not  yet  generally  received  on  account  of  the  difficulty  of  estimating  the 
very  small  quantity  of  nitrogen.  The  nitrogenous  organic  matter  undei'- 
goes  gi-adual  transformation,  and  forms  ammonia,  and  nitrous  and  nitric 
acids.  The  exact  steps  of  this  process  are  perhaps  complicated.  On  keep- 
ing the  water  the  nitrites  disapjoear,  and  in  some  cases  the  nitrates  also 
gradually  diminish,  probably  from  the  action  of  bacteria.  A.  Miiller '  found 
the  residue  of  a  well-water  gave  "with  sodium  hydi'ate  a  herring-LLke  odor, 
which  seemed  like  trimethylamme. 

Many  of  the  "organic  matters"  in  water  are  not  actually  dissolved,  but 
are  so  finely  suspended  that  they  pass  through  filtering  paper.  There  is 
no  doubt  that  among  this  "  suspended  organic  matter  "  many  small  plants 
and  animals  are  always  included.  It  is  probably  owdng  to  the  variation  in 
the  quantity  of  suspended  organic  matter  (living  and  dead)  that  water  from 
the  same  soiu'ce  sometimes  gives  different  results  on  anatysis,  even  though 
the  water  be  taken  at  the  same  time.  Diuing  its  flow  in  open  conduits, 
however,  a  species  of  purification  goes  on,  by  means  of  subsidence,  the 
action  of  water-plants,  and  to  some  moderate  extent  by  oxidation.  On  the 
whole  these  processes  apjoear  in  India  to  render  river-water,  in  spite  of  all 
the. contaminations  it  receives,  purer  than  tank  and  well-water."  The  free- 
dom from  noxious  substances  is  also  aj)parently  gi-eater  in  India  in  the 
quick-running  streams,  which  may  also  depend  upon  purification  taking 
place  in  them.' 

3.  Impurities  of  Storage. 

The  chance  of  substances  getting  into  the  water  of  wells,  and  tanks,* 
and  even  of  cisterns  in  houses,  is  very  great.  Sui'face  washings  and  soak- 
age  contaminate  wells  and  tanks,  and  leakages  from  i:)ipes,  j)assage  of  foul 
air  tlu'ough  pipes,  or  direct  absoi-ption  of  air  by  an  uncovered  surface  of 
water,  introduce  impiuities  into  cisterns.''  It  is  singular  in  how  many 
ways  cisterns  and  tank  waters  get  foul,  and  what  care  is  necessary  not  only 
to  place  the  cistern  under  safe  conditions  at  first,  but  to  examine  it  from 
time  to  time  to  detect  contamination  of  the  water.  In  India,  especially, 
the  tank  water  is  often  contaminated  l^y  clothes  washed  near,  or  actually 
in,  the  tank  ;  by  the  passage  even  of  excrement  directly  into  it,  as  well  as 
by  sui'face  washings,  so  that  in  fact  in  some  cases  the  village  tank  is  one  of 

'  Roth  and  Lex,  Militar-Gesundheitspfl. ,  p.  16. 

'  Palmer  shows  this  clearly  in  a  very  interesting  paper  in  the  Indian  Medical 
Gazette  for  December,  1870. 

^  Much  influence  has  been  ascribed  to  oxidation,  and  doubtless  in  part  correctly ; 
but  Dr.  Frankland  has  shown  its  effect  to  be  limited.  The  Irwell  river,  after  pai-sing 
Manchester,  runs  11  miles  to  its  junction  with  the  Mersey  without  further  material 
pollution,  and  falls  over  6  weirs ;  yet  the  purification  by  oxidation  is  trillinir.  By 
siphoning  water  from  one  vessel  to  another  so  as  to  represent  a  run  of  96  miles,  the 
organic  carbon  was  only  reduced  6.4  per  cent,  and  the  organic  nitrogen  28.4  per  cent. 
This,  however,  is  widely  different  from  running  in  an  open  river  bed. 

•*  In  two  examples  of  (.^o  called)  rain-water  collected  in  tanks  in  the  marsh  near 
Tilbury  Fort  for  the  use  of  the  troops,  the  solids  were  found  to  be  respectively  41  and 
145  grains  per  gallon  (Army  Medical  Reports,  vol.  xvii. .  p.  214). 

^  A  good  case  of  ab.sorption  by  an  open  cistern  of  gases  from  water  clo.«ets  and 
urinals  is  recorded  by  Druitt  (Medical  '1  imes  and  Gazette,  September,  1869).  The 
water  as  supplied  contains  .08  part  per  million  of  albuminoid  ammonia  ;  after  absorp- 
tion, 17  parts. 


WATER.  29 

tlie  chief  causes  of  the  sickness  of  the  people.  There  is,  perhaps,  no  point 
on  which  the  attention  of  the  sanitary  officer  should  be  more  constantly 
fixed  than  that  of  the  storage  of  water,  either  on  the  large  or  small  scale. 

In  shallow  wells  (4  to  30  feet  deep)  the  soakage  water  from  the  gTound 
in  loose  soils  of  chalk  and  sand  is  often  very  impure.  Thus  in  a  town  the 
well-water  often  shows  evidence  of  nitrites,  nitrates,  and  ammonia,  and 
chlorine  far  in  excess  of  river-water  in  the  neighborhood,  though  the 
strata  are  the  same.'  Occasionally,  by  constant  passage  of  the  water,  a 
channel  is  formed,  which  may  suddenly  discharge  into  the  well ;  and  prob- 
ably some  of  the  cases  of  sudden  poisoning  from  water  have  thus  arisen. 

A  well  drains  an  extent  of  gTound  about  it  nearly  in  the  shape  of  an 
inverted  cone.  The  area  must  depend  on  the  soil ;  but  the  experiments 
at  Grenelle  and  Passy  show  that  the  radius  of  the  area  drained  is  equal  to 
four  times  the  depth  at  least,  and  that  it  often  exceeds  this.^  Professor 
Ansted  states  that  the  deepest  (non-Aj-tesian)  well  will  not  drain  a  cone 
which  is  more  than  half  a  mile  in  radius. 

In  some  cases  a  well  at  lower  level  may  receive  the  drainage  of  siu-- 
rounding  hills  flowing  down  to  it  from  great  distances.  Good  coping 
stones,  so  as  to  protect  from  surface  washings ;  good  masonry  for  several 
feet  below  the  siu-face  of  wells  in  very  loose  soils,  so  as  to  prevent  super- 
ficial soakage,  are  necessary  in  all  shallow  weUs. 


4.  Imptjeities  of  Distribution. 

If  water  is  distributed  by  hand,  i.e.,  by  water-carts,  barrels,  or  skins, 
there  is  necessarily  a  great  chance  of  its  being  fouled.  In  India,  where 
the  water  is  generally  carried  by  water-carriers  (Bhisties),  inspection  of 
the  carts  or  skins  should  be  systematically  made,  and  whenever  it  be  pos- 
sible, pij)es  should  be  substituted  for  the  mde  method  of  hand  conveyance. 
But  even  pipes  may  contaminate  water ;  metals  (lead,  zinc,  and  iron)  may 
be  partly  dissolved  ;  wood  rots,  and  if  the  pipes  are  occasionally  empty, 
impure  air  may  be  drawn  into  them,  and  be  afterward  absorbed  by  the 
water.  ^  In  towns  supplied  on  the  constant  system,  when  the  pipes  are  be- 
coming empty  the  flow  of  water  from  a  tap  has  drawn  foul  water  or  air 
through  a  pipe  at  some  distance,  and  in  this  way  even  the  water  of  the 
mains  has  been  befouled. 

Coal  gas  passing  into  the  ground  from  leaking  of  gas-pipes  sometimes 
finds  its  way  into  wells,  or  even  into  water-pipes.  In  Berlin,  in  1864,  out 
of  940  pubhc  wells,  39  were  contaminated  by  admixture  with  coal  gas.  A 
good  instance  is  related  by  IVIr.  Harvey,^  where  the  main  pipes  were  often 
empty  and  gas  penetrated  into  them.  Having  regard  to  the  cases  in  which 
gases  from  the  soil  (from  leaking  gas-pipes,  sewers,  etc.)  find  their  way 
into  water-pipes,  it  would  seem  important  not  to  lay  down  water-pipes  near 
any  other,  or,  what  is  better,  have  all  pipes  in  sub-ways  where  they  can  be 
inspected. 

■  Eoth  and  Lex,  op.  cit  ,  p.  43. 

^  Etudes  sur  le  mouvement  des  Eaux,  par  J.  Dupuit. 

^  Cases  of  this  sort  are  given  in  the  Reports  of  the  Medical  Officer  of  the  Privy 
Council,  No.  ii.,  new  series.  See  Dr.  Blaxall  on  Fever  at  Sherborne,  Dorset,  and  Dr. 
Buchanan  on  the  Fever  at  Caiua  College,  Cambridge.  In  the  latter  case  foul  trap- 
water  was  sucked  in  from  the  closets.  At  Croydon,  blood  was  sucked  in  this  way 
from  a  butcher's  shop. 

*  Food,  Water,  and  Air,  February,  1872,  p.  68. 


30  PRACTICAL   HYGIENE. 

SECTION  m. 

'  PURIFICATION   OF   WATER. 

Without  Filtration. 

1.  Exposure  to  Air  in  divided  Currents. — This  was  fi  plan  proposed  by 
Lind,  for  the  water  of  the  African  west  coast,  more  than  one  hundred 
years  ago,  and  frequently  revived  since.  The  water  is  simply  poured 
through  a  sieve,  or  a  tin  or  wooden  plate,  pierced  with  many  small  holes, 
so  as  to  cause  it  to  fall  in  finely  divided  streams,  or  a  hand-jDump  is  in- 
serted in  a  cask  of  water,  and  the  water  is  pumped  up,  and  made  to  fall 
through  perforated  sheets  of  tin.  It  soon  removes  hydrogen  sulphide, 
offensive  organic  vapors,  and,  it  is  said,  dissolved  organic  matter.  The 
same  plan  has  been  used  in  Russia  on  a  large  scale,  the  Avater  being  al- 
lowed to  fall  down  a  series  of  stej)s,  jiassing  through  wire  gauze  as  it  does 
so.     In  Paris,  also,  it  has  been  employed  on  the  small  scale. 

2.  Boiling  and  Agitation. — This  plan  gets  rid  of  calcium  carbonate,  iron 
in  part,  and  hydrogen  sulphide,  and  lessens,  it  is  said,  organic  matter.  It 
is  uncertain  if  boiling  will  completely  destroy  the  poisons  of  the  specific 
diseases,  but  it  is  highly  probable.  It  will  not  destroy  completely  all  bac- 
teria, or  at  least  their  germs  still  live,  and  Lex  found  some  bacteria,  still 
moving  rapidly,  at  a  temperatui-e  of  127°  C."  T^iidaU's  experiments  have 
shown  that  there  are  stages  in  the  life  of  bacteria  during  which  they  can 
resist  almost  any  moist  heat.  But  as  they  soften  before  proi:)agation  a 
solution  can  be  successfully  sterihzed  by  repeated  boilings,  so  as  to  attack 
the  several  crops  of  bacteria  in  their  vulnerable  condition.  Most  fungus 
spores  are  killed  by  boiling. 

3.  Aluminous  Salts. — Alum  has  been  used  for  centuries  in  India  and 
China,  to  purify  water  from  suspended  matters.  It  does  this  very  effec- 
tually, if  there  be  calcium  carbonate  in  the  water ;  calcium  suliDhate  is 
formed,  and  this  and  a  bulky  aluminium  hydrate  entangle  the  floating  par- 
ticles and  sink  to  the  bottom.  Mr.  Alfred  Bird  has  proposed  aluminium 
tersulphate,  which  is  equally  efficacious ;  it  is  an  acid  liquid,  containing 
about  .4  grain  of  the  sulphate  in  each  minim  ;  and  M.  Bellamy"  has  also 
proposed  a  modification  of  the  alum  process,  by  adding  additional  potash 
to  a  solution  of  alum  till  the  precipitate  is  redissolved.  The  quantity  of 
crystallized  alum  to  be  used  should  be  about  six  grains  per  gallon  ;  of  Mr. 
Bird's  fluid  (sulphate  of  alumina),  twenty  drops. 

From  numerous  experiments  on  purification  with  crystallized  alum, 
and  with  Mr.  Bird's  patent  liquid,  with  and  without  calcium  carbonate  in 
the  water,  it  is  clear  not  only  that  calcium  carbonate  ought  to  be  in  the 
Avater,  but  that  the  action  of  both  alum  and  Bird's  fluid  is  made  more 
upon  the  suspended  organic  matters  than  upon  those  actually  dissolved  ; 
and,  indeed,  having  regard  to  the  great  difficulty  of  insuring  that  water  is 
actually  free  from  minute  suspended  matters,  it  is  even  a  question  whether 
aluminous  salts  will  act  in  any  appreciable  degree  on  dissolved  organic 
matters.     But  on  suspended  matters,  both  organic  and  mineral,  the  effect 

'  Sanderson  puts  the  death-point  of  common  septic  bacteria  at  about  110"  C.  or 
2C0"  F. 

-  Comptes  Rendus  de  I'Acad. ,  November  11,  1867,  p.  799. 


•WATEE.  31 

is  very  great  indeed.  Common  alum  and  Bird's  liquid  seem  practically 
equal ;  but  alum,  being  solid,  is  more  convenient  for  transport.  ^ 

If  a  sedimentons  water  is  extremely  soft,  a  little  calcium  cKloride  and 
sodium  carbonate  should  be  put  in  before  the  alum  is  added. 

4  Addition  of  Lime  Water  (Clark's  patent). — By  combining  with  car- 
bonic acid,  it  causes  almost  all  the  calcium  carbonate  previously  and  newly 
formed  to  be  thrown  down.  It  also  throws  down  suspended  and  a  certain 
proportion  of  dissolved  organic  matters,  and  also,  it  is  said,  iron.  It  does 
not  touch  calcium  and  magnesium  sulphate  and  chloride." 

5.  Sodium  Carbonate,  with  boiling,  throws  down  lime,  and  possibly  a 
little  lead,  if  present. 

6.  Addition  of  Potassium  or  Sodium  Permanganate  (Condy's  red  fluid). 
— Pure  Condy's  fluid  readily  removes  the  smell  of  hydrogen  sulphide  and 
the  pecuhar  offensive  odor  of  impure  water  which  has  been  kept  in  casks 
or  tanks.  If  it  forms  a  precipitate  of  manganic  oxide,  it  also  carries  down 
suspended  matters  ;  but  the  formation  of  this  precipitate  is  very  uncertain. 
The  action  on  the  dissolved  organic  matters  will,  of  course,  vary  with  the 
nature  of  the  substance  ;  some  of  the  organic  matters,  both  animal  and 
vegetable,  will  be  oxidized  ;  but  in  the  cold  it  will  not  act  upon  the  whole 
of  these  substances,  and  some  organic  matters  are  not  touched. 

One  objection  to  the  use  of  the  permanganate  is  that  it  often  communi- 
cates a  yellow  tint  to  the  water,  arising  from  suspended  finely  divided 
peroxide  of  manganese.  This  is  probably  of  no  moment  as  far  as  health  is 
concerned,  but  it  is  unpleasant.  Sometimes  the  addition  of  a  little  alum 
will  carry  down  this  suspended  matter  ;  boiling  may  be  used  but  often  has 
no  effect.     Sometimes  nothing  removes  it  but  filtration. 

The  indications  for  the  use  of  permanganate  are  these.  In  the  case  of 
any  foul-smelling  or  suspected  water,  add  good  Condy's  fluid,  teaspoonful 
by  teaspoonful,  to  3  or  4  gallons  of  the  water,  stirring  constant^.  When  the 
least  permanent  pink  tint  is  perceptible,  stop  for  five  minutes  ;  if  the  tint  is 
gone,  add  36  drops,  and  then,  if  necessary,  30  more,  and  then  allow  to  stand 
for  sis  hours  ;  then  add  for  each  gallon  6  grains  of  a  solution  of  crystalHzed 
alum,  and  if  the  water  is  very  soft,  a  httle  calcium  chloride  and  sodium  car- 
bonate, and  allow  to  stand  for  twelve  or  eighteen  hours. 

There  are  many  cases  in  which  this  plan  may  be  useful ;  and  as  the 
permanganate  certainly  removes  smells  and  oxidizes  in  the  cold  to  some 
extent,  it  is  a  very  good  introduction  to  the  alum  process,  and  does  work 
which  alum  alone  wiU  not  do.  But  it  cannot  be  considered  a  complete 
purifier  of  water  from  all  organic  matters.  Its  oxidizing  power  is,  how- 
ever, often  useful  in  cleaning  charcoal  filters,  as  will  be  presently  noted. 

7.  Perchloride  of  Iron. — It  has  been  found  that  the  water  of  the  Maas 
in  Holland,  which  is  turbid  from  clay  and  finely  suspended  organic  matters, 
and  gives  rise  in  consequence  to  diarrhoea,  is  completely  purified  by  per- 
chloride of  iron  in  the  proportion  of  about  2|-  grains  of  the  sohd  perchloride 
to  1  gallon  of  water.  ^     It  is  a  powerful  oxidizing  agent. 

Use  of  the  Strychnos  potatorum. — In  India  the  fruit  of  the  Strychnos 
potatorum  is  used,  especially  by  the  better  class  of  Hindoos,  to  purify  water. 

'  The  headquarter  wing  of  the  92d  Highlanders,  going  up  the  Indus  in  1868,  suf- 
fered from  diarrhoea  from  the  use  of  the  water ;  the  left  wing  used  alum,  and  had  no 
diarrhoea.  The  right  wing  then  used  it,  and  the  diarrhoea  disappeared. — Indian  Med- 
ical Gazette,  August,  1869,  p.  158. 

'^  This  plan  has  been  carried  out  with  great  success  on  a  large  scale,  in  the  form 
known  as  the  Porter-Clark  process,  and  also  in  a  modified  form  by  Messrs,  Atkins. 

3  Chemical  News,  May,  1869,  p.  239. 


32  PRACTICAL    HYGIENE. 

It  is  beaten  into  a  paste,  and  iiibbed  on  the  inside  of  the  \rater  jar  or  cask. 
Dr.  Mouat  says  that  it  is  chiefly  iised  for  the  river- water  at  the  seasons 
when  it  is  laden  with  silt,  and  that  about  30  gi-ains  are  used  for  100  gallons 
of  water,  which  act  in  twenty-fom-  hours.  Its  action  appeal's  to  be  on  sus- 
pended matters,  which  it  possibly  caiiies  down  b}'  giving  to  the  water  a 
delicate  albuminous  coagiilum,  so  that  it  purifies  water  on  the  same  princi- 
ple as  beer  is  fined.'  Dr.  O'Shaughnessy  thought  its  action  was  connected 
with  its  astringency.  Some  expeiiments  on  its  action  were  made  at  Netley, 
bvit  -without  any  satisfactory  result.  It  did  not  even  clear  the  water  thor- 
oughly from  suspended  matters,  and  it  had  no  effect  on  the  amount  of  ni- 
trous acid,  ammonia,  or  of  oxidizable  organic  matters,  as  far  as  these  could 
be  judged  of  by  potassium  pennanganate.  Renewed  experiments  are,  how- 
ever, necessaiy. 

8.  Immersion  of  Iron  Wire  and  Magnetic  Oxide  of  Iron  (Medlock). — 
This  plan  is  said  to  decompose  organic  matter.  Charcoal  and  ferric  oxide 
ai'e  sometimes  mixed. 

9.  Immersion  or  boiling  of  certain  Vegetables,  especially  those  containing 
tannin,  such  as  tea,"  kino,  the  Laurier  rose  [Nerium  Oleander,  which  is  also 
rubbed  on  the  inside  of  casks  in  Barbary),  bitter  almonds  (in  Eg;s'iDt). 

10.  Charring  the  inside  of  Casks. — This  is  an  effectual  plan,  and  Berthol- 
let  considered  it  more  efiectual  than  the  immersion  of  j^ieces  of  charcoal ; 
the  charring  can  be  renewed  from  time  to  time. 

To  jDut  these  facts  in  another  form  : — 

Organic  matter  is  got  rid  of  most  readily  by  exposure  to  air,  boiling, 
agitation,  charcoal,  alum,  potassium  pennanganate,  astringents. 

Carbonate  of  Lime  by  boiling  and  addition  of  caustic  hme. 

Iron,  by  boiling  and  lime  water,  and  in  pai't  by  charcoal.^ 

Calcium  and  viagnesium  sulphate  and  chloride  cannot  be  got  rid  of. 

It  should  be  remembered  that  some  water-plants  have  a  purifying  effect, 
apparently  from  the  large  quantity  of  oxygen  they  give  out ;  and  this  takes 
place  sometimes  though  the  water  itself  is  green. 

With  Filteation. 

Sand  and  Gravel. — On  the  large  scale,  water  is  received  into  settling 
resei'vou's,  where  the  most  bulky  substances  subside,  and  is  then  filtered 
through  gravel  and  sand,  either  by  descent  or  ascent,  or  both.* 

'  Pereira,  Pharmaceutical  Journal,  vol.  ix.,  p.  478. 

^  In  the  north  of  China,  and  especially  during  winter,  the  water  of  the  Peiho  be- 
comes very  impure,  and  contains  not  only  suspended  matters,  but  dissolved  animal 
matter  in  large  quantity,  which  gives  the  water  a  disagreeable  offensive  smell.  The 
Chinese  never  drink  it  except  as  tea,  which  is  cooled  with  a  lump  of  ice,  if  it  is  desired 
to  drink  it  cold.  In  this  way  they  secure  themselves  from  all  bad  effects  of  this  water 
(Friedel,  Das  Klima  Ost-Asiens,  p.  CO).  The  Europeans  use  ahim  and  charcoal ;  but 
these  do  not  always  entirely  remove  the  taste.  The  Tartars  also  use  their  "brick  tea  " 
to  purify  the  water  of  the  steppes,  which  would  otherwise  be  undrinkable. 

^  Chevalier,  Traite  des  Dc-sinfect. ,  p.  147.  In  the  Ashanti  campaign,  under  the  di- 
rections of  Surgeon-Major  V.  GouJdsbury,  C.M.G.,  the  water  was  purified  in  the  fol- 
lowing way,  in  the  absence  of  proper  filters: — Alum  was  added  to  precipitate  suspended 
matter — the  water  was  passed  through  a  rough  filter,  consisting  of  (1)  sponge  ;  (2) 
sand  ;  (3j  charcoal  in  pieces  ;  it  was  then  boiled,  and  a  few  drops  of  solution  of  potas- 
sium permanganate  added.  Water,  even  taken  from  a  hole  in  a  marsh,  was  innocuous 
after  this  treatment. 

■*  A  good  account  of  the  engineering  plans  and  filtration  of  the  London  Water  Com- 
panies will  be  found  in  a  work  called  The  Water  Works  of  London,  by  Messrs.  Col- 
bum  &  Shaw,  1867. 


WATEE.  33 

The  London  "R-ater  companies  usually  employ  a  depth  of  3  to  5  feet  ;  in 
the  latter  case,  the  upper  stratum  of  18  inches  or  2  feet  is  composed  of 
sand,  the  lower  3  feet  are  made  up  of  gTavel,  gradually  increasing  in  coarse- 
ness, fi-om  pieces  the  size  of  a  small  pea  and  bean  to  that  of  a  middle-sized 
potato.  A  stratrun  of  oyster  shells,  about  1^  inch  in  thickness,  has  been 
used  by  some  companies  instead  of  a  layer  of  gravel ;  but  this  plan  is  not 
general.  If  •the  filter  is  3  feet  in  thickness,  the  upper  15  inches  ai-e  sand, 
and  the  lower  21  inches  are  gravel. 

The  pressure  of  water  in  these  filters  is  not  great ;  the  depth  of  the 
water  is  never  above  2  feet,  and  some  companies  have  only  1  foot.  From 
70  to  75  gallons  is  th,e  usual  quantity  which  should  pass  through  in  twenty- 
four  hours  for  each  square  foot ;  but  some  companies  filter  more  quickly, 
viz.,  at  the  rate  of  a  gallon  per  twenty- four  houi-s  for  each  square  inch,  or 
144  gallons  per  square  foot. 

The  sand  should  not  be  too  fine  ;  the  shai-p  angular  particles  are  the 
best.  The  action  seems  chiefly,  perhaps  altogether,  mechanical ;  the  sus- 
pended impurities,  both  mineral  and  organic,  rub  upon  and  adhere  to  the 
angles  and  plane  surfaces  of  the  sand,  which  ai-e  gradually  encnisted,  and 
after  a  certain  time  the  sand  has  to  be  cleaned.  The  effect  on  suspended 
matters,  both  organic  and  mineral,  is  certainly  satisfactoiy.  On  dissolved 
organic  matter  it  is  less  so.'  j\Ii'.  "Witt's  experiments  show  only  a  removal 
of  aboiit  5  per  cent. 

Some  experiments  were  made  at  Netley  on  a  sand  filter  of  1  square 
foot  sui'face,  and  made  in  imitation  of  a  London  water  company's  filter, 
\xz.,  15  inches  of  fine,  well-washed  white  sand,  and  20^  inches  of  gravel, 
gradually  increasing  in  coarseness.  The  first  eight  gallons  were  thrown 
away,  so  as  to  avoid  the  faUacy  of  including  the  distilled  water  with  which 
the  sand  had  been  washed. 

This  sand  filter  had  some  effect  in  lessening  the  dissolved  constituents, 
both  mineral  and  organic,  but  the  effect  was  limited  ;  it  stopj)ed  organic 
matter  after  it  had  ceased  to  arrest  hme.  After  a  longer  time  it  became 
useless,  and  required  washing. 

It  is  yet  uncertain  whether  the  action  of  sand  on  organic  matter  is  at 
all  chemical,  i.e.,  whether  the  organic  matter  is  oxidized  in  its  transit ; 
considering  what  an  amount  of  au'  is  contained  in  the  interstices  of  sand, 
and  how  finely  the  water  is  divided  in  its  transit,  some  amount  of  oxidation 
is  probable,  but  good  chemical  evidence  is  yet  wanted.  Mr.  Shield's  ex- 
periments, given  in  the  note,  seem  opposed  to  the  probabihty  of  much 
chemical  action.  On  dissolved  mineral  matters  sand  exerts  at  fu-st,  and 
when  in  thick  layers,  a  good  deal  of  action  ;  much  sodium  chloride  can  be 
removed  ;  and  Professor  Clark  has  stated  that  even  lead  can  be  got  rid  of 
by  filteiing  through  a  thick  stratum.  Very  finely  divided  clay  seems  to 
pass  thi'ough  more  readily  than  any  other  suspended  matters." 

'  In  a  sand  and  p^ravel  filter.  33  inches  in  thickness,  Mr.  Shield  (Proc.  Inst,  of 
Civil  Engiuutrs  for  18G7)  gives  the  following-  numbers  : — The  original  amount  of  or- 
ganic matter  being  .8906  gram  per  gallon,  the  amount  after  filtration  was  as  follows 
—after  23  hours  action,  1.102  ;  after  120  hours,  .648  ;  after  24U  hours.  .917  ;  after  376 
hours,  .809.  So  that,  while  on  the  whole,  the  sand  removed  some  organic  matter,  the 
amount  is  really  inconsiderable. 

-  A  peculiar  difficulty,  never  experienced  in  England,  has  been  discovered  in  the  fil- 
tering, through  sand,  of  the  Hooghly  water  at  Calcutta  ;  during  the  rainy  season  the 
fine  mud  brought  down  penetrates  very  deeply  into  the  filters,  and  rapidly  chokes 
them  ;  in  the  dry  season  this  does  not  happen  ;  the  suspended  matters  are  arrested,  as 
in  England,  near  the  upper  surface  of  the  sand.  Mr.  D.  Waldie  (Journal  of  the  Asi- 
atic Society  of  Bengal  for  1873,  part  11,  p.  210)  explains  this  by  showing  that  in  the 
Vol.  I.— 3 


34  PRACTICAL   HYGIENE. 

Tlie  fine  white  sand  is  the  best ;  it  should  be  chosen  carefully,  and  well 
washed,  and,  if  possible,  heated  to  redness  before  use. 

Listead  of  sand  and  gravel,  trap-rock  has  been  used. 

Sponge. — Sponge  has  a  considerable  effect  in  mechanically  arresting 
suspended  particles,  but  very  Httle  on  dissolved  matters. 

Animal  Charcoal. — Pirre  animal  charcoal  (deprived,  as  far  as  possible, 
of  calcium  phosphate  and  carbonate  by  washiag  or  by  hycb-ochloric  acid) 
used  to  be  considei-ed  one  of  the  best  filtering  materials.  The  particles  of 
charcoal  should  be  weU  pressed  together,  and  the  passage  of  the  water 
should  not  be  too  quick.  Contact  with  the  water  for  about  four  minxites 
appears  sufficient.  There  is  a  large  (and,  if  the  Layer  of  charcoal  be  deep 
enough,  complete)  removal  of  suspended  matters,  both  mineral  and  organ- 
ic :  water  even  deeply  tinged  comes  through  a  good  chai'coal  filter  very 
clear  and  bright.  So  also  dissolved  organic  and  mineral  matters  are  re- 
moved by  charcoal  in  the  fii*st  instance.  All  eridence  agrees  in  respect  of 
that  point.  But  then  its  power  is  limited,  and  after  a  time  it  ceases  to  be 
efficient. 

Li  exj)eriments  made  with  animal  charcoal  at  Netley  (by  Drs.  F.  de 
Chaumont  and  J.  L.  Notter)  it  was  found  that  it  had  a  very  rapid  and  pow- 
erful effect  upon  dead  or  decomi^osing  organic  matter,  but  that  it  allowed 
fresh  organic  matter,  such  as  fresh  egg  albumen,  to  pass  through  to  a 
large  extent  unchanged.'  This  suggests  serious  considerations  with  refer- 
ence to  the  effect  upon  disease  poisons.  It  was  also  found  (as  in  ]VIi\ 
Byrne's  experiments)  that  after  a  time  the  filtering  action  not  only  ceased, 
but  that  the  charcoal  began  to  give  back  some  of  the  organic  matter  it  had 
removed.  The  same  result  takes  place  if  the  water  be  left  too  long  in  con- 
tact with  the  charcoal.  Water  filtered  through  charcoal,  if  it  be  kept  for 
any  length  of  time,  shows  some  evidence  of  low  fonns  of  organic  life — in 
some  instances  a  copious  deposit  forming.  This  may  be  due  either  to 
spores  or  germs  passing  through  unchanged,"  or  to  the  phosphates  yielded 
by  the  charcoal  affording  a  favorable  nutrient  for  germs  absorbed  from 
the  atmosphere.  For  these  reasons  it  seems  unadrisable  to  use  charcoal 
for  filtration  on  a  large  scale,  independent  of  the  consideration  of  exj^ense. 
The  plan  of  placing  charcoal  filters  in  Avater  cisterns,  now  often  practised, 
ought  also  to  be  given  up.  The  conclusions  to  be  aiTived  at  with  regard 
to  charcoal  as  a  filtering  medium  are  these  : — (1)  It  acts  both  chemically 
and  mechanically,  and  is  at  first  both  raj^id  and  efficient.  (2)  With  a  good 
bulk  of  material,  water  may  be  passed  through  nearly  as  rapidly  as  it  can 
flow  and  be  well  purified.  (3)  Water  must  not  be  left  in  contact  with  the 
charcoal  longer  than  is  necessary  for  filtration,  as  it  is  apt  to  take  up  organ- 
ic matter  again.  (4)  Water  filtered  through  charcoal  must  not  be  stored 
for  any  time,  but  must  be  used  immediately,  as  if  kept  it  is  apt  to  become 

rainy  season  the  water  contains  much  less  saline  matter  than  in  the  dry  season  ;  it  is 
this  saline  matter  which  seems  to  act  on  and  so  cause  colierence  of  the  particles  of  mud, 
so  that  they  become  larger  and  coarser,  and  are  moi-e  easily  arrested.  In  order  to 
remedy  this,  Mr.  Waldie  proposes  the  addition  of  substances  to  the  water  during  the 
rains,  which  may  cause  this  coalescence  ;  he  has  tried  a  great  number  of  experiments 
and  different  substances,  on  the  whole  crystallized  alum  and  perchlonde  of  iron  are 
the  best  ;  ■').'5.4  tti.  of  crystallized  alum,  or  1!).  15  IT>.  of  perchloi'ide  of  iron,  were  found 
to  be  necessary  for  the  clariiication  of  one  million  gallons  of  muddy  Hooghly  water 
durins:  the  rainy  season. 

'  See  Sanitary  Record,  Oct  ,  1876,  p.  288,  and  A.  M.  D.  Reports,  vol.  xix  ,  p.  170. 

'-'  This  ajipears  the  more  probable.  Minute  diatoms  were  found  in  water  which 
had  been  kept  for  some  months  that  had  passed  through  Crease's  large  filter  tanks 
at  Parkhurst. 


WATER.  35 

charged  with  minute  living  organisms.  (5)  Since  fresh  organic  matter  may 
pass  through  it  unchanged,  animal  charcoal  cannot  be  conhdentty  depended 
upon  to  piuify  water  from  disease  poisons.  (6)  The  power  of  charcoal  is 
limited  ;  with  a  moderately  good  water  it  remains  efS.cient  for  some  time, 
but  with  an  impure  water  it  soon  becomes  inactive.  In  most  cases  it  ought 
to  be  cleaned  or  renewed  every  thi-ee  months. 

Vegetable  Charcoal — Peat  Charcoal — Seaweed  Charcoal. — The  first  is  much 
less  efficacious  than  animal  charcoal — even  useless  according  to  I'rankland. 
The  others  are  rather  more  effectual,  but  do  not  appear  to  be  very  power- 
ful ;  they  should  only  be  used  when  animal  charcoal  cannot  be  obtained. 

Spongy  Iron. — This  substance,  obtained  by  roasting  haematite  ii'on  ore, 
is  porous  metallic  hon,  and  not  unlilce  animal  charcoal  in  apj)eai'ance.  It 
occupies  a  space  of  about  twenty  cubic  teet  to  the  ton.  Its  action  on 
water  is  both  mechanical  and  chemical,  for  it  arrests  suspended  matter  and 
also  oxidizes  organic  matter  in  solution.  It  acts  upon  water  itself,  decom- 
posing it  and  setting  free  hydi'ogen — the  oxygen  being  afterward  given 
up  to  organic  matter  that  may  come  in  contact  with  it.  Its  oxidizing 
power  is  very  great,  although  perhaps  a  Httle  slow.  Eipeiimeuts  at  Net- 
ley  '  showed  that  it  could  be  depended  ujDon  to  remove  the  gTeater  part  of 
the  dissolved  organic  matter,  and  with  prolonged  exjDosui'e  the  whole  of  it 
in  many  instances.  It  has  not  much  effect  on  mineral  matter,  but  removes 
lead.  It  fields  a  httle  hon  to  the  watei',  which,  however,  can  be  removed 
by  fui'ther  filtration  thi-oiigh  prepared  sand — that  is,  sand  or  fine  gi-avel 
with  pyi'olusite.  Beyond  this  nothing  is  yielded  to  the  water,  which  comes 
out  quite  clear  and  pure,  and  may  be  stored  for  a  long  time  without  under- 
going any  change  or  showing  signs  of  the  production  of  h-ving  organisms 
— or  in  any  way  favoring  putrefaction."  Water  left  in  contact  with  it 
does  not  deteriorate.  It  retains  its  filtering  power  a  long  time,  very  much 
longer  than  animal  charcoal.  Those  properties  render  it  suitable  for  use 
on  a  large  scale,  and  it  has  been  so  used  in  several  j)laces  ;  as,  for  examjDle, 
in  the  Water  Works  of  Antwerp.  On  the  whole,  it  must  be  looked  upon 
as  one  of  the  most  powerful  and  lasting  filtering  media  we  have. 

Carferal. — This  substance  has  been  introduced  within  the  last  two  or 
three  years.  It  is  a  black  granular  matter,  bearing  an  external  resemblance 
to  granular  animal  charcoal.  Its  specific  gTarit}'  is  2.879,  and  its  bidk  in 
its  usual  condition  is  about  25  cubic  feet  to  the  ton.  Its  method  of  manu- 
factui'e  and  composition  have  not  as  yet  been  made  known,  so  far  as  can  be 
ascertained — but  it  consists  of  a  mixture  of  charcoal  and  u'on  in  small 
quantities  with  a  basis  of  clay.  ^  It  has  very  considerable  puiif^ing  powers, 
and  acts  very  rapidly,  even  upon  fresh  albumin,  yielding  nothing  deleteri- 
ous to  the  water,  which  may  be  stored  for  a  time  without  the  production 
of  any  organisms.  Its  lasting  powers  appear  to  be  slightly  better  than 
those  of  the  animal  charcoal,  although  inferior  to  those  of  spongj:  hon.^ 
There  is,  however,  the  objection  that  it  appears  to  have  no  definite  compo- 
sition. It  is  also  probable  that  there  is  more  than  one  sort  in  the  market, 
or  that  the  material  is  adulterated  from  time  to  time,  a  thing  difficult  to 
detect  when  the  original  composition  is  uncertain. 

Domestic  Filters. — On  a  small  scale,  a  number  of  substances  have  been 

'  A  M   D.  Reports,  vol.  xx.,  p.  205  et  seq. 

-  See  M.  Gust.avBischof,  "  Oa  Putrescenc  Organic  Matter  in  Potable  Water,"  Proc. 
Royal  See,  Xo.  80,  1S77  ;  also  "  Sanitary  Notes  on  Potable  Water,"  Sanitary  Rec- 
ord, vol.  X.,  p.  337 

^  Hence  the  name  "  Carferal,"  from  the  first  syllables  of  CV/rbon, /e?Tam,  and  al- 
nmina.  ^  See  A.M.D.  Reports,  vol.  xx.,  p.  205  et  seq.,  and  vol.  xxi.,  p.  228. 


36  PRACTICAL   HYGIENE. 

used,  such  as  animal  and  vegetable  charcoal,  in  granules  or  powder,  or 
made  into  blocks,  or  fine  silica  impregnated  with  charcoal  (silicated  carbon 
filters),  haematite  and  magnetic  iron  ores,  the  so-called  magnetic  carbide, 
spongy  iron,  manganic  oxide,  flannel,  wool,  sponges,  porous  sandstones 
(natural  and  artificial),  etc. 

The  Souchon  filters,  which  are  much  employed  in  Paris,  are  made  of 
diaphragms  of  wool,  which  is  jDartially  tanned  by  boiling  in  solution  of 
alum  and  cream  of  tartar,  then  dyeing  in  infusion  of  gall-nuts,  and  wash- 
ing in  solution  of  sodium  carbonate.  The  filter  of  ~SL  Fonvielle,  also  used 
in  Paris,  is  composed  of  nine  layers  of  sponges,  pounded  sandstone,  and 
gravel. 

The  "  Filtre  Ri^pide "  of  Maignen  is  an  ingenious  an-angement,  by 
which  a  large  straining  surface  is  presented  to  the  water  by  the  spreading 
of  asbestos  cloth  over  a  fi-ame,  or  over  a  perforated  cone  of  porcelain.  Any 
filtering  medium  in  powder  or  granules  may  be  mixed  with  the  water  and 
settles  on  the  cloth  ;  this,  of  course,  can  be  renewed  as  required. 

The  "  Filtre  Chanoit  "  is  much  used  in  Fi-ance.  The  straining  mate- 
rial is  ground  slag  ("  Scoi'ie  de  fonte  "),  and  the  filter  requires  to  be  used 
under  j^ressure  (5  centimeters)  ;  by  this  means  a  cushion  of  air  is  com- 
pressed, and  acts  as  a  pxu-ifier. 

The  filters  in  the  market  in  this  countiw  are  very  numerous,  but  the 
most  imjiortant  are  the  following  : — 

1.  Those  containing  animal  charcoal,  in  granules  or  powder. 

2.  Animal  charcoal  compressed  into  blocks  by  admixtui-e  with  siUca 

and  other  substances. 

3.  Spongy  iron  filters. 

4  Those  containing  cai'feral  and  other  substances  of  a  nature  chiefly 
mineral. 

The  essentials  of  a  good  filter  are  the  following  : — 

1.  That  eveiy  part  of  the  filter  shall  be  easily  got  at,  for  the  purposes 

of  cleaning,  or  of  renewing  the  medium. 

2.  That  the  medium  have  a  suificiently  purifying  power,  and  be  i^res- 

ent  in  sufiicient  quantity. 

3.  That  the  medium  yield  nothing  to  the  water  that  may  favor  the 

growth  of  low  forms  of  life. 

4.  That  the  purifying  power  be  reasonably  lasting. 

5.  That  there  shall  be  nothing  in  the  construction  of  the  filter  itself 

that  shall  be  caj)able  of  undergoing  putrefaction,  or  of  peldmg 
metaUic  or  other  impurities  to  the  water. 

6.  That  the  filtering  material  shall  not  be  able  to  clog,  and  that  the  de- 

livery of  the  water  shall  be  reasonably  rapid. 

The  fii'st  of  these  conditions  obviously  sets  aside  all  filters  of  the  older, 
and  what  used  to  be  the  usual,  pattern,  where  only  a  small  layer  of  filter- 
ing material  was  present,  which  was  cemented  up  so  as  not  to  be  reached 
without  breaking  open  the  aj)paratus. 

The  second  condition  is  fulfilled,  so  far  as  filtei-ing  power  is  concerned, 
])y  a  number  of  media  ;  with  regard  to  bulk  of  material  this  is  also  faii'ly 
well  attended  to  in  the  filters  when  loose  material  is  used — but  where 
sohd  blocks  are  employed  the  size  is  often  quite  incommensurate  with  the 
work  they  are  called  upon  to  do. 

The  third  condition  is  comphed  with  by  spongy  u*on,  good  samples  of 
carferal,  and  some   other  materials — but  (as  before  mentioned)  not  by 


WATEE.  37 

animal  charcoal  in  the  loose  condition.  As  solid,  blocks,  it  seems  to  yield 
less  to  water  than  in  the  gTanular  condition. 

The  fourth  condition  depends  a  good  deal  upon  the  relative  degxee  of 
impiu'ity  of  the  water.     The  siDongy  ii'on  on  the  whole  lasts  the  longest. 

The  Jifth  condition  demands  that  nothing  organic  shall  be  used  in  the 
construction  of  the  filter,  or  in  the  packing  of  the  interior.'  Iron  or  other 
metal  must  be  protected  from  the  action  of  the  water." 

The  sixth  condition  is  generally  fulfilled  when  the  material  is  loose  and 
when  the  water  is  not  too  full  of  suspended  matter.  Sometimes  sponge  is 
used  to  arrest  suspended  matter,  but  it  is  so  apt  to  get  foul  that  its  use 
had  better  be  avoided.  The  block  filters  are  very  apt  to  clog,  a  slimy  sub- 
stance forming  on  their  sm-face.  This  is  partly  obviated  now  by  the  use 
of  asbestos  strainers  (as  in  the  silicated  carbon  filter).  Spongy  iron  is  apt 
to  cake  unless  kept  constantly  covered  with  water,  but  this  is  arranged  for 
in  the  new  forms  of  filter.  As  regards  rapidity  of  delivery,  the  animal 
charcoal  and  the  cai'feral  (when  the  sample  is  really  good)  have  the  advan- 
tage over  spongy  iron  and  block  filters — in  the  following  ratio  : — 

1.  Animal  Charcoal,  j  Water  runs  through  fairly  weU  pui-ified  in 

2.  Carferal,  (      2^  to  4  minutes. 

3.  Sihcated  Carbon,  Average  exposure,  15  minutes. 

4.  Spongy  Ii'on,'  "  "  22 

It  is  obvious  that,  for  reasons  of  convenience,  one  filter  may  be  prefer- 
able to  the  others  according  to  circumstances.  If  the  Avater  is  requhed 
immediately  in  considerable  quantity,  and  is  to  be  consumed  at  once,  either 
animal  charcoal  or  carferal  would  be  used.  In  the  other  cases,  where  the 
delivery  is  slower,  the  size  or  the  number  of  the  filters  would  have  to  be 
arranged  accordingly. 

Cleansing  of  Filters. — All  filters  when  first  taken  into  use  reqmre  to  be 
washed  by  passing  from  ten  to  twenty  gallons  of  fairly  good  water  through 
them,  according  to  the  size  of  the  filtei',  as  the  filtering  medium  generally 
yields  something  to  water  hi  the  beginning.  It  is  also  necessary  to  ensm-e 
the  removal  of  dust,  etc.,  that  may  be  in  the  ajDparatus.  But  after  a  cer- 
tain time  of  use  ah  filtering  media  not  only  cease  to  be  efiicient,  but  even 
in  some  instances  give  up  impui-ity  to  the  water  passed  tln-ough  them  ;  so 
much  is  this  the  fact  that  cases  of  illness  have  been  traced  to  this  soui'ce, 
and  some  persons  have  thought  the  dangers  of  filtration  were  gi-eater  than 
those  of  unfiltered  water.  There  is  no  doubt  that  the  practice  of  depend- 
ing for  years  upon  the  efiiciency  of  a  filter,  which  has  never  been  cleaned 
or  had  its  material  renewed,  is  fraught  with  danger,  and  there  is  still 
danger  to  be  apprehended  from  many  of  the  so-called  "  self -cleaning " 
filters  which,  in  the  words  of  the  adveriisement,  "  reqmre  no  attention." 
There  is  a  hmit  to  the  power  of  aU  filteiing  materials,  and  no  imphcit  con- 
fidence can  be  placed  in  any  of  the  methods  vaunted  as  "  self -cleaning." 
It  is  not  possible  to  state  positively  the  length  of  time  any  filtering 
material  wUl  remain  efiicient,  so  much  dependmg  upon  the  condition  of 
the  water  and  the  quantity  passed  through.  Animal  charcoal  in  granules 
or  powder  ought  to  be  examined  at  least  every  thi'ee  months.     If  water 

^  Cotton  has  sometimes  been  used  and  gone  rapidly  to  decay. 

^  Water  has  been  found  strongly  charged  with  zinc,  from  the  use  of  so-called  gal- 
vanized iron  in  filters. 

^  Water  can  be  dra-ivn  off  much  more  rapidly  from  this  filter,  if  required,  but  this 
is  not  recommended  by  the  inventor. 


38  PRACTICAL    HYGIENE. 

passed  throuf^h  it  can  be  chemically  and  microscopically  analyzed  and  is 
found  juu'e,  the  charcoal  may  be  continued  in  use — but  in  the  absence  of 
such  assurance  it  will  be  safer  to  take  stejDs  for  cleanmg-  it.  The  best  plan 
of  all  is  to  heat  it  to  redness  luider  cover,  and  then  wash  it  with  distilled 
water  or  the  cleanest  that  can  be  prociu-ed.  Failing-  this,  boiling  it,  with 
or  without  peiToauganate  of  potassium  solution  or  dilute  Condy's  tiuid  and 
a  little  mineral  acid,  is  the  safest  plan.  After  this  it  may  be  exposed  to 
the  au*  and  sun,  thoroughly  washed,  and  then  \ised  agam.  The  perman- 
ganate solution  (or  Condy's  fluid)  should  be  passed  thi'ough  it  luitil  it  comes 
out  a  distinct  pink  color.  Carferal  may  be  treated  in  much  the  same  way 
as  charcoal,  Avitli  the  omission  of  the  permanganate  solution  ;  but  it  must 
be  remembered  that  in  both  cases  the  diu-ation  of  efficiency  dej^ends 
gTeatly  upon  the  bulk  of  the  material  with  reference  to  the  quantity  of 
water  passed  thi-ough  it. 

Spongy  iron  retains  its  efficiency  for  a  long  tune,  and,  as  in  the  filters 
made  ^ith  it  the  flow  of  water  is  expressly  hmited  with  reference  to  the 
bulk  of  material,  the  diflerence  is  solely  in  relation  to  the  greater  or  less 
impiu'ity  of  the  water  acted  upon.  Its  efficiency  may  genei'ally  be  de- 
pended upon  for  a  year,  and  unless  the  water  be  very  impiu-e,  even  for  a 
considerably  longer  tune.  So  long  as  the  water  filtered  through  it  appears 
chemically  and  microscojiically  pure,  the  filti-ation  may  be  canied  on  with 
confidence.  "When  the  hmit  of  efficiency  is  reached,  the  only  safe  plan  is 
to  renew  the  charge  of  material,  and  it  is  genei-ally  advisable  to  i)ro\ide  for 
this  renewal  once  a  year  ;  should  circumstances  arise,  however,  to  prevent 
this  renewal,  the  best  plan  for  cleaning  is  to  subject  all  the  material  to  the 
action  of  fire,  up  to  a  low  red  heat,  then  to  wash  the  whole  well,  and  return 
it  into  the  filter.  The  cleansing  with  permanganate  and  acid  must  not  be 
attempted. 

Filters,  where  the  material  is  cemented  up  and  cannot  be  removed, 
ought  to  be  abandoned  altogether. 

Strainers  of  sponge,  or  any  material  which  cannot  stand  the  action  of 
fii'e,  ought  also  to  be  given  up.  Asbestos  forms  an  excellent  stramer,  and 
can  be  heated  to  redness,  so  as  to  destroy  all  organic  matter,  as  often  as  re- 
quii'ed. 

Block  Filters  are  generally  vmdesirable  forms  ;  but  if  used,  they  may  be 
cleansed  by  carefully  brushing  the  surface,  pumping  ail*  in  the  revei-se  way, 
and  treating-  with  pennanganate  as  above  described.  They  are  of  various 
sizes,  from  small  pocket  filters  to  large-sized  domestic  filters  deUvering 
thirty  to  fifty  gallons  a  day.  The  pocket  filters  are  nsefid  as  sti-ainers,  but 
their  small  size  must  make  the  diu-ation  of  then-  oxidizing  power  very  short. 
They  ought  to  be  frequently  bnished  and  washed  in  clean  water,  with  per- 
manganate if  possible. 

Cistern  and  Pipe  Filters. — Filters  are  sometimes  placed  in  cisterns, 
behig  constantly  immersed  in  the  water  to  be  filtered.  This  is  an  objec- 
tionable plan,  and  ought  to  be  abandoned.  PijDe  filters  are  those  which 
are  placed  in  the  course  of  a  supply  pipe,  and  tap-filters  those  which  are 
fitted  on  to  a  deHvery  tap.  The  objection  to  most  of  those  filters  is  that 
they  are  generally  much  too  small  for  the  work  expected  from  them,  as 
they  are  usually  represented  by  a  small  cylinder  of  block  carbon  or  a  few 
ounces  of  animal  charcoal.  For  proper  filtration  the  only  way  is  to  have  a 
full-sized  filter  attached  to  the  supply  pipe,  with  a  ball-cock  or  similar  ap- 
paratus for  filling  it.'     The  object  is  of  coui-se  twofold— first,    to  ensure 

'See  Fig.  11,  p.  110. 


WATEE.  39 

that  all  the  water  drawn  shall  be  filtered,  and,  second,  to  save  the  time  re- 
quired when  the  filter  has  to  be  filled  by  hand. 

Service  Filters  for  Land  and  Sea. — Lieut. -Col.  Crease,  C.B.,  Royal 
Marine  Artillery,  has  arranged  some  excellent  forms  of  filters,  both  small 
for  barrack,  hospital,  or  ambulance  use,  and  large  tanks  for  shij)s,  or  for 
large  bodies  of  men  on  shore.  The  principle  of  them  all  is  a  filter  of  strong 
durable  material,  which  yields  nothing  to  water,  space  for  a  large  quantity 
of  filtering  material,  and  a  rapid  dehvery.  The  small  filters  may  be  earth- 
enware or  iron,  the  latter  being  protected  internally  by  a  patent  cement ; 
the  larger  tanks  are  of  iron,  protected  in  the  same  way.  The  material 
originally  used  was  sand  and  animal  charcoal  in  separate  compartments. 
This  answered  very  well,  and  was  re|)orted  uj)on  very  favorably  by  Sur- 
geon-General Sir  A.  D.  Home,  KC.B.,  V.C,  in  the  Ashanti  War.' 

Carferal  is  now  emjDloyed,  so  that  the  whole  bulk  is  active  filtering 
material.  By  using  a  large  quantity  of  the  material  with  a  rapid  dehvery, 
a  storage  reservoir  becomes  unnecessary.  The  delivery  can  be  regulated 
by  screwing  down  or  loosening  a  plate  in  the  filter,  so  as  to  compress  the 
material,  or  slacken  the  pressiu'e  as  requii'ed. 


SECTION  IV. 

EFFECTS  OF  AN  IXSUFFICIENT  OR  IMPURE  SUPPLY  OF  WATER. 
Sub-Section  I. — Insufficient  Supply. 

The  consequences  either  of  a  short  supply  of  water  for  domestic  pur- 
poses, or  of  difficvilty  in  removing  water  which  has  been  used,  are  very- 
similar.  On  this  point  much  valuable  information'  was  collected  by  the 
Health  of  Towns  Commission  in  their  invaluable  Reports.''  It  was  then 
shown  that  want  of  water  leads  to  impurities  of  all  kinds  ;  the  person  and 
clothes  are  not  washed,  or  are  washed  repeatedly  in  the  same  water  ;  cook- 
ing water  is  used  scantily,  or  more  than  once  ;  habitations  become  dirty, 
streets  are  not  cleaned,  sewers  become  clogged  ;  and  in  these  various  ways 
a  want  of  water  jproduces  uncleanliness  of  the  very  air  itself. 

The  result  of  such  a  state  of  things  is  a  general  lowered  state  of  health 
among  the  population  ;  it  has  been  thought  also  that  some  skin  diseases — 
scabies,  and  the  epiphytic  affections  especially — and  ophthalmia  in  some 
cases,  are  thus  i^ropagated.  It  also  appears  likely  that  the  remarkable 
cessation  of  spotted  typhus  among  the  civilized  and  cleanly  nations  is  in 
part  owing,  not  merely  to  better  ventilation,  but  to  more  frequent  and 
thorough  washing  of  clothes. 

The  deficiency  of  water  leading  to  insufficient  cleansing  of  sewers  has  a 
great  effect  on  the  spread  of  typhoid  and  of  choleraic  diarrhoea  ;  and  cases 
have  been  known  in  which  outbreaks  of  the  latter  disease  have  been  arrest- 
ed by  a  heavy  fall  of  rain. 

Little  is  known  with  certainty  of  the  effects  produced  on  men  by  de- 
ficiency in  the  supply  of  water.  Under  ordinary  circumstances,  the  sensa- 
tion of  thirst,  the  most  delicate  and  imperative  of  all  our  feelings,  never 
permits  any  great  deficiency  for  a  long  time,   and  the  water-removing 

I  A.  M.  D.  Reports,  vol.  xv.,  p.  247. 

^  First  and  Second  Reports  (with  evidence)  of  the  Health  of  Towns  Commission,. 
1844  and  1845. 


40  PRACTICAL    HYGIENE. 

organs  eliminate  Avitli  wonderful  rapidity  any  excess  that  may  be  taken,  so 
as  to  keep  the  amount  in  the  body  within  certain  limits.  But  when  cir- 
cumstances prevent  the  supply  of  water,  it  is  well  known  that  the  wish  to 
di'ink  becomes  so  great,  that  men  will  run  any  danger,  or  undergo  any 
pain,  in  order  to  satisfy  it.  The  exact  bodily  condition  thus  produced  is 
not  precisely  laiown,  but  from  experiments  on  animals  and  men,  it  would 
appear  that  a  lessened  amount  of  water  in  the  body  diminishes  '  the  ehm- 
ination  of  the  pulmonary  carbonic  acid,  the  intestinal  excreta,  and  all  the 
important  urinary  excreta. 

The  more  ob^dous  eifects  produced  on  men  who  are  deprived  for  some 
time  of  water-  is,  besides  the  feehng  of  the  most  painful  thii-st,  a  great 
lowering  of  muscular  strength  and  mental  vigor.  After  a  time  exertion 
becomes  almost  impossible,  and  it  is  wonderful  to  see  what  an  extraordinaiy 
change  is  produced  in  an  amazingly  short  time  if  water  can  be  then  jDro- 
cured.  The  supply  of  water  becomes,  then,  a  matter  of  the  most  urgent 
necessity  when  men  are  undergoing  great  muscular  efforts,  and  it  is  veiy 
important  that  the  sujoply  should  be  by  small  quantities  of  water  being 
frequently  taken,  and  not  by  a  large  amoimt  at  any  one  time.  The  restric- 
tion of  water  by  trainers  is  based  on  a  misapprehension  :  a  little  water,  and 
often,  should  be  the  rule. 

Sub-Section  II. — Impure  Supply. 

At  present,  owing  probably  to  the  difficulty  of  making  analyses  of 
waters,  the  exact  connection  between  impure  water  and  disease  does  not 
stand  on  so  precise  an  experimental  basis  as  might  be  wished.  There  are 
some  persons  who  have  denied  that  even  considerable  organic  or  mineral 
impurity  can  be  j^roved  to  produce  any  bad  effect  ;  while  others  have 
beheved  that  some  mineral  ingredients,  such  as  calcium  carbonate,  are 
useful 

It  may  be  true  that  water  containing  a  large  quantity'  of  organic  matter, 
or  much  calcium  and  magnesium  sulphate,  has  been  used  for  long  periods 
without  any  ill  effects.  The  water  of  the  Canal  de  I'Ourcq,  which  contains 
much  calcium  bicarbonate  and  some  calcium  and  magnesium  sulphate,  was 
found  by  Pai'ent-Duchatelet  to  produce  no  bad  effect,  and  Boudet  more 
recently  asserted  the  same  thing.  ^ 

In  some  of  these  cases,  however,  very  Uttle  careful  inquiry  has  been 
made  into  the  state  of  health  of  those  using  the  water,  and  that  most  fal- 
lacious of  all  evidence,  a  general  impression,  without  a  careful  collection  of 
facts,  has  often  been  the  only  ground  on  which  the  ojjinion  has  been  come 
to.  As  weU  obsen^ed  by  Mr.  Simon,  in  one  of  his  philosophical  Eej^orts,^  we 
cannot  expect  to  find  the  effect  of  impure  water  always  sudden  and  violent ; 
its  results  are  indeed  often  gradual,  and  may  elude  ordinary  observation, 
yet  be  not  the  less  real  and  appreciable  by  a  close  inquiry.  In  fact,  it  is  only 
when  striking  and  violent  effects  are  produced  that  public  attention  is 
ai-rested  ;  the  minor  and  more  insidious,  but  not  less  certain,  evils  are 
borne  with  the  indifference  and  apathy  of  custom.  In  some  cases  it  is  by 
no  means  improbable  that  the  use  of  the  impiu'e  water,  which  is  supposed 

'  The  experiments  of  Falck  and  Scheffer  on  animals,  and  of  Hosier  on  men  and 
women,  are  here  referred  to. 

-  The  Canal  de  I'Ourcq  (which  has  a  boat  population  of  about  40,000)  is  now  aban- 
doned as  a  source  or  drinking  water,  and  the  greater  part  of  Paris  is  supplied  from 
the  rivers  Vanne  and  Seine. 

^  Second  Annual  Report  to  the  City  of  London,  p.  121. 


WATEE.   ,  41 

to  be  innocuous,  lias  been  really  restricted,  or  that  experience  lias  shown 
the  necessity  of  purification  in  some  way.  This  much  seems  to  be  certain, 
that  as  precise  investigations  proceed,  and,  indeed,  in  proportion  to  the 
care  of  the  inquiiy  and  the  accuracy  of  the  examination,  a  continually  in- 
creasing class  of  cases  is  found  to  be  connected  with  the  use  of  impure 
water,  and  it  seems  only  reasonable  to  infer  that  a  still  more  rigid  inquiiy 
will  fui'ther  prove  the  fi'equency  and  imjDortance  of  this  mode  of  origin  of 
some  diseases. 

Animal  organic  matter,  especially  when  of  fsecal  origin  ;  vegetable  or- 
ganic matter,  when  derived  from  marshes  ;  and  some  salts  and  metals  are 
the  principal  noxious  ingredients. 

Of  the  hui-tful  substances  the  sus^Dended  animal,  and  especially  fsecal 
matters,  are  probably  the  worst.  At  least,  it  is  remarkable  how  frequently, 
both  in  outbreaks  of  diarrhoea  and  t_)q3hoid  fever,  the  reports  notice  tur- 
bidity, discoloration,  and  smell  of  the  water.  It  is  this  fact  which  makes 
the  examination  of  color  and  tui'bidity  important.  The  thoroughly  dis- 
solved organic  matters  appear  less  hui-tful  ;  at  least  there  is  some  evidence 
that  perfectly  clear  waters,  though  containing  much  matter  dissipated  by 
heat,  and  consisting  of  dissolved  organic  matter  or  its  derivatives,  are  often 
taken  without  injury.  Probably,  also,  the  rxpre  recent  the  fsscal  contam- 
ination, the  more  injuiious,  since  the  most' poisonous  attacks  on  record 
have  been  in  cases  of  wells  into  which,  after  slow  percolation  for  some 
time,  a  sudden  gush  of  sewage  water  has  taken  place. 

It  has  been  frequently  stated  that  the  readily  oxidizable  organic  matters 
in  water  are  the  most  dangerous.  This  opinion  has  probably  arisen  from 
the  idea  that  a  substance  in  rapid  chemical  change  is  more  likely  to  excite 
some  corresiDonding  and  hurtful  action  in  the  body  ;  and  it  ma}^  be  true, 
but  there  is  no  existing  evidence  which  can  be  trusted  on  the  point.  There 
is,  on  the  other  hand,  some  evidence  that  animal  matters  forming  fatty 
acids  give  rise  to  salts  which,  though  not  oxidizing  into  nitrous  and  nitric 
acid,  are  as  hurtful  as  the  more  oxidizable  substances. 

Of  late  years,  too,  an  opinion  has  been  expressed  that  the  amount  of 
the  mineral  substances  is  of  little  consequence.  This  can  be  true  only  in 
a  Hmited  sense  ;  there  are  some  mineral  substances,  such  as  sodium  chlo- 
ride or  carbonate,  or  calcium  carbonate,  which,  Tvithin  certain  limits,  ap- 
pear to  do  no  harm.  But  in  the  case  of  other  minerals,  such  as  calcium 
and  magnesium  sulphates  and  chlorides,  and  calcium  nitrate,  there  can  be 
little  doubt  that  their  use  is  injurious  to  many  persons.  It  seems  also 
probable '  that  a  combination  of  impiuities,  and  especially  the  coexistence 
of  organic  matter  and  calcium  sulphate,  is  hurtful  ;  at  least  the  analysis  of 
waters  which  have  decidedly  produced  injury  often  shows  that  the  impuri- 
ties have  been  numerous. 

As  far  as  at  present  known,  the  existence  of  infusoria  of  different  kinds 
is  not  hurtful,  though  they  may  indicate  by  their  abundance  the  presence 
of  organic  impurity.  The  eifect  of  microzymes,  algce,  or  fungi,  in  drink- 
ing water  is  also  a  matter  of  which  little  or  nothing  is  known,  though  it  is 
very  probable  that  future  research  may  bring  out  something  important  in 
this  du'ection. 

The  most  practical  way  of  stating  the  facts  connected  with  the  produc- 
tion of  disease  by  water  mil  be  to  enumerate  the  diseases  which  have 
been  traced  to  the  use  of  impure  water,  and  to  state  the  nature  of  the 
impurities. 


42  PRACTICAL   HYGIENE. 


1.     AFFECTIOXS    OF    THE    ALIMENT.iRT    3IUC0US    MEMBEAXE. 

It  is  reasonable  to  suppose  that  tlie  impurities  of  water  would  be  likely 
to  produce  their  greatest  effect  upon  the  membrane  with  which  they  come 
first  in  contact.     This  is  in  fact  found  to  be  the  case. 

Affections  of  the  Stomach — Dyqyejysia. 

Symptoms  which  may  be  refen-ed  to  the  convenient  term  dyspepsia, 
and  which  consist  in  some  loss  of  appetite,  vague  uneasiness  or  actual  pain 
at  the  ejngastrium,  and  slight  nausea  and  constipation,  with  occasional 
diarrhoea,  are  caused  by  water  containing  a  large  quantity  of  calcium  sul- 
phate and  chloride,  and  the  magnesian  salts.  Dr.  Sutherland  found  the 
hard  water  of  the  red  sandstone  rocks,  which  was  formerly  much  used  in 
Liverjiool,  to  have  a  decided  effect  in  producing  constipation,  lessening 
the  secretions,  and  causing  visceral  obstructions  ;  and  in  Glasgow,  the  sub- 
stitution of  soft  for  hard  water  lessened,  according  to  Dr.  Leech,  the 
prevalence  of  dyspeptic  complaints.  It  is  a  well-known  fact  that  grooms 
object  to  give  hard  water  to  their  horses,  on  the  gi'ound  that  it  makes  the 
coat  staring  and  rough — a  ftsult  which  has  been  attributed  to  some  de- 
rangement of  digestion.  The  exact  amount  which  will  produce  these 
symptoms  has  not  been  determined,  but  water  containing  more  than  8 
grains  of  each  substance  indi\-idually  or  collectiveh'  appears  to  be  injurious 
to  many  persons.  This  would  correspond  to  about  10  degrees  of  perma- 
nent hardness.  A  much  less  degree  than  this  will  affect  some  persons.  In 
a  well  water  at  Chatham,  which  was  found  to  disagi-ee  with  so  many  pei'- 
sons  that  no  one  would  use  the  water,  the  main  ingi-edients  were  19  grains 
of  carbonate  of  hme,  11  grains  of  calcium  sulphate,  and  13  grains  of  sodium 
chloride  per  gallon.  The  total  solids  were  50  grains  per  gallon.  In  an- 
other case  of  the  same  kind,  the  total  solids  were  58  grains  per  gallon,  the 
calcium  carbonate  was  22,  the  calcium  sulj^hate  11,  and  the  sodium  chlo- 
ride 14  grains  per  gallon. 

Ii-on,  in  quantities  sufficient  to  give  a  slight  chalybeate  taste,  often  pro- 
duces shght  dyspepsia,  constipation,  headache,  and  general  malaise.  Cus- 
tom sometimes  partly  removes  these  effects. 

Dia7'rhoea. 

Many  conditions  produce  diarrhoea. 

(a)  Suspended  Mineral  Substances. — Clay,  Marl — as  in  the  cases  of  the 
water  of  the  Maas,  the  Mississippi,  the  Missouri,  Eio  Grande,  Kansas,'  of 
the  Ganges,  and  many  other  rivers — will  at  certain  times  of  the  year  pro- 
duce diarrhcea,  especially  in  persons  unaccustomed  to  the  water.  The  hiU 
diarrhoea  at  Dhurmsala  is  produced,  apparently,  by  suspended  very  fine 
scales  of  mica.^ 

(b)  Suspended  Animal,  and  especially  Fcecal  3Iatlers,  have  jjroduced 
diarrhoea  in  many  cases  ;  such  water  always  contains  dissolved  organic 
mattei-s,  to  which  the  effect  may  be  partly  owing.  The  case  of  Croydon 
in  1854  (Carpenter)  is  one  of  the  most  striking  on  record.  Li  cases  in 
which  the  water  is  largely  contaminated  with  suspended  sewage,  it  is  im- 

'  Hammond's  Hygiene,  p.  218. 

-  Whitwell,  vide  Dr.  Macnamara's  8th  Report  on  Potable  Waters  in  Bengal,  Appen- 
dix, p.  44. 


WATER.  43 

portant  to  observe  that  the  symptoms  are  often  markedly  choleraic  (purg- 
ing, vomiting,  cramps,  and  even  some  loss  of  heat).  This  point  has  been 
again  noticed  by  Oldekop  of  Astrachan, '  who  found  marked  choleraic  symp- 
toms to  be  produced  by  the  water  of  the  Volga,  which  is  impregnated 
with  sewage.  Seven  cases  in  one  house  of  violent  gastro-intestinal  derange- 
ment (vomiting,  diarrhoea,  coHe,  and  fever),  produced  by  water  contami- 
nated by  sewage  which  had  passed  into  the  cistern,  are  recorded  by  Dr. 
Gibb."  In  the  prison  at  Halle  an  outbreak  of  dian-hcea  was  traced  by 
Dolbruck  to  the  contamination  of  water  with  putrid  substances.  In  St. 
Petersburg  the  water  of  the  Xeva,  which  is  rich  in  organic  substances, 
give  diarrhoea  to  strangers.'' 

Suspended"  animal  and  vegetable  substances,  washed  off  the  gi'ound  by 
heavy  rain  into  shallow  wells,  have  often  produced  diaiThoea,  as  at  Prague 
in  1860,  when  an  endemic  of  "  cataiTh  of  the  alimentaiy  canal"  was  caused 
by  heavy  floods  washing  impurities  into  wells. ^ 

(c)  Su-^'pended  Vegetable  Substances. — In  this  country,  and  also  in  the 
late  American  civil  war,  several  instances  have  occurred  of  diarrhoea  aris- 
ing from  the  use  of  surface  and  ditch  water,  which  ceased  when  wells  were 
sunk  ;  possibly  there  might  be  also  animal  contamination.  It  is  not,  there- 
fore, cpiite  certain  that  suspended  vegetable  matter  was  the  vera  causa. 
Surgeon-Major  Gore  has  recorded  a  violent  outbreak  of  dian-hcea  at 
Bulama,  on  the  west  coast  of  Africa, °  produced  by  the  water  of  a  well;  the 
water  was  itself  pui'e,  but  was  milky  from  suspended  mattei*s,  consisting 
of  debris  of  plants,  chlorojohyll,  minute  cellular  and  branched  algce,  monads, 
polygastrica.  and  minute  pai'ticles  of  sand  and  clay.  "^Tien  filtered  the 
water  was  C[uite  hai-mless. 

{d)  Dissolved  Animal  Organic  Matter.- — The  opinion  is  veiy  -widely  dif- 
fused that  dissolved  and  putrescent  animal  organic  matter,  to  the  amount 
of  3  to  10  grains  per  gallon,  may  produce  diarrhoea.  This  is  possibly  cor- 
rect, but  two  points  must  be  conceded — 1st,  That  there  are  usually  other 
impuilties  which  aid  the  action  of  the  organic  matter ;  and  2d,  That  or- 
ganic matter,  even  to  the  amount  of  10  to  15  grains  per  gallon,  may  exist 
without  bad  eftects,  if  it  be  perfectly  dissolved.  In  the  latter  case  the 
water  is,  however,  always  clear  and  sj^arkhng,  never  tainted  or  discolored. 
The  fi*equent  presence  of  other  impurities  renders  it  difficult  to  assign  its 
exact  influence  to  dissolved  oi'ganic  matters. 

In  the  case  of  a  well-ventilated  coui't  in  Coventry,"  where  diaiThoea  was 
constantly  present,  the  water  contained  5.68  grains  per  gallon  of  volatile 
and  combustible  matter,  but  then  it  contained  also  no  less  than  105  gi-ains 
of  fixed  salts,  which,  as  the  water  had  a  permanent  haixlness  of  51.6^ 
(Clai-k's  scale)  after  boiling,  must  have  consisted  of  calcium  and  magnesium 
sulphates  and  chlorides.  It  also  contained  alkaline  salts,  nitrates,  and  am- 
monia. The  composition  was  therefore  so  complex,  that  it  is  diflicult  to 
assign  to  the  organic  matter  its  share  in  the  eifects. 

The  animal  organic  matter  derived  from  graveyards  appears  to  be  es- 
pecially hiu'tful ;  here  also  ammoniimi  and  calcium  nitrites  and  nitrates 
may  be  present. 

(e)  Dissolved  Vegetable  Matter. — There  is  some  evidence  to  show  that 

^  Virchow's  Archiv,  baud  xxvi.,  p.  117. 

^  British  :Medical  Journal,  Oct.,  1870. 

^  Ilisch,  quoted  by  Roth  and  Lex,  Mil. -G-esundheitspfl. ,  p.  24. 

*  Canstatt's  Jahresb  ,  1863,  vol.  ii..  p.  31. 

^  Report  on  Hygiene  by  Dr.  Parkes,  Army  Medical  Report,  vol.  v..  p.  428. 

«  Greenhow,  Second  Report  of  the  Medical  Officer  of  the  Privy  Council,  ISBO,  p.  75. 


44  PRACTICAL    HYGIENE. 

this  produces  diarrhoea.  Wanklyn  cites  the  case  of  the  Leek  workhouse 
and  also  that  of  Biddulph  Moor,  iu  both  of  which  vegetable  matter  in  solu- 
tion appeared  to  pi'oduce  diarrhoea. 

(/)  Fetid  Gams. — Water  containing  much  hydrogen  sulphide  will  give 
rise  to  diarrhoea,  especially  if  organic  matter  be  also  present.  In  the 
Mexican  War  (1861-G2),  the  French  troops  suffered  at  Orizaba  from  a 
peculiar  dyspepsia  and  dian-hoea,  attended  with  immense  disengagement 
of  gas  and  enormous  eructations  after  meals.  The  eructed  gas  had  a  strong 
smeU  of  hydrogen  sulphide. '  This  was  traced  to  the  use  of  water  from 
sulphurous  and  alkaline  springs  ;  even  the  best  waters  of  Orizaba  contained 
organic  matter  and  ammonia  in  some  quantity.  The  exjDeriments  of  Pro- 
fessor Weber  have  shown  what  marked  effects  are  produced  by  the  injec- 
tion of  hydrogen  sulphide  in  solution  in  water  into  the  blood  ;  is  it  possible 
that  water  containing  animal  organic  matter  may  occasionally  form  SH,j 
after  absorption  into  the  blood,  and  that  the  poisonous  effect  of  some  water 
may  be  owing  to  this  ?  The  symptoms  of  poisoning  by  water  contaminated 
by  sewage  are  sometimes  very  like  those  noted  by  Weber  in  his  experi- 
ments, viz.,  diarrhoea  and  even  choleraic  symptoms  (lowering  of  tempera- 
ture), and  irritation  of  the  lungs,  spine,  hver,  and  kidneys. 

The  absorption  of  sewer  gases,  as  when  the  overflow-pipe  of  a  cistern 
opens  into  the  sewei's,  will  cause  diarrhoea.  This  seems  perfectly  proved 
by  the  case  recorded  by  Dr.  Greenhow,  in  Mr.  Simon's  second  report.' 

{g)  Dissolved  Mineral  Matters,  if  passing  a  certain  point,  produce 
diarrhoea.  Boudin  refers  to  an  outbreak  of  diarrhoea  at  Oran,  in  Algiers, 
which  was  distinctly  traced  to  bad  water,  and  ceased  on  the  cavise  being 
removed  ;  the  composition  of  the  water  is  not  explicitly  given,  but  it  con- 
tained lime,  magnesia,  and  carbonate  of  soda.  Sulphates  of  lime  and 
magnesia  also  cause  diarrhoea,  following  sometimes  constiiDation.  The 
selenitic  well  waters  of  Paris  used  to  have  this  effect  on  strangers.  Parent- 
Duchcitelet '  noticed  the  constant  excess  of  patients  furnished  by  the  prison 
of  St.  Lazare,  in  consequence  of  diarrhoea,  and  he  traced  this  to  the  water, 
which  "  contained  a  very  large  proportion  of  sulj^hate  of  lime  and  other 
purgative  salts  ;  "  and  he  tells  us  that  Pinel  had  noticed  the  same  fact 
twenty  years  before  in  a  particular  section  of  the  Salpetriere.  In  some  of 
the  West  Indian  stations,  the  water  drawn  from  the  calcareous  formation 
has  been  long  abandoned,  in  consequence  of  the  tendency  to  diarrhoea 
which  it  caused. 

Calcium  nitrate  waters  also  produce  diarrhoea.  A  case  is  on  record,  in 
which  a  well  water  was  obliged  to  be  disused,  in  consequence  of  its  impreg- 
nation with  butyrate  of  calcium  (105  grains  per  gallon),  which  was  derived 
from  a  trench  filled  with  decomposing  animal  and  vegetable  matters.' 

Brackish  water  (whether  rendered  so  by  the  sea,  or  derived  from  loose 
sands)  produces  diarrhoea  in  a  large  percentage  of  persons,  and  at  some  of 
the  Cape  frontier  stations  water  of  this  character  formerly  caused  much 
disease  of  this  kind.  In  a  water  examined  at  Netley,  which  became  brack- 
ish from  sea  water,  and  which  produced  diarrhoea  in  almost  all  persons, 

'  Poncet,  in  Rec.  de  Mem.  de  Med.  Mil.,  1868,  p.  218.  The  exact  words  are  "  une 
odeur  d'acid  sulfurique,"  but  "  sulfhydrique  "  must  be  meant. 

^  Second  Report  of  the  Medical  Officer  of  the  Privy  Council,  Pari.  Paper,  1860,  p. 
153. 

'  Hygiene  Publique,  t.  i.,  p.  286. 

•*  Zeitschriffc  fur  Hygiene,  vol.  i..  p.  166.  See  also  a  remark  on  the  effect  of  calcium 
and  potassium  iiitiate  in  causing  a  tendency  to  diarrhoea  in  the  Report  on  the  Drain- 
age of  Berlin  (Die  Kanalisation  von  Berlin,  1868,  pp.  27,  28). 


WATER.  45 

tlie  amount  of  cliloricle  of  sodium  was  found  to  be  253  grains  per  gallon. 
But,  douljtless,  a  much  less  quantity  tlian  this,  especially  if  chloride  of 
magnesium  be  present,  ^iU  act  in  this  way. 

(h)  MetoJlic  Impregna.tion. — Occasionally  animal  organic  matter  acts  in 
an  indirect  way,  by  producing  nitrites  and  nitrates,  which  act  on  metals. 

Dr.  Baedeker,^  a  j^hysician  in  "Witten,  was  called  to  some  cases  of  sick- 
ness produced  apparently  by  water.  On  examining  the  point,  he  forma 
the  water  was  drawn  from  a  pump  with  a  copper  cylinder,  and  contained 
a  considerable  quantity  of  copper,  which  seemed  to  be  in  combination  with 
some  organic  matter."  Lead  (as  might  have  been  anticipated)  was  also 
largely  present  in  this  water,  as  leaden  pumps  were  used  ;  iron,  on  the 
contrai-y,  was  not  dissolved. 

Dysentery. 

Dysentery  also  is  decidedly  produced  by  impure  water,  and  this  cause 
ranks  high  in  the  etiology  of  dysenteiy,  though  perhaps  it  is  not  the  first. 

Several  of  the  older  amiy-siu-geons  refer  to  this  cause.  Pringle  does  so 
several  times,  and  also  Donald  Munro.^  In  the  "West  Indies,  Lemj)riere,^ 
in  1799,  noticed  the  increase  of  bowel  complaints  in  Jamaica  in  May,  when, 
after  floods,  the  water  was  bad  and  turbid,  "  and  loaded  with  dirt  and  filth." 
He  also  mentions,  that  at  Kingston  and  Port  Eoyal  the  dysenteiy  was  owing 
to  brackish  watei\  It  was  not,  however,  for  many  years  after  this  that 
fresh  soui'ces  of  water  were  sought  for  in  the  West  Indies,  and  that  rain- 
water began  to  be  used  when  good  spring  or  river  water  could  not  be 
got. 

Davis  ^  mentions  as  a  curious  fact,  in  reference  to  the  West  Indies,  that 
ships'  crews,  when  ordered  to  Tortola,  were  "invariably  seized  with 
fluxes,"  which  were  caused  by  the  water.  But  the  inhabitants  who  used 
tank  (i.e.,  rain)  water  were  fi'ee  ;  and  so  well  knovra.  was  this,  that  when 
any  resident  at  Tortola  was  invited  to  dinner  on  board  a  man-of-wai',  it  was 
no  unusual  thing  for  him  to  carry  his  drinking  water  T\ith  him. 

The  dysenteiw  at  Walcheren,  in  1809,  was  in  no  small  degree  owing  to 
the  bad  water,  which  was  almost  everr^'here  brackish. 

The  epidemic  at  Guadaloupe,  in  1847,  recorded  by  Comuel,  seems  also 
quite  conclusive  as  to  the  effect  of  impui'e  water  in  causing  not  merely 
isolated  cases,  but  a  wide-spread  outbreak." 

In  1860,  at  Prague,  there  were  many  cases  of  dysenteiy,  clearly  traced 
to  the  use  of  water  of  wells  and  spiings  rendered  foul  by  substances 
washed  into  the  water  by  heavy  floods.     Exact  analyses  were  not  made. 

On  the  west  Coast  of  Africa  (CajDe  Coast  Castle),  an  attack  of  dysenteiy 
was  traced  by  Surgeon-Major  Oakes  to  the  passage  of  sewage  from  a  cess- 
pool into  one  of  the  tanks.  "  This  was  remedied,  and  the  result  was  the 
almost  total  disappearance  of  the  disease." 

^  Pappenheim's  Beitrage,  heft  iv. ,  p.  49. 

^  The  amount  of  copper  required  to  produce  poisonous  symptoms  appears  to  be 
doubtful.  It  is  said  that  the  miners  in  the  desert  of  Attacama,  in  South  America, 
prefer  to  use  water  containing  so  much  copper  as  to  have  a  distinct  green  color,  rather 
than  the  ^Yater  brought  up  from  the  wells  near  the  shore  in  skins,  which  give  it  an 
unpleasant  taste.  It  is  true  that  it  is  used  for  making  coffee,  and  may  thus  be  to  a 
certain  esteit  purified. 

^  Campaigns  in  Flanders  and  Germany. 

4  Vol  i.,  p.  25. 

*  On  the  Walcheren  Fever,  p.  10. 

®  See  a  review  by  the  late  Dr.  Parkes  on  Dysentery,  in  the  British  and  Foreign 
Medical  and  Chirurgical  Review  for  1847,  for  fuller  details  of  this  epidemic. 


46  PRACTICAL    HYGIENE. 

That  in  the  East  Indies  a  great  deal  of  dysentery  lias  been  produced  by 
impure  water,  is  a  matter  too  familiar  almost  to  be  mentioned  (Annesley  ; 
Twining).  Its  constant  prevalence  at  Secunderabad,  in  the  Deccan,  appears 
to  have  been  pai-tiy  owing  to  the  water  which  jjercolated  through  a  large 
gi-aveyard.  One  bf  the  sources  of  water  contained  119  gi-ains  of  solids  per 
gallon,  and  in  some  instances  there  were  8,  11,  and  even  30  grains  per  gal- 
lon of  organic  matter.' 

Champouillon "  has  recorded  a  case  in  which  two  regiments  used  the 
impure  water  from  the  Canal  de  TOui-cq,  neai*  Paris.  One  regiment  mixed 
the  water  with  coffee  or  red  wine,  the  tannin  of  wliich  united  with  the  or- 
ganic matter  ;  this  regiment  had  no  dysentery.  The  second  regiment  used 
brandy,  which  precipitated  the  organic  matter  on  the  side  of  the  vessel, 
where'  it  putretiecL  This  regiment  suffered  from  dysenteiy ;  the  substi- 
tution of  red  wine  for  brandy  stopped  the  disease. 

The  gi-eat  effect  produced  by  the  impure  water  of  Calcutta  in  this  way 
has  been  pointed  out  by  Che  vers.  ^ 

In  time  of  war  this  cause  has  often  been  present ;  and  the  gi'eat  loss  by 
dysenteiy  in  the  Peninsula,  at  Ciudad  Eodi-igo,  was  partly  attributed  by 
Su-  J.  M'Grigor  to  the  use  of  water  passing  through  a  cemetery  where 
nearly  20,000  bodies  had  been  hastily   inteiTcd. 

The  impurities  which  thus  produce  dysentery  appear  to  be  of  the  same 
kind  as  those  which  cause  the  allied  condition,  dian-hoea.  Suspended 
earthy  matters,  suspended  animal  organic  matter,  calcium  and  magnesium 
sulphates  and  chlorides,  calcium  and  ammonium  nitrates,  large  quantities 
of  sodium  and  magnesium  chlorides  in  solution,  appear  to  be  the  usual 
ingi-edients  ;  but  there  are  few  perfect  analyses  yet  known.  ^ 

The  obseiTations  which  j^rove  so  satisfactorily  that  the  dysenteric  stools 
can  propagate  the  disease,  make  it  j)robable  that,  as  in  the  case  of  t^-phoid 
fever  and  cholera,  the  accidental  joassage  of  dysenteric  evacuations  into 
drinking  water  may  have  some  share  in  spreading  the  diseasa 

2.    AFFECTION    OF    OTHER   MUCOUS   MEMBR.VKES   BESIDES   THE  ALIMENTARY. 

Little  has  yet  been  done  to  trace  out  this  point.  At  Prague,  after  the 
severe  flood  of  18G0,  bronchial  catarrh  was  frecjuent,  jirobably  caused 
chiefly  by  the  chills  arising  from  the  gi-eat  evaporation  ;  but  it  was  noticed 
that  bronchial  catarrh  was  most  common  when  the  chinking  water  was 
foulest  and  produced  dysentery.  Possibly  the  bronchial  and  the  urinary 
mucous  membranes  may  also  suffer  from  foul  water  ;  the  point  is  well 
worthy  of  close  investigation. 

3.    SPECIFIC    DISEASES. 

That  some  of  the  specific  diseases  are  disseminated  by  drinking  water 
is  a  fact  which  has  only  attracted  its  due  share  of  attention  of  late  years. 
It  is  certainly  one  of  the  most  imj)ortant  stej^s  in  etiolog}^  which  has  been 

'  Indian  Report,  p.  44. 

2  Rec.  de  Mem.  de  Med.  Mil.  1873.  Sept.,  p.  230. 

^ndiau  Annals.  No.  17,  p.  70.  18(34. 

*  A  loc.ilized  epidemic  of  dysenteiy  occurred  in  some  barracks  at  Niirtberg  in  the 
summer  of  1S72.  oO  caseg  and  4  deaths  taking  place  among  the  soldiers.  The  absorp- 
tion of  putrefaction  ga.ses  from  the  cloaca  in  the  wings  of  the  building  by  the  drinking 
water,  was  considered  to  be  the  cause  ;  the  water  couiained  nitrates  and  free  am- 
monia. An  individual  predisposition  to  the  disease  appeared,  however,  to  be  also 
necessary.     (Schmidt's  Jahrbiicher,  1874,  vol.  i.,  p.  25.) 


TTATER,  47 

made  in  this  centiny,  and  the  chief  merit  of  its  discovery  is  due  to  the 
late  Dr.  Snow. 

JIalarious  Fex:ers. 

Hippocrates  states  that  the  spleens  of  those  who  diink  the  water  of 
marshes  become  enlarged  and  hard ;  and  Rhazes  not  only  asserted  this, 
but  affirmed  that  it  generated  fevers.  Little  attention  seems  to  have  been 
paid  to  this  remark,  and  in  modem  times  the  opinions  of  Lancisi,  that  the 
air  of  marshes  is  the  sole  cause  of  intennitteuts,  has  been  so  generally 
adopted,  that  the  possibihty  of  the  introduction  of  the  cause  by  means  of 
water,  as  well  as  of  aii',  was  overlooked.  Still,  it  has  been  a  very  general 
behef  among  the  inhfibitants  of  marshy  countries,  that  the  water  could  pro- 
duce fever.  Henry  Marshall '  says  that  the  Singhalese  attribute  fevers  to 
impure  water,  "  especially  if  elephants  or  buffaloes  have  been  washing  in 
it,"  and  it  is  to  be  presumed  that  he  referred  to  periodical  fevers.  On 
making  some  inquiries  of  the  inhabitants  of  the  Jiighly  malarious  plains  of 
Troy,  cluiing  the  Crimean  wai'.  Dr.  Parkes  formd  the  villagers  universally 
stated,  that  those  who  drank  marsh  water  had  fever  at  all  times  of  the 
yeai',  while  those  who  di'ank  pure  water  only  got  agTie  dining  the  late  sum- 
mer ar;d  autumnal  months.  The  same  belief  is  prevalent  in  the  south  of 
India  ;  and  in  Western  Candeish,  Canai'a,  Balaghut,  and  Mysore,  and  in 
the  deadly  "NYynaad  district,  it  is  stated  by  31r.  Bettington  of  the  Madi-as 
Civil  Service,  that  it  "is  notorious  that  the  water  produces  fever  and 
affections  of  the  spleen."  Tne  essay  by  this  gentleman"  gives,  indeed, 
some  extremely  strong  evidence  on  this  point.  He  refers  to  villages 
placed  under  the  same  conditions  as  to  marsh  air,  but  in  some  of  which 
fevers  are  prevalent,  in  others  not ;  the  only  difference  is,  that  the  latter 
are  supphed  with  pure  water,  the  fonner  with  marsh  or  nullah  water  full 
of  vegetable  debris.  In  one  village  there  were  two  sources  of  supj)ly, — a 
tank  fed  by  sui'face  and  marsh  water,  and  a  spiing  ;  those  only  who  drank 
the  tank  water  got  fever.  In  a  village  (Tulliwaree)  no  one  used  to  escape 
the  fever  ;  oMr,  Bettington  dug  a  well,  the  fever  disappeai'ed,  and,  duiing 
fourteen  years,  had  not  returned. 

Another  village  (Tambatz)  was  also  "  notoriously  unhealthy  ; "  a  well 
was  dug,  and  the  inhabitants  became  healthy.  Nothing  can  well  be 
stronger  than  the  positive  and  negative  evidence  brought  fcn\"ard  in  this 
paper. 

Dr.  Moore  ^  also  noted  his  opinion  of  malarious  disease  being  thus  pro- 
duced ;  and  M.  Commaille '  has  since  stated,  that  in  Mai'seilles  paroxysmal 
fevers,  formerly  unknown,  have  made  their  appearance,  since  the  supply  to 
the  city  has  been  taken  from  the  canal  of  Mai'seilles.  In  reference  also  to 
this  point,  Dr.  Townsend,  the  Sanitary  Commissioner  for  the  Central 
Provinces  in  India,  mentions  in  one  of  his  able  reports  '"  that  the  natives 
have  a  current  opinion  that  the  use  of  river  and  tank  water  in  the  rainy 
season  (when  the  water  always  contains  much  vegetable  matter)  ■s\ill  al- 
most certainly  produce  fever  (i.e.,  ague),  and  he  beheves  there  are  many 
cuTumstances  supporting  this  view.  In  this  way  the  prevalence  of  ague  in 
dry  elevated  spots  is  often,  he  thinks,  to  be  explained.  He  mentions  also 
that  the  people  who  use  the  water  of  streams  draining  forest  lands  and 
rice  fielde  "  suffer  more  severely  from  fever  (ague)  than  the  inhabitants  of 
the  open  plain  drawing  their  water  from  a  soil  on  which  wheat  gTOws.     In 

^  Topography  of  Ceylon,  p.  .52.      -  Indian  Annals,  1856,  p.  526.       '  Ibid.,  1867. 

'  E-ec.  de  Mem.  de  Med.  Mil.,  Nov..  1868,  p   427. 

^  For  1870,  published  at  Nagpore  in  1871,  para.  14.3  et  seq. 


48    ■  PRACTICAL    HYGIENE. 

the  former  case  tliere  is  far  more  vegetable  matter  in  the  Tvater.  The  Upper 
Godavery  tract  is  said  to  be  the  most  agueish  in  the  province,  yet  there  is 
not  an  acre  of  marshy  gi-ound  ;  the  people  use  the  water  of  the  Goda- 
very, which  drains  more  dense  forest  land  than  any  river  in  India. 

In  the  "Landes"  (of  southwest  France),  the  water  from  the  extensive 
sandy  plain  contains  much  vegetable  matter,  obtained  from  the  vegetable 
deposit,  which  binds  together  the  sihceous  particles  of  the  subsoil.  It  has 
a  marshy  smell,  and,  according  to  Faure,  produces  intermittents  and  vis- 
ceral engorgements.  Dr.  Blanc,  in  his  papers  on  Abyssinia,  mentions  that 
on  the  march  from  ]\Iassowah  to  the  highlands,  Mr.  Prideaux  and  himself, 
who  drank  water  only  in  the  form  of  tea  or  coffee,  entirely  escaped  fever, 
while  the  others  who 'were  less  careful  suffered,  as  Dr.  Blanc  beheves,  from 
the  water. 

The  same  facts  have  been  noticed  in  this  counti-y.  Many  years  ago  Mr. 
Blower  of  Bedford  mentioned  a  case  in  which  the  ag-ue  of  a  ^•illage  had 
been  much  lessened  by  digging  weUs,  and  he  refers  to  an  instance  in  which, 
in  the  parish  of  Houghton,  almost  the  only  family  which  escaped  ague  at 
one  time  was  that  of  a  fai-mer  who  used  well-water,  while  all  the  other  per- 
sons di'ank  ditch  water.' 

At  Sheerness  the  use  of  the  ditch  water,  which  is  highly  impui-e  with 
vegetable  debris,  has  been  also  considered  to  be  one  of  the  chief  causes  of 
the  extraordmary  insalubrity." 

At  Versailles  a  sudden  attack  of  ague  in  a  regiment  of  cavalry  was 
traced  to  the  use  of  sm-face  water  taken  from  a  mai'shy  district.^ 

The  case  of  the  Argo,  recorded  by  Boudin,^  is  an  extremely  sti'ong 
one.  In  1834,  800  soldiers  in  good  health  embarked  in  thi-ee  vessels  to 
pass  from  Bona  in  Algiers  to  Mai'seilles.  They  all  aiiived  at  Marseilles 
the  same  day.  In  two  vessels  there  were  680  men  without  a  single  sick 
man.  In  the  thii-d  vessel,  the  Ai-go,  there  had  been  120  men  ;  thii'teen 
died  diu'ing  the  shori  passage  (time  not  given),  and  of  the  107  sunivors 
no  less  than  98  were  disembarked  with  all  forms  of  paludal  fevers,  and  as 
Boudin  himself  saw  the  men,  there  was  no  doubt  of  the  diagiiosis.  The 
crew  of  the  Argo  had  not  a  single  sick  man. 

All  the  sokliers  had  been  exposed  to  the  same  influences  of  atmos- 
phere before  embarkation.  The  crew  and  the  soldiers  of  the  Ai-go  were 
exposed  to  the  same  atmospheric  condition  during  the  voyage  ;  the  influ- 
ence of  air  seems  therefore  excluded.  There  is  no  notice  of  the  food, 
but  the  production  of  malarious  fever  from  food  has  never  been  suggested. 
The  water  was,  however,  different — in  the  two  healthy  ships  the  water  was 
good.  The  soldiers  on  board  the  Ai'go  had  been  supplied  with  water  from 
a  mai'sh,  which  had  a  disagi-eeable  taste  and  odor  ;  the  crew  of  the  Argo 
had  pure  water.  The  eridence  seems  here  as  nearly  complete  as  could  be 
wished.  ^ 

One  veiy  important  circumstance  is  the  rapidity  of  development  of  the 
malarious  disease  and  its  fatahty  when  introduced  in  water.  It  is  the 
same  thing  as  in  the  case  of  dian-hoea  and  dysentei-y.     Either  the  fever- 

*  Snow  On  the  Mode  of  Communication  of  Cholera.  2d  edit  ,  1855,  p.  130. 

'  Is  it  not  possible  that  the  great  decl.ne  of  agues  in  England  is  partly  due  to  a 
purer  drinking  water  being  now  used  ?  Formerly,  there  can  be  no  litile  doubt,  when 
there  was  no  organized  supply,  and  much  fewer  wells  existed,  the  people  must  have 
taken  their  supply  from-  surface  collections  and  ditches,  as  they  do  now,  or  did  till 
lately,  at  Sheerness. 

'  Grainger's  Report  on  Cholera,  Appendix  CB),  page  95  ;  foot-note. 

*  Traite  de  Gcographie  et  de  Statistique  Medicales,  1857.  t.  i.,  p.  142. 

*  Eitter,  Hirsch  in  Jahresb.  f  lir  gen.  Med.  for  1869,  p.  192. 


WATER. 


49 


making  cause  must  be  in  larger  quantity  in  the  water,  or,  "wliat  is  equally 
probable,  must  be  more  readily  taken  up  into  the  circulation  and  carried 
to  the  spleen,  than  when  the  cause  enters  by  the  lungs. 

In  opposition,  however,  to  all  these  statements  must  be  placed  a  remark 
of  Finke's,'  that  in  Hungary  and  Holland  marsh  water  is  daily  taken  with- 
out injury.  But  in  Hungary,  Dr.  Grosz  states  that,  to  avoid  the  injurious 
effects  of  the  marsh  water,  it  is  customary  to  mix  brandy  with  it,  "a  cus- 
tom which  favors  hyjDertrophies  of  the  internal  organs."^  Professor  Colin, 
of  the  Val  de  Grace,  who  is  so  well,  known  for  his  researches  on  intermit- 
tent fever,  ^  is  also  inclined  to  question  the  production  of  paroxysmal  fevers 
by  marsh  water.  He  cites  numerous  cases  in  Algiers  and  Italy,  where 
impure  marsh  water  gave  rise  to  indigestion,  diarrhoea,  and  dysentery,  but 
in  no  case  to  intermittent  fever,  and  in  all  his  obser^^ations  he  has  never 
met  with  an  instance  of  such  an  origin  of  ague.  He  therefore  denies  this 
power,  and  in  reference  to  the  celebrated  case  of  the  Ai-go,  without  ven- 
turing to  contest  it,  he  yet  views  it  with  suspicion,  and  questions  whether 
Boudin  has  given  the  exact  details. 

An  instructive  case,  however,  is  recorded  by  Brigade-Surgeon  Faughf 
The  artillery  c[uartered  at  Tilbury  Fort  (in  the  Gravesend  district)  have  gen- 
erally suffered  more  or  less  from  ague,  whilst  the  people  at  the  railway 
station,  and  the  coast-guard  and  their  families  in  the  shij)  Ijmg  just  outside 
the  fort,  never  suffer  from  malarious  poisoning.  The  troops  have  been 
supj)lied  with  drinking  water  fi-om  two  undergTound  tanks  which  receive 
rain-water  from  the  roof  of  the  barracks,  whilst  the  other  persons  above 
mentioned  draw  their  diinking-water  from  a  spring  near  the  railway  sta- 
tion. From  December,  1873,  to  July,  1874,  the  troops  were  supphed  from 
the  same  soui'ce,  on  account  of  the  barrack  tanks  being  out  of  repair.  The 
followinef  table  shows  the  retiu-ns  of  sickness  : 


S  aJ 

O          of 

s  a 

Date. 

ti 

•0  M 

^'"3  .2.1  s 

Water  used. 

s  -^ 

i;    s  "S  =  r 

"0.9 

s     ■§  tf-^  fe 

m 

<^ 

11^    < 

^=5  a 

1872. 

Jan.  to  June  . . . 

103 

34 

33 

66 

Water  from  bar- 
rack tanks. 

1873. 

Jan.  to  June. . . . 

102 

12 

11.8 

23.6 

Water  from  bar- 
rack tanks. 

1873-4. 

Dec,     1873,     to 

July,  1874. . . . 

90 

1* 

1.1 

1.9 

Water  from 
spring  at  the 
railway  station. 

1874-5. 

Nov. ,     1874,     to 

March,  1875.. 

53 

4t 

7.6 

22.8 

Water  from  bar- 
rack tanks. 

The  ana]y.ses  of  the  waters 
showed  that  the  tanks  were 
exposed  to  soakage  from  the 
surrounding  salt  marsh,  for 
the  so-called  rain  water 
yielded  41.3  grains  per  gal- 
lon of  total  solids  in  the  one 
case,  and  145.25  in  the  other, 
the  chlorine  being  respective- 
ly 12.8  and  33.9.  The  station 
water  gave  38  grains  total 
solids  and  only  3.3  of  chlo- 
rine. As  regards  organic  mat- 
ter, the  tank  waters  showed 
actually  less  impurity  than 
the  station  water  by  the  am- 
monia method,  but  by  the 
permanganate  method  they 
were  three  times  as  impure. 
For  full  details  and  for  the 
microscopic  examination,  see 
the  original  paper. 


*  This  case  was  in  hospital  only  five  davs  :  it  occurred  only  a  few  days  after  the  arri~val  of  the  battery, 
t  None  of  these  had  ever  had  ague  before;  two  had  to  be  sent  on  furlough,  being  much  debilitated  by 
malaria. 


'  Oesterlen's  Handb.  der  Hygiene,  2d  edit.,  1857,  p.  129  ;  foot-note. 
^  Quoted  by  Wutzur,  Reise  in  dem  Orient  Europas,  band  i. ,  p.  101. 
^  De   ringestion    des  eaux  Marecageuses  comme   cause  de  la  Dysenterie  et  dea 
Fievres  Intermittenles,  par  L,  Colin,  Paris,  1872. 
■'Army  Medical  Reports,  vol.  xvii.,  p.  212. 
Vol.  I.— 4 


50  PRACTICAL   HYGIEJ!TE. 

Another  case  of  importance  is  that  recounted  by  C.  Smart,  Capt.  and 
Assist. -Surg.,  U.  S.  A."  In  the  Rocky  Mountain  district  of  North  Amer- 
ica a  fever  prevails,  which  is  popularly  known  as  the  Mountain  fexer  ;  it  is 
evidently  malarious,  and  is  amenable  to  quinine.  There  is,  however,  no 
malai-ious  district  in  the  neighborhood,  and  cases  of  intermittent  fever 
from  the  plains  recover  rapidly  there,  and  the  disease  occiu-s  sometimes 
when  the  thermometer  is  at  times  below  zero,  and  always  below  the  fi-eez- 
ing-point,  but  most  frequently  at  times  when  fever  does  not  occur  in  the 
plains,  but  which  coincide  with  the  melting  of  the  snows,  ^-iz.,  May,  June, 
and  July.  Dr.  Smart  found  that  all  the  water  in  the  rivers  contained  a 
large  excess  of  organic  matter,  the  purest  showing  from  0.19  to  0,28  per 
million  of  albuminoid  ammonia,  whilst  the  springs  showed  only  0.10.  The 
amount  was  much  increased  after  heavy  snow-fall,  and  on  analyzing  the 
snow  he  was  suiimsed  to  find  it  contains  a  large  excess  of  organic  matter, 
esiDCcially  that  which  fell  in  Large  heaxx  tkkes  (as  high  sometimes  as  0.58 
of  albxuuinoid  ammonia).  Dr.  Smart  concludes  that  vegetable  organic  mat- 
ter is  blown  up  fi-om  the  plains  and  precipitated  ■v\-ith  the  snow,  and,  when 
the  latter  melts,  canied  into  the  streams.  At  stations  where  care  is  taken 
with  the  water-supply,  and  especially  where  suspended  matter  is  pre- 
vented as  much  as  possible  from  getting  into  the  water,  the  disease  is 
shght.= 

The  possibihty  of  the  transmission  of  the  poison  of  paroxysmal  fevers 
through  di-inkiug- water  must  be  looked  upon  as  still  more  probable,  should 
the  riews  of  Klebs  and  Tommasi-Cmdeli  be  definitely  confirmed. 

Typhoid  Fever. 

The  behef  that  typhoid  fever  can  spread  by  means  of  water  as  well  as 
air  appears  to  be  quite  of  modei-n  origin,  though  some  epidemics,  such  as 
the  "  Schleim-fieber  "  of  GiJttingen  in  17G0,  were  attributed  in  part  to  the 
use  of  impiu-e  water.  In  1822,  Walz,  at  Saarlouis,  in  18-13,  Miiller,  at 
Mayence,  and  in  18-48,  E.  A.  W.  Eichter,  at  Vienna,  published  cases  illus- 
trative of  this.'  In  1852,  Dr.  Austua  Flint'  pubhshed  the  particulars  of  a 
similar  outbreak  of  t^•]^)hoid  fever  at  the  hamlet  of  North  Boston  (Ei-ie, 
U.  S.)  m  1843. 

In  1852-53,  a  severe  outbreak  of  t^-phoid  fever  took  place  at  Croydon, 
and  was  thoroughly  investigated  by  many  competent  obsei-^-ers  ;  and  it  was 
shown  by  Dr.  A.  Caipeuter  that  it  was  partly,  at  any  rate,  spread  by  the 
pollution  of  the  diinking  water  from  the  contents  of  cesspools. 

In  1856,  Dr.  Routh^  and  in  1859,  Dr.  W.  Budd"  pubhshed  very  conclu- 

'  For  details  see  A.M.U.  Reports,  vol.  xix. .  p.  190. 

'  In  my  Report  on  Hygiene.  A.M.D.  Reports,  vol.  xviii. .  an  analysis  is  given  of  the 
water  of  the  Rakus  Tal  Lake  on  the  northern  side  of  the  Himalayan  range,  the  sam- 
ple having  been  brought  home  by  Lieut. -Col.  H.  Knight,  lale  19th  Regiment  of  Foot. 
In  this  water  the  saline  ammonia  was  O.oO  and  the  albuminoid  0.70  per  million. 
Contrast  this  with  Loch  Katrine  and  other  lakes  in  this  country,  where  the  respective 
amounts  are  under  U.02  and  0.05,  and  we  have  a  difference  which  requires  explana- 
tion. May  it  not  be  that  in  this  country  we  have  so  much  less  snow  as  a  feeder  of 
our  mountain  lakes,  and  also  fewer  districts  from  which  winds  could  carry  up  organic 
matter? — [F.  de  C] 

^  All  these  cases  are  related  by  Riecko  in  his  excellent  work,  Der  Kriegs  und 
Friedens- Typhus.     Xordhausen,  18.50,  pp.  44-.')8. 

■*  Clinical  Reports  on  Continued  Fever.  By  Austin  Flint,  M.  D.  Buffalo,  1852.  p. 
380. 

^  Faecal  Fermentation  as  a  Cause  of  Difiease.     Pamphlet.     Lond.,  1856,  p.  34, 

°  Lancet,  Oct.  29,  1859,  p.  432. 


WATEE.  51 

sive  cases.     The  latter  had  long  been  convinced  of  the  occasional  propaga- 
tion of  t^^Dhoid  fever  in  this  way. 

In  1860  an  outbreak  of  tj-phoid  fever  occurred  at  the  Convent  of  Sisters 
of  Charity  at  Munich.  31  persons  out  of  120  were  attacked  between  15th 
September  and  the  4th  of  October  with  severe  illness,  and  14  of  these  cases 
were  true  tyj^hoid  ;  4  died.  The  cause  was  traced  to  wells  impregnated' 
with  much  organic  matter  (and  among  other  things  typhoid  dejections),  and 
containing  nitrates  and  lime.  On  the  cessation  of  the  use  of  this  water, 
the  fever  ceased.' 

.  The  propagation  of  tyj)hoid  fever  in  Bedford  would  certainly  appear, 
from  Mi\  Simon's  report,"  to  have  been  jDartly  through  the  medium  of  the 
water.  Dr.  Schmitt'  has  for  several  years  paid  particiilai'  attention  to  this 
point,  and  in  1861  pubhshed  several  very  striking  cases. 

A  case  bearing  on  the  same  point  was  brought  before  the  Metropohtan 
Officers  of  Health  in  1862,*  by  Mr.  "^'ilkinson  of  Sydenham.  In  this  case 
the  water  was  contaminated  by  absolution  of  sewer  gases. 

In  1862  a  vei'y  sudden  and  severe  outbreak  of  tj'phoid  in  a  barrack  at 
Munich  was  traced  to  water  impregnated  with  fsecal  matter  ; — on  ceasing  to 
use  the  water,  the  disease  disappeared.^  In  1865  a  veiy  remai'kable  out- 
break of  tj'plioid  occurred  at  Eatho,  in  Scotland,  and  was  traced  to  diinking 
water  contaminated  with  sewage.  "^  In  1866  typhoid  fever  broke  out  in  a 
gu'ls'  school  at  Bishopstoke,  near  Southampton,  and  was  traced  unequivo- 
cally to  the  bursting  of  a  sewer  pipe  into  the  well.  The  water  was  disa- 
greeable both  to  smell  and  taste.  17  or  18  j)ersons  were  affected  out  of  26 
or  28.  Several  very  striking  instances  are  recorded  in  Mr.  Simon's  Reports 
by  Drs.  Seaton,  Buchanan,  and  Thorne,'  and  in  some  of  these  cases  analyses 
of  the  water  were  made,  which  showed  it  to  be  impulse,  and  to  contain  or- 
ganic sewage,  or  its  derivatives.  A  veiy  good  case,  at  the  Garnkh'k  works 
in  Glasgow,  is  recorded  by  Dr.  Perry.*  Dr.  De  Eenzy,  the  Sanitary  Com- 
missioner of  the  Punjab,  has  also  published  a  remarkable  paper  on  the 
extinction  of  typhoid  fever  in  Millbank  Prison,  and  shows,  from  the  statis- 
tics of  many  years,  that  the  fever  has  entirely  disappeared  since  the  use  of 

'  Edinburgh  Medical  Jonmal,  Jan.,  1862,  p.  1153.  See  also  Gietl,  Die  Ursachen  des 
Enter.  Typhus  in  Manchen,  1865,  p.  58. 

2  Third  Heport  of  the  Medical  Officer  of  the  Privy  Council.  1860. 

^  Jo  urn.  de  Med.  de  Bruxelles,  Sept.,  1861  ;  and  Canstatt's  Jahresb.  for  1861,  band 
iv.,  pp.  182,  183.     See  the  2d  edition  of  this  work  for  a  short  account  of  them. 

4  British  Medical  Journal,  March  1,  1862. 

5  Gietl.  Die  Ursachen  des  Ent.  Typhus  in  Miinchen,  1865.  p.  62.  In  this  little  book 
is  much  evidence  to  show  the  propagation  of  typhoid  by  foul  water  and  by  deficient 
arrangements  for  removal  of  excreta,  as  well  as  many  instances  of  the  carrying  of  the 
disease  from  place  to  place,  analogous  to  those  narrated  by  Bretonneau  many  years 
ago. 

^  Edin.  Med.  Joum.,  Dec.  1865.  In  this  case  a  groom  came  to  the  house  ill  with 
typhoid  from  Dundee,  and  thus  introduced  the  disease. 

'  Dr.  Seaton' s  Report  on  Tottenham  (Report  of  Medical  Officer  to  the  Privy  Coun- 
cil for  1866,  p.  215j.  Dr.  Buchanan  on  Guildford  (Ibid,  for  1867,  p.  34) ;  Dr.  Thome's 
Report  on  Terling  (Ibid.,  p.  41);  Dr.  Buchanan's  Report  on  Wicken-Bonant  (12th  Re- 
port, p.  72).  In  all  these  instances  the  evidence  reaches  the  highest  degree  of  proba- 
bility, and  in  the  cases  of  Guildford  and  Wicken-Bonant  of  almost  absolute  certainty. 
See  also  Report  on  Sherborne  by  Dr.  Blaxall  ;  on  Cains  College,  Cambridge,  by  Dr. 
Buchanaa  (both  in  No.  ii..  new  series) ;  on  Lewes  by  Dr.  Thome  (Xo.  iv..  new  series); 
also  the  case  of  Over-Darwen  (Sanitary  Record,  187.5) ;  case  given  by  Dr.  Stallard  (Lan- 
cet, Feb.,  1872) ;  Dr.  Barclay's  Reports  on  Bangalore  (Army  Med.  Reports,  vol.  xiii., 
p.  208).  Geissler  also  quotes  from  Hagler  a  very  strong  case  occurring  at  Lausen. 
(Schmidt's  Jahrb.,  1874,  No.  2,  p.  185.; 

*  Lancet,  June,  1868. 


62  PKACTICAL    HTGIEN'E. 

Thames  "water  "was  given  up  ;  the  disappearance  was  comcident  "with  tho 
change  in  the  water  supply.  Two  excellent  cases  are  recorded  by  Dr. 
Clifford  Allbutt'  and  one  by  Dr.  "Wohlrab,  which  are  free  from  ambiguity.^ 
A  very  good  case  is  recorded  by  Dr.  Latham.^  Tyj^hoid  was  introduced 
into  a  ^^llage,  and  spread  by  the  agency  of  contaminated  ch-inking  water. ^ 

A  destiaactive  outbreak  took  place  at  Caterham  and  Redhill  duiing  1878. 
This  was  investigated  by  Dr.  Tliorne  Thome,  who  traced  it  to  contamina- 
tion of  the  water-supply  by  the  stools  of  a  workman  suffering  fi-om  mUd 
t^'phoid,  who  was  emjDloyed  in  the  Company's  wells.  The  disease  was  con- 
fined to  those  who  consumed  the  water,  and  ceased  after  the  wells  were 
pumjDed  out  and  cleansed.  The  inmates  of  the  Lunatic  Asylum  and  the  de- 
tachment of  troops  at  Caterham  ban-acks  used  the  water  from  the  asylum 
well,  and  did  not  suffer.^ 

That  water  may  be  the  mediiim  of  propagating  tyj^hoid  thus  seems  to 
be  proved  by  sufficient  evidence  ;  and  it  has  been  admitted  by  men  who 
have  paid  special  attention  to  this  subject,  as  Jenner,  W.  Budd,  and  Simon. 

Two  cpiestions  arise  in  connection  with  this  subject — 

1.  As  typhoid  lever  undoubtedly  spreads  also  through  the  air,  What  is 
the  proportion  of  cases  disseminated  by  watei-,  as  compared  with  those  dis- 
seminated by  ail'?     No  answer  can  yet  be  given  to  this  question. ° 

There  is  one  point  of  some  interest.  '\Yhen  the  dates  of  attack  are  given, 
it  is  curious  to  observe  how  short  the  incubative  period  apjiears  to  be  ; 
while  it  is  j^robable  that  it  takes  many  days  (8  to  14)  after  the  tyjDhoid  jDoi- 
son  has  entered  with  the  air  before  the  early  malaise  comes  on,  in  some  of 
the  cases  of  tyi)hoid  brought  on  by  water,  two  or  three  days  only  elapse 
before  the  symptoms  are  marked.' 

A  very  large  number  also  of  the  susceptible  persons  who  drink  the  water 
are  affected. 

2.  "Will  decomposing  sewage  in  water  produce  typhoid  fever,  or  must 
the  evacuations  of  a  typhoid  j^atient  pass  in  ?  This  is  pari  of  the  larger 
question  of  the  origin  and  j)ropagation  of  specific  poisons.  It  is  certainly 
remarkable,  in  the  range  of  cases  recorded  by  Schmitt,  how  uniformly  the 
possibility  of  the  passage  of  typhoid  stools  is  disregarded.  Everything  is 
attributed  to  fsecal  matters  merely.     A  case  recorded  by  Dr.  Downes,*  in 

'  See  Report  on  Hygiene,  Army  Med.  Dept.  Bl'^e  Book,  1860,  p.  23. 

*  Archiv  der  Heilk.,  vol.  xii.,  p.  1,'A  (1871). 
'  Lancet,  July  15,  1871. 

■*  A  remarkable  case  is  reported  by  Dr.  Zuckschwerdt  occurring  in  the  orphr.n 
asylum  at  Halle  in  1871.  Also  by  Dr.  Burkart  at  Stutt<.'art,  at  Reinhartsdorf  in  Switz- 
erland, and  at  Schandau,  all  distinctly  traceable  to  impure  water.  (Schmidt's  Jahr- 
biicher,  1874.) 

^  See  Report,  by  Dr.  Thome  Thome  ;  also  A.M.D.  Reports,  vol.  xx..  p.  222. 

*  Mr.  Simon,  in  his  second  Report,  new  scries,  gives  a  ta!)le  of  14t)  outbreaks  inves- 
tigated by  his  officers  in  187u-7y  (4  years),  in  all  of  which  great  escremental  pollution 
of  air  or  water,  or  generally  of  both,  was  found.  Biermer.  from  an  analysis  of  1,800 
cases,  cites  evidence  of  water  carriage  (Schmidt's  Jahrb.,  1878,  No.  8,  p.  i9.j). 

*  Dr.  W.  Budd  says,  in  a  letter  to  the  late  Dr.  Parkes,  —  '•  In  the  cases  in  which  the 
poison  is  conveyed  by  water,  infection  seems  to  be  much  more  certain ;  and  I  have 
reason  to  think  that  the  period  of  incubation  is  materially  shortened.  An  illustration 
of  this  seems  to  be  furnished  by  the  memorable  outbreak  which  occurred  at  C'owbridge 
some  years  ago,  and  which  pre.sented  this  unexampled  fact  :  that  out  of  some  90  or 
100  persons  who  went  to  a  race  ball  at  the  principal  inn  thf-re.  more  than  one-third 
were  within  a  short  time  laid  up  with  fever.  In  this  case  there  was  satisfactory  rea- 
son to  think  that  the  water  was  contaminated,  though  there  was  no  chemical  exami- 
nation." In  the  attack  at  Gu'ldford.  however,  the  incubative  period  was  not  shortened, 
as  Dr.  Buchanan  calculates  it  at  11  days;  neither  was  it  shortened  at  Caterham. 

8  Lancet,  April  27,  1872. 


WATEE.  53 

which  six  eases  of  typhoid  resulted  from  the  overflow  of  non -typhoid  sew- 
age into  a  well,  supports  this  view.  On  the  other  hand,  in  the  cases  re- 
corded by  Allbutt  and  Wohlrab,  already  referred  to,  contaminated  water 
had  been  used  for  some  time  without  producing  typhoid  fever.  Persons 
affected  with  typhoid  (enteric)  fever  then  entering  the  place,  theii-  dis- 
charges passed  into  the  drinking  water,  and  then  an  outbreak  of  typhoid, 
followed.  An  extremely  strong  case  is  given  by  Ballard.*  Very  polluted 
water  had  been  used  for  years  by  the  inhabitants  of  the  village  of  Nunney 
without  causing  fever,  when  a  person  with  enteric  fever  came  from  a  dis- 
tance to  the  village,  and  the  excreta  from  this  person  were  washed  into  the 
stream  supplying  the  village.  Between  June  and  October,  1872,  no  less 
than  76  cases  occuiTed  out  of  a  poiDulation  of  832  persons.  All  those  at- 
tacked drank  the  stream  water  habitually  or  occasionally.  All  who  used 
filtered  rain  or  well  water  escaped,  except  one  family  who  used  the  water  of 
a  well  only  4  or  5  yards  from  the  brook.  The  case  seems  c[uite  clear — first, 
that  the  water  caused  the  disease  ;  and  secondly,  that  though  polluted  with 
excrement  for  years,  no  enteiic  fever  appeared  until  an  imj)ortant  case  in- 
troduced the  vii'us.  Positive  e\ldence  of  this  kind  seems  conclusive,  and 
we  may  now  safely  assume  that  the  presence  of  typhoid  evacuations  in  the 
water  is  necessary.  Common  fsecal  matter  may  produce  diarrhoea,  which 
may  perhaps  be  febrile,"  but  for  the  jDroduction  of  enteric  fever  the  speci- 
fic agent  must  be  present.  The  opinion  that  the  stools  of  typhoid  are  the 
special  carriers  of  the  poison  was  first  exphcitly  stated  by  Canstatt,^  and 
was  also  ably  argued  by  W.  Budd. 

Cholera. 

Few  of  the  earlier  investigators  of  cholera  appear  to  have  imagined  that 
the  specific  poison  might  find  entrance  by  the  means  of  drinking-water. 
There  is  an  intimation  of  the  kind  in  a  remark  by  Dr.  Miiller  ;*  and  Jame- 
son ^  alludes  to  the  efiect  of  impiu-e  water,  but  in  a  cui'sory  way. 

In  1819  the  late  Dr.  Snow,  in  investigating  some  circumscribed  out- 
breaks of  cholera  in  Horsleydown,  Wandsworth,  and  other  places,  came  to 
the  conclusion  that,  in  these  instances,  the  disease  arose  from  cholera  evac- 
uations finding  their  way  into  the  drinking  water.  Judging  from  the  light 
of  subsequent  experience,  it  now  seems  extremely  probable  that  this  was 
the  case,  and  to  Dr.  Snow  must  certainly  be  attributed  the  very  great  mer- 
it of  discovering  this  most  important  fact.  At  first,  certainly,  the  evidence 
was  defective, '^  but  gradually  fresh  instances  were  collected,  and  in  1854 

'  Report  to  the  Local  Government  Board,  on  an  outbreak  of  enteric  fever  at  Nun- 
ney. Sept..  1872. 

2  A  good  instance  is  given  by  Mr.  R.  Bond-Moore  (London  Medical  Record,  May  27, 
1874,  page  827),  as  occurring  at  Sedgely  Park  school.  Two  years  previously  the  water 
supplv'  became  contaminated  with  ordinary  sewage,  but  no  typhoid  fever  resulted,  al- 
though there  was  diarrhcea,  sicknes^i,  great  languor,  and  great  prostration.  The  leak- 
ing drain  was  repaired,  and  the  attack  ceased.  Two  years  after,  typhoid  was  intro- 
duced by  one  of  the  boys,  and  spread  apparently  by  the  use  of  the  closets. 

2  '•  Wahrscheinlich  sind  die  Exhalationen  des  Krankes,  seine  Excremente.  vielleicht 
die  typliosen  After gebilde  im  Darme,  die  Triiger  des  Contagiums." — Canstatt,  Spec. 
Path,  und  Ther.,  2'd  edit.,  band  ii.,  p.  572  (1847). 

"  Einige  Bemsrkuugen  iiber  die  Asiat.  Cholera.     Hanover,  1848,  p.  36. 

"  Bengal  Report  of  1820. 

*  There  seemed  at  once  an  a  priori  argument  adverse  to  this  view,  as,  at  that  time, 
all  evidence  was  against  the  idea  of  cholera  evacuations  being  capable  of  causing  the 
disease.  They  had  been  tasted  and  drunk  (in  1832)  by  men.  and  been  given  to  ani- 
.mals,   without  effect.     Persons  inoculated  themselves  in  dissections  constantly,  and 


54  PRACTICAL    HYGIENE. 

occuiTed  the  celebrated  instance  of  the  Broad  Street  pump  in  London, 
Avhich  was  investigated  bv  a  committee,  whose  report,  drawn  up  by  Mr. 
John  Marshall,  of  University  College,  with  great  logical  power,  contains 
the  most  convincing  evidence  that,  in  that  instance,  at  any  rate,  the  poison 
of  cholera  found  its  way  into  the  body  through  drinking-water/ 

In  1855  Dr.  Snow  published  a  second  edition  of  his  book,  giving  an 
account  of  all  the  cases  hitherto  known,  and  adding  some  evidence  also  as 
to  the  introduction  in  this  way  of  other  specific  poisons.* 

The  facts,  at  present,  may  be  briefly  summed  up  as  follow^  : — 

1.  Local  outbreaks,  in  which  contamination  of  the  drinking-water  was 
either  proved  or  in  which  the  evidence  of  the  origin  and  succession  of  cases 
seemed  to  make  it  certain  that  the  cause  was  in  the  drinking-water.  In 
England,  Dr.  Snow  and  others  have  thus  recorded  cases  occurring  in  1849 
and  1854  at  llorsleydown,  Broad  Street,  Wandsworth,  West  Ham,  etc. 
In  1865  the  important  outbreak  at  Newcastle-on-Tyne,'  when  all  the  cir- 
cumstances pointed  veiy  strongly  to  the  influence  of  the  impure  Tyne  water. 
In  1865  occurred  the  remarkable  and  undoubted  case  of  water  poisoning 
at  Theydon  Bois,  recorded  by  Mr.  Radcliffe,*  and  in  the  following  year  the 
violent  outbreak  in  the  East  of  London  was  sujoposed  to  be  connected  with 
the  cii'culation  of  impure  water  by  the  East  London  Water  Works  Com- 
pany. Much  discussion  has  taken  place  as  to  the  real  influence  of  the  im- 
pure water,  which  it  is  admitted  on  all  hands  was  used.  Mr.  Eadclifl'e  ^ 
and  Dr.  Farr "  collected  the  evidence  in  favor  of  the  opinion  that  the  sud- 
den outburst  was  really  oAving  to  this  water  ;  while  Dr.  Letheby  and  some 
others  expressed  doubts  on  this  point,  chiefly  on  account  of  the  diflficvilty 
of  reconciling  with  the  hv7)othesis  certain  exceptional  cases  both  of  immu- 
nity and  of  attack.  The  evidence  in  favor  of  the  water  being  the  cause  ap- 
j)ears  extremely  strong,  and  far  greater  difficulty  arises  if  that  view  is  not 
received  than  is  caused  by  the  exceptional  cases  referred  to,  and  of  which 
we  may  not  know  all  the  particulars.  In  the  same  year  (1866)  an  appar- 
ently unequivocal  case  of  production  of  cholera  by  the  drinking  of  water 
of  a  tank  on  board  a  steamer  occuiTed  at  Southampton.' 

A  veiy  striking  case  at  Utrecht  is  noticed  by  Snellen,'^and  is  given  by 
Dr.  Ballot,  of  Rotterdam,  who  has  adduced  much  strong  evidence  on  the 
influence  of  the  foul  water  in  Holland  in  spreading  cholera.* 

bathed  their  hands  in  the  fluids  of  the  intestines ;  in  India  the  pariahs  who  removed 
excreta,  and  everywhere  the  washerwomen  who  washed  the  clothes  of  the  sick,  did  not 
especially  suffer.  And  to  these  arguments  must  be  added  the  undoubted  fact,  that 
there  were  serious  deficiencies  of  evidence  in  Dr.  Snow's  early  cases.  (See  review  by 
Dr.  Parkes  in  the  British  and  Foreign  Medical  Chirurgical  Review,  April,  1S55.) 

'  Report  on  the  Cholera  Outbreak  in  St.  James's,  Westminster,  in  1854.  London, 
Churchill,  ISoo.  Every  point  is  discussed  in  this  Report  with  a  candor  and  precision 
which  leaves  nothing  to  be  desired.  For  further  evidence  on  this  outbreak,  see  Indian 
Sanitary  Report :  evidence  of  Dr.  Dundas  Thomson,  p  272. 

''  On  the  Mode  of  Communication  of  Cholera.  By  John  Snow,  M.D.  London, 
Churchill,  2d  edition,  18r>5. 

^  For  full  particulars,  see  Dr.  Farr's  Report  on  Cholera  in  England.  1806,  p.  33. 

■*  Report  of  the  Medical  Officer  to  the  Privy  Council  for  1865  (Eighth  Report),  p. 
438. 

5  Report  of  Ihe  Medical  Officer  to  the  Privy  Council  for  1866.  p.  266. 

*  Report  on  the  Cholera  Epidemic  of  1866  in  England.  Supplement  to  the  29th 
Annual  Report  of  the  Reo-istnir-General,  1868. 

^  Report  of  Medical  Officer  to  Privy  Council  for  1866,  p.  244.  In  this  case  the 
water  was  foul  tasted,  and  was  certainly  contaminated  with  s-ewage. 

"  Medical  Times  and  Gazette,  May,  18()fl.  Thus  it  was  found  that  those  who  drank 
the  water  of  the  Polders  (reclaimed  lands)  died  at  the  rate  of  17.7  per  1,000  ;  those 
who  drank  the  well-water,  16.8  per  1,000;  those  who  drank  river-water,  11.9  per 


WATEE.  00 

During  tlie  epidemic  in  1866,  except  in  the  East  London  case,  no  such 
striking  instances  of  local  outbreak  ti'oni  vrater  contamination  were  re- 
corded as  in  1819,  but  there  were  in  some  parts,  and  especially  in  Scot- 
land, as  noticed  by  Dr.  Stevenson  ]\lacadam,'  very  striking  coincidences 
between  the  abatement  of  the  disease  and  the  introduction  of  a  fi-esh  and 
pm'e  supjoly. 

In  Germany  choleraic  water-poisoning  has  not  only  been  less  noticed, 
but  the  gi-eat  authority  of  Pettenkofer  is  against  its  occui-rence.  At  Mu- 
nich, Pettenkofer'  could  find  no  evidence  whatever  in  favor  of  the  spread 
by  water,  nor  does  he  consider  that  any  fiu'ther  evidence  was  fui-uished  by 
the  epidemics  in  Germany  in  1873-71.^  Even  Hii'sch,  who  was  favorable 
to  the  water  theoiy,  expresses  himself  -oith  considerable  caution  ;  ^  and 
Giinther,  in  his  careful  Avork  on  Cholera  in  Saxony,  °  asserts  that  no  influ- 
ence whatever  was  exerted  by  di'inking-water.  No  evidence  could  be  ob- 
tained either  in  Baden  or  in  villages  neai-  Vienna.*  And  as  in  all  cases  the 
observers  were  not  only  quite  competent,  but  were  fully  cognizant  of  the 
opinions  held  in  England,  this  negative  evidence  is  of  gi'eat  weight.  At 
the  same  time,  it  cannot  be  allowed  to  outweigh  the  Enghsh  cases,  and, 
moreover,  even  in  Germany  some  positive  evidence  has  been  given.  Dr. 
Eichter '  attributes  a  preponderant  influence  in  a  local  outbreak  among 
the  workmen  of  a  sugar-manufactory  to  the  pollution  of  the  drinking 
water  by  sewage  ;  and  a  still  more  striking  case  is  recorded  by  Dr.  Din- 
ger,* in  which  the  discharges  of  a  cholera  patient  passed  into  a  brook,  in 
which  also  the  clothes  were  washed  ;  the  water  of  this  brook  being  used 
for  drinking,  there  was  a  sudden  and  very  fatal  outbreak  aftecting  the  per- 
sons who  took  the  water. 

In  India  the  evidence  for  cholera  water  poisoning  has  now  become  veiy 
strong.  The  gi-eat  cholera  outbreak  of  1860  and  1861  was  attributed  by 
some  medical  officers  to  the  defilement  of  the  tank  water  "into  which  the 
general  ordure  of  the  natives  is  washed  dui-ing  the  rainy  season  ; " "  and 
still  more  recently,  what  appears  to  be  a  striking  instance  has  occurred. 
No  one  can  read  the  able  account  given  by  Dr.  Cuningham  and  Dr.  Cut- 
liffe^'  of  the  apj)earance  of  cholera  among  the  vast  crowd  of  pilgTims  after 
the  great  bathing  day  at  Hurdwar,  without  coming  to  the  conclusion  that 
it  was  a  case  of  water-poisoning  on  a  gigantic  scale.  Cholera  broke  out 
again  at  Hurdwar  in  1879  (the  pilgrimage  takes  place  every  twelve  years), 
but  in  his  report  on  this  epidemic  Dr.  J.  M.  Cuningham  endeavors  to 
thi-ow  doubts  upon  the  propagation  by  means  of  water.     The  circum- 

1,000;  those  who  drank  rain-water  filtered,  only  5.3  per  1,000.  The  city  of  Amster- 
dam itself,  supplied  by  an  aqueduct  with  rain-water  from  the  downs  near  Haarlem, 
had  only  4  per  I.UOO.  In  Rotterdam,  during;  the  epidemic,  the  mortality  fell  to  one- 
half  immediately  on  pure  water  being  supplied  in  the  streets.  (See  paper  by  J.  C. 
Jager. ) 

^  Transactions  of  the  Eoyal  Scottish  Society  of  Arts,  vol.  vii. ,  p.  341  (1867). 

-  Zeitsch.  fiir  BioL,  band  i. .  p.  353. 

''  Ueber  Cholera  and  deren  Beziehung  zur  parasitaren  Lehre,  von  Mas  von  Petten- 
kofer, 1S80. 

•*  Berieht  der  Commission  des  Deutschen  Eeiches,  heft  i. ,  saite  13. 

^  Die  I-dische  Cholera  in  Sachsen  im  Jahre  1865,  p.  125. 

*  Volz  and  Witlacil,  quoted  by  Hirsch  in  Jahresb.  der  gen.  Med.  for  1867.  band 
ii.,  p.  221. 

''  Archiv  der  Heilk. ,  1867,  p.  472. 

*  Ibid. ,  p.  84. 

'  M'William,  Epidem.  Society  Trans.,  vol.  i.,  p.  274. 

'"  Report,  of  the  Sanitary  Commissioner  with  the  Government  of  India  for  1S67. 
Calcutta,  1868. 


56  PRACTICAL    HYGIENE. 

stances,  however,  were  very  similar  in  the  two  cases.'  Drs.  T.  Lewis  and 
Douglas  Cunningham  discredit  the  influence  of  water;"  and  Dr.  D.  Cun- 
ningham stiys,' — "  One  point  seems  worthy  of  remark,  and  that  is,  that 
there  is  no  evidence  of  tlie  existence  of  any  common  condition  affecting 
local  sources  of  water  suj^ply,  and  simultaneously  affecting  the  prevalence 
of  cholera  and  bowel-complaints." 

That  in  India,  liowever,  the  cholera  poison  is  often  caiiied  by  water 
appears  j)robable,  not  only  from  the  Hm-dwar  outbreaks,  but  from  the 
very  sudden  and  violent  outbreaks  and  the  great  sewage  contamination  in 
the  Avater  of  many  districts.^ 

In  Central  India  Dr.  Townsend^  has  given  strong  reasons  for  behe^dng 
that  the  cholera  of  18G8-69  was,  to  a  large  extent,  dependent  on  water- 
fouling.  Dr.  Macnamara"  has  given  some  good  evidence  on  the  same 
side,  and  Dr.  Cleghom'  has  noted  some  striking  proofs  of  the  same 
fact.* 

Dr.  ]\L  C.  Farnell,  Sanitary  Commissioner  of  Madras,  points  out  the 
immunity  of  Madras  from  cholera  since  the  new  water  supply  was  obtained 
from  the  Red  HiUs  ;  the  same  immunity  extending  to  the  districts  using 
the  water,  whereas  other  places  which  do  not  use  it  still  suffer  from  the 
disease.  Guntur  always  suffered  from  cholera  up  to  18G8,  since  which 
time  it  has  been  j^racticaUy  free,  following  the  greater  care  for  the  water 
supply  begun  by  Dr.  Biggwither  and  carried  out  by  Dr.  TyrreU."  A  re- 
markable case  is  recorded  by  the  Rev.  J.  Delj)ech,  at  Vadakencoulam. '" 
Cholera  was  confined  to  the  higher  castes,  who  drank  of  a  particular  well 
exposed  to  contamination.  Among  the  lower  castes  none  suffered,  except 
one  woman  who  Avashed  for  the  higher  caste  women.  The  lower  caste 
people  drank  from  other  wells,  which  were  less  exposed  to  pollution. 

So  also  in  other  countries  ;  in  the  attack  which  caused  such  losses  to 
the  French  Division  in  the  Dobnidscha  in  1855,  when  the  wells  were  sup- 
posed to  be  poisoned,  and  to  the  English  cavah'y  at  Devna,"  the  water  was 
apparently  the  means  of  carrying  the  disease. 

In  evidence  of  this  kind,  we  must  remember  that  each  successive  in- 
stance adds  more  and  more  weight  to  the  instances  previously  observed, 

'  See  Fcction  vi.  of  the  Sixteenth  Annual  Report  of  the  Sanitary  Commissioner 
with  the  Government  of  India,  1880. 

^  Cholera  in  Relation  to  Certain  Physical  Phenomena. 
^  Medico-Topographical  Report  on  Calcntta. 

*  Vide  Report  on  the  Sanitary  Administration  of  the  Punjaub  for  1867,  and  sub- 
seqtient  years,  by  A.  C.  C.  De  Renzy,  Esq.     (Cases  of  Peshawur  and  Amritzur.) 

^  Report  on  Cholera  in  the  Central  Provinces. 

*  On  Asiatic  Cholera,  see  pp.  <328  et  seq. 
'  Indian  Medical  Gazette,  March,  1873. 

*  See  also  the  remarkable  case  of  the  Yerrauda  gaol,  reported  by  Surgeon-Major 
H.  Blanc.  Out  of  1,279  prisoners  there  were  24  cases  of  cholera  in  5  days,  with  8 
deaths.  Of  those,  22  cases  occurred  among  lo4  prisoners  employed  as  a  road-gang, 
and  only  2  among  all  the  others  variously  employed.  It  was  shown  that  the  road- 
gang  alone  drank  of  water  from  the  Mootla  River,  a  little  below  the  spot  where  the 
clothes  of  two  cholera  patients  from  the  village  had  been  washed  and  their  bodies 
burnt  a  few  days  before.  The  rest  of  the  prisoners  drank  the  usual  water  supply  laid 
on  from  a  lake  near  Poonah.  In  the  two  cases  among  those  otherwise  emploj'ed 
direct  infection  was  undoubted  in  one,  as  he  attended  on  cholera  patients,  and,  c  n- 
trary  to  orders,  took  his  meals  in  the  cholera  ward,  and  drank  water  that  had  been 
standing  there;  the  other  man  slept  near  one  of  the  first  cases,  the  patient  vomiting 
in  his  immediate  vicinity. 

"  Indian  Medical  Gazette.  AprU,  1883. 
"'Ibid.,  December  1,  187.9. 
"  MS.  essay  of  Dr.  Cattell. 


WATER.  5T 

until,  from  tbe  mere  accumulation  of  cases,  the  cogency  of  the  argument 
becomes  irresistible. 

2.  The  evidence  derived  from  such  local  outbreaks  is  supported  by  that 
drawn  frora  the  history  of  more  general  attacks,  in  "svhich  districts  supplied 
with  impure  water  by  a  water  company  have  suffered  gTeatly,  while  other 
districts  in  the  same  locality,  and  presenting  otherwise  the  same  conditions, 
were  supphed  with  ptu'e  water,  and  suffered  very  httle.  Thus  the  Regis- 
trar-General has  shown  that  the  districts  supplied  in  1853,  pari  by  the 
Lambeth  Company  with  a  pui-e  water,  and  part  by  the  Southwark  Com- 
pany with  an  impure  water,  suffered  much  less  than  the  districts  supphed 
by  the  latter  company  alone  (the  proporiion  was  61  and  94  cases  respec- 
tively to  100,000  of  population).  Schiefferdecker,  in  KlJnigsberg,  has  also 
given  evidence  to  show  the  different  extent  in  which  districts  in  the  same 
city  supphed  with  pui-e  and  impure  water  suffer.  ^ 

In  Berlin,  in  1866,  in  the  houses  supphed  with  good  water  the  number 
of  houses  in  which  cholera  occuiTed  was  36.6  per  cent.  ;  in  the  houses  with 
bad  water  was  52.3  per  cent.'^ 

3.  Additional  arguments  can  be  drawn  from  instances  in  which  towns 
which  could  not  have  had  water  contaminated  with  sewage  have  escaped, 
and  instances  in  which  towns  which  have  suffered  severely  in  one  epidemic 
have  escaped  a  later  one,  the  only  difference  being  that,  in  the  interval,  the 
supply  of  water  was  improved.  Exeter,  Hull,  Newcastle-on-Tyne,  Glasgow, 
and  Moscow  are  instances  of  this.  Tt\'o  very  good  cases  are  related  by  Dr. 
Acland.^  The  parish  of  St.  Clement  was  supplied  in  1832  with  filthy  water 
from  a  sewer-receiving  stream.  In  181:9  and  1854  the  water  was  fi'om  a 
purer  source.  In  the  first  year,  the  cholera  mortality  was  great ;  in  the 
last  years,  insignificant.  In  Copenhagen  a  fresh  water  supply  was  in- 
troduced in  1859.  Although  cholera  had  prevailed  veiy  severely  there 
previously,  in  1865  and  1866  there  were  only  a  few  cases. ■*  In  Haar- 
lem, in  Holland,  cholera  prevailed  in  great  intensity  in  1849.  In  1866  it 
returned,  and  again  prevailed  as  severely  in  all  parts  of  the  town  except 
one.  The  pari  entuely  exempted  in  the  second  epidemic  was  inhabited 
by  bleachers,  who,  between  1849  and  1866,  had  obtained  a  fresh  source  of 
pure  water.  ^ 

In  looking  back,  with  this  new  reading  of  facts,  it  would  seem  that  some 
older  reported  cases  of  sudden  cessation  of  cholera  can  be  explained,  such 
as  the  case  of  Breslau,  in  1832,  when  the  shutting  up  of  a  pump  was  fol- 
lowed by  the  very  rapid  dechne  of  the  disease.  Doubtless,  however,  in 
other  cases  the  causes  of  the  cessation  are  different ;  hea^w  rain,  by  cleans- 
ing arr  and  sewers,  and  by  stopping  the  evolution  of  effluria,  will  sometimes 
as  suddenly  aiTest  cholera.  Most  important  evidence  is  given  by  Professor 
Forster  of  Breslau.''  He  shows  that  five  towns  of  Silesia  (of  5,000  to  12,000 
inhabitants)  are  entirely  free  from  cholera,  which  never  spreads,  even  when 
introduced.  The  only  common  condition  is  a  water  supply  from  a  distance 
which  cmmol  be  contaminated.  In  Glogau  (13,000)  half  the  water  is  from 
a  distance  and  half  from  wells  :  those  using  the  former  remain  free,  those 
using  the  latter  are  attacked.     In  one  case  in  Breslau,  on  a  well  becoming 


1  See  Report  on  Hygiene,  Army  Med.  Dept.  Report,  vol.  xii. ,  p.  241. 

^  Die  Kanalisation  von  Berlin.  1868,  p.  30. 

3  Cholera  in  Oxford  in  1854.  by  H.  W.  Acland,  M.D.,  p.  51. 

'^  Hornemann  in  Virchow's  Archiv,  band  .53,  p.  156. 

6  Ballot,  British  Med.  Journal,  April,  1869. 

^  Die  Verbreitung  der  Cholera  durch  die  Bronnen,  Breslau,  1873. 


58  PRACTICAL    HYGIENE. 

contaminatecl,  eleven  persons  were  immediately  attacked. '  Dr.  A,  Fergus'' 
has  pointed  out  that  in  Glasgow,  when  the  whole  city  was  supphed  from 
the  river,  cholera  was  universal  in  1848  ;  whilst  in  1854  it  was  chiefly  con- 
fined to  the  north  side,  which  still  di-ew  water  from  the  river,  the  south 
Fide  with  a  pure  water  supply  being  practically  free  from  it.  In  1866  the 
whole  city  had  the  pure  Loch  Katrine  supply,  and,  although  cases  of  cholera 
were  imported,  it  got  no  hold  on  the  city  whatever. 

So  also  other  curious  facts  in  the  history  of  cholera  become  explicable. 
The  prevalence  of  cholera  in  Eussia,  with  an  outdoor  temperature  below 
zero  of  Fahr.,  has  always  seemed  an  extraordinary  circumstance,  which  it 
appeared  only  jjossible  to  explain  by  supposing  that,  in  the  houses,  the 
foiil  air  and  tlie  artificial  temperatm-e  must  have  given  the  poison  its  neces- 
sary conditions  of  development.  But  Dr.  Routh  has  pointed  out '  that,  in 
the  poorer  Eussian  houses,  every  thing  is  thrown  out  round  the  dwellings  ; 
then,  owing  to  the  cold  and  the  expense  of  In'inging  drinking  water  from  a 
distance,  the  inhabitants  content  themselves  with  taking  the  snow  near  their 
houses  and  melting  it.  It  is  thus  easy  to  conceive  that,  if  cholera  evacua- 
tions are  thus  thrown  out,  they  may  be  again  taken  into  the  body.  This 
is  all  the  more  likely,  as  cholera  stools  have  little  smell  or  taste,  and,  when 
mixed  even  in  large  quantity  -with,  water,  cannot  be  detected  by  the  senses. 

We  may  therefore  conclude  that  the  cholera  evacuations,  either  at  once 
or  after  undergoing  some  special  fermentative  or  transformation  change, 
pass  into  drinking  water  or  float  about  in  the  atmosphere.  In  either  case 
they  are  received  into  the  mouth  and  swallowed,  and  produce  their  effects 
directly  on  the  mucous  membrane,  or  are  absorbed  into  the  blood.  The 
relative  frequency  of  each  occui'rence,  the  incubative  jDeriod,  and  the  sev- 
erity of  the  disease  jiroduced,  are  points  still  uncertain. 

C.  Macnamara  states  ^  that  the  dangerous  period  is  when  the  water  into 
which  cholera  stools  are  passed  is  swarming  with  vibriones,  and  that  when 
ciUated  infusoria  appear  danger  is  over.  He  speaks  strongly  on  this  point, 
and  from  actual  experience. 

In  addition  to  the  production  of  cholera  from  drinking-water  containing 
the  cholera  stools,  it  has  been  supposed  that  the  use  of  impure  water  of 
any  kind  ]jredif<poses  to  cholera,  though  it  cannot  absolutely  jDroduce  the 
disease.  The  facts  ah*eady  quoted  on  the  influence  of  the  Lambeth  water 
seem  to  support  this  \dew ;  but  some  German  evidence  in  1866  does  not 
favor  it,^  although  later  ewlence  seems  to  do  so."  If  the  water  acts  in 
this  way,  it  may  be  by  causing  a  constant  tendency  to  diarrhoea,  or  by 
carrying  into  the  alimentary  canal  organic  matter  which  may  be  thrown 
into  special  chemical  changes  by  a  small  quantity  of  cholera  poison,  which 
has  been  introduced  with  air  or  food  and  swallowed,  or  by  lowering  the 
resistance  of  the  body,  and  rendering  it  more  favorable  as  a  nidus  for  the 
poison. 

'  In  India  also  similar  results  are  found.  CuUen  cites  the  case  of  Hurda,  rendered 
free  from  cholera  by  improved  conditions  of  water  supply.  Payne  reports  that  the 
new  water  supply  of  Calcutta  has  had  the  strongest  effect  in  diminishing  the  mor- 
tality from  cholera.  See  also  the  Report  on  the  Cholera  in  America  in  1873,  for  cases 
of  water  carriage. 

^  British  MeJical  Journal,  1879,  vol.  ii..  p.  336. 

^  F«cai  Fermentation,  p.  24. 

*  Asiatic  Cholera,  p.  330. 

'  i^ee  Report  on  Hygiene,  Army  Medical  Dept.  Report,  vol.  vii.,  p.  33.'5. 

*  Pistor  of  Oppeln,  Cholera  Epidemic  of  1873-74  ;  see  6th  part  of  the  Report  of  the 
Cholera  Commissioners  of  the  German  Empire. 


"WATER.  59 


Yellow  Fever. 


As,  like  dysentery,  typhoid  fever,  and  cholera,  the  alimentary  mucous 

.  membrane  is  primarily  affected  in  yellow  fever,  there  is  an  d,  priori  proba- 

bihty  that  the  cause  is  swallowed  also  in  this  case,  and  that  it  may  possibly 

enter  with  the  drinking-water.     But  no  good  evidence  has  been  yet  brought 

forward. 

Boudin  '  quotes  a  case  from  Eochard  in  which  a  French  frigate  (ia  1778) 
took  in  water  at  San  Jago,  where  yellow  fever  prevailed.  Some  days  after- 
ward yellow  fever  ^broke  out  with  such  violence  that  two-thirds  of  the 
crew  were  attacked.  "And  the  proof  that  the  only  cause  was  the  water," 
says  Eochard,  "  was  that  the  persons  hving  with  the  captain  had  with  them 
i'ars  filled  with  water  from  Europe,  and  all  escaped."  Boudin  very  jDroperly 
observes,  that  this  evidence  is  very  defective  ;  but  yet  we  must  remember 
how  completely  the  ^propagation  of  marsh  and  typhoid  fevers,  and  of  cholera 
by  water,  has  been  overlooked,  and  how  exactly  this  sudden  and  extensive 
attack  resembles  the  case  of  the  Argo. 

The  Barrack  Commissioners  have  also  directed  attention  to  the  fact  of 
the  great  impurity  of  the  water  at  Gibraltar  at  the  time  of  the  yellow  fever 
epidemic  ;  a  difficulty  which  still  remains  to  be  dealt  with  in  the  event  of 
the  introduction  of  any  epidemic  disease. 

The  other  Zymotic  Diseases. 

Of  the  other  zymotic  diseases  the  only  ones  likely  to  be  propagated  by 
means  of  water  are  scarlet  fever  and  diphtheria.  The  evidence  for  such 
propagation  was  formerly  very  slight,  but  since  attention  has  been  drav?n 
to  the  subject  numerous  cases  have  occurred  which  have  been  attributed  to 
water-poisoning, — working  either  directly  through  water  drunk  as  such,  or 
by  its  being  mixed  vpith  milk.  There  seems  no  primd  facie  reason  against 
such  a  channel  of  infection  in  the  case  of  scarlet  fever,  particularly  as  epithe- 
hum  scales  are  so  often  found  in  contaminated  water.  As  regards  diph- 
theria, the  question  is  a  httle  more  complicated,  for  the  direct  communica- 
tion through  the  use  of  the  same  drinking  vessel  might  simulate  water 
carriage,  as  pointed  out  by  Dr.  A.  Downes.  '^  Some  imjjortant  evidence  has, 
however,  been  collected  by  Dr.  B.  Browning '  and  others.  It  would  also 
appear  that  ordinary  throat  ulcer  (if  this  be  really  different  from  diphthe- 
ria) may  be  propagated  in  this  way.  It  has  been  suggested  that  erysipelas 
is  sometimes  due  to  contaminated  water,  but  of  this,  however,  there  is  as 
yet  no  conclusive  evidence. 

4.    DISEASES    OF    THE    SKIN,    AND    SUBCUTANEOUS    TISSUES. 

A  curious  endemic  of  boils  occurred  in  the  vicinity  of  Frankfort  in  1848. 
It  was  confined  to  a  small  number  of  persons,  and  presented  favorable  op- 
portunities for  investigation.  An  elaborate  inquiry  was  made  by  Dr.  Cle- 
mens," which  certainly  seems  to  indicate  that  the  complaint  was  caused  by 
drinking  water  containing  hydrogen  suljohide  gas,  which  was  set  free  in 
some  large  chemical  works,  and  was  washed  down  by  the  rains  into  the 

1  Traite  de  Geog.  et  de  Stat.  Med..  1858,  t.  i.,  p.  141. 

2  Sanitary  Record.  1879-80,  vol.  xi.,  p.  51. 

3  Ibid.,  p.  13. 

*  Henle's  Zeitschrift  fiir  Nat.  Med.,  1849,  vol.  viii.,  p.  215. 


60  PRACTICAL   HYGIENE. 

brooks  from  which  drinking-water  was  derived.  The  case  is  most  elabo- 
rately and  logically  argued,  but  it  certainly  seems  remarkable  that  other  in- 
stances of  the  same  kind  should  not  have  been  observed,  especially  as  in 
some  trades  there  is  disengagement  of  large  quantities  of  SH„  into  the  at- 
mosphere, and  as  the  drinking  of  sulphui-etted  springs  is  so  common. 

The  i^eculiar  forms  of  boil  or  ulcer  common  in  many  cities  in  the  East  have 
been  in  some  cases  referred  to  the  water.  The  Aleppo  eril,  the  Damascus 
ulcei',  and  some  other  diseases  of  an  analogous  kind,  which  have  the  pecu- 
liarity of  occm-ring  only  once  in  hfe,  are  possibly  more  connected  with  the 
true  contagions  ;  but  the  unhealthy  boils  or  ulcers  so  common  in  India,  es- 
pecially in  the  northwest  and  along  the  frontier,  are  probably  connected 
with  bad  water.  The  so-called  Delhi  boil  has  much  decreased  in  frequency 
since  the  waters  of  the  Jumna  were  used  instead  of  the  imj^ure  well-water,* 
but,  on  the  other  hand,  Fleming's  observations  have  thrown  doubt  on  the 
fact  of  the  water  being  to  blame.  The  later  obseiwations  of  Drs.  D.  Ctm- 
ningham  and  T.  Lewis  have  tended,  on  the  other  hand,  to  weaken  those  of 
Fleming,  and  to  show  that  the  water  is  probably  to  blame.  With  regard 
to  the  frontier  ulcers  in  India,  Dr.  Alcock,  A.]\I.I).,  has  given  some  curious 
eridence,  which  seems  to  connect  them  with  vegetable  detritus  and  the  evo- 
lution of  hydrogen  sulphide. 

The  elephantiasis  of  the  Arabs  (the  so-called  Barbadoes  leg  or  Pachyder- 
mia) has  been  ascribed  to  organic  impurities  in  water,  which  may  be  true, 
if  the  disease,  as  is  now  suggested,  be  due  to  a  i/aciWu*- which  might  be  con- 
veyed in  water. 

5.    DISEASES    OF    THE   BOXES. 

Water,  impregnated  with  sulphurous  acid,  gives  rise  in  cattle  to  a  num- 
ber of  serious  symptoms,  among  others  to  diseases  of  the  bones.  The  sul- 
phm-  dioxide  evolved  from  the  copper  works  at  Swansea  has  caused  numer- 
ous actions  on  account  of  the  loss  of  herbage  and  cattle.  Rossignol  ^  states 
that  water  highly  charged  with  calcium  carbonate  and  sulphate  was  found 
to  give  rise  to  exostoses  in  horses  ;  pui-e  water  being  given,  the  bones 
ceased  to  be  diseased. 


6.    CALCULL 

It  has  long  been  a  popular  opinion  that  drinking  Hme  waters  gives  rise 
io  calculi  (calcium  phosphate  and  oxalate).  Several  medical  writers  have 
held  the  same  oj^inion,  and  have  adduced  individual  instances  of  calculi 
(phosphatic  ?)  being  apparently  caused  by  hard  waters,  and  cured  by  the 
use  of  soft  or  distilled  water.  On  a  lai-ge  scale,  statistical  eridence  is  ap- 
parently wanting.  The  excess  of  cases  of  calculi  in  Norwich  and  Norfolk 
generally  is  not,  in  Dr.  Richardson's  opinion,  attributable  to  the  water.' 
Dr.  J.  Murray,  of  Newcastle,  has  given  some  evidence '  to  show  a  connec- 

'  See  Annual  Report  of  San.  Com.  with  the  Government  of  India  for  1867,  p.  178 
(1868).  Some  excellent  analyses  of  the  Delhi  waters  are  given  by  Dr.  Sbeppard  ;  ride 
D.  Macnamara's  Second  and  Third  Reports  of  the  Analyses  of  Potable  Waters  in  the 
Bong:il  Pres'dency.     Calcutta,  1868. 

-  Trait i  d'Hygiene  Militaire,  1857,  p.  .357. 

'  Med.  History  of  England ;   Medical  Times  and  Gazette,  1864,  p.  100. 

*  British  Medical  Journal,  September,  1873. 


WATEE.  6 1 

tion  between  the  lime  waters  and  calculi,  especially  phospliatie,  but  it  does 
not  appear  to  be  more  cou\'incing  than  that  previously  adduced. 

At  Canton  stone  is  common,  while  at  Amoy,  Shanghai,  Ningpo,  and 
other  places,  it  is  not  met  with.  The  cause  of  the  difference  is  not  known, 
but  it  is  not  calcium  carbonate  in  the  water,  as  the  Chinese  always  drink 
boiled  water/ 

Professor  Gamgee,  however,  states  that  sheep  are  particularly  affected 
by  calculus  in  the  limestone  districts. 


»  i.    GOITKE. 

The  opinion  that  impure  drinking  water  is  the  cause  of  goitre  is  as  old 
as  Hippocrates  and  Ai-istotle,  and  has  been  held  by  the  majority  of  phy- 
sicians. The  opinion  may  be  said  actually  to  have  been  put  to  the  test  of 
the  experiment,  since  both  in  France  and  Italy  the  di'inking  of  certain 
waters  has  been  resorted  to,  and  apparently  with  success,  for  the  purpose 
of  producing  goitre,  and  thereby  gaining  exemption  from  military  con- 
scription." And  this  is  supported  by  the  evidence  of  Bally,  Coindet,  and 
by  many  of  the  French  army  siu-geons,  who  have  seen  goitre  produced 
even  in  a  few  days  (eight  or  ten)  by  the  use  of  certain  waters."  While, 
conversely,  Johnston  saw  goitre,  which  was  common  in  a  jail,  disapj)ear 
when  a  pure  water  was  used.*  Apart  from  this,  the  evidence  for  the  causa- 
tion by  water  is  extremely  strong,  many  cases  being  recorded  where,  in 
the  same  village,  and  under  the  same  conditions  of  locality  and  social  Hfe, 
those  who  drank  a  pariicular  water  suffered,  while  those  who  did  not  do  so 
escaped."  The  latest  author  who  has  written  on  this  subject,  and  who  has 
accumulated  an  immense  amount  of  evidence,  M.  Saint-Lager,  expresses 
himself  very  confidently  on  the  point. 

The  impurity  in  the  water  which  causes  goitre  is  not  yet  precisely 
known.  It  is  certainly  not  owing  to  the  want  of  iodine,  as  stated  by  Chatin, 
and  there  is  little  probabihty  of  its  being  caused  by  organic  matters,  by 
fluorine,  or  by  silica.  On  the  other  hand,  the  coincidence  of  goitre  with 
sedimentous  water  is  very  frequent.  Since  the  elaborate  geological  in- 
quiries of  M.  Grange  "  and  the  analyses  of  the  waters  of  the  Isere,  magne- 
sian  salts  in  some  form  have  often  been  considered  to  be  the  cause,  to 
which  many  add  lime  salts  also  ;  and  certainly  the  evidence  that  the  waters 
of  goitrous  places  is  derived  from  limestone  and  dolomitic  rocks,  or  from 
serpentine  in  the  granitic  and  metamorphic  regions,  is  very  strong.  The 
investigations  now  include  the  Alps,  Pyrenees,  Dauphine,  some  parts  of 
Russia,  Brazil,  and  districts  in  Oude  in  Northwest  India.  A  table  com- 
piled from  Dr.  M'CleUan's  work  ^  is  very  striking  : — 


'  Dr.  Wang,  in  Chinese  Customs  Report  for  1870,  p.  71. 

"  Among-  other  evidence  on  this  point,  the  work  of  M.  Saint-Lager  (Sur  les  causes 
du  Cretinisme  et  du  Goitre  endimique,  Paris,  1867)  may  be  cited  (p.  191  et  seq.),  as 
he  appears  to  have  carefully  looked  into  the  evidence.  See  also  Baillarger  (Comptes 
Rendus  de  I'Acad.,  t.  Iv. ,  p.  475),  who  states,  though  this  has  been  denied  by  Rey, 
that  horses  and  mules  become  affected  from  drinking  the  water  of  the  Isere. 

^  Encyclopajdia  of  Practical  Medicine,  vol.  i.,  art.  Bronchocele,  p.  32ii. 

^  Edin.  Monthly  Journal,  May,  1855. 

*  Saint-Lager  (op.  cit. )  cites  several  strong  cases  (p.  192  et  seq.). 

^  Ann.  de  Chimie  et  de  Phys.,  vol.  xxiv.,  p.  364. 

'  Medical  Topography  of  Bengal.  The  facts  on  cretinism  are  also  included,  with- 
out desiring  to  ex^jresB  any  opinion  on  the  relation  between  goitre  and  cretinism. 


62 


PRACTICAL    HYGIENE. 


Goitre  and  Cretinism  in  Kumaon  (Oude). 


"Water  derived  from 

Percentage  of  Population  affected. 

With  Goitre. 

With  Cretinism. 

Granite  and  gneiss 

0.2 
0 

0.54 
0 
33 

0 

Mica,  slate,  and  hornblende 

0 

Clay  slate 

0 

Oreen  sandstone 

0 

Limestone  I'ocks 

3.0 

There  are,  however,  not  •wanting  analyses  of  water  of  goitrous  regions 
which  show  that  magnesia  may  be  absent  (in  Eheims,  according  to  Mau- 
men^  ;  in  Auvergne,  according  to  Bertrand  ;  in  Lombardy,  according  to 
Demortain  ;  and  Saint-Lager  enumerates  other  cases),  while  it  has  been 
also  denied  that  there  need  be  any  excess  of  lime.  M.  Saint-Lager,  basing 
his  opinion  partly  on  these  negative  instances,  partly  on  his  own  experi- 
ments with  the  soajD-test,  which  show  no  relation  between  hardness  of 
water  and  goitre,  and  partly  on  the  negative  results  of  exjDeriments  on 
animals  ■uitli  calcium  sulphate  and  magnesian  salts,  denies  altogether  the 
connection  between  goitre  and  calcium  and  magnesium  sulphates  and  car- 
bonates. He  states  also  that  M.  Grange  has  now  himself  given  up  the  be- 
lief of  magnesia  being  the  essential  agent  of  goitre,"  and  argues  that  the 
constituent  of  the  water  which  is  the  actual  cause  is  either  iron  pyrites 
(ferrum  sulphide),  or  more  infrequently  copper  or  some  other  metallic  sul- 
phide. AjQd  he  explains  M'Clellan's  results  by  the  supposition,  based  on 
an  expression  of  that  writer,  that  in  the  limestone  districts  of  Kumaon  the 
water  had  traversed  the  metalliferous  strata  of  the  rocks.  Saint-Lager 
does  not  support  his  opinion  by  actual  chemical  analyses,  but  he  brings 
forward  geological  e^■idence  on  a  large  scale,  to  prove  that  the  endemic  ap- 
pearance of  goitre  coincides  with  the  metalliferous  districts.  He  has  also 
made  experiments  on  animals  'uith  ii-on  salts,  which  do  not  appear  conclu- 
sive, although  he  believes  he  produced  in  some  cases  an  efifect  on  the  thy- 
roid. His  h;\-pothesis  seems  to  fail  from  his  want  of  chemical  analyses.  He 
has  made  out  a  case  for  inquiry  rather  than  for  conclusion. 

In  some  observations  made  by  Dr.  Ferguson  on  the  goitrous  part  of  the 
Bai'ee  Doab  district*  (a  boulder- gravel  subsoil),  the  water  is  said  to  be 
largely  charged  -oith  lime.  La  the  jail  at  Durham,  Johnston  '  states  that 
when  the  water  contained  77  grains  per  gallon  (chiefly  of  lime  and  mag- 
nesian salts),  aU  the  prisoners  had  swellings  of  the  neck  ;  these  disappeared 
when  a  purer  water,  containing  18  grains  in  the  gallon,  was  obtained.* 

Goitre  may  be  rapidly  produced.  Bally  noticed  that  certain  waters  in 
Switzerland  would  cause  it  even  in  eight  or  ten  days,  and  cases  almost  as 
rapid  have  occm-red  in  other  places.^ 

'  Sur  les  causes  du  Cretin,  et  du  Goitre,  p.  237. 

*  Sanitary  Administration  of  the  Punjab  for  1871,  Appendix  4,  p.  33. 
^  Ed  n.  Monthly  Journal,  May,  1855. 

•*  In  Xottmg-hara  the  people  attribute  goitre  to  hardoess  of  water.  Generally  it 
appears  only  with  mag^nesium  limestone. 

*  Many  instances  are  recorded  in  the  French  military  medical  journal,  Recueil  de 
Mem.  de  Mud.  Mil, ,  of  the  acute  goitre  produced  in  a  few  days. 


WATER.  63 

Dr.  J.  B.  Wilson  (late  A.M.D.)  carried  out  some  inquiries  at  Bhagsoo, 
Dhurmsala,  where  goitre  prevails  extensively.  He  analyzed  specimens  of 
the  drinking  water  within  a  radius  of  ten  miles,  and  found  them  excep- 
tionally pure,  only  three  showing  traces  of  Hme,  and  none  giving  any  evi- 
dence of  magnesia  or  iron.^ 

It  seems,  therefore,  that  the  question  is  still  undecided,  and  it  is  much 
to  be  desu'ed  that  more  extended  inquiry  should  be  made,  with  careful 
analyses,  such  as  have  been  made  by  Dr.  Wilson, — as  well  as  records  of 
local  and  other  conditions,  which  probably  contribute  more  or  less  to  the 
production  of  the  disease. 

8.    ENTOZOA,    OE    OTHEE   AKCVIALS. 

Whereas  the  Tcenia  solium  and  the  Tcenia  mediocanellata,  and  many 
entozoa,  find  their  way  into  the  body  with  the  food,'  the  two  foi*ms  of  the 
Bothriocephalus  latus  {T.  lata)  may  pass  in  with  the  diinking  water. ^  Both 
embi-yo  and  eggs  (but  principally,  or  perhaps  entii'ely,  the  fonuer)  exist  in 
the  river  water.  The  cihated  embryo  moves  for  several  days  very  actively 
in  water  ;  it  may  after  a  time  lose  its  cihary  covering,  and  then,  not  being 
able  to  move  further,  perishes  ;  or  it  may  find  its  way  into  the  body  of 
some  animal,  and  there  develop  into  the  Bothriocejjhalics  latus. 

It  is  most  common  in  the  interior  of  Russia,  Sweden,  in  part  of  Poland, 
and  in  Switzerland. 

Distoma  hepaiicuvi  [Fasciola  hepatica). — The  eggs  are  developed  in  wa- 
ter, and  the  embiyos  swim  about  and  live,  so  that  introduction  in  this  way 
for  sheep  is  probable,  and  for  men  is  possible. 

The  Ascaris  lumhricoides  (Eound-worm)  appears  also  sometimes  to  enter 
the  body  by  the  drinking  water.  At  Moulmein,  in  Biu'mah,  during  the 
wet  season,  and  especially  at  the  commencement,  both  natives  and  Evu'o- 
peans,  both  sexes  and  all  ages,  were,  foii;y  years  ago,  so  aifected  by  lum- 
brici  that  it  was  almost  an  ejDidemic.^  The  only  circumstance  common  to 
all  classes  was  that  the  drinking  water,  drawn  chiefly  from  shallow  wells, 
was  greatly  contaminated  by  the  substances  washed  in  by  the  floods  of  the 
excessive  monsoon  which  prevails  there.  Dr.  Paterson  ""  has  also  noticed 
similar  facts  in  England. 

Leuckari "  has  no  doubt  of  the  passage  of  the  ascarides'  eggs  into  drink- 
ing water  ;  and,  indeed,  they  have  been  actually  seen  in  the  water  by 
Mosler.'  But  it  seems  yet  doubtful  (as  all  experiments  have  failed  in  pro- 
ducing from  the  drinking  water  the  worms  in  animals)  whether  the  eggs 
alone  will  suffice,  and  it  seems  possible  that  they  must  pass  thi'ough  some 
other  host  before  developing  in  the  human  intestine.     This  is  also  the 

'  Indian  Annals  of  Medical  Science  ;  also  Aitken's  Science  and  Practice  of  Medi- 
cine. 7th  edit.,  vol.  ii..  p.  1009. 

-  Dr.  Oliver's  observations  in  India  show  that  cattle  may  get  tcenia  ova  from  the 
water  ;  so  that  men  may  do  the  same.     (See  Aitken's  Med.,  7th  ed.,  vol.  i.,  p.  207.) 

^  See  especially  a  paper  by  Dr.  Knocb  in  the  Peterburger  Med.  Zeitsch.  for  1861- 
An  abstract  is  given  in  the  Lancet,  Jan.  25.  1862  ;  and  the  paper  in  full  is  printed  in 
Virchow's  Archiv,  band  xxiv.,  453.  Cobbold,  however,  doubts  the  direct  ec trance  in 
this  way,  and  thinks  it  more  probable  that  fish  form  the  host  for  the  ova,  wnich  after 
development  in  the  fish,  may  find  their  way  into  the  bodies  of  men  who  eat  the  fish. 

*  The  native  treatment  is  the  powder  of  a  fungus  (Wah-mo)  derived  from  the  fe- 
male bamboo.  It  is  most  useful.  See  paper  by  Dr.  Parkes  in  the  London  Journal  of 
Medicine,  1849. 

'  Aitken's  Practice  of  Medicine,  7th  ed.,  i. ,  p.  157. 

^  Die  Menschlichen  Parasiten,  band  ii.,  p.  220. 

''  Virchow's  Archiv,  band  xviii.,  p.  249. 


64  PRACTICAL    HYGIENE. 

opinion  of  Cobbold.  Mosler  attributed  in  his  case  much  influence  to  the 
large  amount  of  vegetable  food  taken  by  the  persons  affected. 

The  Dochmius  duodenalis  [Slrongylus  duodenalis,  A/ichi/Iosfomian  feu 
SderostomaduodenaJe)  would  aj)pear  fi-om  Leuckart's  statement'  to  be  in- 
troduced by  impure  water. ^ 

Oxi/nris  vermicularisi,  very  common  in  children,  but  occasionally  also 
found  in  adults,  is  probably  sometimes  taken  through  water.' 

P'daria  Bracuneulus  (Guinea-wonn). — The  introduction  by  water  of 
Fdaria  has  long  been  a  favorite  opinion.  It  has  been  a  matter  of  debate 
whether  it  is  taken  into  the  stomach  as  drink,  and  thence  finds  its  way 
(like  Tricldna,  to  the  muscles)  into  the  subcutaneous  cellular  tissue,  or 
whether  it  penetrates  the  skin  during  bathing  or  wading  in  streams.  The 
latter  opinion  seems  to  be  the  more  probable  in  the  majority  of  cases.* 

Boiling  the  water  before  drinking  appears  to  have  a  preservative 
effect.' 

Fdaria  sanguinis  hominis  (Lewis)  appears  to  find  its  way  into  the  blood 
of  man  through  water  in  a  cui'ious  way.  "Dr.  Manson  has  found  that  the 
mosquito  is  an  active  agent  in  the  projDagation  of  the  Fdaria.  The  em- 
bryos are  taken  into  the  mosquito's  stomach  with  the  blood  of  persons  in- 
fected by  the  hsematozoon,  the  fuiiher  development  of  which  shortly  begins 
in  the  stomach  of  the  mosquito.  Thence  they  are  transfeiTed  to  the  water, 
whence  it  is  assumed  that  it  again  finds  entrance  into  the  body  of  man."  ° 

Bilharzia  hcematohia. — From  the  observations  of  Griesmger,  John  Har- 
ley,'  and  Cobbold,  there  seems  no  doubt  that  the  embryos  of  this  entozoon 
live  in  water,  and  the  animal  may  be  thus  introduced  probably  by  the 
medium  of  some  other  animal.  Dr.  Batho  doubts,  however,  this  introduc- 
tion by  water,  since  the  entozoon  occun-ed  in  persons  using  rain-water  and 
pure  mountain  stream  water.* 

Leechei^. — Reference  has  ah'eady  been  made  to  the  swallowing  of  small 
leeches,  which  fix  on  the  pharynx,  and  in  the  posterior  nares.  Cleghorn ' 
noticed  that  coughs,  nausea,  and  spitting  of  blood  were  thus  caused.  In 
a  march  of  the  French  near  Oran,  in  Algiers,  more  than  400  men  were  at 
one  time  in  hospital  from  this  cause.  In  some  cases  the  repeated  bleed- 
ings from  the  laiynx  have  simulated  hsemoj^tysis  and  jDhthisis,  and 
have  produced  ansemia.  A  leech,  once  fixed,  seldom  falls  off  si^ontaneously. 
In  India  no  accidents  of  this  kind  are  on  record,  yet  we  must  assume  that 
they  occasionally  occur. 

'  Yirchow's  Archiv,  band  ii.,  p.  46.5. 

*  The  importance  of  the  discovery  of  Griesinger  ^Archiv  fiir  Phys.  Heilk.,  1854,  p. 
55.5),  that  the  so-called  widely  spread  Egyptian  chlorosis  is  caused  by  DocJimius  dvo- 
dennlis,  has  hardly  been  sufficiently  appreciated.  Not  only  anaemia  and  liver  diseases, 
but  symptoms  referred  to  dysentery  and  hemorrhoids,  are  often  so  produced.  And  as 
similar  facts  have  now  been  observed  in  Brazil.  Arabia,  and  Madagascar,  it  seems  im- 
possible but  that  in  India  tne  formidable  affections  caused  by  Dochmius  should  not  be 
common. 

=  Aitken.  vol.  i..  p.  183. 

■*  See  Dr.  Aitken's  long  and  excellent  chapter  on  this  disease,  in  his  Practice  of 
Medicine,  7th  ed.,  vol.  i.,  p.  169,  et  seq.,  for  a  discussion  on  the  water  and  earth 
question. 

^  Greenhow,  in  Indian  Annals,  1856,  p.  557. 

*  Aitken,  op.  oit. ,  i.,  185. 

'  Med.  Chir.  Trans.,  vol.  xlvii. ,  p.  65,  and  vol.  lii.,  p.  379. 
^  Army  Med.  Rep  ,  vol.  xii..  p.  504. 
»  Diseases  of  Minorca,  1768,  p.  38. 


"WATER.  65 


9.    LEAD,    MEECUEY,    AESENTC,    COPPEE,    AND   ZINC    POISONING. 

It  is  only  necessary  to  mention  the  fact  of  metals  passing  into  the 
dimking  %Yater,  either  by  trade  refuse  being  poiu-ed  into  streams,  or  by 
the  water  dissolving  the  metal  as  it  flows  thi-ough  pipes  or  over  metallic 
surfaces. 

In  1864  a  factory  at  Basle  discharged  water  containing  arsenic  into  a 
pond,  from  which  the  ground  and  adjacent  wells  were  contaminated,  and 
severe  illness  in  the  persons  who  di-ank  the  well-water  was  produced.^ 

General  Conclusions. 

1.  An  endemic  of  dian-hoea,  in  a  community,  is  almost  always  owing 
Either  to  impure  air,  impure  water,  or  bad  food.  If  it  affects  a  number 
of  persons  suddenly,  it  is  probably  owing  to  one  of  the  two  last  causes, 
and  if  it  extends  over  many  famihes,  almost  certainly  to  water.  But  as 
the  cause  of  im2:)urity  may  be  transient,  it  is  not  easy  to  find  experimental 
proof. 

2.  Dian'hoea  or  dysentery,  constantly  affecting  a  community,  or  return- 
ing periodically  at  certain  times  of  the  year,  is  far  more  likely  to  be  pro- 
duced by  bad  water  than  by  any  other  cause. 

3.  A  very  sudden  and  localized  outbreak  of  either  typhoid  fever  or 
cholera,  is  almost  certainly  owing  to  introduction  of  the  j^oison  by  water. 

4.  The  same  fact  holds  good  in  cases  of  malarious  fever,  and,  especially 
if  the  cases  are  very  grave,  a  possible  introduction  by  water  should  be 
carefully  inquired  into. 

5.  Tne  introduction  of  the  ova  of  certain  entozoa  by  means  of  water  is 
proved  in  some  cases — is  probable  in  others. 

6.  Although  it  is  not  at  present  possible  to  assign  to  every  impurity  in 
water  its  exact  share  in  the  production  of  disease,  or  to  prove  the  precise 
influence  on  the  public  health  of  water  which  is  not  extremely  im2:)ure,  it 
appears  certain  that  the  health  of  a  community  always  imjoroves  when  an 
abundant  and  j)ure  water  supply  is  given  ;  and,  apart  fi-om  this  actual  e^i- 
dence,  we  are  entitled  to  conclude,  from  other  considerations,  that  abundant 
and  good  water  is  a  primary  sanitary  necessity. 


SECTION  V. 

EXAMINATION   OF   WATER   FOR   HYGIENIC   PURPOSES. 

The  analysis  of  water  for  hygienic  pui'poses  has  for  its  object  to  ascer- 
tain whether  the  water  contains  any  substances  either  suspended  or  dis- 
solved which  are  likely  to  be  hurtful.  There  are  some  substances  which 
we  know  are  not  likely  to  do  any  harm,  such  as  carbonate  of  sodium,  cal- 
cium, and  magnesium  in  small  quantities.  Others  are  at  once  viewed  with 
suspicion  as  indicating  an  animal  origin,  and  therefore  being  probably  de- 
rived from  habitations  or  resorts  of  men  or  animals,  or  fi'om  decaying  bod- 
ies. In  other  cases  substances  in  themselves  harmless,  such  as  nitrates, 
nitrites,  and  ammonia,  are  suspicious  from  implying  the  co-existence  of,  or 
the  previous  contamination  of  the  water  by  nitrogenous  substances.  The 
difficulties  in  the  hygienic  examination  of  water  are  not  inconsiderable.    A 

^  Rolh  and  Lex,  Milit.  Gesundsheitpfi.,  p.  41. 
Vol.  L— 5 


G6  PRACTICAL    HYGIENE. 

judgment  must  be  generally  come  to  from  a  collation  of  all  tlie  evidence, 
rather  than  from  the  results  of  one  or  two  tests. 

Collection. 

Great  care  must  be  taken  that  a  fair  sample  of  the  water  is  collected  in 
perfectly  clean  glass  vessels  (not  in  earthenware  jars) — '\Yinchester  quarts, 
which  hold  about  half  a  gallon,  and  can  be  obtained  of  most  chemists,  are 
most  convenient ; — they  should  be  repeatedly  washed  out  with  some  of 
the  water  to  be  examined.  In  taking  water  from  a  stream  or  lake,  the 
bottle  ought  to  be  plunged  below  the  surface  before  it  is  tilled.  In  draw- 
ing from  a  pipe,  a  portion  ought  to  be  allowed  to  run  away  fii'st,  to  get  rid 
of  any  impurity  in  the  pipe.  In  judging  of  a  town  supply,  samples 
should  be  obtained  direct  from  the  mains,  as  well  as  from  the  houses. 
The  bottle  should  be  stoppered  ;  a  cork  should  be  avoided,  excej)t  in 
great  emergency,  but  if  used  it  should  be  quite  new,  well  tied  down,  and 
sealed. '  No  luting  of  any  kind  (such  as  linseed  meal  and  the  like)  should 
be  used. 

For  a  complete  sanitary  investigation  half  a  gallon  is  necessary,  but 
with  a  Utre  or  a  couple  of  pints  a  pretty  good  examination  can  be  made  if 
more  cannot  be  obtained.  If  a  detailed  mineral  analysis  is  required  (which 
will  only  be  seldom)  a  gallon  ought  to  be  provided.  It  is  always  advisable 
to  have  a  good  supply  in  case  of  breakage  or  accident.  The  "  W.  O.  Cir- 
culars "  direct  two  Winchester  quarts  of  each  samj^le  to  be  sent."  The 
examination  ought  to  be  undei-taken  immediately  after  collection,  if  possi- 
ble. If  this  cannot  be  done,  then  as  short  a  time  as  may  be  should  be  al- 
lowed to  elapse, — for  changes  in  the  most  imjDortant  constituents  take  place 
M-ith  gi-eat  rapidity.'  Pending  examination,  it  ought  to  be  kept  in  a  dark, 
cool  place. 

The  fullest  infonnation  ought  always  to  be  furnished  with  the  sample, 
the  following  being  the  most  important  particulars  : — 

1.  Source  of  the  water,  viz.,  from  tanks  or  cisterns,  main  or  house  pipe, 

spiing,  river,  stream,  lake,  or  weU. 

2.  Position  of  source,  strata  so  far  as  they  are  known. 

3.  If  a  well  ;    depth,  diameter,   strata  through  which  sunk,  whether 

impeiwiously  steined  in  the  upper  pai-t,  and  how  fai-  down.  Total 
depth  of  well  and  depth  of  water  to  be  both  given.  If  the  well  be 
open,  furnished  with  cover,  or  with  a  pump  attached. 

4.  Possibility  of  impurities  reaching  the  water  :    distance  of  well  from 

cessjDOols,  drains,  middens,  manure-heajos,  stables,  etc.;  if  drains 
or  sewers  discharge  into  streams  or  lakes  ;  proximity  of  cultivated 
land. 

5.  If  a  siu'face-water  or  rain-water,  nature  of  collecting  sui'face  and 

conditions  of  storage. 

6.  Meteorological  conditions,  with  reference  to  recent  drought  or  ex- 

cessive rainfall. 

7.  A  statement  of  the  existence  of  any  disease  supjDosed  to  be  connected 

with  the  water  supply,  or  any  other  special  reason  for  requiring 
analysis. 

'  W.  O.  Circulars,  clause  82,  June,  1876  ;  clau.se  12,  .January,  1877;  and  clause  81, 
April.  1878.  direct  water  to  be  sent  in  stoppered  glass-bottles. 

-'  FranklanJ  recommends  from  one  Winchester  quart  of  the  worst  waters  to  three 
of  the  purest. 

3  For  some  interesting  experiments  on  this  point,  see  Hehner,  in  the  Analyst,  vol. 
iii.,  p.  177. 


WATEE.  67 

Any  fnrtlier  information  that  can  be  obtained  will  always  be  nsefiiL 
Each  bottle  should  also  be  distinctly  labelled,  so  as  to  corresiDOud  with  the 
official  letter  or  invoice. 

"^Tien  it  is  j^ossible,  it  is  most  desirable  that  the  medical  officer  or  ana- 
lyst should  visit  the  locality  itself  whence  the  water  is  obtained  ;  in  this 
way  he  may  obtain  information  which  might  otherwise  escape  him.  If 
the  analysis  can  be  made  immediately  on  the  spot,  it  will  be  all  the  more 
valuable. 

Sub-Section  I. 

'Physical  Examination  of  Water. 

The  following  points  are  to  be  noted  : — 

1.  Color.  4.  Lustre. 

2.  Clearness.  5.  Taste. 

3.  Sediment,  6.  Smell. 

1.  Color. — This  may  be  judged  of  by  allowing  any  sediment  to  settle, 
and  then  pouring  off  the  sui^ernatant  water  into  a  tall  glass,  placed  upon 
a  piece  of  white  paper.  Or  a  horizontal  tube  of  colorless  glass  with  glass 
ends  may  be  used.  The  stratum  should  be  of  sufficient  thickaess,  if  pos- 
sible tico  or  three  feet,  but  a  fair  idea  of  the  color  may  be  obtained 
Avith  18  inches  or  even  a  foot.  The  Society  of  Public  Analysts  recom- 
mends 24  inches.  If  a  tube  be  used,  it  may  either  be  half  full,  and  the 
tint  compared  with  the  color  of  the  air  in  the  upper  half  when  directed 
against  a  well  illuminated  white  surface  ;  or,  better  still,  it  may  be  filled, 
and  the  comparison  made  with  a  second  tube  placed  alongside,  filled  with 
pm-e  distilled  water.  Perfectly  pure  water  has  a  bluish  tint,  but  most  or- 
dinary waters  have  either  a  grayish,  greenish,  yellow,  or  bro^m  appear- 
ance. The  best  samples  are  those  colored  bluish  or  grayish.  Green  wa- 
ters owe  their  color  to  vegetable  matter,  chiefly  unicellular  algce,  and  are 
usuaUy  harmless.  Yellow  or  brown  waters  are  most  to  be  feared,  as  their 
color  is  often  due  to  animal  organic  matter,  chiefly  sewage.  It  is  some- 
times, however,  owing  to  vegetable  matter,  such  as  peat,  and  under  those 
circumstances  it  is  not  generally  hm-tful  : — it  may  also  be  caused  by  salts 
of  ii'on,  although  in  most  cases  the  ii'on  is  precipitated  as  ferric  oxide  in 
the  sediment. 

2.  Clearness. — The  presence  or  absence  of  turbidity  may  be  judged  of 
in  the  same  way  as  the  color,  only  the  water  should  be  shaken  up,  so  as 
to  distribute  the  suspended  matter  and  simulate  its  condition  when 
drawn.  The  depth  necessary  to  obscure  printed  matter  may  be  used  as  a 
measure.  Occasionally  water  remains  hazy  or  tru-bid,  even  after  standing 
for  some  time ;  in  such  a  case  the  suspended  matter  is  in  very  fine  division, 
such  as  is  sometimes  found  with  sulphate  of  calcium,  minute  scales  of 
mica,  etc. 

3.  Sediment. — The  nature  of  the  sediment  may  be  roughly  judged  of  by 
the  eye,  as  to  whether  it  is  mineral  or  vegetable,  or  stained  mth  iron  or 
the  like.  The  larger  living  forms,  such  as  Anguillulce,  water-fleas,  leeches, 
etc.,  may  also  be  detected.  But  the  only  satisfactoiy  examination  is  to  be 
made  with  the  microscope. 

4.  Lustre. — The  lustre  or  brilHancy  (eclat)  has  been  recommended  as  a 
good  physical  indication  of  the  amount  of  aeration  (Grerarclin).  The  dif- 
ferent degrees  may  be  noted  in  any  convenient  way,  such  as  nil,  dull, 
vitreous,  or  adamantine,  which  is  an  ascending  scale  from  zero  to  the  maxi^ 
mum  brightness. 


68  PRACTICAL    HYGIENE. 

5,  Tafite. — Taste  is  an  uncertain  indication.  Any  badly  tasting  water 
should  be  rejected  or  j)uritied  before  use.  Suspended  animal  organic 
matters  often  give  a  peculiar  taste,  so  also  vegetable  matters  in  stagnant 
"waters.  Some  growing  plants,  as  lemnia  and  i^Utia,  give  a  bitter  taste  : 
but  most  growing  plants  have  no  taste.  Perfectly  dissolved  animal  matter 
is  frequently  quite  tasteless.  As  regards  dissolved  mineral  matters,  taste 
is  of  little  use,  and  differs  much  in  different  persons.     On  an  average — ' 

Sodium  chloride  is  tasted  when  it  reaches  75             gi'ains  per  gallon. 

Potassium     "  "  "  20 

Magnesium  "  "  "  50  to  55 

Calcium  sulphate,  "  "  25  to  30 

"      carbonate,  '    "  "  10  to  12 

"     nitrate,  "  "  15  to  20 

Sodium  carbonate,  "  "  60  to  65 

Iron,             "  "  "  .2                   "                 " 

Iron  is  thus  the  only  substance  which  can  be  tasted  in  veiy  small  quan- 
tities. A  permanently  hard  water  has  sometimes  a  ^iecvMox  fade,  or  slightly 
saline  taste,  if  the  total  salts  amount  to  35  or  40  grains  per  gallon,  and  the 
calcium  sulphate  amounts  to  6  or  8  grains.  The  taste  of  good  drinking 
water  is  due  entirely  to  the  gases  dissolved  ;  water  nearly  free  from  car- 
bonic acid  hardness,  such  as  distilled  water,  is  not  so  pleasant  as  the  brisk 
well  carbonated  waters  ;  it  may  be  called  flat,  but  it  is  difficult  to  define 
the  kind  of  taste  or  absence  of  it." 

6.  Smell. — The  water  may  be  warmed,  or  distilled,  when  the  odor  of 
fecal  matter  is  often  brought  out  clearly  both  in  the  distillate  and  residue. 
If  the  water  is  put  in  a  stoppered  bottle,  which  it  half  fills,  and  is  exjoosed 
to  hght,  and  then  opened  and  smelt  after  a  few  days,  commencing  putre- 
faction, or  the  fomiation  of  butyric  acid,  or  something  similar,  can  some- 
times be  detected.  Tiemann  recommends  that  the  water  should  be  heated 
to  110°  or  120°  Fahr.  ;  if  hydrogen  sulphide  be  present,  add  a  little  cop- 
per sulphate,  which  precipitates  it,  and  permits  any  putrid  smell  to  be 
perceived. 

The  Society  of  Public  Analysts '  recommends  heating  the  water  in  a 
wide-mouthed  stoppered  bottle  to  100°  F.  (38°  C).  This  may  be  done  by 
immersing  it  in  water.  Any  particular  smell  should  be  recorded,  if  dis- 
tinctly recognized — Avith  its  degi-ee  of  intensity,  such  as  nil,  very  slight, 
dight,  marked,  etc.,  as  the  case  may  be.  Sometimes  an  offensive  smell  is 
detected  on  boiling,  which  is  not  otherwise  jDcrceived.^ 

Although  the  physical  characters  give  only  an  imperfect  idea  of  the  value 
of  a  water,  they  are  yet  important  when  no  further  examination  can  be 
made.  If  a  water  be  colorless,  clear,  free  from  suspended  matter,  of  a 
brilliant  (or  adamantine)  lustre,  devoid  of  smell  or  taste,  except  such  as  is 
recognized  to  be  the  characteristic  of  good  potable  water,  we  shall  in  the 
large  majority  of  cases  be  justified  in  pronouncing  it  a  good  and  whole- 
some water  ;    whilst,  according  as  it  deviates  from  these  characters,  we 

"  Dr.  F.  de  Chaumont,  Army  Medical  Report  for  1862  (vol.  iv.,  p.  355). 

'  Arguing-  from  the  apparent  preference  many  persons  have  for  water  containing 
some  saline  matter,  Wanklyn  has  suggested  the  addition  of  sodium  chloride  to  drink- 
ing water,  to  the  extent  of  50  grains  per  gallon. 

"  N.B. — Where  the  letters  S.P.A.  occur,  they  mean  "  Society  of  Public  Analysts," 
and  refer  to  rules  published  in  the  Analyst,  July  and  August,  1881. 

*  See  Dupre,  Analyst,  1878,  p.  2(35. 


WATEE.  69 

shall  be  proportionately  justified  in  regarding  it  witli  suspicion.  Sus- 
pended matter  is  probably  tbe  most  dangerous,  but  it  may  well  be  that 
minute  particles,  the  "  resting  spores  "  of  disease-causing  organisms,  may 
exist  without  revealing  themselves  by  any  visible  tiu'bidity  (or  even  to 
a  cui'sory  microscopic  examination)  ;  nor  must  we  shut  our  eyes  to 
the  possibility  of  hurtful  dissolved  substances,  so  that  when  our  opinion 
of  a  water  is  based  only  on  its  physical  characters  the  fact  ought  to  be 
duly  recorded. 

Sub-Section  IE. — Examixation  of  Suspentjed  Matters. 

The  suspended  matters  may  be  either  mineral  (sand,  clay,  chalk,  fine 
films  of  mica,  iron  peroxide),  or  dead  animal  or  vegetable  matters,  or  h^ing 
creatures  (plants  and  animals). 

To  determine  the  Nature  of  the  Suspended  Matters. 

Pour  some  of  the  water  into  a  long  glass  as  ah-eady  described,  and  ob- 
serve its  appearance.  Suspended  sand  or  clay  gives  a  yellow,  or  yellow- 
white  turbidity  ;  vegetable  humus  and  peat  give  a  darkish,  sewage  gives  a 
hght  brown  color  ;  but  the  color  or  tui'l^idity  alone  is  a  very  insufficient 
test.  Then  boil  the  water,  and  poui'  it  back  into  the  long  glass.  Sand, 
chalk,  and  heavj'  particles  of  the  kind  will  be  deposited  ;  finely  suspended 
sewage  and  vegetable  matter  is  httle  afiected,  unless  it  be  a  chalk-water, 
when  the  deposit  of  calcium  carbonate  may  carry  c1o'\\ti  the  suspended 
matter.  When  the  water  is  commencing  to  boil,  smell  it  to  see  if  there  is 
any  trace  of  sewage. 

^Microscopic  Exajjen-atiox.  ^ 

The  examination  vdth  the  microscope  can,  however,  alone  give  accurate 
information  of  the  natui'e  of  the  suspended  matters.  Very  high  powers 
(1,000  or  1,200  diameters)  are  necessary  for  a  complete  examination,  though 
lower  powers  will  give  much  information. 

If  the  matter  is  entirely  suspended,  a  drop  of  the  water  must  be  taken 
at  once  ;  but  when  it  can  be  obtained,  a  little  of  the  sediment  is  more  sat- 
isfactory. To  get  a  sediment,  the  water  should  be  placed  in  a  conical  glass 
(the  space  of  which  ought  to  be  rounded,  -not  pointed,  at  the  bottom),  care- 
fully covered  and  allowed  to  stand  for  a  few  houi's  ;  and  the  upper  part 
of  the  water  is  then  poiu-ed  away  or  siphoned  off.  In  special  cases,  where 
it  is  important  to  know  the  exact  condition  of  the  suspended  matters,  be- 
fore they  undergo  change  by  the  action  of  the  atmosphere  of  the  room 
or  laboratoiy  where  they  may  be  kept,  they  should  be  collected  in  vacuum 
tubes  and  sealed.  A  very  small  amount  of  sediment  can  be  thus  got 
at.  An  immense  number  of  dead  and  h"\ing  things  are  often  found  in 
water,  which  it  would  be  impossible  to  enumerate,  but  which  may  be  con- 
veniently considered  under  two  great  and  several  minor  divisions.  The 
best  kind  of  pipette  for  taking  up  the  sediment  for  transfer  to  the  glass 
shde  is  a  plain  straight  tube,  without  bulb  and  without  any  narroviing  to 
a  point  at  either  end  ; — the  diameter  may  be  from  Jg-  to  -|  of  an  inch  (1^ 
to  3  millimetres). 

'  For  a  good  resume  of  this  part  of  the  examination,  reference  may  be  made  to 
Professor  Macdonald's  excellent  work.  A  Guide  to  the  Microscopic  Examination  of 
Drinking-water,  by  J.  D.  Macdonald,  R.N.,  F.E,. S.,  Deputy  Inspector-General  of 
Hospitals  and  Fleets,  Professor  of  Naval  Hygiene,  Army  Medical  School. 


70  PRACTICAL    HYGIENE. 


1.    INANIMATE  SUBSTANCES, 

(a)  Mineral  particles  may  be  easily  known  ;  sand  appeai-s  as  large  angu- 
lar particles,  often  showing  distinct  conchoidal  fracture  ;  clay  and  marl  as 
round  smooth  globules  unafl'ected  by  acids ;  carbonate  of  calcium  (chalk) 
sometimes  smooth,  but  often  crystalline,  soluble  in  acids  with  effervescence. 
Ii'on  peroxide  aj^pears  in  reddish  brown  masses  of  an  amoi-jihous  charac- 
ter ;  it  is  easily  dissolved  in  acid,  and  strikes  a  deep  blue  with  the  feri-o- 
cyanide  of  potassium  (yellow  prussiate). 

(b)  Vegetable  rnatters :  portions  of  wood,  leaves,  bits  of  the  veins, 
parench}Taa,  or  ducts  are  easily  recognized.  When  vegetable  tissue  is  more 
decomposed  nothing  is  seen  but  a  dark,  opaque,  structureless  mass.  Any 
dark  foi-mless  mass  of  this  kind  in  water  is  almost  certainly  decayed  vege- 
table matter.  Bits  of  textile  fabrics  (cotton,  linen)  are  not  uncommon,  and 
are  important  as  indicating  that  the  water  is  contaminated  with  house 
refuse.  So  also  the  cells  of  the  potato,  or  spii-al  threads  of  cabbage  and 
other  vegetables  used  by  men,  are  of  value  as  indications  of  the  same  kind. 
Carbonaceous  masses  also  occm*,  either  portions  of  soot  from  coal  smoke, 
or  bits  of  chaiTed  wood.  Sometimes  fragments  of  pajjer  are  met  with, 
probably  washed  into  the  water  from  drains  or  cesspools. 

((■)  Animal  matters,  consisting  of  bits  of  wool,  haii',  and  remains  of 
animals  of  all  kinds,  such  as  wings  and  legs  of  insects,  spiders  and  their 
webs,  jDortions  of  the  skin  of  water  animals,  or  of  fish,  etc.,  ai"e  not  uncom- 
mon. Sewage  matters  having  a  darkish  brown  or  reddish  color,  and  often  in 
globular  masses,  and  thus  distinguishable  from  the  flatter  and  more  spread- 
out  vegetable  matter,  are  sometimes  seen.  In  the  London  water,  as  sup- 
plied thirty  years  ago,  Hassall  recognized  these  little  "ochreous"  masses, 
and  found  that  nitric  acid  brought  out  a  pink  tint.  He  thought  them  to 
be  portions  of  muscular  fibre,  tinged  with  bile.  Epithelium  (from  the  skin 
of  men)'  and  hairs  of  animals  are  not  unfi-equent.  The  identification  of  these 
matters  is  of  moment,  as  indicating  the  particular  source  of  the  contamina- 
tion. Anytliing  which  can  be  imequivocally  traced  to  the  habitations  of 
men  must  always  cause  the  water  to  be  regarded  with  suspicion,  as,  if  one 
substance  from  a  house  can  find  its  way  in,  others  may  do  so  too. 

2.    LIVING   ORGANISMS.'' 

These  are  often  found  in  the  sediment,  but  sometimes  also  float  in  the 
water  above  the  sediment.  They  are  almost  innumerable,  and  as  inmiature 
fonns  and  various  stages  of  development  are  seen,  it  is  often  difficult  or 
imj)ossible  to  name  all  of  them. 

{d)  Bacteria,  vibriones,  or  microzymes. — Under  these  .terms  are  meant 
the  small  points  or  jointed  rods,  sometimes  moving  rapidly,  sometimes 
slowly  or  motionless.  Distinctions  are  made  between  these  three  by  some, 
while  by  others  the  three  terms  are  used  as  synonyms.^  High  powers  (and 
preferably  with  immersion  lenses)  are  required  to  see  them  properly.    When 


'  Epitheliam  from  tlie  skin  breaks  down  slowly  in  water  ;  soakage  for  many  months 
does  not  destroy  it.  Epithelium  from  the  mouths  of  cattle  is  sometimes  found.  This 
was  the  case  in  some  water  examined  at  Netley,  got  from  a  catch-pit  in  Parkhurst 
Forest. 

'  Numerous  plates  of  the  various  organisms  found  in  the  Thames  water  have  been 
given  by  Hassall.  (Micrt  scopic  Examination  of  the  Water  supplied  to  Loudon,  by  A. 
H.  Hassall.  M.D.,  1860.     Food  and  its  Adulteration,  by  the  same  author,  187(J.) 

*  Frequently  spoken  of  as  Bactei-oids  and  smaller  forms  as  Bacteriform  puncta. 


WATEE.  71 

tiiey  appear  in  water  it  is  necessary,  as  Lex  '  lias  shown,  that  besides  oxy- 
gen three  conditions  must  be  present — (1)  an  organic  carbonaceous  sub- 
stance ;  (2)  a  nitrogenous  substance,  which  need  not  be  organic — a  nitrate, 
for  example,  will  well  nouiish  bacteria,  and  is  reduced  to  nitrite  by  their 
growth ; "  (3)  a  phosphate,  which,  however,  may  be  in  exceedingly  small 
quantity.  The  bacteria  may  either  originally  exist  in  the  water,  or  be  in- 
troduced. Burdon-Sanderson's  expeiiments,  however,  are  not  favorable  to 
the  introduction  of  bacteria  fi'om  the  air,  though  large  numbers  of  cells 
which  seem  to  belong  to  the  same  class  can  be  obtained  from  the  air. 
It  appears  from  Bmxlon-Sanderson's  observations  that  the  germs  (if  the 
term  be  allowed)  of  hacteria  may  exist  in  water  and  be  indetectable  by  the 
highest  microscopic  powers,  or  even  by  Tyndall's  test  of  the  electric 
beam.  To  detect  these  the  test  by  cultivation,  or  what  may  be  called  the 
microzyme  test  for  icater,  can  be  employed.  Take  a  little  recently  prepared 
clear  Pasteur's  fluid,  ^  boil  it,  and  put  one  or  two  C.C.  into  a  test-tube  pre- 
viously strongly  heated  to  356°  Fahr.  (180°  C),  drop  in  three  or  four  di-ops 
of  the  water,  and  close  the  mouth  of  the  tube  with  cotton  wool.  If  micro- 
zymes  or  their  germs  exist  in  the  water,  in  a  few  days  the  hcj^uid  becomes 
milky  from  countless  bacteridia. 

As,  however,  even  distilled  water  and  the  purest  ice-water  may  contain 
bacteridia,  tlie  test  cannot  be  used  as  a  positive  indication  of  good  or  bad 
water,  except  in  connection  with  others,  and  with  due  regard  to  tempera- 
ture, which  has  a  great  effect.  AU  it  will  show  is,  that  the  greater  or  less 
rapidity  of  appearance  of  opalescence  will  prove  that  microzymes  are  more 
or  less  abundant. 

At  present  there  seems  no  reason  to  think  that  common  (putrefactive) 
bacteria  and  vibriones  are  in  themselves  hurtful,  but  they  indicate  the  exist- 
ence of  putrefactive  organic  matter,  which  is  a  danger.  But  there  may  be, 
and  jDrobably  are,  forms  of  bacteria  which  are  more  dangerous,  and  which 
may  hereafter  be  distinctly  differentiated  by  careful  cultivation. 

Both  spirilluvi  and  bacillus  can  also  be  often  detected  in  water.  In  ad- 
dition to  microzymes  the  water  wdU  always  contain  various  aUied  protozoa, 
which  are  usually  termed  monads  or  zoogloea,  and  which  seem  to  have  the 
same  significance  as  bacteridia^ 

(e)  Fungi. — In  any  water  which  contains  nitrogenous  matter  (of  animal 
natiire,  at  any  rate),  sugar,  and  a  little  phosphate, /an^i  will  soon  appear, 
and  the  spores,  no  doubt,  enter  from  the  atmosphere.  Spores,  spore-cases, 
and  delicate  mycehum  can  be  seen,  and  often  bacteridia  co-exist.  If  fungi 
are  found  in  water  they  indicate  impurity,  and  such  water  should  not  be 
used  if  it^can  be  avoided,  or  should  be  purified.  °  Boihng  does  not  kill  the 
fungi,  according  to  Heisch ;  charcoal  filtration  does  so,  according  to  the 
same  observer,  though  later  experience  has  shown  that  this  is  not  always 

1  Centralblatt  fiir  die  Med.  Wiss.,  No.  20.  1872,  p.  305. 

^  Eventually  the  nitrite  disappears,  nitrogen  being  liberated. 

^  Pasteur's  fluid  is  composed  of  10  grammes  of  crystallized  sugar ;  5  grammes  of  am- 
monium tartrate  ;  1  of  well-burnt  yeast  ash,  and  100  C.C.  of  distilled  water.  It  should 
be  quite  clear.     It  is  a  capital  breeding-ground  for  microzymes  or  fungi. 

*  According  to  Dr.  Macdonald,  "  All  analogy  would  go  to  indicate  that  the  Zoogloea 
form  of  Bacterium  termo  may  be  regarded  as  the  primary  or  normal  state  of  this  or- 
ganism, the  surrounding  gelatinous  matter  being  simply  the  representative  of  that 
which  forms  the  indefinite  frond  of  Microlialoa,  or  Palmella,  for  example "  (op.  cit. , 
p.  14). 

8  In  the  cases  of  malarious  fever  at  Tilbury  Fort  (Army  Med.  Reports,  vol.  xvii  ) 
fungoid  structures  were  found  in  the  water  whose  use  was  coincident  with  the  fever, 
but  were  absent  from  the  water,  following  on  whose  use  the  fever  ceased. 


72  PRACTICAL    HYGIENE. 

the  case.  Animal  charcoal  adds  some  phosphate  to  the  water,  and  in  this 
way  aids  the  growtli  of  fungi.  Spongy  ii'on  gives  off  no  phosphate,  and 
water  filtered  through  it  is  quite  freed  irom  fiaigi. 

Heisch  '  states  that  sewage  matter  in  water  gives  rise,  when  sugar  is 
added  to  the  water,  to  a  pecuhar/«»(/(<^',  which  he  describes  as  formed  of 
very  small,  perfectly  spherical  transparent  cells  arranged  in  graj^e-like 
bundles  ;  they  gi-ow  rapidly  into  myceha,  and  are  attended  A\-ith  the  special 
chai-acter  of  producing  the  odor  of  butyric  acid.  The  mycehum  soon  dis- 
appears. 

Dr.  Frankland  doubts  whether  fungi,  which  are  readily  produced  by 
adding  sugar  to  sewage  water,  are  distinctive  of  sewage,  as  appai'ently 
similar  cells  are  caused  by  other  animal  matters. 

The  identification  of  the  sjDores  oi fungi,  and  even  of  the  mycelium  as 
seen  in  water,  is  so  extremely  difficult  that  it  Avould  be  at  present  rash  to 
affirm  that  any  fungoid  elements  are  distinctive  of  fecal  mattei*.  The 
butjTic  acid  smell  also  is  given  off  by  so  many  impure  waters  that  it  could 
hai'dly  be  used  as  a  test  for  f;i?ces. 

(/)  Ahjce,  diatoms,  and  desmids  are  found  in  almost  all  running. streams, 
and  are  also  seen  in  many  well  waters.  They  cannot  be  held  to  indicate 
any  great  impiu'ity  ;  and  to  condemn  water  on  account  of  tlieir  presence 
would  be  really  to  condemn  all  waters,  even  rain,  in  which  minute  algoid 
vesicles  ( protucocci)  are  often  found. 

The  forms  of  the  various  confci-cte  in  water  are  very  numerous  ;  some 
being  colored  gi'een,  whilst  at  other  times  they  are  cpiite  colorless,  round, 
isolated,  or  clustered  vesicles.  The  immature  forms  may  not  be  easy  of 
identification.  The  diatoms  are  always  readily  recognized  and  identified. 
It  may  be  stated  generally  that  organisms  of  a  grass-green  color,  such  as 
the  green  algce,  need  not  be  objected  to  ;  but  the  bluish  green,  such  as  the 
Oscillatorians,  Nostoc,  etc.,  are  less  desirable  ;  not  that  they  are  probably 
directly  injurious,  but  as  indicating  an  impure  water,  and  as  being  apt  to 
give  rise  to  an  unpleasant  ("pig-pen")  odor.  Leptothrix  ochrwa,  which 
was  at  one  time  thought  to  be  connected  with  a  special  disease  poison,  is 
really  harmless,  and  is  mostly  found  in  waters  containing  a  good  deal  of 
iron  peroxide  ;  such  waters  are  usually  singulaii}'  free  from  noxious  organic 
matter. 

(g)  Ehizopoda,  especially  amcehce  and  similar  forms,  may  often  be  de- 
tected with  high  powers.  They  appear  to  indicate,  like  lyacteridia,  the 
existence  of  putref;sing  substances,  but  this  is  not  yet  certain.  They  are 
not  found  in  first-class  waters. 

(h)  Euglente  (of  different  species,  such  as  E.  viridis,  E.  p)iirum,,  etc.) 
are  found  in  many  waters,  especially  of  ponds  and  tanks."  Cilitited,  free, 
and  rapidly  moving  infusoria,  belonging  to  several  kinds  of  common  pro- 
tozoa, such  as  kolpoda,  paramecium,  coleps,  stentor,  kerona,  sti/lonychia, 
oxytricha,  etc.,  are  also  found.  The  abundance  of  these  bodies  indicates, 
of  course,  that  the  water  contains  food  for  them,  and  this  must  be  either 
vegetable  or  animal  organic  matter,  but  the  mere  presence  of  these  infusoria 
will  not  show  which  it  is.  Hassall  noticed,  however,  in  1850,  that  the 
Thames  water  below  Brentford,  where  it  was  mixed  with  sewage,  swarmed 
ivith  paramecia,   while  at  Kew,  where  the  water  was  fi'eer  from  sewage 

'  CTaemical  News,  June,  1870. 

2  There  appears  reason  to  believe  that  all  or  most  of  the  flagellate  animalcules  are 
vegetable,  and  ihe  minuter  (such  as  monus)  aie  probably  connected  with  the  reproduc- 
tion of  higher  forms,  such  as  fungi. 


WATEE. 


73 


matters,  they  had  almost  disappeared.  Subsequent  observations  have  not, 
however,  proved  the  relation  between  paramecia  and  animal  matter  in  the 
water  to  be  sufficiently  constant  to  allow  the  former  to  be  used  as  a  test  of 
the  latter.  Fixed  or  slow  moving  infusoria,  as  the  vorticellce,  are  also  often 
seen  in  river  waters. 

In  many  waters  the  living  objects  in  the  above  five  classes  comprise  all 
that  are  likely  to  be  seen,  but  in  the  other  cases  there  are  animals  of  a 
larger  kind. 

(i)  Hydrozoa,  especially  the  fresh-water  polyps,  are  common  in  most 
stUl  waters,  and  do  not  indicate  anything  hiu'tful. 

{k)  Worms,  or  their  eggs  and  embryos,  belonging  to  the  class  Scolecida, 
may  occur  in  water,  and  are  of  gTeat  importance.  The  eggs  and  joints  of 
the  tape-worm,  the  embryos  of  Bothriocephali,  the  eggs  of  the  round  and 
thread  worms,  and  perhaps  the  worms  themselves,  the  Guinea-worm,  and 
other  kinds  of  Filaria  ;  the  eggs  of  Dochmius  duodenalis,  and  other  disto- 
mata,  and  the  embryos  of  Bilharzia,  have  all  been  recognized  in  water, 
though  it  has  not  yet  been  shown  that  in  all  cases  they  can  be  thus  intro- 
duced into  the  human  body.  That  Filaria  sanguinis  hominis  may  be  taken 
in  drinking-water  is  most  probable,  seeing  that  its  host,  the  mosquito,  is 
developed  in  water,  the  larvae  of  the  latter  being  found  in  great  quantity  in 
tanks  and  cisterns.  Worms  themselves  cannot  well  be  overlooked,  but 
both  eggs  and  the  free-moving  embryos  are  sometimes  difficult  of  identifi- 
cation. The  greatest  care  should  be  used  in  examining  water  to  detect  ova. 
In  India,  the  abundance  of  minute  Filarice  has  led  to  the  general  term  of 
"  tank  worm  "  being  applied. 

The  jjresence  of  even  common  Anguilluloe  in  water  shows  generally  an 
amount  of  impiu'ity,  and  such  a  water  must  be  regarded  with  great 
suspicion.  Small  leeches  also  are  not  imcommon  in  both  still  and  running 
waters. 

The  wheel  animalcules  are  common  enough,  and  cannot  be  regarded  as 


Fig.  2. 


Fig.  3. 


very  important,  though  certainly  when  they  exist  there  must  be  a  good  deal 
of  food  for  them,  and  consequently  impurity  of  water. 

(l)  Entomostraca  (such  as  the  water  flea,  Daphnia  pulex,  Fig.  2  ;  Cyclops 
quadricornis,  Fig.  3  ;  Sida,  Moina,  Polyphemus,  and  others)  are  very  com- 
mon in  the  spring  ;  they  occur  in  so  many  good  waters  that  they  cannot 
be  considered  as  indicating  any  dangerous  impurity.  It  is  said  that  they 
are  only  found  near  (within  one  or  two  feet)  of  the  surface.  Amphipoda 
(Gammar us  pulex)  may  also  be  met  with  ;  as  weU  as  Isopoda  [Asellus  aquor 


74  PRACTICAL    HYGIENE. 

ticus),  and  Tardigrada  (water  bears),  especially  if  water  that  has  been 
stagnant  gets  washed  into  tanks,  cisterns,  or  water-butts. 

(»))  There  are,  of  course,  many  other  tolerably  large  animals  often 
found  in  water ;  the  larvae  of  the  water  gnat  {Dyfiscus),  the  water  boatman 
or  skip-jack  (Notonccta  glauca),  and  the  pupa  form  of  many  insects,  may  be 
found,  but  they  are  chieHy  in  pond  water. 

So  many  are  the  objects  in  water  that  the  observer  will  be  often  veiy 
much  at  a  loss,  first,  to  identify  them,  and  secondly,  to  know  what  their 
presence  implies.  The  best  way  is  first  to  see  what  objects  appear  to  be 
mineral,  or  non-living  vegetable  substances,  and  to  fix  the  origin  and  esti- 
mate the  quantity  as  far  as  it  can  be  done.  Then  to  turn  to  the  living 
organisms  and  to  look  attentively  for  bacteridia,  aimjehop,  fungi,  and  ova, 
and  small  worms  and  leeches.  If  none  of  these  exist,  the  water  cannot  be 
considered  dangerous.  Cihated  infusoria  of  various  kinds,  Diatom}^,  Den- 
mid  s,  and  Algoe,  are  chiefly  important  in  connection  with  microscopic  evi- 
dence of  decaying  vegetable  matters,  and  with  chemical  tests  showing 
much  dissolved  organic  impurity  in  the  water. 

The  subjoined  plates  show  the  principal  objects  found  in  a  deep  well 
water  (Plate  I.)  ;  in  a  slow  running  stream  (Plate  II.)  ;  in  Thames  water 
taken  in  18G8  above  Teddington  Lock  (Plate  III.) ;  in  water  from  a  spring 
near  Railway  at  Tilbury  (Plate  IV.), 

Chemical  Examination  of  the  Sediment. 

The  amount  of  sediment  is  told  by  taking  two  ecpxal  quantities  of 
water  (say  ^  litre),  evaporating  one  quantity  to  dryness  at  once,  and  the 
other  after  subsidence  and  filtration,  so  that  suspended  matters  are  as  far 
as  possible  sejDarated,  and  then  weighing  the  two  residues.  The  dift'er- 
ence  between  the  two  weights  gives  the  amount  of  the  sediment.  Or  a 
certain  amount  of  water  may  be  allowed  to  stand  until  all  the  sediment 
has  fallen  ;  the  water  is  poured  off,  and  the  sediment  dried  and  weighed. 
If  good  Swedish  filtering  paper  is  obtainable,  the  sediment  may  be  ob- 
tained at  once  ;  two  filters  should  be  moistened  with  dilute  hydrochloric 
acid,  then  washed  with  distilled  water,  and  then  dried.  The  amount  of 
ash  in  one  filter  should  then  be  determined  by  incineration  ;  the  sediment 
should  be  collected  on  the  other  filter,  dried,  weighed,  and  then  incin- 
erated. The  ash  of  the  filter  itself  b(  ing  known,  the  weight  of  the  ignited 
sediment  is  the  total  weight,  less  the  ash  of  the  filter.  If  it  be  wished  to 
carry  the  analysis  farther,  the  sediment  is  incinerated  ;  mineral  matter 
remains,  while  all  animal  and  vegetable  matter,  whether  previously  inani- 
mate or  living,  is  destroyed.  This  matter  of  such  various  origin  is  gen- 
erally stated  under  the  vague  terms  of  organic  or  volatile  matter,  but  this 
gives  no  idea  of  its  origin.  Some  of  this  so-called  organic  matter  may 
have  been  dead  ;  another  portion  liviug.  The  mineral  matter  may  be 
further  determined  by  digesting  in  weak  hydrochloric  acid  by  the  aid  of 
heat ;  the  undissolved  matters  are  silica  and  aluminium  silicate  ;  lime, 
iron,  and  magnesia  will  be  dissolved,  and  can  be  tested  for  as  hereafter 
given, 

Sub-Section  III. — Examination  of  Dissolved  Matters. 

In  all  examinations  of  water,  if  the  sediment  is  not  expressly  referred 
to,  it  is  to  be  understood  that  the  examination  refers  only  to  the'  dissolved 
matters.     These  are  gases  or  solids. 


Description  of  Pla^e  L 

Sediment  from  South  wing  Well,  Netley,  drawn  loith  the  Camera  lueidaa^  the 
distance  of  10  inches  fro^n  the  centre  of  eye-piece  to  paper. 

The  presence  of  infusoria  and  animals  of  low  type  indicates  the  pres- 
ence of  organic  matter,  animal  or  vegetable,  and  it  is  therefore  important 
to  note  their  jDresence  ;  but  it  has  not  at  present  been  shown  that  they-  are 
in  themselves  at  all  hurtful 

aaa  Actinophrys  Sol,  early  and  complete  stages,  x  260. 
h  Supposed  decomposing  amoeba-like  expansions  of  Gromia  fluvi- 

atnis,  X  435. 
c  Fragment  of  cai'bonate  of  lime,  x  435. 
d  Navicula  viridis,  x  435. 
e  Grammatophora  marina  ?  x  435. 
f  Supposed  encysted  stage  of  Euglena  "\iiidis,  x  485. 
g  Pinnate  conferva,   x  780. 
hhh  Fragments  of  decaj-ing  vegetable  matter,  x  65. 
ii  Fragments  of  carbonaceous  substance. 
j  Part  of  conferva  filament.  Conferva  floccosa  ?  showing  the  various 

conditions  of  the  protoplasm  in  the  old  and  new  cells,  x  435. 
k  Part  of  leaf  of  Sphagnum  or  bog-moss,  x  108. 
I  Grammatophora  mai'ina,  x  435. 
771  jMinute  sjiores  with  zoospores  ?  x  435. 
n  Diatoma  hyalinum,  x  435. 
o  Cell  with  dividing  protoplasm,  x  435. 
p  Oxytricha  lingua,   x  260. 
q  Kotifer  vulgaris,  small,  x  108. 
r  Anguillula  lluriatilis,  x  108. 
s  Pei'anema  globosa,  x  108. 
t  Stato  blast  of  a  fresh- water  zoophj'te?  x  108. 
u  Arthrodesmus  incus,  x  435. 
V  IVIinute  Desmidipe,  Scenedesmus  obtusus,  x  780. 
w  OsciUaria  (oscillatoria)  hevis,  x  780. 
X  Homoeocladia  fihf ormis  ?  x  435, 
y  Ankistrodesmus  falcatus,  x  435. 
z  Minute  moving  particles,  x  435. — (?)  Zoosporea 


Plate  I. 


X    65  Too  ^' 

X  108  -oW  ^ 

X  260  T^o  - 

X  4d5    1  oflu  *- 

X  780  ToVff  >- 


Description  oi'  Plate  II. 

Sediment  of  Ditch  Water,  draion  with  the  Camera  lucida  at  the  distance  of 
10  inches  from  eye-piece  to  paper. 

a  Decaying  vegetable  matter,  cellular  tissue,  x  108. 

h  Pleurosigma  formosuiii,  before  di\idiag,  x  170. 

c  Oxytricha  gibba,  x  108. 

d  Ampliileptus  auser,  x  170. 

e  Euglena  \ii-idis,  x  285. 

f  Supposed  urceola  of  some  rotifer,  x  108. 

g  Surii-ella  gemma,  x  108. 

h       Do.         do.        x  65. 

i  Foraminifera,  x  65. 

j  Traclileocerca  linguifera,  x  65. 

k  Small  Planaiia  ?  ovisacs  distended,  x  65. 

I  Navicula  vii-idis,  x  285. 

m  Paramecium  aurelia,  x  170. 

n  Coleps  liirsutus,  x  285. 

o  Pleuronema  crassa,  x  285. 

p  Moniu'a  dulcis,  x  170. 

q  Surirella  splendida,  x  170. 

r  Biddulplna  pulchella,  x  285. 

s  Sui-u-ella  striatula,  x  170. 

t  Rotifer,  Mouolabis  conical?  x  108. 

u  Ai'egma,  spore  cases,  x  285. 

V  Stentor  ceiiileus  ?  do.  v.  x  contracted,  x  170. 

to  Trineiiia  acinus  ?  x  170. 

X  Pinnularia  grandis,  x  170. 

y  GjTOsigma  angulatum  before  dividing,  x  170. 

z  Alyscum  saltans?  x  170. 
aa  Synedra  ulna,  x  170. 
hh  Amplnprora  alata,  x  285. 
cc  Gyrosigma  Spencerii,  x  285. 
dd  Nitzscliia  sigma,  x  170. 
ee  Brachionus  angularis,  x  170. 
ff  Young  Vorticella  ?  x  170. 
gg  Gyrosigma  fasciola,  x  285. 
hh  Traclielius  strictus,  x  285. 

ii  Cocconema  Boeckii,  x  170. 

jj  Confervoid  cell  ?  with  divided  protoplasm,  x  285. 

kk  Euplotes  Charon,  x  170l 


Plate 


Description  of  Plate  IEL 

Drawing  of  Sediment  in  Thames  Water,  taken  just  above  Teddington  Lock,  in 
April,  1878.  Notice  the  evidence  of  impui^ities  from  men,  viz.,  epithe- 
lium, woollen,  cotton,  and  flax  fibres. 

Fig.  1.  Coleps  hirsutus. 

2.  Bodo  grandis. 

3.  Actinophrys  Eicliornii. 

4.  Epithelium  (tessellated). 

5.  Leucoplirys  striata. 

6.  Anguillula  fluviatilis. 

7.  Paramecium  chrysalis,  dividing  (?  sexual  stage). 

8.  Vorticella  microstoma. 

9.  Kerona,  young? 

10.  Vorticella  microstoma  (stemless). 

11.  Paramecium  aurelia. 

12.  Conferva. 

13.  Cocconema  lanceolatum. 
14  Synedra  splendeus. 

15.  Gyrosigma  attenuatum. 

16.  Gomphonema  acuminatum. 

17.  Wool  fibre,  dyed. 

18.  Cotton  fibre,  dyed. 

19.  Conferva  floccosa. 

20.  Hair,  barbed,  of? 

21.  Kerona  mytilus. 

22.  Siliceous  spicule. 

23.  Diatonia  vulgare. 

24.  Fungi  (?  Torula). 

25.  Flax  fibre. 

26.  Arthrodesmus  quadricaudatus. 

27.  Stylonichia?  histrio,  diriding. 

28.  Paramecium  caudatum. 

29.  Woody  fibre,  ?  rootlets. 

30.  Pollen. 

31.  Vegetable  tissue  and  mycelium,  -with  spores. 

32.  Decaying  vegetable  matter. 

33.  Gomphonema  curvatum. 

34.  Spores  of  Fungi  (?  Aregma). 

35.  Ajitherozoid  of  ? 

36.  Encysted  spore. 

Decaying  vegetable  matter  and  infusoria  abundant. 


Plate   III. 


^So 


Plate  IV. 


References. 


a,  a,  a,  Bro-wn  Vegetable  Cells  (probably  Sporangial),  probably  disengaged  gonidia  of 

6,  Scales  of  Epithelium.  lichens  (Leighton). 

c,  Glaucoma  Scintillans. 

d,  Monas  Lens. 

e,  e,  Aspidisca  Denticulata,  or  Coccudina. 
/,/,  Oxytriclia  Gibba  ;  /'  young. 

^,  Vorticella  Convallaria. 

Ti,  Bacterium  Termo  in  a  broad  sheet. 

«,  Localized  Groups  of  a  larger  form. 

k,  Crystalline  Particles,  probably  quartz 


Hammer- 

Somerset 

smith. 

House. 

Greenwich. 

Woolwich. 

45.2 

55.6 

48.3 

4.1 

1.5 

.25 

.25 

15.1 

16.2 

15.4 

14.5 

WATER.  75 

Gases. — Oxygen,  nitrogen,  carbon  dioxide,  hydrogen  sulpLide,  and 
carburetted  hydrogen  are  the  most  usual  gases.  If  the  »three  former 
co-exist,  as  is  generally  the  case,  the  oxygen  is  usually  in  larger  rela- 
tive amount  than  in  atmospheric  air,  as  it  often  reaches  32  per  cent.^ 
The  amounts  of  oxygen  and  carbon  dioxide  depend  so  much  on  varying 
conditions,  such  as  the  amount  of  exposure  to  the  air,  the  growth  or  ab- 
sence of  plant  life,  and  the  presence  of  animals,  as  to  render  the  propor- 
tions, absolute  and  relative,  of  the  gases  so  variable,  that  few  inferences  of 
hygienic  importance  can  be  drawn  from  their  determination.  A  lessen- 
ing, however,  at  one  j)art  of  its  course,  in  the  quantity  of  oxygen  which  a 
certain  water  is  known  to  contain,  may  be  useful,  as  pointing  out  that 
organic  matter  has  been  in  the  water.  ^ 

Thus  Professor  MiUer  found  that  Thames  water  contained  the  follow- 
ing amount  of  gases  in  C.C.  per  litre,  in  its  flow  down  stream  : — 

Kingston. 

Carbon  dioxide,  .  30.3 

Oxygen, 7.4 

Nitrogen, 15. 

The  stability  of  the  nitrogen,  the  increase  in  the  C0„,  and  the  lessen- 
ing of  the  oxygen,  are  well  seen.  If  water  contain  much  CO.,,  bubbles  of 
the  gas  form  on  the  sides  of  the  glass  in  which  the  water  is  j)laced.  So 
far  as  our  knowledge  extends  at  present,  there  seems  to  be  but  little  in- 
formation obtained  by  the  determination  of  the  amount  of  gases  in  water ; 
but  if  it  is  decided  to  do  so,  we  require  a  mercurial  trough,  a  graduated 
tube-measure  to  be  filled  with  mercury  and  inverted  into  the  trough,  a 
flask  and  a  connecting  tube  with  a  bulb  blown  on  it.  The  flask  is  filled 
with  water  and  connected  with  the  bulb-tube  by  an  india-rubber  tube, 
which  is  to  be  closed  by  a  clamp.  Some  water  is  put  into  the  bulb,  and 
boiled  ;  this  is  to  expel  air  from  the  connecting  tube  ;  and  when  this  is 
done,  the  end  of  the  tube  is  put  into  the  mercurial  trough  under  the  ves- 
sel filled  with  mercury,  the  clamp  is  removed  from  the  india-rubber  tube, 
and  the  water  is  cautiously  boiled  for  an  hour.  The  gases  collect  in  the 
mercurial  tube,  and  are  measured  (due  regai-d  being  had  to  temperature 
and  pressure,  and  the  other  corrections)  ;  the  C0„  is  absorbed  by  potash, 
the  oxygen  by  potassium  pyrogaUate,  and  the  nitrogen  is  read  as  the 
residue. 

As  regards  the  CO^,  there  is  an  objection  to  this  method,  as  the  heat 
decomposes  the  calcium  and  magnesium  bicarbonates,  and  therefore  the 
amount  of  CO,  evolved  is  greater  than  existed  in  the  water  as  free  car- 
bonic acid.  On  the  other  hand,  it  is  impossible  by  heat  alone  to  obtain 
all  the  oxygen  and  nitrogen.' 

'  Atmospheric  air,  according  to  Bunsen's  co-efficients  of  absorption,  ■would  dis- 
solve in  water  in  the  proportion  of  65. 1  of  nitrogen  and  34. 9  of  oxygen^ — Wanklyn, 
Wj,ter  Analysis,  p.  103. 

'^  Up  to  recently  Gerardin  considered  that  the  degree  of  oxygen  (oxymetrie)  was 
the  best  test  of  a  water's  purity.  He  has  since  modified  this  view  considerably.  The 
importance  of  the  indication  is  also  greatly  lessened  by  the  fact  that  deep  well  waters, 
of  undoubted  potable  excellence,  yield  extremely  little  oxygen — often  not  more  than 
the  Thames  at  Woolwich. 

^  The  plan  of  determining  the  oxygen  by  means  of  the  sodium  hydrosulphite,  sug- 
gested by  Schiitzenberger  and  G-orardin,  is  ingenious  and  rapid,  but  it  has  the  incon- 
venience of  requiring  the  reagent  to  be  freshly  prepared,  as  ic  will  not  keep.  (See 
Comptes  llendus  de  I'Academie  des  Sciences  ;  Lefort,  Traite  de  chimie  hydrologique ; 
Annales  d' Hygiene,  Janvier,  1877.) 


7G  PRACTICAL    HYGIENE. 

As  this  operation  is  a  rather  delicate  one,  and  requires  some  practice, 
and  as  the  information  it  gives,  in  a  hygienic  point  of  view,  does  not  ap- 
pear to  be  so  nseful  as  that  obtained  by  other  methods,  it  my  be  omitted 
except  in  cases  where  the  amount  of  aeration  is  considered  veiy  important. 
The  amount  of  free  CO.,  can  also  be  determined  approximately  by  the 
soap  solution  subsequently  described.  Dr.  Macnamara  has  proposed '  a 
still  simpler  method  for  the  examination  of  water  in  India. 

Dr.  Fi'ankland  has  proposed  a  very  ingenious  plan  for  extracting  the 
gases  from  water  without  heat.  It  is  an  application  of  the  Sprengel 
pump,  in  which  the  Torricellian  vacuum  of  a  barometer  is  made  to  act  as 
an  air-pump.  The  gases  can  be  extracted  either  at  the  ordinary  or  boil- 
ing temperature.  This  plan  may  be  useful  in  laboratories  Avhere  miach 
■water  analysis  is  carried  on,  but  it  can  hardly  at  present  be  applied  by 
army  medical  officers. 

Hydrogen  sulphide  sometimes  occurs  in  water  as  a  consequence  of  the 
decomposition  of  sulphates  by  organic  debiis,  even  by  the  cork  of  the  bot- 
tles, the  SH.,  being  afterwards  liberated  by  carbonic  acid.  In  some  min- 
eral waters  (Marienbad)  hj'drogen  sulphide  aj^pears  when  algce  are  in  the 
water,  but  not  without.  ^ 

If  the  gas  is  present  in  any  quantity,  it  can  be  detected  by  the  smell. 
Alkaline  sulphides  have,  however,  less  smell.  Both,  even  without  smell, 
can  be  detected  by  salts  of  lead.  A  large  quantity  of  water  should  be 
taken  in  an  evaporating  dish,  and  a  little  clear  lead  subacetate  or  acetate 
allowed  to  flow  tranquilly  over  the  surface.  Black  fibres  of  lead  sulphide 
are  formed.  If  lead  acstate  is  mixed  with  solution  of  soda  until  the  pre- 
cipitate which  at  first  forms  is  redissolved,  a  very  delicate  test-liquor  is 
obtained.  Solution  of  sodivim  nitro-pi-usside  is  also  a  delicate  test,  and 
gives  a  beautiful  violet-purple  color.  As  it  acts  only  on  the  alkaline  sul- 
phides, a  little  solution  of  soda  or  ammonia  must  also  be  added  to  detect 
the  free  hydrogen  sulphide. 

Cai'buretted  hydrogen  in  small  quantity  in  water  is  not  readily  detected, 
but  Tiemann  says  that  warming  the  water  to  110°  Fahr.  will  enable  the 
smell  to  detect  coal-gas,  when  chemical  reagents  fail.  Generally  there  are 
other  impurities,  especially  if  it  be  derived  from  gas  impregnation.  In 
larger  quantity  it  sometimes  bubbles  up  from  the  water  of  stagnant  pools, 
particularly  if  there  be  much  vegetable  matter  ;  and  in  the  cases  of  some 
natural  springs  in  petroleum  districts,  can  be  ignited. 


Dissolved  Solids. 

The  chemical  examination  of  the  dissolved  matters  is  divided  into  the 
qualitative  and  the  quantitative. 


QuALITATrV'E   EXAMINATION    OP   DlSS0L\^ED    SoLIDS. 

The  water  may  be  either  at  once  treated,  or,  in  the  case  of  some  con- 
stituents, it  should  be  concentrated  by  evaporation. 

'  Scheme  of  Water  Analysis  for  India. 

^  Archiv.  fiir  Wiss.  Heilk.,  1864,  No.  III.,  p.  261. 


WATEE. 


77 


Wafer  not  Concentrated. 


Substance  sought 
for. 


Eeaction . 


Lime 


Chlorine 


Sulphuric  Acid . 


Nitric  Acid . 


Nitrous  Acid 


Ammonia 


Reagents  to  be  used,  and  efEects. 


Litmus  and  turmeric  pa- 
pers ;  usual  red  or  brown 
reactions. 


Oxalate  of  ammonium. 
Wiiite  precipitate. 


Nitrate  of  silver,  and  dilute 

nitric  acid. 
White  precipitate  becoming 

lead  color. 

Chloride  of  barium  and  dilute 

hydrocliloric  add. 
White  precipitate. 


Brucine  solution^  audi  pure 

sulphuric  acid. 
A  pink  and  yellow  zone. 


Iodide  of  potassium '  and 
stoj'ch  in  solution  and  di- 
lute sulphuric  acid. 

An  immediate  blue  color. 


Solution  of  metaphenylene- 
diamine  and  dilute  sul- 
phuric acid  (G-riess'  test) 
— a  yellow  color  more  or 
less  immediate  according 
to  amount  of  nitrous  acid. 

Ne-ssler^s  solution.  ^ 
j  A  yellow  color  or  a  yellow 
brown  precipitate. 


Usually  neutral.  If  acid,  and  acidity 
disappears  on  boiling,  it  is  due  to  car- 
bonic acid.  If  alkaline,  and  alkalin- 
ity disappears  on  boiling,  to  ammonia 
(rare).  If  permanently  alkaline,  to 
sodium  carbonate. 

Six  grains  per  gallon  give  turbidity; 
sixteen  grains  considerable  precipi- 
tate. 

One  grain  per  gallon  gives  a  haze  ;  four 
grains  per  gallon  give  a  marked  tur- 
bidity ;    ten    grains,    a   considerable 

precipitate. 

One  and  a  half  grain  of  sulphate  gives 
■     no  precipitate  until  after  standing  ; 
three  grains  give  an  immediate  haze, 
and,  after  a  time,   a  slight  precipi- 
tate. 

The  sulphuric  acid  should  be  poured 
gently  down  to  form  a  layer  under 
the  mixed  water  and  brucine  solu- 
tion ;  half  a  grain  of  nitric  acid  per 
gallon  (=0.7  per  lOO.OUO)  gives  a 
marked  pink  and  yellow  zone  ;  or,  as 
recommended  by  Nicholson,  2  C.  C. 
of  the  water  may  be  evaporated  to 
dryness ;  a  drop  of  pure  sulphuric 
acid  and  a  minute  crystal  of  brucine 
be  dropped  in;  .01  grain  per  gallon 
(=.0143  per  lOO.OOU)  can  be  easily 
detected. 

Add  the  solution  of  iodide  of  potassium 
and  starch,  and  then  the  acid ;  the 
blue  color  should  be  immediate ; 
make  a  comparative  experiment  with 
distilled  water. 

This  is  a  very  delicate  test ;  a  yellow 
color  will  appear  in  the. water  in  half 
an  hour,  if  there  be  only  one  part  of 
nitrous  acid  in  10,000,000  of  water. 


If  in  small  quantity,  several  inches  in 

depth    of   water   should    be    looked 
down  through  on  a  white  ground. 


'  See  Appendix  A,  vol.  ii. 


78 


PRACTICAL    HYGIENE. 


Water  not  Concentrated — Continued. 


Substance  sought 
for. 


Iron 


Beagents  to  be  used,  and  efEects. 


Bemarks. 


Bed  and  yeUoi/j  prussiateJi  of 

pota.<<h,  and  dilute  HCi. 
Blue  precipitate. 


Hydrog-en     Sal-    A  salt  of  lend. 


phide. 

Alkaline     S  u  1  ■ 
phides. 


Oxidizable   mat- 


Black  precipitate. 


Nitroprumde  of  sodium. 
A    beautiful    violet-purple 
color. 


Gold  cliloride. 


ter,   including    Color   varying    from    rose- 
organic  mat-        pink    through    violet    to 


ter. 


Do. 


olive ;    a   dark   violet   to 
black  precipitate. 


Note  the  darkening  of  the 
silver  cMoride  in  testing 
for  chlorine. 


The  red  for  ferrous  and  the  yellow  for 
ferric  salts. 


When  the  water  is  heated  the  smell  of 
hydrogen  sulphide  may  be  percep- 
tible. 

A  black  precipitate  with  lead,  but  no 
color  with  nitroprusside  shows  that 
the  hydrogen  sulphide  is  uncom- 
bined. 

The  water,  which  should  be  neutral  or 
feebly  r.cid.  must  be  boiled  for  twenty 
minutes  with  the  gold  chloride.  If 
no  nitrous  acid  be  present,  the  reac- 
tion may  generally  be  considered  due 
to  organic  matter. 

Compare  with  a  precipitate  produced 
in  a  pure  solution  of  a  chloride. 


JjeSkA.  or  Co^-^er.'^    Ammonium  sulphide.    Dark  Place  some  water  (100  C.C.)  in  a  white 


Zinc. 


color,  not  cleared  up  by 
hydrochloric  acid. 


Hydrogen  Stdphide.  A 
white  precipitate. 

If  zinc  be  in  considerable 
quantity,  it  is  generally 
present  as  bicarbonate, 
and  gradually  forms  a 
film  of  carbonate  on  the 
surface  of  the  water. 
This  film  may  be  col- 
lected and  heated  on  pla- 

.  tinum  foil.  If  a  residue 
remain  yellow  when  hot 
and  white  on  cooling,  the 
presence  of  zinc  is  indi- 
cated. This  reaction  is 
very  delicate.^ 


dish,  and  stir  up  \vith  a  rod  dipped  in 
ammonium  sulphide ;  wait  till  color 
produced,  then  add  a  drop  or  two  of 
hydrochloric  acid.  If  the  color  dis- 
appears, it  is  due  to  iron ;  if  not,  to 
lead  or  copper. - 

This  test  is  not  available  if  there  be 
iron  present,  should  the  water  be 
alkaline.  It  forms,  however,  in  per- 
fectly neutral  waters,  but  not  in  acid. 


'  Sidney  Harvey  C Analyst,  vol.  vi. ,  p.  146)  recommends  smaU  crystals  of  potassium 
bichromate.  According  to  him  -,^7  of  a  grain  per  gallon  gives  an  immediate  turbidity, 
^V  after  fifteen  minutes,  and  jV  after  thirty  minutes. 

'  Wanklyn.  ^  Prankland,  "Water  Analysis,  1880,  p.  44. 


WATEK. 


79 


Water  Concentrated  to  -^j^th  [in  a  porcelain  dish). 


Substance  sought 
for. 

Reagents  to  be  used,  and  effects. 

Remarks. 

Magnesia 

Oxalate  of  ammonium  to  pre- 

A   precipitate    forms    in    twenty-four 

cipitate  lime,  then  after 

hours,   and   is  the  triple   phosphate 

filtration  a  few  drops  of 

either  in  the  shape  of  prisms  or  in 

phosphate  of  sodium,    of 

feathery  crystals. 

chloride    of    ammonium, 

and  of  liq.  ammonia.    A 

crystalline  precipitate  in 

twenty-four  hours. 

Phosphoric  Acid. 

Molybdate    of    ammonium 

Add  the  nitric  acid,   and  stir  with  a 

and  dilute  nitric  acid. 

glass  rod,  then  add  twice  the  quan- 

A well-marked  yellow  color, 

tity  of  molybdate  and  boil. 

and  on  standing  a  pre- 

cipitate. 

Nitric  Acid 

Brucine  test. 

If  the  nitric  acid  is  in  small  quantity, 
it  may  not  be  detected  in  the  uncon- 
centrated  water. 

Silicic  Acid 

Evaporate    to    dryness, 

The  residue  may  be  weighed,  and  thus 

moisten  with  strong  hy- 

the  silica  determined  quantitatively. 

drocTdoric   acid ;    after 

A  little  clay  or  oxide  of  iron  will  be 

standing,  add  boiling  dis- 

sometimes mixed  with  it. 

tilled    water  ;    pour    off 

fluid  ;  dry,  ignite  ;  repeat 

the  treatment  with   hy- 

drochloric acid  and  water; 

dry,  ignite  again,  and  the 

residue  is  silica,  or  sili- 

cate of  aluminium. 

Lead  or  Copper. 

As  before. 

If  quantity  be  very  small. 

Arsenic 

c 

Marshes  or  BeiiucKs  tests. 

Water  should  be  rendered  alkaline  with 
sodium  carbonate  before  concentra- 
tion, then  acidulated  with  hydro- 
chloric acid. 

Zinc 

Evaporate  to  dryness ;  treat 
residue  with  caustic  pot- 

This is  necessary  if  the  quantity  be 
small,  or  if  iron  be  present. 

ash  or  ammonia,  filter  and 

If  a  film  of  carbonate  forms  on  concen- 

test filtrate  with  hydrogen 

tration,  it  may  be  tested  on  platinum 

sulphide;  a  -svhite  precipi- 

foil, as  before  described. 

tate  falls. 

Inferences  from  the  Qualitative  Tests. 

Sometimes  no  time  can  be  given  for  quantitative  determinations,  and 
the  qualitative  tests  are  the  only  means  available  by  which  the  question 
so  constantly  put,  whether  a  water  is  wholesome  or  not,  can  be  in  some 
degree  answered.' 

If  chlorine  be  present  in  considerable  quantity,  it  either  comes  from 
strata  containing  chloride  of  sodium  or  calcium,  from  impregnation  of  sea- 

'  Kubel  and  Tiemann  rely  very  greatly  on  the  qualitative  tests. 


80  PRACTICAL    HYGIENE. 

water,  or  from  admixture  of  liquid  excreta  of  men  and  animals.  In  the 
first  ease  the  water  is  often  also  alkaline,  from  sodium  carbonate  ;  there  is 
an  absence,  or  nearly  so.  of  oxidized  organic  matters,  as  indicated  by  ni- 
tric and  nitrous  acids  and  ammonia,  and  of  organic  matter  ;  there  is  often 
much  sulphm-ic  acid.  These  characters  are  common  in  deep  well  waters. 
If  it  be  fi-om  calcium  chloride,  there  is  a  large  precipitate  with  ammonium, 
oxalate  after  boiling.  If  the  chlorine  be  from  impregnation  with  sea-water, 
it  is  often  in  veiy  large  quantity  ;  there  is  much  magnesia,  and  little  evi- 
dence of  oxidized  products  from  organic  matters.  If  from  sewage,  the 
chlorine  is  marked,  and  there  is  coincident  evidence  of  nitric  and  nitrous 
acids  and  ammonia,  and  sometimes  phosphoric  acid  ;  and  if  the  contam- 
ination be  recent,  of  oxidizable  organic  matters.  A  stream  fouled  by  ani- 
mals or  excreta  may  thus  show  at  different  times  of  the  same  day  diti'erent 
amounts  of  chlorine,  and  this,  in  the  absence  of  rain,  will  indicate  contam- 
ination. 

Ammonia  is  almost  always  present  in  very  small  quantity,  but  if  it  be 
in  large  enough  amount  to  be  detected  without  distillation  it  is  suspicious. 
If  nitrates,  etc.,  be  also  present,  it  is  likely  to  be  from  animal  substances, 
excreta,  etc.  Nitrates  and  nitrites  indicate  previously  existing  organic 
matters,  probably  animal,  such  as  excreta,  remains  of  animals,  etc.;'  but 
nitrates  may  also^  arise  fi'om  vegetable  matter,  although  this  is  probably 
less  usual.  If  nitrites  largely  exist,  it  is  generally  supposed  that  the  con- 
tamination is  recent.  The  coincidence  of  easily  oxidized  organic  matters, 
of  ammonia,  and  of  chlorine  in  some  quantity,  would  be  in  favor  of  an 
animal  origin.  If  a  water  gives  the  test  of  nitric  acid,  but  not  nitrous  acid, 
and  very  little  ammonia,  either  potassium,  sodium;  or  calcium  nitrate  is 
present,  derived  from  soil  impregnated  with  animal  substances  at  some 
anterior  date.  If  nitrites  are  present  at  first,  and  after  a  few  days  disap- 
pear, this  ai-ises  fi'om  continued  oxidation  into  nitrates  ;  if  nitrates  disap- 
pear, it  seems  probable  this  is  caused  by  the  action  of  bacteria,  or  other 
low  forms  of  life.  Sometimes  in  such  a  case  nitrites  may  be  formed  from 
the  nitrates.  Phosphoric  acid,  if  in  any  marked  quantity,  indicates  origin 
from  p)hosphatic  strata  (which  is  uncommon)  or  sewage  impregnation. 
■\Vanklyn  has  ridiculed  the  idea  of  phosphoric  acid  being  present  in  any 
appreciable  quantity  in  water,  if  (as  is  almost  always  the  case)  lime  be  also 
present.  But,  independent  of  the  fact  that  the  reaction  of  phosphoric  acid 
is  obtained  in  water,  Hehner  has  clearly  shown  that  phosphoric  acid  does 
exist  in  appreciable  quantity  as  phosphates,  especially  in  polluted  waters. 
Lime  in  large  quantity  indicates  calcium  carbonate  if  boiling  removes  the 
lime,  sulphate  or  chloride  or  nitrate  if  boiling  has  little  eftect.  Testing 
for  calcium  carbonate  is  important  in  connection  with  purification  'oith 
alum.  Sulphuric  acid  in  large  cpantit}',  with  httle  Hme,  indicates  sul- 
phate of  sodium,  and  usually  much  chloride  and  cai'bonate  of  sodium  are 
also  present,  and  on  evaj^oration  the  water  is  alkaline.  Large  evidence  of 
nitric  acid,  with  little  evidence  of  organic  matter,  indicates  old  contamina- 
tion ;  if  the  organic  matter  be  large,  and  especially  if  there  be  nitrous  acid 
as  weU  as  nitric  present,  the  impregnation  is  recent.  It  may  also  indicate 
the  absence  of  the  nitrifying  ferment  from  the  water. 

'Dr.  Fraakland  ha.s  considered  these  substances  as  the  representatives  of  '"pre- 
vious sewage  contamination."  In  many  cases  they  are  so.  but  it  cannot  be  held  that 
they  are  always  so  ;  any  nitrogenous  suV  stance,  quite  apart  from  sewage,  may  furnish 
them,  so  that  the  phrase  has  been  objected  to,  and  is  better  avoided. 

*  Analyst,  vol.  v.,  p.  135. 


WATER. 


8r 


Tabular  View  of  Inferences  to  he  Drawn  from  Qualitatwe  Examination. 


Oxidizable 

Chlorine. 

matter  by 

aold 
Chloride  or 

Silver 
Chloride. 

Nitrates. 

Nitrites. 

,            .        Phos- 
Ammoma.     ^^^^_ 

Sul- 
phates. 

Classi- 
fication            Remarks, 
of  Water. 

Slight . . 

Slight  . . . 

Nil  

NU  .... 

Nil Nil  .... 

Trace  . . 

Good ...  A  perfectly  pure 

1 

1               1 

1     water. 

Marked. 

Nil     or  Nil 

Nil  .... 

Marked. .  Present.  Trace  . . 

Good ...  A     good    water, 

trace. 

probably    from 
a  deep  well. 

Marked. 

Slight  . . . 

Marked  .. 

Nil   or 

Trace . . .  Trace  . .  Trace  . . 

Usable. .  Probably  old  ani- 

trace. 

1     mal  contamina- 
tion. 

Large  . . 

Slight  . . . 

N  i  1    0  r 

trace. 

NU  .... 

Nil 

Nil  or  Marked, 
trace. 

Usable. .  Probably      some 

1     contamination 

with  sea-water. 

Slight . . 

W  e  1  1  - 

Marked  to 

NU  .... 

Nil 

Nil   or  Nil   or 

Usable..  Probably  vege- 

marked. 

large. 

trace. 

trace. 

•  1     table  impurity: 
1     peat  ? 

Marked. 

Nil     or 
trace. 

Marked  .. 

Nil    or 
trace. 

Marked.. 

Marked. 

Marked. 

Snspi- Probably  a  shal- 
cious.       low   well,    con- 
taminated with 
urine. 

Slight . . 

Marked . . 

Present  .. 

Present. 

Marked.. 

Trace  . . 

Trace  . . 

Impure.  Probably      water 
contaminated 
with    sewer 

gases. 

Marked. 

Large 

Marked  .. 

Marked. 

Marked. . 

Marked. 

Marked. 

Impure.  Water     contami- 
nated with  sew- 
1     age. 

To  the  above  qualitative  tests  would,  of  course,  be  added  the  phj'sical 
characters,  which  would  to  some  considerable  extent  influence  the  conclu- 
sions to  be  drawn.  When  possible,  the  microscopic  appearances  ought 
also  to  be  carefully  noted,  as  the  presence  of  such  substances  as  epithelium, 
house  refuse,  etc.,  will  sometimes  justify  lis  in  condemning  a  water  which 
may  appear  chemically  only  suspicious. 

A  water  containing  in  appreciable  quantity  any  metal  (except  iron), 
other  than  the  alkaline  and  earthy  metals,  is  to  be  condemned. 

A  water  containing  any  gas,  other  than  oxygen,  nitrogen,  or  CO^,  is  to 
be  considered  suspicious,  and  not  to  be  used  without  boiling  or  filtration, 
or  both. 

Quantitative  Examination  of  Dissolved  Solids. 

The  discrepancies  which  are  sometimes  found  in  the  consecutive  anal- 
yses, or  in  analyses  by  two  observers  of  the  same  water,  probably  often 
arise  from  the  difficulty  of  always  separating  the  suspended  matters. 
Consequently  two  samples,  apparently  similar,  may  in  reality  contain  va- 
riable quantities  of  suspended  matters  which-  affect  the  determination  of 
the  solids,  or  influence  other  tests. 

To  avoid  this  source  of  fallacy,  if  the  water  be  sedimentous,  the  por- 
tion to  be  examined  for  solids  should  be  placed  in  a  well-stoppered  bottle 
in  a  dark  place  for  twenty-four  or  forty-eight  hours,  until  all  sediment  has 
subsided,  and  the  clear  water  should  be  then  siphoned  off.  If  the  sedi- 
ment is  too  fine  to  subside,  the  water  must  be  filtered  through  j)aper  (pre- 
viously well  washed  with  weak  hydrochloric  acid,  and  then  vsdth  distilled 
water,  and  then  dried),  but  if  possible  filtration  should  be  avoided. 

Of  the  solids  in  water,  some  are  mineral,  and  derived  fi'om  the  mineral 
Vol.  I.— 6 


82  PRACTICAL    HYGIENE. 

constituents  of  the  soil,  such  as  lime,  magnesia,  and  part  of  the  chlorine, 
and  of  the  sulphiu'ic,  carbonic,  and  siUcic  acids  ;  others  aie  also  inorganic, 
but  are  derived  from  the  remains  of  animals  or  vegetables,  by  oxidation  or 
solution,  or  from  the  atmosphere,  such  as  ammonia,  nitric  acid,  nitrous 
acid,  some  of  the  chloiine,  and  of  the  svdphuric  and  phosphoric  acids. 
Other  constituents,  derived  from  numerous  som-ces,  ai-e  vegetable  or  animal 
matters,  which  are  usually  unstable,  and  are  undergoing  disintegration  and 
oxidation.  They  may  be  nitrogenous  or  not.  The  composition  of  these 
substances  is  doubtless  extremely  various  ;  the  determination  of  the  total 
quantity  is  ditficult ;  the  separation  of  the  difierent  kinds  from  each  other, 
at  present,  impossible. 

The  methods  by  which  the  quantity  of  this  organic  matter  (to  use  its 
famihar  name)  can  be  expressed  have  been  lately  much  debated,  and  even 
now  there  is  no  general  agi-eement ; '  nor,  at  present,  is  there  any  plan  by 

'  The  following  plans  Lave  been  tried  at  successive  times  :  — 

1.  The  estimivticn  by  ig-nition  of  the  dried  solids.  However  useful  ignition  is  as 
indicating  the  presence  of  nitrites,  nitrates,  or  organic  matter,  the  results  are  very 
uncertain  as  regards  quantity,  owing  to  the  loss  of  hygroscopic  water,  the  decompo- 
sition of  carbonates,  and  errors  arismg  in  recarbonating.  the  loss  of  nitrites  ;nd 
nitrates,  and  in  some  cases  of  chlorine,  as  well  as  the  destruction  of  organic  matter. 
Hence  •'  substances  driven  off  by  heat,'  or  "  volatile  substances,"  is  not  an  equiva  eut 
expression  for  '•  organic  matters." 

2.  Precipitation  by  perchloride  of  iron,  weighing,  incinerating,  and  weighing  again. 
The  difficulty  here  is  that  all  the  organic  matter  is  not  precipitated,  and  other  mineral 
substances  may  be. 

8.  The  determination  of  the  nitrogen  and  carbon  in  the  organic  substances.  This 
is  the  plan  proposed  by  Dr.  Frankland,  who  determines  the  nitrogen  in  the  ammonia, 
nitric  and  nitrous  acids,  which  may  be  present,  aud  also  that  in  organic  combination, 
and  in  this  way  gets  at  the  nitrogen,  which  must  have  formed  part  of  the  organic 
matter  ( "  organic  nitrogen  ").  In  the  same  way  the  carbon  existing  other  than  in  the 
shape  of  carbon'c  acid  is  determined  ("organic  carbon  "j.  He  has  proposed  a  most 
ingenious  and  beautiful  process,  the  most  recent  and  best  account  of  which  is  con- 
tained in  his  Water  Analysis  for  Sanitary  Purposes,  p.  59,  1880.  This  plan  requii-es 
so  much  apparatus,  time,  and  skill,  as  to  be  quite  beyond  the  reach  of  medical  offi- 
cers, and  it  would  also  appear  that  in  the  hands  of  even  very  able  chemists  it  gives 
contradictory  results  ;  the  quantities  are  in  fact  so  small,  and  the  chances  of  error  so 
repeated,  that  in  its  present  form  this  really  beautiful  plan  seems  not  adapted  for 
hygienic  water  analysis.  It  is  also  difficult  to  know  what  construction  should  be  put 
on  the  results  ;  a  water  containing  much  non-nitrogenous  organic  matter  may  give  a 
very  much  hirger  amount  of  '•  organic  carbon  "  than  a  water  containing  a  much  smaller 
amount  of  nitrogenous  matter,  and  yet  be  much  less  hurtful. 

4.  The  determination  of  the  nifrogen  of  the  organic  matters  (as  ammonia)  by  means 
of  alkaline  permanganate  of  potassium  (•'  albuminoid  ammonia"),  after  all  ammonia 
existing  as  such  in  the  water  has  been  got  rid  of.  This  plan,  proposed  by  Wanklyn 
and  Chapman,  has  the  merit  of  simplicity  and  rapidity.  It  has  been  objected  to  by 
Frankland  on  the  ground  that  the  whole  of  the  nitrogen  is  not  obtained.  There  is  no 
doubt  of  this;  but  Wanklyn  affirms  that  the  quantity  obtained  is  constant,  and  there- 
fore comparison  between  different  waters  can  be  instituted.  Thudichum  and  Dupre, 
in  their  work  on  Wine  (p.  2(j2),  state  that  they  find  the  albuminoid  ammonia  process 
so  accurate  for  albumen  in  wine,  that  they  use  it  in  preference  to  other  methods.  It 
must  be  confessed  that  this  point  has  not  been  probed  to  the  bottom,  aud  that  espe- 
cially the  relation  of  the  "  albuminoid  ammonia"  to  disease  produced  by  the  water 
has  not  been  yet  made  out  The  '•  albuminoid  ammonia  "  of  pure  potable  water  h;is 
been  simply  taken  as  a  standard,  and  the  wholesomeness  of  other  waters  judged  .  f  by 
reference  simply  to  this.  But  at  the  present  time  it  is  the  most  convenient  ]irocess 
we  have,  and  (with  some  reservation  as  to  the  precise  inferences  to  be  drawn  from  it) 
it  has  been  pretty  generally  adopted. 

5.  Two  "other  processes,  that  of  Dittmar  and  Robinson,  and  that  of  Pupre  and 
Hake,  are  described  in  Frankland's  Water  Analysis,  but  neither  seems  adapted  for  the 
use  of  medical  officers. 

6.  Estimation  of  the  organic  matter  in  terms  of  the  oxygen  required  to  oxidize  it, 


WATER.  83 

■which  dissolved  vegetable  may  be  distinguished  from  animal  matter,  except 
by  reference  to  the  microscopic  characters  of  the  sediment,  to  the  source 
of  the  vi^ater,  and  the  coincident  inorganic  substances. 

The  quantitative  processes  which  appear,  in  a  hygienic  sense,  to  be 
most  useful  are  as  follow  : — 

Determination  of — 

1.  Dissolved  solids,     (a)  Total.     (6)  Fixed,     (c)  Volatile. 

2.  Chlorine. 

3.  Hardness,     (a)  Total     (b)  Fixed,     (c)  Eemovable. 

4.  Free  or  saline  qmmonia  and  nitrogenous  organic  matter. 

(a)  Free  ammonia, 

(b)  Albuminoid  ammonia. 

5.  Oxidizable  matter  and  products  of  organic  oxidation. 

(a)  In  terms  of  oxygen  required  for  total  oxidizable  matter. 

(b)  In  terms  of  oxygen  required  for  organic  matter  only.. 

(c)  Niti'oiis  acid. 

(d)  Nitric  acid. 

6.  Phosphoric  acid  in  phosphates. 

7.  Sulphuric  acid,  silica,  iron,  and  the  alkaline  carbonates,  may  be  deter- 
mined, but  are  seldom  required. 

The  statement  of  results  is  usually  given  in  this  country  in  grains  per 
gallon,  or  in  parts  in  100,000  ;  or  it  may  be  given  in  grammes  per  litre, 
which  is  the  same  as  parts  per  1,000,  and  by  shifting  the  decimal  point  to 
the  right,  parts  per  10,000,  100,000,  or  per  1,000,000  are  obtained,'  It 
is  much  to  be  desired  that  one  uniform  mode  should  be  definitively  adopted, 
in  order  to  avoid  the  confusion  which  at  present  undoubtedly  exists  in  this 
country. 

1.     DETERMINATION    OF    THE    DISSOLVED    SOLIDS. 

{a)  Total  solids. — The  remark  already  made  about  suspended  matters 
must  be  attended  to  ;  if  possible,  obtain  a  clear  water  by  subsidence  rather 
than  by  filtering  through  pajDer.  The  solids  are  determined  by  evapora- 
tion. If  very  good  scales  are  available,  200  C.C.  of  the  water  are  sufficient,^ 
if  the  scales  are  inferior,  500  or  1,000  C.C.  of  the  water  must  be  taken  ; 
then  evaporate  to  dryness  with  a  moderate  heat,  taking  care  that  the  water 

the  permanganate  of  potassium  being  the  oxidizing  agent.  This  process  (originally 
proposed  by  Forchammer  of  Copenhagen)  has  been  much  used  and  much  objected  to, 
and  some  chemists  have  now  given  it  up.  It  gives,  certainly,  only  an  approximation, 
requires  care,  and  will  only  indicate  tl^e  organic  matter  capable  of  oxidation.  Yet  it 
gives  really  useful  information,  as  it  often  adds  additional  evidence  to  Wanklyn's 
method,  and  gives  some  indication  as  to  the  old  or  recent  origin  of  nitric  acid,  and  is 
easy  of  application.  The  objections  urged  against  it  by  Frankland  have  been  recently 
modified,  and  it  is  acknowledged  as  a  process  of  value,  when  properly  applied.  It 
would  be  very  undesirable  to  discontinue  it ;  and  in  those  cases  where,  from  want  of 
apparatus,  the  distillation  necessary  for  Wanklyn  and  Chapman's  method  cannot  be 
done,  it  is  at  present  absolutely  essential,  Kubel  and  Tiemann  reject  both  Frankland's 
and  Wanklyn's  methods  as  untrustworthy,  and  trust  to  modifications  of  the  perman- 
ganate process.  For  further  discussion  of  the  subject,  see  under  "  Organic  Matter," 
later  on. 

'  Grammes  per  litre  are  converted  into  grains  per  gallon  by  multiplying  by  70, 
Milligrammes  per  litre,  if  multiplied  by  .07,  are  brought  into  grains  per  gallon. 
Grains  per  gallon  are  converted  into  parts  per  100,000  by  dividing  by  .7  ;  parts  per 
100,000  are  brought  into  grains  per  gallon  by  multiplying  by  .7. 

For  equivalents  of  the  metrical  weights,  see  Appendix  B,  vol.  ii. 

'■'  Wanklyn  recommends  a  "miniature  gallon"  of  70  C.Cs.,  which,  he  says,  evapo- 
rates in  one  hour.  This  is  too  small  a  quantity  to  work  on,  Becker  of  Rotterdam 
has  introduced  very  good  scales  at  a  low  price. 


84  PEACTICAL    HYGIENE. 

does  Bot  boil,  else  there  may  be  loss  from  spurting.  K  the  smaller  quan- 
tity be  taken,  the  whole  evaporating  may  be  conducted  in  one  vessel  (of 
platinum  if  possible)  ;  but  if  the  larger  amount  must  be  used,  the  evapora- 
tion should  be  commenced  in  a  large  evaporating  dish,  and  the  concentrated 
water  and  dej30sit,  if  any,  transfeiTed  into  a  small  weighed  crucible.  The 
transference  demands  great  care,  so  that  none  of  the  solids  shall  remain 
iucrusted  in  the  evaporating  dish.  All  the  contents  of  the  large  dish  being 
transfeiTed,  evaporate  to  complete  dryness  in  an  air,  water,  or  steam  bath, 
•at  212^  Fahr.  (100°  C).  Weigh  as  soon  as  the  capsule  is  cold,  as  the  dried 
mass  may  be  hygroscopic.  It  may  be  necessary  to  replace  it  in  the  bath 
and  weigh  again  after  an  interval  of  half  an  hour.  If  there  is  no  material 
difference  the  drying  is  completed. 

Professor  Wanklyn  advises  a  very  simple  form  of  steam  bath.  A  com- 
mon two-gallon  tin  can  is  taken,  a  perforated  cork  fitted  in  the  mouth,  and 
a  funnel  passed  through  the  perforation  ;  the  crucible  is  jDlaced  in  the 
funnel,  a  little  roll  of  j)aper  being  j^laced  between  the  funnel  and  crucible 
to  let  the  steam  pass.     Water  is  boiled  in  the  tin  can. 

Bischof 's  bh'd-fountain  apparatus  is  very  convenient  for  evaporation. 

Dr.  Frankland  recommends  that  the  heat  shall  not  be  carried  above 
212°  Fahr.  (100°  C),  while  some  chemists  advise  a  heat  of  over  300'"  (148° 
C).  At  212°  (100°  C),  sufficiently  complete  drying  can  be  obtained  by 
prolonged  exposure,  wlailst  at  the  higher  temperature  we  risk  destroying 
the  organic  matter. 

The  SP.A.  recommend  evaporating  first  in  a  water  bath,  then  drying 
the  residue  at  220°  Fahr.  (104:  .5°  C),  and  finally  cooling  lander  a  desiccator. ' 
It  would  be  well  not  to  exceed  220°  Fahr.  (104.5°  C). 

The  determination  of  the  total  solids  is  an  important  point,  and  should 
be  carefully  done.  It  gives  a  control  over  the  other  quantitative  determi- 
nations, and  if  erroneous  may  make  the  other  conclusions  wrong. 

(6)  Fixed  solids. — Incinerate  the  diied  solids  at  as  low  a  heat  as  pos- 
sible ;  watch  the  process,  and  note  if  there  be  much  blackening,  or  if  any 
fumes  can  be  seen,  or  any  smell  be  perceived  as  of  burnt  horn.  A  jiiece 
of  filtering  paper  dij^ped  in  solution  of  potassium  iodide  and  sta^-ch,  and 
then  dried,  or  a  j^iece  of  ozone  paper,  should  be  held  over  the  crucible  to 
detect  any  nitric  oxide  which  may  be  given  off. 

(c)  Volatile  solids.— The  loss  on  ignition  may  be  stated  as  "  volatile  sub- 
stances." It  consists  of  destructible  organic  matters,  nitrates,  nitrites, 
ammoniacal  salts,  combined  water,  combined  carbonic  acid,'^  and  sometimes 
chlorides.  The  variableness  of  the  composition  of  the  "volatile  sub- 
stances "  has  led  to  the  disuse  of  the  process  by  ignition  as  too  uncertain. 
Combined  with  other  evidence  it  gives,  however,  some  useful  indications.  The 
incinerated  solids  may  be  examined  for  silica  and  iron,  as  hereafter  noted. 

The  statement  of  the  results  may  be  given  in  various  ways,  as  before 
mentioned,  but  the  ratios  most  used  nowadays  are  parts  in  100,000  (equal 
to  centigrammes  per  litre)  or  grains  in  a  gallon  (equal  to  parts  in  70,000). 

Example:  1.   Total  solids. — 200  C.Cs.  dried  as  described  : 

Weight  of  dish  and  residue,  .         .         .         19.27  gTammes. 
of  dish  alone,     ....         19.23 


Difference,         .         .  0.04 

being  grammes  of  total  soHds  in  200-  C.Cs.  of  water. 

'  Tiemann  recommends  150°  to  180°  C,  equal  to  S42°  to  354°  F. 
"^  This  may  be  partly  restored  by  adding  a  little  saturated  solution  of  ammoniuni 
carbonate,  and  then  drying  and  driving  off  the  excess  of  ammonia. 


WATER.  85 

To  bring  to  grammes  per  litre : 

0.04  X  5  =  0.20  =  gTammes  per  litre. 
Shifting  the  decimal  point  two  places  to  the  right,  we  have  20  centi- 
grammes per  htre,  or  20  parts  in  100,000. 
To  bring  to  grains  per  gallon : 

20  X  0.7  =  140  gTains  per  gallon. 
2.  Fixed  solids. — The  above  residue  is  inciaerated,  and  the  CO,  restored 
to  the  earthy  cai'bonates  if  required. 

"Weight  of  incinerated  residue  and  dish,         19.26 
"      '  of  dish  alone,    .         .         .         .  19.23 


Difference,  being  grammes  of  fixed  solids 

in  200  C.C.  of  water,  .         .         .         .  0.03 

0.03  X  5  =  0.15  per  litre  =  15  pai'ts  per  100,000. 
15.  X  .07  =  10.5  grains  per  gallon. 
3.    Volatile  solids : 

Parts  per  100,030.        Grains  per  gallon. 

Total  soHds,  =  20.0  140 

Fixed     "  =  15.0  10.5 


Difference,  being  volatile  solids,       5.0  3.5 

2.    DETEEiJIN'ATIOX    OF    CHLOEIXE. 

Chlorine  may  be  determined  very  rapidly  by  the  volumetric  method. 
For  this  pui*pose  a  solution  of  potassium  mono-chromate  and  a  standard 
solution  of  silver  nitrate  are  required.' 

Take  100  C.C.  of  the  water  to  be  examined  ;  place  it  in  a  glass  vessel 
standing  on  a  piece  of  white  paper  ;  add  1  C.C.  of  potassium  mono-chromate 
solution,  which  must  be  free  from  chloiine,  drop  in  the  silver  nitrate  fi-om 
the  burette,  and  stii"  after  each  addition.  The  red  silver  chi'omate  which 
is  at  fii'st  formed  will  disappear  as  long  as  any  chlorine  is  present.  Stop 
directly  the  least  red  tint  is  permanent.  Neither  the  solution  of  silver  nor 
the  water  must  be  acid  ;  if  the  latter  is  acid,  it  should  be  neuti-alized  with 
a  httle  precipitated  carbonate  of  calcium.  The  number  of  C.Cs.  of  silver 
solution  used  gives  exactly  the  parts  of  chlorine  per  100,000  of  water.  To 
bring  to  gTains  per  gallon,  multiply  by  0. 7. 

Example. — In  100  C.C.  of  water,  1  C.C.  of  potassium,  mono-chromate 
and  1.5  C.C.  of  silver  solution  gives  a  pei-manent  red  tint,  therefore  the 
water  contains  1.5  parts  per  100,000  of  chlorine  ;  1.5  x  0.7  =  1.05  gi'ains 
per  gallon. 

3.    H.\P.DXESS. 

Clark's  very  useful  soap  test  offers  a  ready  mode  of  determining  this  in 
a  manner  cjuite  sufficient  for  hygienic  and  economic  pui-poses.  The  pro- 
cesses with  the  soap  test  may  be  divided  into  ts\'o  headings. 

I.  The  determination  of  the  aggTegate  earthy  salts,  and  free  carbonic 
acid,  as  expressed  by  the  term  toto.l  hardness.  The  aggTegate  determination 
can  be  divided  into  two  kinds  of  hardness,  \iz.,  that  which  is  unaffected 
and  that  which  is  affected  by  boiling,  and  these  are  termed  the  permanent 
and  the  removable  hardness. 

'  Por  the  preparatioa  of  the  solutions;  see  Appendix  A,  vol.  ii. 


86  PRACTICAL   HYGIENE. 

n.  The  determination  of  the  amount  of  certain  constituents,  as  the 
lime,  magnesia,  sulj)huric  acid,  and  free  carbonic  acid.  These  results  are 
only  approximative,  especially  in  the  case  of  the  magnesia ;  but  they  are 
very  useful,  as  they  give  us  enough  information  for  hygienic  purposes,  and 
are  done  in  a  very  short  time. 

Apparatus  and  Reagent  required  for  the  Soap  Test. — Burette  divided  into 
tenths  of  a  cubic  centimetre  ;  measure  of  50  C.C.  or  100  C.C.  ;  stojii^ered 
bottles  of  about  100  C.Cs.  (4  oimces)  capacit3\  Standard  soap  solution, 
1  C.C.  =  2.5  milligrammes  of  calcium  carbonate.' 

Rationale  of  the  Process.  — When  an  alkaline  oleate  is  mixed  with  pure 
water,  a  lather  is  given  almost  immediately ;  but  if  lime,  magnesia,  iron, 
baryta,  alumina,  or  other  substances  of  this  kind  be  present,  oleates  of  these 
bases  are  formed,  and  no  lather  is  given  until  the  earthy  bases  are  thrown 
down.  Free  (but  not  combined)  carbonic  acid  prevents  the  lather.  The 
soap  combines  in  equivalent  proportions  with  these  bases,  so  that  if  the 
soap  solution  be  graduated  by  a  solution  of  known  strength  of  any  kind,  it 
wiU  be  of  equivalent  strength  for  corresponding  solutions  of  other  bases. 
There  are,  however,  one  or  two  points  which  render  the  method  less  cer- 
tain. One  of  these  is,  that,  in  the  case  of  magnesia,  there  is  a  tendency  to 
form  double  salts  (Pla;)^air  and  Campbell),  so  that  the  determination  of 
magnesia  is  never  so  accurate  as  in  the  cases  of  hme  or  baryta.  Carbonic 
acid  appears  to  unite  in  equivalent  proportions  when  it  is  passed  through 
the  soap  solution  ;  but  if  it  be  diffused  in  water,  and  then  shaken  iip  with 
the  soap  solution,  two  equivalents  of  the  acid  unite  with  one  of  soap. 

To  avoid  the  repetition  of  the  term  "tenth  of  a  centimetre,"  it  will  be 
convenient  to  call  each  tenth  of  a  centimetre  one  measure,  and  this  precipi- 
tates 0.25  of  a  milligramme  of  calcium  carbonate.^ 


Processes  ivith  the  Soap   Test. 

(a)  Determination  of  the  total  Hardness  of  the  Water. — Take  50  C.C.  of 
the  water  ;  put  it  in  a  small  stoppered  bottle,  and  add  the  soap  solution 
from  the  burette  ;  shaking  it  strongly  after  each  addition  until  a  thin  uni- 
form beady  lather  spreads  over  the  whole  surface  without  any  break.  If 
the  lather  is  permanent  for  five  minutes,  the  process  is  complete  ;  if  it 
breaks  before  that  time,  add  a  drop  or  two  more  of  the  solution,  and  so 
proceed  until  a  lather  be  obtained  that  is  permanent  for  five  minutes. 

Then  read  off  the  number  of  measures  of  soap  solution  used. 

From  the  total  number  of  measures  (or  tenths  of  a  centimetre)  used,  de- 
duct 2,  as  that  amount  is  necessaiy  to  give  a  lather  with  50  C.C.  of  the 
piu-est  water,  and  this  deduction  has  to  be  made  in  all  the  processes.  The 
soap  solution  which  has  been  used  indicates  the  hardness  due  to  aU  the 
ingredients  which  can  act  on  it ;  in  most  drinking  waters  these  are  only 
lime  and  magnesian  salts,  iron,  and  free  carbonic  acid. 

The  amount  of  this  total  hardness  is,  for  convenience,  usually  expressed 
in  this  country  in  the  manner  proposed  by  Dr.  Clark,  i.e.,  though  depend- 
ent on  various  causes,  it  is  expressed  as  equivalent  to  so  much  calcium 
carbonate  per  gallon,  and  in  Clark's  scale  1  grain  of  calcium  carbonate  per 
gallon  is  called  1  degree  of  hardness. 

This  is  done  as  follows  : — 

'  The  soap  solution  here  recommended  was  suggested  by  Surgeon-Major  Nicholson, 
formerly  R.A. ,  see  Appendix  A,  vol.  ii. 

'  A  weaker  solution  is  often  used,  see  Appendix  A,  vol.  ii. 


WATER.  87 

Each  0.1  CC,  or  in  other  words,  each  measure,  of  our  soap  solution 
corresponds  to  ,25  mgm.  of  calcium  carbonate.  Multiply  this  co-efficient 
by  the  number  of  measures  of  soap  solution  used,  and  the  result  is  the 
hardness  of  50  CC.  of  water  expressed  as  calcium  carbonate.  Then,  as 
we  have  acted  on  one-twentieth  of  a  litre,  multiply  by  20  to  give  the  amount 
per  htre,  and  then  by  0.07  to  bring  the  amount  to  grains  per  gallon. 

Example. — A  lather  was  given  with  3.2  CO.,  or  32  measures  of  the 
soap  solution.  (32—2)  x  .25  x  20  x  0.07  =  10.5  grains  of  calcium  carbon- 
ate per  gallon. 

Hardness  expressed  as  calcium  carbonate  =  10.5°  Clark's  scale  : 

(viz.,  1°=  1  gTain  of  CaCOg  per  gallon.) 

The  same  result  (viz.,  grains  per  gallon)  is  obtained  if  the  number  of 
measures  (less  2)  is  multiplied  by  .35  ;  thus,  32  measures  were  used  : 

(32  -  2)  X  .35  =  10.5. 

The  hardness  is  also  often  expressed  on  the  metrical  system,  as  parts  in 
100,000.  This  is  easily  done  by  taking  one-half  of  the  measures  of  soap 
used,  after  deducting  2  for  the  lather.  Thus,  in  the  previous  example,  32 
measures  were  used : — deduct  2,  there  remain  30  ;  30  -4-  2  =  15  degrees  of 
hardness  on  the  metrical  scale,  or  per  100,000. 

To  convert  metrical  degrees  into  Clark's  scale,  multiply  by  0.7  ;  to  con- 
vert Clark's  scale  into  metrical  degTees,  divide  by  0.7. 

If  the  hardness  of  the  water  exceeds  40  measures  of  the  soap  solution, 
25  CC.  of  water  only  should  be  taken,  and  25  CC  of  distilled  water 
added. 

The  result  must  then  be  multiplied  by  2. 

(b)  The  Permanent  or  Fixed  Hardness.— ^o^iQ.  known  quantity  in  a  flask 
briskly  for  half  an  hour,  and  replace  the  loss  by  distilled  water  from  time 
to  time  ;  allow  it  to  cool  down  to  60°  Fahr.  (15.5°  C)  in  the  vessel,  which 
should  be  corked,  and  determine  hardness  in  50  CC  If  distilled  water  is 
not  procurable,  then  boil  200  CC  down  to  100  ;  take  half  the  remainder  = 
(100  of  unboiled  water)  and  determine  hardness.'  After  deducting  2  meas- 
ures, divide  the  number  of  measures  by  2  for  the  hardness  of  50  CC,  and 
calculate  as  usual. 

By  boiling,  all  carbonic  acid  is  driven  oif ;  all  calcium  carbonate,  excej)t 
a  small  quantity,  is  thrown  down  ;  the  calcium  sulphate  and  chloride  are 
not  affected  if  the  evaporation  is  not  carried  too  far ;  the  magnesium  car- 
bonate at  first  thrown  down  is  re-dissolved  as  the  water  cools.  If  iron  is 
present,  most  of  it  is  thrown  down. 

Example. — Before  boiling,  32  measures,  and  after  boiling  13  measures, 
of  the  soap  solution  were  used  : 

(13  —  2)  X  .25  X  20  X  0.07  =  3.85  degrees  of  Clark's  scale. 
13  —  2  (=  11)  -^  2  =  5.5  degrees  of  the  metrical  scale. 

(c)  Removable  Hardness. — The  difference  between  the  total  and  the 
permanent  hardness  is  the  temporary  or  removable  hardness,  which  in  the 
example  would  be  10.5  —  3.85  =  6.65  degrees  of  Clark's  scale,  and  15  — 
5.5  =  9.5  degrees  of  the  metrical  scale. 

The  amount  of  permanent  hardness  is  very  important,  as  it  chiefly 
represents  the  most  objectionable  earthy  salts — viz.,  calcium  sulphate  and 
chloride,  and  the  magnesian  salts.    The  greater  the  permanent  hardness,  the 

'  If  there  is  much  fixed  hardness  this  process  is  hardly  available. 


S8  PRACTICAL    HYGIENE. 

more  oljjectionable  is  the  "water.     The  pennanent  hardness  of  a  good  water 
should  not,  if  possible,  be  greater  than  3^  or  4°  of  Clai'k's  scale. 
The  determination,  then,  of 

1.  The  total  haixlness, 

2.  The  permanent  or  fixed  hardness, 

3.  The  temporary  or  removable  hardness, 

"will  enable  us  to  speak  positively  as  to  the  hygienic  characters  of  a  "wat^r. 
so  far  as  earthy  salts  are  concerned.' 

'  Delerminntion  of  Certain  Constituents  hy  Soap. — In  many  cases  the  analysis  must 
end  with  the  ahove  processes  ;  but  it  may  be  desirable  to  carry  it  further,  and  to  de- 
termine the  amount  of  some  ingredients  ;  for  example,  lime,  magnesia,  sulphuric  acid, 
carbonic  acid. 

An  approximate  estimate  can  be  given  of  several  of  these  ingredients  by  the  soap 
test,  which  is  sufficient  for  hygienic  purposes  ;  and  an}-  one  who  has  learned  to  deter- 
mine properly  the  hardness  of  a  water  will  be  able  to  carry  on  the  process  into  finer 
details. 

Lime  iy  the  Soap  Test. — Messrs.  L^^ntron  and  Boudet  have  proposed,  after  deter- 
mination of  total  hardness,  to  precipitate  the  lime  by  ammonium  oxalate,  and  then  to 
determine  the  hardness  again.  The  difference  will  be  owing  to  lime  removed.  The 
difficulty  here  is  to  add  enough,  and  not  too  much,  of  ammonium  oxalate,  which  itself 
in  excess  gives  hardness. 

The  best  way  to  perform  this  process  is  to  have  a  perfectly  concentrated  clear  solu- 
tion of  ammonium  oxalate,  and  to  add  to  50  C.C.  of  water  1  drop  for  every  4  measures 
of  soap  solution  used  ;  then  in  other  bottles,  to  add  respectively,  1,  2,  and  3  drops 
more.  Tlien  determine  hardness  of  all  the  bottles,  and  select  the  result  wliich  gives 
the  least  hardness.  In  this  way  we  can  hit  on  the  bottle  which  contains  enough,  but 
not  too  much  ammonium  oxalate.  The  water  need  not  be  filtered,  but  it  should  be 
allowed  to  stand  at  least  for  three  or  four  hoiirs,  or,  better  still,  twenty-four  hours,  be- 
fore the  hardness  is  taken. 

Then  multiply  the  difference  between  the  total  hardness  and  the  hardness  after  the 
addition  of  the  oxalate  by  the  co-efficient  for  lime  ;  this  is  .14  of  a  milligramme,  as  each 
measure  of  the  soap  solution  is  equivalent  to  this  amount  of  lime. 

Example. — Total  hardness 32 

After  lime  precipitated 10 

Difference 22 

22  measures  X  .14  x  2  =  6.16  parts  of  lime  per  100,000,  and  6.16  x  0.7  =  4.312  grains 
per  gallon.  Or  multiply  the  number  of  measures  by  0.28,  this  gives  parts  per  10ti,(lOO  : 
or  bv  .190,  the  result  is  grains  per  gallon.  If  carefully  done,  this  result  will  be  near 
the  truth. 

Magnesia  by  the  Soap  Test. — Bontron  and  Boudet  propose  to  determine  the  magnesia 
by  boiling  the  water  from  which  the  lime  has  been  thrown  down.  All  usual  elements 
of  hardness,  exce])t  the  magnesia,  are  thus  got  rid  of.  This  is  by  no  means  so  accurate 
a  process  as  that  of  the  lime  ;  the  lather  is  formed  much  less  perfectly  and  sharply,  and 
in  addition  the  constitution  of  the  magnesia  and  soap  compound  is  variable.  The  re- 
sult must  be  considered  as  quite  approximative,  but  may  sometimes  be  rendered  more 
accurate  by  diluting  with  distilled  water. 

Take  200  C.C.  of  water  ;  add  to  it  the  number  of  drops  of  solution  of  ammonium 
oxalate  known  to  be  sufficient  by  the  lime  experiment ;  allow  to  stand  for  twenty-four 
hours ;  filter,  boil  for  half  an  hour,  replace  loss  by  distilled  water  ;  allow  to  cool  in  the 
vessel,  which  should  be  well  corked,  and  determine  hardness  in  50  C.C. 

As  the  lime  has  been  thrown  down  and  all  iron  removed,  and  carbonic  acid  driven 
off,  the  hardness  is  owing  to  magnesian  salts  of  some  kind. 

Calculate  as  magnesia,  the  co-efficient  of  which,  for  each  measure  of  soap  solution, 
is  .1,  or,  as  magnesium,  the  co-efficient  of  which  is  .06. 

Example. — Hardness,  after  driving  off  carbonic  acid  by  boiling  and  precipitating 
lime  =  7 

(7—2)  X  .1  x2  =  1.0  part  of  magnesia  per  100,000,  1.0  x  0.7  =  0.7  grain  per  gallon. 
Or  multiply  the  number  of  measures  by  0.2,  the  result  is  parts  per  100,000:   or  by  .14, 
the  result  is  grains  per  gallon. 


WATEE.  89 


4.  DETERMINATION  OP  THE  ORGANIC  MATTERS  AND  THEIR  PRODUCTS  IN  WATER. 

As  already  stated,  the  determination  of  organic  matter  in  water  is  diffi- 
cult, and  many  processes  have  been  proposed.  Some  are  obviously  out 
of  the  question  for  medical  officers,   save  in  exceptional  circumstances. 

Altliougli  this  result  is  approximative,  it  is  really  nearer  the  truth  than  the  deter- 
mination by  weighing  in  the  hands  of  a  beginner. 

Free  Carbonic  Acid  by  the  Soap  Test. — In  order  to  get  rid  of  the  fallacy  from  free 
carbonic  acid  acting  on  the  soap,  Clark  recommended  that  the  water  should  be  well 
shaken  in  a  bottle,  so  as  to  disengage  some  of  the  CO2,  and  then  that  the  air  should  be 
sucked  out.     But  this  does  not  entirely  remove  the  carbonic  acid. 

By  the  soap  test  the  free  carbonic  acid  can  be  determined  in  the  following  way :  — 
Throw  down  all  the  lime  carefully  by  ammonium  oxalate,  without  adding  an  excess, 
and  determine  the  hardness  in  50  C.C.  as  usi^al.  The  hardness  will  be  owing  to  mag- 
uesian  salts,  iron,  if  it  exists  (or  alumina  or  baryta  in  mineral  waters),  and  carbonic 
acid.  If  now,*  the  water,  freed  from  lime,  be  boiled,  and  the  loss  oli  water  replaced  by 
distilled  water,  the  carbonic  acid  will  be  driven  off.  The  hardness  should  he  then 
again  determined.  The  difference  between  the  first  and  second  trials  will  (if  no  iron 
exist  in  the  water)  give  tlie  amount  of  soap  solution  which  had  been  previously  acted 
on  by  the  carbonic  acid. 

Exam/pie. — 1.  Total  magnesian  and  carbonic  acid  hardness. .    =  12  measures. 
2.  Magnesian  hardness   =     7         " 

Carbonic  acid  hardness =     5         " 

1  measure  of  soap  sol.  corresponds  to  .22  milligramme  carbonic  acid.     Therefore, 
.22  X  5  X  20  X  0.07  =  1.54  grain  per  gallon. 

As  2.116  cubic  inches  weigh  one  grain,  multiply  the  number  of  grains  by  2.116  to 
bring  into  cubic  inches  per  gallon. 

1.54x2.116  =r  3.25  cubic  inches. 
Or,  to  shorten  the  calculation,  multiply  the  number  of  measures  of  soap  solution  by 
.65  ;  the  result  is  the  amount  of  cubic  inches  per  gallon. 

5  X  .65  =  3.25  cubic  inches  per  gallon. 

To  state  the  result  in  the  metrical  system,  multiply  the  measures  of  soap  by  0.233  ; 
this  gives  the  volumes  of  CO2  in  100  volumes  of  the  water  ;  or,  multiply  by  233,  which 
gives  the  volumes  in  100,000  vols,  of  water. 

If  much  iron  exists  in  the  boiled  water,  it  must  be  determined,  and  its  amount 
deducted;  one  measure  of  soap  solution  corresponds  to  .14  milligramme  of  iron  (Fe). 

Determination  of  Lime  and  Magnesia  by  Weight. 

It  may  be  desired  to  determine  the  lime  and  magnesia  by  weight,  and  the  following 
processes  can  then  be  used  : 

Lime  by  Weight. — Take  a  known  quantity  of  water  ;  add  ammonium  oxalate,  and 
then  ammonia  enough  to  give  an  ammoniacal  smell.  Allow  precipitate  thoroughly  to 
subside,  and  then  wash  by  decantation,  or  by  throwing  the  precipitate  on  a  small  filter 
of  Swedish  paper,  the  weight  of  the  ash  of  which  is  known.  Decantation  is  recom- 
mended. If  a  filter  is  used,  wash  precipitate  on  filter  ;  dry  ;  scrape  precipitate  from 
filter,  and  place  in  a  platinum  crucible  ;  burn  filter  to  an  ash,  by  holding  it  in  a  strong 
gas  flame,  and  place  it  also  in  the  crucible. .  Heat  the  crucible  to  gentle  redness  for 
fifteen  minutes,  moisten  with  a  little  water,  and  test  with  turmeric  paper.  If  no  reac- 
tion is  given,  the  process  is  done.  If  the  paper  is  browned  (showing  presence  of  caus- 
tic lime),  recarbonate  with  ammonium  carbonate,  drive  off  excess  of  ammonia,  dry, 
and  weigh. 

The  substance  weighed  is  calcium  carbonate,  multiply  by  .56,  and  the  result  is 
lime. 

Mohr's  plan  might  also  be  used,  viz. ,  precipitation  of  the  lime  in  an  ammoniacal 
solution  by  standard  oxalic  acid,  and  then  titration  of  the  excess  of  the  latter  by  per- 
manganate. 

Magnesia  by  Weight, — Take  the  water  from  which  the  lime  has  been  thrown  down  ; 
evaporate  to  a  small  bulk ;  filter  if  there  be  turbidity  ;  add  solution  of  ammonium 
chloride,  and  ammonia  to  slight  excess  ;  then  add  a  solution  of  sodium  phosphate ; 


90  PRACTICAL    HYGIENE. 

Those,  therefore,  are  described  here  which  are  not  only  Hkely  to  give  suf- 
ficient information  for  hygienic  purposes,  but  also  to  be  within  the  range, 
for  the  most  part,  of  the  medical  officer's  appliances. 
The  analysis  may  be  considered  under  two  heads — 

(A)  The  determination  of  rdtrogenous  organic  matters  and  their  pro- 

ducts. 

(B)  The  determination  of   oxidizable  organic  matter,  probably  chiefly 

non-nitrogenous. 

(A)  Includes — 

(a)  The  determination  of  WiBfree,  saline,  or  combined  ammonia. 

(b)  "  of  the  (so-called)  albuminoid  ammonia- 

(c)  .  "  of  the  nitric  acid. 

(d)  "  of  the  nitrous  acid. 

(B)  Includes — 

(e)  The  determination  of  the  oxidizable  organic  matter  by  the  per- 
manganate processes. 


(A)  Determination  of  the  Nitrogenous  Organic  Matters  and  their  Products. 

Determination  of  the  Free  and,  Albuminoid  Ammonia.  — Yoy  this  analysis 
we  require  ' — 1.  A  standard  solution  of  ammonium  chloride,  1  C.C.  of 
which  =  0.01  of  a  milligramme  of  ammonia  (NHJ  ;  2.  Nessler's  solution 

stir  with  a  glass  rod  ;  set  aside  for  twelve  hours  ;  throw  precipitate  on  a  filter,  carefully 
detaching  it  from  the  sides  of  the  glass  ;  wash  with  ammoniacal  water  ;  dry  ;  incin- 
erate in  an  intense  heat ;  weigh,  taking  care  to  deduct  the  ash  of  the  filter  known  by 
previous  experiment.  The  substance  is  magnesium  pyrophosphate ;  multiply  by 
.3603(5  to  get  the  amount  of  magnesia. 

Sulphuric  Acid  by  Weight. — Take  a  known  quantity  of  the  water  (500  to  1,000  CO.), 
acidify  with  hydrochloric  acid  and  evaporate,  but  not  so  far  as  to  run  any  risk  of 
throwing  down  sulphate  of  calcium  ;  filter  ;  and  then  add  chloride  of  barium  ;  allow 
to  stand,  and  wash  the  precipitate  by  decantation ;  dry ;  weigh ;  multiply  precipitate 
by  .34305  to  get  the  amount  of  sulphuric  anhydride  (SO.i)  or  by  .411,  if  it  is  wished  to 
calculate  it  as  SO4. 

Sulphuric  Acid  by  Soap  Test. — This  plan  was  proposed  by  Boutron  and  Boudet,  and 
is  briefly  as  follows  : — The  hardness  of  the  water  being  known,  50  C.C.  of  the  standard 
barytic  solution  (.26  gramme  per  litre)  are  added  to  50  C.C.  of  water,  and  the  mixture 
is  allowed  to  stand  for  twenty-four  hours.  The  hardness  (supposing  no  SO4  were 
present)  would  be  exactly  equal  to  the  original  hardness  of  the  water  and  of  the  ba- 
rytic solution  combined.  But  SO4  being  present,  barium  sulphate  is  precipitated,  and 
there  is  a  loss  of  hardness.  Each  degree  of  loss  equals  .24  mgm.  of  sulphur  tetroxide 
(SO4). 

Example.— Original  hardness 32 

50  C.C.  barytic  solution 22 

54 
After  precipitation 45 

Difference 9 

.24  X  9  X  2  =  4.32  parts  per  100,000  ;  4.32  x  0.7  =  3.02  grains  per  gallon. 

Usually  this  process  gives  good  results.  Occasionally,  from  some  cause  which  is  not 
clear,  the  barium  sulphate  does  not  precipitate.  This  does  not  depend  on  the  amount 
of  sulphuric  acid.  The  ease  with  which  this  process  is  done  renders  it  useful.  The 
barytic  solution  is  only  strong  enough  to  precipitate  6.72  grains  of  sulphuric  acid  (SOj) 
per  gallon,  so  that  half  the  water  only  must  be  taken,  or  less,  if  the  sulphuric  acid  be 
evidently  in  large  amount. 

Short  factors  :  for  SO3  =  0.280,  for  SO4  =  0.336  to  state  as  grains  per  gallon  ;  for 
SO3  =  0.40,  for  SO  4  =  0.48  to  state  as  parts  per  100,000. 

'  For  these  solutions,  see  Appendix  A,  vol.  ii. 


WATER.  91 

as  a  reagent  for  the  detection  of  ammonia  ;  3.  A  solution  of  potassium 
permanganate  and  caustic  potash  ;  4.  Pure  distilled  water. 

(a)  Free  Ammonia. 

Place  in  a  retort  250  C.C.  of  the  water  to  be  examined.  Attach  the 
retort  to  a  Liebig's  condenser,  and  distil  off  about  130  C.C.  ;  collect  1  C.C. 
more  of  the  distillate,  and  test  it  with  a  few  drops  of  Nessler,  to  see  if  any 
ammonia  is  still  coming  over ;  if  so,  the  distillation  may  be  continued 
longer.  Carefully  measure  the  amount  of  distillate  ;  test  a  little  with 
Nessler's  solution  in  o.  test-tube  ;  and,  if  the  color  be  not  too  dark,  take 
100  C.C.  of  the  distillate  and  put  it  into  a  cylindrical  glass  vessel,  placed 
upon  a  piece  of  white  paper.  Add  to  it  1^  C.C.  of  Nessler.  Pour  into 
another  similar  cylinder  as  many  C.C.  of  the  standard  ammonium  cliloride 
solution  as  may  be  thought  necessary  (practice  soon  shows  the  amount), 
and  fiU  up  to  100  C.C.  with  pure  distilled  water  :  drop  in  1^  C.C.  of  Ness- 
ler. If  the  colors  correspond  after  three  to  five  minutes,  the  process  is 
finished,  and  the  amount  of  ammonium  chloride  used  is  read  off.  If  the 
colors  are  not  the  same,  add  a  little  more  ammonium  chloride  so  long  as 
no  haze  shows  itself  ;  if  it  does,  then  a  fresh  glass  must  be  taken,  and 
another  trial  made.  When  the  process  is  completed,  read  off  the  number 
of  C.C.  of  ammonium  chloride  used,  allow  for  the  portion  of  distillate  not 
used,  multiply  by  0.01  and  then  by  4  :  the  result  is  milligrammes  of  free 
ammonia  per  litre,  or  parts  per  million  ;  dividing  by  10  gives  parts 
100,000  ;  multiply  the  latter  by  0.7  to  bring  to  grains  per  gallon. 

Example. — From  250  C.C.  of  water  133  were  distilled  ;  100  C.C.  were 
taken  for  the  experiment ;  4.5  C.C.  of  ammonium  chloride  solution  were 

133 

required  to  give  the  proper  color  ;  then  4.5  x  —    x  0.01  x  4  =  0.2394 

milligramme  of  free  ammonia  per  litre  ;  0.2394  -^  10  =  0.02394  per 
100,000. 

Should  the  color  of  the  distillate  prove  too  dark,  a  smaller  quantity 
may  be  used,  and  made  up  to  100  C.C.  with  distilled  water.  Wanklyn 
recommends  distilling  only  50  C.C,  Nesslerizing  it,  and  then  adding  one- 
third  to  the  result,  on  the  ground  that  (as  he  says)  three-fourths  of  the 
ammonia  come  off  in  the  first  50  C.C.  He  also  states  that  with  smaller 
sized  apparatus  100  C.C.  of  water  give  satisfactory  results.'  The  Society  of 
Public  Analysts  recommend  successive  portions  being  distilled  over,  and 
Nesslerized  until  ammonia  ceases  to  appear.  Practically  we  have  found  at 
Netley  that  the  whole  of  the  ammonia  comes  over  in  the  first  130  C.Cs., 
or  nearly  so. 

The  use  of  permanent  colored  solutions,  corresponding  with  known 
amounts  of  ammonia,  has  been  recommended,  and  caramel  has  been  tried 
at  Netley,  but  the  results  have  not  been  very  satisfactory.  A  calorimeter 
may  be  used  if  i^referred. 

When  a  Liebig's  condenser  cannot  be  obtained,  a  flask  may  be  used 
instead  of  a  retort,  and  the  distillate  conveyed  to  the  receiver  by  a  tube  of 
glass  (or  block  tin)  passing  through  a  vessel  of  cold  water,  which  must  be 
renewed  from  time  to  time.  The  tube  may  be  bent  in  any  convenient 
way,  so  as  to  expose  it  to  the  cooling  water  as  much  as  possible.  Every 
part  of  the  apparatus  must  be  scrupulously  clean  and  well  washed  with 
distilled  water  previous  to  commencing  the  experiment.     The  S.P.A.  rec- 

'  Water  Analysis,  5tlL  edition,  p.  41. 


02  PRACTICAL    HYGIENE. 

ommend  tlint  the  retort  tube  should  be  packed  into  the  condensing  tube 
by  means  of  an  india-rubber  ring  ;  or  it  may  be  done  with  clean  writing- 
paper,  as  Wanklvn  proposes.  In  either  case  the  substance  used  must  be 
quite  clean.  It  is  well  to  wash  the  retort,  flask,  and  glass  tubes  with 
dilute  sulphuric  acid,  and  then  rinse  them  out  clean  with  distilled  water. 
In  distilling,  the  retort  should  be  thnist  well  into  the  flame,  and  the  dis- 
tillation carried  on  rapidly.  If  the  water  is  very  soft  the  addition  of  a 
little  pure  or  recently  heated  sodium  carbonate  may  be  made,  but  in  ordi- 
nary circumstances  it  is  not  necessary,  and  is  not  advisable. 

The  "  free  "  or  "  saline  ammonia  "  represents  the  ammonia  combined 
with  carbonic,  nitric,  or  other  acids,  and  also  what  may  be  derived  from 
urea,  or  other  easily  decomposable  substances,  if  they  are  present.  The 
limit  in  good  Avaters  is  taken  at  0.02  milligramme  per  litre  ;  in  bad  waters 
it  often  reaches  100  times  this  and  more,' 

After  the  distillation  of  the  free  ammonia,  the  residue  of  the  water  in 
the  retort  is  used  for  determining  the  albuminoid  ammonia,  to  be  now 
described. 

(b)  Albuminoid  Ammonia. 

The  object  of  this  process  is  to  get  a  measure  of  the  nitrogenous  or- 
ganic matter  in  water,  by  breaking  it  up  and  converting  the  nitrogen 
into  ammonia  by  means  of  potassium  permanganate  in  presence  of  an 
alkali ;  the  ammonia  can  be  distilled  off  and  estimated  as  above.  It  is  to 
be  understood  that  this  does  not  deal  with  all  the  nitrogenous  matter,  but 
the  results  are  sufficiently  uniform  to  be  useful.  According  to  Wanklyn 
and  Chapman,  the  albuminoid  ammonia  multijDlied  by  10,  gives  a  fair 
approximate  estimate  of  the  nitrogenous  matter  in  water. 

Process. — 25  C.C.  of  the  solution  of  alkaline  jDermanganate  ^  are  added 
to  the  residue  in  the  retort,  after  the  distillation  of  the  free  ammonia,  and 
about  110  to  120  C.C.  distilled  off.  It  is  sometimes  convenient  to  add  a 
little  pure  distilled  water  to  the  residue  if  the  first  distillation  has  been 
carried  rather  far,  "Wanklyn  recommends  successive  quantities  of  50  C.C. 
to  be  distilled  off  and  tested  until  no  more  ammonia  comes  ovei*.  Deter- 
mine the  amount  of  ammonia,  as  was  done  in  the  case  of  the  free  ammonia, 
and  state  the  results  in  this  case  as  albuminoid  ammonia.  In  this  distil- 
lation there  is  sometimes  a  little  difficulty  caused  by  "  bumping,"  especially 
in  the  case  of  bad  waters  ;  to  remedy  this  it  has  been  recommended  to 
use  pieces  of  tobacco-pipe  which  have  been  heated  to  redness  immediately 
before  use.  It  is  bettei',  however,  to  dilute  the  water  if  it  be  a  bad  one, 
and  not  to  distil  too  rapidly. 

(c)   Nitric  Acid. 

Citric  acid  may  be  determined  in  several  ways,  but  two  seem  more 
easily  applicable  than  the  others,  viz.,  1.  Schulze's  aluminium  method 
(modified  by  "Wanklyn  and  Chapman) ;  and  2,  The  copper-zinc  process. 
Both  methods  depend  upon  the  conversion  of  the  nitric  acid  into  ammonia. 

1.  Aluminium  Process. — AVe  require  solution  of  caustic  soda,  perfectly 
free  from  nitrates,  and  aluminium  foil.^  100  C.C.  of  the  water  (50  C.C, 
S.P.A)  are  mixed  with  an  equal  bulk  of  the  soda  solution,  and  jjut  into 
a  retort,  and  a  piece  of  aluminium  foil,  larger  than  is  capable  of  dissolving, 
added.  The  tube  is  weU  corked,  and  the  mixture  left  for  several  hours. 
The  liquid  is  then  distilled  and  Nesslerized  ;  or,  if  the  quantity  of  am- 

*  Wanklyn's  Water  Analysis,  5th  edition,  p.  48.  ^  See  Appendix  A,  vol.  ii. 


VATER.  9  3 

monia  be  very  large,  it  may  be  determined  with  a  standard  acid  solution. 
Precautions  are  suggested  for  the  prevention  of  the  escape  of  ammonia  or 
the  access  of  ammonia  from  the  air,,  but  with  a  good  cork  they  are  hardly 
required. 

2.  Copper-zinc  Process. — A  wet '  copper-zinc  couple  is  prepared,  and 
well  washed  with  distilled  water,  and  afterward  with  some  of  the  water  to 
be  examined.  To  use  it,  put  it  into  a  wide-mouthed  stoppered  bottle,  and 
poTir  in  100  C.C.  of  the  water  to  be  examined  ;  it  is  best  to  fill  the  bottle 
up,  and  to  add  1  per  1,000  of  sodium  chloride,  especially  if  the  water  be 
very  soft.  The  stopper  is  inserted,  and  the  whole  put  aside  for  several 
hours — ten  or  twelve  if  the  temperature  be  below  30"  C.  (86"  Fahr.)  ;  but 
the  process  may  be  hastened  by  warming  up  to  32"  to  38°  C.  (90"  to  100° 
Fahr.),  The  completion  of  the  process  may  be  ascertained  by  the  absence 
of  nitrous  acid,  when  tested  for  by  Griess"  test.  The  water  is  now  to  be 
Nesslerized,  which  can  rarely  be  done  properly  except  after  distillation,  as 
in  the  former  process. 

The  calculation  is  made  by  calculating  out  the  resulting  ammonia  as 
nitrogen  or  as  nitric  acid — the  following  being  the  co-efficients  : 

1  part  of  NH3  =  3.706  of  nitric  acid,  HXO^  =  3.647  of  nitrogen  hex- 
oxide,  NO3  =  3.176,  nitrogen  pentoxide,  XO.  =  0.8235  nitrogen,  N. 

It  is  necessary  to  take  into  account  any  nitrous  acid  or  ammonia  (free 
or  saline)  which  may  be  present,  and  may  have  been  2Dre^•iously  deter- 
mined. Nitrous  acid  (HXO  J  is  to  ammonia  (XHj  as  2.765  to  1  ;  or,  if 
nitrogen  tetroxide  be  taken  (X0„),  then  it  is  to  ammonia  (XH^;  as  2.706 
to  1. 

ExanvpAe. — 100  C.C.  of  water  yielded  0.3371  miUigTamme  of  XH, 
after  treatment  by  either  of  the  above  processes  for  the  reduction  of 
nitrates;  this  was  equal  to  3.371  per  litre.  But  the  sample  had  also 
yielded  0.052  of  free  ammonia,  and  1.27  of  nitrous  acid,  reckoned  as  X0„  ; 
the  latter,  1.27,  divided  by  2.706,  being  eciuivalent  to  0.469  of  XH3  ;  we 
therefore  have 

3.371— (0.052  +  0.469)  =  2.850  ammonia  from  nitric  acid. 


2.850  X  3.706  =  10.562  HXO3 
2.850  X  3.647  =  10.394  XO, 


2.850  X  3.176    =  9.052  X„0. 
2.850  X  0.8235  =  2.347  X.' 


Dividing  these  numbers  by  10,  we  have  parts  per  100,000,  and  multiply- 
ing this  resTolt  by  0.7,  we  have  grains  per  gallon.  The  statement  of  the 
result  as  nitrogen^s  now  becoming  very  general 

{d)  Nitrous  Acid. 

For  the  direct  determination  of  this  the  plan  of  Griess  is  now  recom- 
mended. A  solution  of  metaphenylenediamine  is  prepared,  and  also  a 
dilute  sulphuric  acid,  consisting  of  one  volume  of  strong  acid  to  two  of 
water.  One  C.C.  of  each  solution  is  added  to  100  C.C.  of  the  water  to  be 
examined,  which  is  put  in  a  Xessler  glass  :  a  red  color  is  produced.  An- 
other glass  is  placed  alongside,  and  into  it  are  put  as  much  of  a  standard 
solution  of  potassium  nitrite  as  may  be  necessary,  making  up  the  bulk  to 
100  C.C.  with  distilled  water  ;  then  add  1  C.C.  each  of  the  suliohiuic  acid 
and  the  metaphenylenediamine.     The  remainder  of  the  process  is  carried 

'  In  Frankland's  Water  Analysis,  p.  100,  the  directions  given  are  for  a  cZr?/ couple, 
•which  appears  to  be  an  error.  See  M.  W.  Williams,  Analyst,  vol.  vi.,  p.  36.  For 
preparation,  see  Appendix  A,  vol.  ii. 


94  PRACTICAL   HYGIEN"E. 

on  much  in  the  same  way  as  ordinary  Xesslerizing  for  ammonia.  Cai-e 
must  be  taken  that  the  water  originally  taken  is  not  too  strong,  so  if  the 
red  color  be  too  deep,  smaller  jDortions  diluted  up  to  100  C.C.  must  be 
taken,  until  the  faintest  tint  distinctly  recognizable  is  obtained.  The  stand- 
ard potassium  nitrite'  should  be  of  the  strength  1  C.C.  =  0.01  milli- 
gramme of  NO.,  or  nitrogen  tetroxide.  The  number  of  C.C.  used  gives 
the  miUigrammes  of  XO^  present  in  the  sample  of  water. 

Example. — A  sample  of  water  containing  a  good  deal  of  nitrous  acid 
was  taken,  and  25  C.C,  made  up  to  100  C.C.  with  pure  distilled  Avater, 
were  put  in  a  Xessler  gkiss.  1  C.C.  of  the  sulj^huiic  acid  and  1  C.C.  of 
the  solution  of  metaphenylenediamine  added:  a  distinct  red  color  was 
obtainecL  Into  another  Xessler  glass  7.5  C.Cs.  of  the  standard  potassium 
nitrite  were  put,  made  up  to  100  C.C.  with  distilled  water,  and  the  same 
shade  of  tint  obtained  with  the  solutions  as  above. 

Mgm. 

7.5       X  .01  =  0.075  XO^  in  25  C.Cs.     ■ 
0.075  X     4  =  0.300  NO,  in  100  C.Cs. 

This  equals  0.3  in  100,000  or  0.21  in  1  gallon  ;  multiplying  any  of 
these  results  by  0.304,  gives  the  amount  of  nitrogen  (X). 

The  above  is  now  accepted  as  the  most  accurate  method  of  determining 
nitrites,^  but  some  cai-e  is  requu-ed — for  both  the  water  and  the  coloiing 
solution  must  be  either  colorless  or  be  decoloiized.  It  may  not  be  always 
possible  to  get  the  reagents,  and  then  it  is  best  to  fall  back  upon  the  deter- 
mination of  nitrous  acid  by  the  permanganate  process  to  be  presently  de- 
scribed. 

It  may  be  well  to  mention  here  that  the  method  of  stating  the  results 
vai-ies,  as  in  the  case  of  nitric  acid,  some  reckoning  as  HXO„,  some  as 
N.,05,  and  others  as  X0„.  The  last  is  the  best,  as  it  corresponds  to  CI.  In 
the  same  way  XO,  is  to  be  preferred  for  the  nitric  acid,  SO^  for  the  sul- 
phiiric  acid,  and  PO^  for  the  j^hosphoric  acid. 

(B)  Determination  of  Oxidizable  Matter  in  Water. 

The  oxidizable  matter  in  water  consists  of  oxidizable  organic  matter, 
nitrites,  ferrous  salts,  and  hydrogen  sulphide.  The  last  can  be  easily 
recognized  by  the  smell,  and  got  rid  of  by  gently  warming  the  water.  Fer- 
rous salts  are  rare,  but,  if  present,  they  impart  a  distinct  chalybeate  taste 
to  the  water  if  theii'  amoimt  reaches  the  fifth  of  a  grain  of  ii-on  per  gaUon 
(about  0.3  part  per  100,000).  Generally  theu-  presence  may  be  dis- 
regarded. There  remain,  therefore,  the  oxidizable  organic  matter,  ana 
nitrous  acid  as  nitrites.  For  detennining  these  the  potassium  perman- 
ganate is  veiy  convenient. 

(e,)  Total  Oxidizable  Matter  in  terms  of  Oxygen  required  for  its  Oxidation. 
— A  solution  of  potassium  pennanganate  is  required,  which  in  jiresence  of 
an  acid  is  capable  of  pelding  0.1  mHligi-amme  of  oxygen  for  each  C.C. 

Process. — Take  a  convenient  quantity  of  the  water  to  be  examined,  say 
250  C.C.  ;  add  3  C.C.  of  sulphuric  acid  ;  drop  in  the  permanganate  solu- 
tion from  a  burette  until  a  pink  color  is  established  ;  wai-m  the  water  up 
to  140'  Fahr.  (60^  C),  di'opping  in  more  permanganate  if  the  color  disap- 
pears ;  when  the  tempera tiire  reaches  140^  Fahr.  remove  the  lamp  ;  con- 

'  For  the  preparation  of  the  solutions,  see  Appendix  A,  vol.  ii. 

"See  Franklaud,  Water  Analysis,  p.  40;  also  M.  W.  Williams,  in  Analyst,  vol.  vi., 
p.  36. 


WATEE.  95 

tinue  to  drop  in  permanganate  until  the  color  is  permanent  for  about  ten 
minutes.  Then  read  off  the  number  of  C.C.  used,  multiply  by  0.1  to  get 
the  miUigrammes  of  oxygen,  and  by  4  to  get  the  amount  per  litre. 

Examjjle. — 250  C.C.  of  water,  with  3  C.C.  of  sulphuric  acid,  required 
3.5  C.C.  of  permanganate  to  give  a  permanent  color  ;  3.5  xO.l  x4  =  1.4 
milligramme  of  oxygen  per  litre  required  for  total  oxidizable  matter, 
1.4  X  0.1  =  0.14  per  100,000.' 

It  must  be  remembered  that  this  includes  both  organic  matter  and 
nitrous  acid.     We  must  now  differentiate  these. 

(ej  Organic  Oxidizable  Hatter  in  terms  of  Oxygen  required  for  its  Ox- 
idation.— Take  250  C.C.  of  water  to  be  examined  ;  add  3  C.C.  of  sulphuric 
acid  as  above ;  boil  the  water  briskly  for  twenty  minutes  ;  allow  it  to 
cool  down  to  140°  Fahr.  (60°  C.)  ;  then  add  the  permanganate  until  a 
pink  color  is  established  for  ten  minutes.  Calculate  out  the  oxygen  as 
above,  stating  the  result  as  milligrammes  per  Litre  required  for  oxidizable 
organic  matter,  or,  shortly,  as  organic  oxygen. 

The  rationale  of  this  process  is  the  driving  off  of  the  nitrous  acid  by 
boiling  with  sulphuric  acid. 

(63)  Nitrous  Acid. — This  can  now  be  determined  easily  by  calculating 
from  the  difference  between  the  two  preceding  processes.  Each  milli- 
gramme of  oxygen  represents  2.875  milligrammes  of  nitrous  acid;  we 
must  therefore  multiply  the  difference  by  this  factor,  and  the  result  is  ni- 
trous acid  in  milHgrammes  per  Utre. 

Example. — A  sample  of  water  yielded,  by  process  (ej,  0.14  part  of  oxy- 
gen per  100,000  ;  by  process  (e„),  0.075.  Then  we  have  0.140  —0.075  = 
0.065  =  centigramme  or  0.65  milligramme  of  oxygen  required  for  nitrous 
acid,  0.65  x  2.875  =  1.87  milHgramme  per htre  of  nitrogen  tetroxide  (NOJ; 
1.87  X  0.1  =  0.187  per  100,000. 

Hassall^  has  suggested  an  improvement  on  the  above  process  (de  Chau- 
mont's),  namely,  instead  of  boiling  away  the  nitrous  acid,  to  distil  it  over 
and  determine  it  directly  in  the  distillate.  Fresenius  proposes  a  some- 
what similar  plan,  only  using  acetic  acid  for  the  distillation,  and  then  sul- 
phuric acid  for  the  subsequent  titration.  Of  course,  if  distillation  is  re- 
sorted to,  the  NO^  can  be  determined  by  Griess'  method. 

One  or  two  precautions  are  necessary  in  the  permanganate  processes. 
In  process  (ej  permanganate  must  be  added  to  the  water  from  the  very 
commencement,  in  order  not  to  lose  nitrous  acid,  which  may  be  driven  off 
as  the  water  is  being  heated.  The  faintest  tinge  of  color  that  can  be  dis- 
tinctly seen  ought  to  be  accepted,  provided  it  remain  for  ten  minutes.  Care 
must'be  taken  to  add  the  sulphuiic  acid  in  every  case  at  the  beginning  ; 
if  this  is  not  done  a  brown  color  is  struck  which  spoils  the  experiment. 
Sometimes  this  color  appears,  even  after  acid  is  added,  and  is  then  prob- 
ably due  to  excess  of  organic  matter  ;  dilution  with  distilled  water  some- 
times remedies  this.  The  permanganate  solution  always  acts  upon  the 
india-rubber  tube  of  the  common  burette,  therefore  it  is  always  well  to 
use  a  burette  with  a  glass  stop-cock,  or  to  run  off  the  portion  which  has 
been  in  contact  with  the  india-rubber,  before  beginning  the  experiment. 

The  S.P.A.  instructions  recommend  another  method  of  operation  (sug- 
gested by  Tidy)  including  two  determinations,  viz.,  one  in  which  the  oxy- 
gen absorbed  within  fifteen  minutes  is  calculated,  and  another  within  foTir 

'  If  special  accuracy  is  required,  a  correction  for  color  may  be  made,  by  deducting 
0.06  from  the  result  stated  as  milligrammes  of  oxygen  per  litre. 
^  Adulterations  Detected,  1876,  p.  84. 


96  PRACTICAL    HYGIENE. 

hours.  The  processes  are  canied  on  at  a  temperature  of  80"  Fahr.  (26.7" 
C).  Two  bottles,  stopj^ered  and  of  about  12  oz.  (340  C.C.)  capacity,  are 
used,  into  each  (after  being  thoroughly  cleaned,  rinsed  with  sulphm-ic  acid 
and  then  with  the  water  to  be  examined)  250  C.C.  of  the  water  are  to  be 
l)ut,  and  warmed  in  a  bath  to  80°  Fahr.  (26.7'  C).  Then  add  10.  C.C. 
of  dilute  sulphuric  acid  (1  vol.  to  3  vols,  of  water)  and  10  C.C.  of  the 
standard  potassimn  permanganate  solution.  Fifteen  minutes  after  the 
addition  of  the  potassium  peimanganate,  one  of  the  bottles  must  be  re- 
moved from  the  bath,  and  two  or  three  drops  of  the  potassium  iodide  sohi- 
tion  added,  to  remove  the  pink  color.  After  thorough  mixture,  run  from 
a  burette  the  standard  solution  of  sodium  hyposulphite,  until  the  yeUow 
color  is  nearly  destroyed,  then  add  a  few  drops  of  starch  water,  and  con- 
tinue the  addition  of  the  h^-posulphite  until  the  blue  color  is  discharged. 
If  the  titration  has  been  properly  conducted,  the  addition  of  one  drop  of 
l^otassium  permanganate  solution  will  restore  the  blue  color.  At  the  end 
of  foiu-  hours  remove  the  other  bottle,  and  titrate  as  above  described. 
Should  the  pink  color  of  the  water  in  the  bottle  diminish  rai^idly  dming 
the  foul'  hours,  further  measured  quantities  of  the  standard  solution  of 
potassium  pennanganate  must  be  added  from  time  to  time,  so  as  to  keep 
it  markedly  pink. 

The  h}-posulphite  solution  must  be  standardized  by  making  a  blank  ex- 
periment with  distilled  w'ater,  and  this  must  be  rej)eated  fi'om  time  to  time 
as  it  does  not  keej)  well.  Let  A  be  the  quantity  of  h}-posulphite  required 
in  the  blank  experiment,  and  let  B  be  the  amount  required  for  250  C.C. 
of  the  water  examined, — then  : 

(A — B)  X  0.01  =  oxygen  absorbed  per  100,000  parts : 

this  multiplied  by  10  gives  the  milligrammes  per  litre. 

It  is  of  coui'se  to  be  understood  that  the  nitrous  acid,  if  present,  must 
be  allowed  for,  and  other  oxidizable  substances  ehminated  before  the  ox- 
ygen for  organic  matter  is  definitively  recorded. 

The  permanganate  process  is  the  only  one  that  is  practicable  for  medi- 
cal officers,  that  gives  us  any  measui'e  of  the  oxidizable  organic  matter  in 
water,  and  is,  in  the  present  state  of  oui*  knowledge,  indispensable,  imper- 
fect though  its  indication  may  be.  It  is  certainly  an  aid  to  oui-  judgment 
of  the  condition  of  a  drinking  w^ater,  being  to  Frankland's  carbon  process 
something  the  same  as  the  albuminoid  ammonia  method  is  to  his  nitrogen 
one.  Frankland  has  fully  acknowledged  this  relation  in  his  latest  work,' 
and  has  proposed  a  series  of  factors  by  which  to  multiply  the  oxygen  ab- 
sorbed, so  as  to  express  the  result  in  terms  of  organic  carbon.  These  fac- 
tors are  based  on  the  observed  relations  between  the  two  processes  in  a  very 
large  number  of  experiments,  and  are  formed  by  dividing  the  average  car- 
bon by  the  average  oxygen.  The  factors  differ  for  different  kinds  of  water 
in  the  following  proportions : 

River  vsrater, 

Deep  well  water, 
Shallow  well  w'ater. 
Upland  surface  water, 

so  that  1  milligramme  of  oxygen  absorbed  indicates  a  probable  amount 
of  only  1.8  of  organic  carbon  in  an  upland  surface  water,  but  as  much  as 
5.8  in  a  deep  well  water. 

1  Water  Analysis,  1880,  p.  55. 


c 



2.38 

o 

(C 

^ 

5.80 

(( 

:=: 

2  28 

(( 

— 

1.80 

WATER.  97 

No  process  gives  us  thoroughly  trustworthy  information,  but  for  the 
army  or  navy  medical  officer,  or  any  one  not  provided  with  a  well- 
appointed  laboratory,  the  jDermanganate  process,  combined  with  the  al- 
buminoid ammonia  process,  gives  as  much  information  as  is  likely  to  be 
got  at  present,  and  sufficient  for  hygienic  purposes.  It  must  be  re- 
membered that  the  permanganate  does  not  act  upon  fatty  substances, 
starch,  urea,  hippuric  acid,  creatin,  sugar,  or  gelatine. 

Action  of  Permanganate  in  presence  of  an  Alkali. 

In  order  to  avoid  some  of  the  fallacies  and  inconveniences  of  the  test 
with  acid,  F.  Schultze'  tried  the  following  plan,  which  was  slightly 
modified  by  Lex.  Five  or  more  vessels,  each  containing  60  C.C  of  the 
water  to  be  examined,  are  taken,  and  to  each  2  C.C.  of  thin  milk  of  lime 
are  added,  and  then  1,  2,  3, 4,  5  C.C,  etc.,  of  the  permanganate  solution  (viz., 
.395  gramme  per  litre)  are  added,  and  left  for  three  hours.  At  the  end  of 
that  time  some  of  the  samples  ^vill  be  decolorized,  others  still  colored  ; 
if  No.  1  and  No.  2  are  colorless,  and  No.  3  is  colored,  then  the  amount 
of  permanganate  destroyed  is  between  2  and  3  C.C.  As  in  the  cold  each 
equivalent  of  jjermanganate  only  gives  off  3  (not  5  atoms)  of  oxygen,  each 
C.C.  corresponds  not  to  .1,  but  to  .06  mihigramme  of  oxygen."  It  is  for 
this  reason  that  60  C  C.  of  water  are  taken  instead  of  100,  for  it  is  evident 
that  if  1  C.C.  of  the  permanganate  solution  gives  only  .06  milhgTamme  to 
60  C.C,  it  is  the  same  as  .1  to  100  C.C.  of  the  water.  The  calculation  of 
the  results  is  thus  easy  ;  if,  for  example,  Nos.  1  and  2  are  decolorized, 
while  No.  3  is  colored,  the  amount  of  oxygen  required  is  between  .2  and 
.3  milligramme  for  100  C.C,  or  2  and  3  per  litre.  If  60  C.C.  of  a  water 
take  less  than  3  C.C.  of  the  permanganate  solution  to  give  it  a  color  per- 
manent for  two  hours,  it  is  a  good  water  (according  to  Lex)  so  far  as  this 
test  is  concerned  ;  if  3  and  4  C.C  are  required  it  is  a  medium  water,  and 
if  the  5  C.C.  do  not  give  a  color  the  water  is  bad. 

5.   PHOSPHORIC  ACID  IN  PHOSPHATES, 

The  incinerated  total  residue  of  the  solids  is  to  be  treated  with  a  few 
drops  of  nitric  acid,  and  the  silica  rendered  insoluble  by  evaporation  to 
dryness.  The  residue  is  then  taken  up  with  a  few  di'ojos  of  dilute  nitiic 
acid,  some  water  is  added,  and  the  solution  is  filtered  through  a  filter  pre- 
viously washed  with  dilute  nitric  acid.  The  filtrate,  which  should  measui-e 
3  CCs.,  is  mixed  with  3  C.C.  of  molybdate  solution,  gently  warmed,  and 
set  aside  for  fifteen  minutes  at  a  temperature  of  80°  Fahr.  The  result  is 
reported  as  "  traces,"  "  heavy  traces,"  or  "  very  heavy  traces,"  when  a 
color,  turbidity,  or  definite  precipitate  are  respectively  produced,  after 
standing  fifteen  minutes.  The  precipitate  may  also  be  collected  and 
weighed,  if  thought  desu-able.  For  this  jDUi-pose  it  ought  to  be  washed 
with  the  least  quantity  of  distilled  water,  and  then  dissolved  to  neutrahty 
in  dilute  ammonia.  The  solution  thus  obtained  is  evaporated  with  re- 
peated additions  of  small  quantities  of  water,  and  the  resulting  residue  is 
weighed.     The  weight,  divided  by  28.6,  gives  the  amount  of  phosphoric 

'  Eoth.  and  Lex,  op.  cit.,  p.  91. 

'  With,  sulphuric  acid  the  followina:  is  the  reaction  : 

2  (KMn04)  +  3(H,S04)  =  K.,S04  +  2(iVInS04)  +  SCH^O)  +  O5. 
without  acid  the  reaction  is  : 

2(K:Mn05)  +  H2O  =  2(11^02)  +  2(KH0)  +  O3. 
Vol.  L— 7 


98  PRACTICAL    HYGIENE. 

anhydride,    P^O,,   (Hehner).     To  express  it  in  terms  of  PO^,   divide  by 
21.4,  or  multiply  by  0.0467. 

6.  The  determination  of  sulphuric  acid  has  been  already  referred  to 
(page  90,  note)- 

Determination  of  Uie  Earthy  and  Alkaline  Carbonates  by  Mohr's  Process. 

This  is  a  very  elegant  process,  and  may  be  useful.  The  solutions  re- 
quired are  :  standard  solution  of  sulphuric  acid,'  1  C.C.  of  wliicli  saturates 
5  mgms.  of  calcium  carbonate  ;  and  a  coloring  solution,  such  as  cochineal 
or  phenolphthaleiua 

Process. — Take  70  C.C.  of  the  watei*  to  examine,  and  add  a  drop  or  two  of 
cochineal  solution,  which  gives  a  carmine  red  color.  Then  run  in  the 
standard  acid  solution  till  the  color  becomes  yellow  or  brown-yellow. 
Read  off  the  number  of  C.C.  used,  and  multiply  by  5.  The  result  is 
grains  of  earthy  and  alkaline  carbonates  per  gallon,  stated  at  calcium  car- 
bonate.    Divide  the  result  by  0.7  to  get  parts  per  100,000. 

Exartiple. — 70  C.C.  of  a  sample  of  water,  reddened  with  cochineal,  re- 
quired 3.9  of  standard  solution  to  make  it  yellow  :— then  3.9  x  5  =  19.5  = 
grains  per  gallon  of  earthy  and  alkaline  carbonates  as  calcium  carbonate, 
and  19.5  -^  0.7  =  27.857  parts  per  100,000.  If  the  water  be  not  alkaline 
to  test  j)aper,  the  result  will  represent  calcium  carbonate  only.  Should 
the  latter  be  ah'eady  known  (through  the  hardness),  the  difference,  if  any, 
will  represent  sodium  carbonate,  and  may  be  calculated  out  as  such,  1  C.C. 
=  5.3  mgms.  of  sodium  carbonate. 

Iron,  Silica,  Lead,  Copper,  Arsenic,  Zinc. 

Iron  is  seldom  required  to  be  determined  quantitatively,  but  it  may  be 
done  by  a  colorimetric  test  (as  suggested  by  Wanklyn).  Either  the  water 
may  be  tested  directly,  or,  what  is  better,  the  incinerated  residue  of  the 
solids  may  be  treated  with  pure  hydrochloric  acid,  and  made  up  to  100  C. 
C.  with  distilled  water.  A  cubic  centimeter  of  solution  of  ferrocyanide  of 
potassium  is  added,  which  will  strike  a  blue  color.  A  comparative  experi- 
ment with  a  standard  solution  of  ii-on  may  be  made.'^  This  is  a  better 
process  than  the  permanganate  method,  which  with  small  quantities  of  iron 
gives  very  uncertain  results. 

Silica  may  be  determined  from  the  incinerated  residue  by  treating  it 
with  strong  nitric  or  hydrochloric  acid,  evaj)orating  to  dryness,  and  again 
treating  with  acid  ;  distilled  water  (about  50  C.C.)  is  then  added,  and  a 
Uttle  heat  apphed  till  everything  soluble  is  dissolved ;  the  residue  is 
silica,  which  may  be  collected  on  a  small  filter,  ignited  and  weighed.  A 
number  of  Indian  waters  contain  considerable  quantities  of  sihca,  either 
combined   or  in  the  susjaended  matter.^ 

Lead,  Copper,  Arsenic,  Zinc. — The  mere  presence  of  these  metals  in  ap- 
preciable quantity  is  enough  to  condemn  a  water,  therefore  it  will  seldom 
be  necessary  to  detei-mine  their  amount  quantitatively. 

Inferences  from  the  Quantitative  Tests. 

The  conclusions  to  be  drawn  from  the  qualitative  tests  hold  good  for  the 
quantitative,  only  greater  precision  is  given.     It  must,  however,  be  under- 

'  See  Appendix  A,  Vol.  ii.  ^  See  under  Alum  in  bread. 

'Dr.  Nicholson,  A.M.D.,  has  noticed  that  the  water  at  Kamptee,  both  from  the 
river  and  from  wells,  contains  from  2  to  6  grains  per  gallon  of  silica  derived  from  mi- 
caceous gravel ;  it  is  combined  with  magnesia,  and  it  renders  the  soap  test  inapplicable. 


WATER.  99 

stood  that  such  conclusions  are  still  only  approximative,  and  they  are  only 
of  a  certain  value  when  all  the  circumstances  of  the  case  are  taken  into 
consideration.  Some  chemists  have  gone  so  far  as  to  say  that  they  would 
rather  know  nothing  about  the  sample,  and  merely  wish  it  marked  with 
some  distinctive  mark,  such  as  A  or  B,  or  1  or  2  ;  their  confidence  being 
so  great  in  the  indications  of  their  analyses,  that  they  feel  convinced  they 
can  give  a  perfectly  trustworthy  opinion  on  the  wholesomeness  or  other- 
wise from  these  alone.  There  is  no  doubt  that  a  practised  chemist  may 
make  a  fairly  good  guess  under  such  circumstances,  but  as  a  rule  an 
opinion  so  formed  is  worth  very  httle.  It  is,  of  course,  desirable  that  an 
analyst  should  come  to  his  inquiry  perfectly  unbiassed  ;  but  before  adopt- 
ing a  conclusion  as  regards  a  water  the  medical  officer  will  always  do  well 
to  obtain  every  item  of  information  about  it  that  is  possible  to  get, — other- 
wise he  is  sure  to  faU.  sooner  or  later  into  error.  Thus,  constituents  may 
be  present  in  a  deep  well-water  and  have  no  particular  significance,  whilst 
in  a  shallow  well-water  they  would  be  sufiicient  to  condemn  it.  At 
present  we  have  little  or  no  means  of  positively  distinguishing  vegetable 
from  animal  organic  matter  ;  yet  it  is  obvious  that  an  amount  of  the  former 
would  be  admissible  which  could  not  be  allowed  of  the  latter. 

Mr.  Wigner  has  proposed  a  scale  of  valuation,  in  which  a  certain  nu- 
merical value  is  attached  to  each  constituent.'  The  scale  is  an  ingenious 
one,  but  it  would  hardly  be  advisable  to  adopt  it  definitively  as  yet,  and  the 
Society  of  Public  Analysts  have  dechned  to  do  so  for  the  present. 

The  inadvisability  of  drawing  hard  and  fast  lines  on  the  subject  is 
being  now  more  generally  recognized  ;  and  the  remark  of  Mr.  Charles 
Ekin  ^  is  very  apposite,  for  he  says  it  is  as  if  six  typhoid  germs  were  harm- 
less and  7ii7ie  were  hurtful.  It  may  be  true  that  the  larger  the  dose  of 
poison  the  more  certain  the  eifect,  but  we  know  too  little  at  present  to 
allow  us  to  say  where  the  hne  is  to  be  drawn.  At  the  same  time,  some 
approximation  to  classification  may  be  made.  The  Reports  on  Hygiene 
in  the  A.  M.  D.  Annual  Reports,  vols,  xviii.  to  xxi.,  may  be  referred  to  for 
tables  of  water  analyses,  with  approximate  classifications. 

Subjoined,  in  pp.  103-106,  are  tables  of  typical  waters  divided  into  four 
classes, — 1.  Pure  and  wholesome  ;  2.  Usable  ;  3.  SuspicioiTS  ;  and  4. 
Impure.  These  are  merely  suggested  as  general  guides,  some  latitude 
being  necessary,  according  to  circumstances. 

1.  Chlorine  in  Chlorides. — The  purest  waters  contain  small  quantities 
of  chlorides,  generally  less  than  one  grain  of  chlorine  per  gallon  (1.4  per 
100,000).  Rain-water  generally  contains  0.22  to  0.5  per  100,000  (0.15  to 
.35  per  gallon).  An  increase  in  ordinary  drinking-water  may  be  due  to 
sea-water,  salt-bearing  strata,  or  sewage,  or  other  impurities.  In  the  two 
former  cases  it  is  comparatively  innocent,  but  in  the  last  it  may  be  an  in- 
dication of  dangerous  contamination,  in  which  case  it  is  usually  connected 
with  an  increase  in  the  ammonias,  the  oxidizable  matter  and  the  nitrogen 
acids.  Sewage  contamination  can  never  take  place  without  some  increase 
in  the  chlorides,  unless  it  be  through  gaseous  emanations.  Some  deep 
wells  contain  large  quantities  of  chlorides,  but  the  other  details  of  the 
analysis  wiU  show  that  this  is  not  due  to  any  recent  contamination.  Gen- 
erally speaking,  however,  an  excess  of  chlorine  is  a  reason  for  suspicion, 
until  a  satisfactory  explanation  of  its  presence  is  obtained.^ 

'  See  Analyst,  vol.  vi.,  p.  122. 

2  Potable  Water,  by  Charles  Ekin,  F.C.S.    J.  &  A.  Churchill. 

'  Good  deep  well-water  may  contain  10  grains  of  chlorine  per  gallon  :  sewage  efflu- 
ent (as  at  Aldershot)  only  3.8. 


100  PRACTICAL    HYGIENE. 

2.  Solids,  Total  and  Volatile. — The  amount  of  solids  varies  very  greatly 
Avitb  the  source  of  the  water.  Pure  upland  surface  waters  contain  very 
little,  sometimes  not  more  than  2  or  3  grains  in  a  gallon.  The  Loch 
Katrine  water,  supplied  to  Glasgow,  yields  only  1.68  per  gallon  (2.4  per 
100,000)  ;  Thirlmere  Lake,  proposed  as  the  supply  for  Manchester,  about 
the  same  ;  and  Vyrnwy,  proposed  as  the  su2)ply  for  Liverjiool,  2.38  per 
gaUon  or  3.4  per  100,000. 

On  the  other  hand,  waters  from  pui'e  sources  other  than  upland  sur- 
face show  much  more  than  this.  On  the  whole,  w'e  may  lay  it  down  that 
the  purest  upland  surface  waters  seldom  contain  more  than  about  5  grains 
per  gallon  (or  about  7  parts  per  100,000),  but  that  considerable  latitude 
may  be  admitted  in  waters  from  deep)  wells,  chalk  strata,  and  the  like. 

Of  the  solids  not  more  than  about  1  grain  per  gallon  (1.4  per  100,000) 
ought  to  be  volatile,  or  capable  of  being  driven  off  by  a  red  heat.  The 
solids  should  blacken  very  sHghtly  on  ignition.  A  little  deviation  from 
this  rule  is  admissible  in  water  from  peat  land. 

3.  Ammonia,  Free  and  Albuminoid. — Pure  waters  yield  from  7iil  to  0.002 
l)er  100,000  of  free  ammonia,  and  from  nil  to  0.005  per  100,000  of  albuminoid 
ammonia.  Usable  water  may  contain  up  to  0.005  per  100,000  of  free,  and 
0.01  per  100,000  of  albuminoid  ammonia.  These  numbers,  however,  re- 
quire qualification,  for  they  may  be  exceeded  in  cases  where  water  is 
thoroughly  good  for  dietetic  pvirposes.  Rain  water  often  contains  a  large 
amount  of  free  ammonia,  probably  derived  from  soot,  and  it  appears  to  be 
harmless. 

Deep  wells  often  show  a  large  amount  of  free  ammonia  and  chlorides 
without  necessarily  indicating  pollution  ;  but  the  same  amounts  in  a  shal- 
low well  would  point  to  probable  sewage  pollution,  or  at  least  to  the 
presence  of  urine. 

The  presence  of  a  considerable  amount  of  albuminoid  ammonia,  with 
little  free  ammonia  and  chlorides,  is  generally  indicative  of  vegetable  or- 
ganic matter,  often  peaty.  This  is  the  character  of  the  greater  part  of  the 
water  supply  of  Ireland. 

The  real  significance  of  the  albuminoid  ammonia,  has  been  much  dis- 
cussed, but  the  results  obtained  are  sufficiently  uniform  to  give  us  a  con- 
venient measure  of  purity,  provided  we  are  careful  not  to  draw  the  hne 
too  close.  All  the  nitrogen  of  the  organic  matter  is  certainly  not  obtained 
by  this  method,  but  this  is  immaterial  so  long  as  the  23i"oj)ortion  is  fairly 
maintained.  The  results  correspond  to  a  certain  extent  with  the  organic 
nitrogen  of  Frankland,  and  the  process  is  much  more  feasible  for  medical 
officers  generally. 

4.  Nitric  and  Nitrous  Acids  in  Nitrates  and  Nitrites. — The  significance  of 
these  is  very  important.  Nitric  acid  is  the  ultimate  stage  of  oxidation  of 
nitrogenous  organic  matter,  and  when  present  in  water  it  is  almost  al- 
ways the  result  of  previous  pollution,  either  of  the  water  itself  or  of  the 
strata  through  which  it  flows.  It  gives  us  no  information,  however,  as  to 
the  exact  time  when  the  pollution  took  jDlace.  In  some  samples  from  deep 
wells  it  is  e\ddent  that  the  pollution  must  have  been  very  ancient.  It  has 
been  distinctly  shown  by  Schloesing  and  Muntz  '  and  by  E.  Warington '' 
that  nitrification  is  a  fermentative  jDixDcess  excited  and  carried  on  through 
the  agency  of  a  minute  organism,  just  as  ordinary  fennentation  is  carried 
on  thi'ough  the  medium  of  torula.     Nitrous  acid  indicates  the  presence  of 

'  Comptes  Rendus,  Ixxxiv..  .301  ;  Ixxxv.,  1018;  Ixxxvi.,  892;  Ixxxix.,  891,  1074. 
■.     «  Chem.  Soc.  Journ.,  1878,  xxviii.,  44 ;  1879,  429.     Cliem.  News,  xliv.,  217. 


WATER.  101 

organic  matter  tindergomg  change  :  it  is  either  a  stage  in  the  direct 
oxidation  of  such  matter,  progressive  or  arrested,  or  a  retrogression  from 
nitric  acid  in  consequence  of  the  latter  having  yielded  uj)  a  part  of  its  oxy- 
gen. In  this  way  nitrous  acid  might  retrograde  still  further  and  become 
convei'ted  again  into  ammonia,  or  be  dissipated  as  nitrogen.  Nitrous  acid 
is  a  much  more  important  substance  than  nitric,  as  indicating  present 
danger,  and  a  very  small  amount  of  it  is  sufficient  to  remove  a  water  into 
the  suspicious  class.  It  is  rare  to  find  any  of  the  higher  forms  of  hfe  in  a 
water  rich  m  nitrites,  although  bacteria  may  be  found.  Pure  water  ought 
to  be  quite  free  from  nitrites,  and  ought  to  show  only  traces  at  most  of 
nitrates, — the  limit  being  about  0.032  per  100,000  of  nitric  acid, — repre- 
senting of  combined  nitrogen  0.014  per  100,000.  The  total  combined 
nitrogen  (including  that  in  the  free  ammonia)  would  be  0.016  per  100,000  ; 
whilst  the  total  nitrogen  (including  that  in  the  albuminoid  ammonia) 
would  be  0.023  per  100,000.  The  presence  of  nitrites  is  suspicious  :  the 
marked  presence  of  nitrates  ought  to  be  a  ground  for  careful  inquiry.  In 
some  soils,  especially  sands  and  gravels,  and  in  ferruginous  soils  the  pro- 
cess of  nitrification  goes  on  extremely  rapidly,  and  the  existence  of  impur- 
ity may  escape  notice  if  the  examination  for  nitric  acid  be  omitted. 

5.  Oxygen  absorbed. — This  ought  not  to  exceed  about  0.0250  per 
100,000  for  organic  matter  alone, — that  is,  after  deducting  any  that  may 
be  absorbed  by  nitrous  acid  if  jDresent.  This  latter,  however,  should  not 
be  present  in  a  water  of  the  first  class.  The  experiment  to  be  done  with 
permanganate  and  acid  at  a  temperature  of  140°  Fahr.  (60°  C). 

Prankland  and  Wigner  allow  four  times  the  above  amount  for  upland 
surface  waters,  and  double  the  above  amount  for  other  waters, — the  experi- 
ment being  performed  for  four  hours  at  a  tempei'ature  of  80°  Fahr 
(27°  C). 

In  water  with  little  chlorine  and  little  or  no  free  ammonia,  a  higher 
amount  than  the  above  may  be  present  without  danger,  as  in  all  prob- 
ability it  will  be  due  to  vegetable  matter. 

6.  Hardness.— The  fixed  hardness  should  not  exceed  2°  of  Clark's  scale, 
or  3°  of  the  metrical  scale.  The  total  hardness  may  vary  more,  but  if 
possible  should  not  exceed  5°  or  6°  (Clark),  or  7°  to  8.5°  (metrical). 

7.  Phosphates. — The  presence  of  these  in  any  marked  quantity  will 
generally  corroborate  inferences  as  regards  sewage  contamination  drawn 
from  the  other  indications. 

Sulphates. — An  excess  of  sulphates  will  in  many  cases  also  indicate  con- 
tamination, though  they  may,  like  chlorine,  come  from  innocuous  sources. 

8.  Metals. — Pure  water  should  contain  no  heavy  metal,  although  a  trace 
of  iron  may  be  found  sometimes.  In  some  cases  iron  seems  beneficial,  as 
it  helps  to  oxidize  the  organic  matter.  The  presence  of  any  other  heavy 
metal  ought  to  condemn  the  water. 

9.  The  presencee  of  hydrogen  sulphide  or  alkaline  sulphides  ought  to 
condemn  the  water. 

It  is  always  advisable  to  get  information  if  possible  as  to  the  usual  com- 
position of  a  water  to  be  examined,  as  even  slight  variations  may  suggest 
a  clue  to  the  nature  or  cause  of  an  impurity.  The  microscoj^ic  examination 
of  the  sediment  ought  always  to  be  performed  where  possible,  as  it  often 
affords  important  information  when  the  chemical  investigation  fails.  Thus, 
the  presence  of  such  objects  as  muscular  fibre,  wheaten  starch  cells,  mucous 
epitheliiim,  disintegrating  masses  of  paper,  etc.,  are  sufiicient  alone  to 
condemn  water  (especially  if  it  be  from  a  shallow  well),  even  when  the 
chemical  constituents  are  within  limits,  as  they  are  undoubted  evidences 


102 


PRACTICAL    HYGIENE. 


of  animal  contamination,  almost   certainly  sewage.     In   such   cases   tlie 
nitric  acid  is  nearly  alwaj^s  large  in  amount. 

The  folio wiug  is  the  form  of  Report  at  present  used  at  Netley : 


Report  on  a  Sample  of  Drinking  Water. 


From 
Source 


Drawn 

Received 
Examined 


18 
18 
18 


Color  (through  18  ins.) 

Turbidity 

Sediment 


Physical  Characters. 

Lustre . 
Taste. . 
Smell  . 


Chemical  Analysis. 


Qualitative  {water  unconcentrated). 

Lime 

Magnesia 

Chlorine 

Sulphuric  acid 

Phosphoric  acid 

Fixed 

Temporary  or  Removable  . . 

Total 


Ammonia 

Nitric  acid 

Nitrous  acid   

Oxidizable  matter. 
Iron  or  Lead 


Hardness. 


Degrees  of 
Clark's  Scale. 


parts  per 
100,0U0. 


Quantitntive. 

Volatile  matter  (by  incineration  and  after  re-carbonatirg) 
Oxygen  required  for  oxidizable  organic  matter 

JV.JS.— xhe>e  constituents,  f  Ammonia  free 

with  the  oxidizable  org.anic     Ammonia  albuminoid. . 
matter,  indicated  bv  the  oxv-  K  -kt-..   •  •  j   i-Kr\  \ 

gen  required,  are  ihcludedln  |  ^}^r\Q,   acm  (.WUs) 

the  Volatile  Matter. 


l^  Nitrous  acid  (NOo) 

Total  nitrogen  included  in  ) 
nitrates  and  nitrites  ) 

Chlorine 

Calcium  carbonate 

Fixed  hard  salts 

Sulphuric  acid  (SO4) 

Alkaline  carbonates 

Sodium  or  other  metal  (combined  with  CI  or  SO4) ) 

not  included  in  fixed  hard  salts  ) 

Silica,  alumina,  iron,  etc 


Total  solids  (by  evaporation) 


Microscopic  Clutracters. 
Jtemarks. 


Laboratory,  Army  Medical  School, 

Royal  Victoria  Hospital,  Netley, 


Professor  of  Military  Hygiene. 


"WATER. 


103 


The  following  tables  give  an  approximate  view  of  the  composition  of 
drinking  waters  of  the  four  classes  : 

1.  Pure  and  Wholesome  Water. 


Character  or  Constituents. 


Physical  characters  :  Colorless,  or  bluish  tint ;  transparent, 
sparkling,  and  well  aerated  ;  no  sediment  visible  to 
naked  eye ;  no  smell ;  taste  palatable. 


Chemical  Constituynts. 


1.  Chlorine  in  chlorides under 

2.  Solids  in  solution :  total . .  under 
Solids  in  solution:  -volatUejindcr 
N.B. — The  solids  on  incinera- 
tion should  scarcely  blacken. 

3.  Ammonia,  free  or  saline,  .under 
Ammonia,  albuminoid . . .  under 

4.  Nitric  acid  (NOa),  I ^,^^,^ 

m  nitrates ) 

Nitrous  acid  (NO2),  ) 
in  nitrites f 

Nitrogen  in  nitrates under 

Total  combined  nitrogen,  in- 
cluding that  in  the  free  am- 
monia  under 

Total  nitrogen,  including  that 
in  the  albuminoid  am- 
monia  under 

5.  Oxygen    absorbed    by    organic 

matter  within  half  an  hour, 
by  permanganate  and  acid  at 
140'  F.  (60'  C.) under 

Do.  in  fifteen  minutes,  at  80°  F. 
(27'  C.) under 

Do.  in  four  hours,  at  80°  F. 
(27'  C.) under 

6.  Hardness,  total under 

Hardness,  fixed under 

7.  Phosphoric  acid  in  phos- 

phates   

Sulphuric  acid  in  sulphates .... 

8.  Heavy  metals 

9.  Hydrogen     sulphide,     alkaline 

sulphides 


Grains 
per  gallon, 
1  in  TO.OOO. 


1.0000 

5.C000 
1.0000 


0.0014 
0.0035 

0.0226 

nil. 
0.0100 

t  0.0113 
[  0.0160 

i-  0.0175 


0.0100 

0.0350 

6.0° 
2.0° 

traces. 

traces, 
nil. 

nU. 


Centi- 
grammes 
per  litre, 
1  in  1C.U,0U0. 


1.4000 

7.1428 
1.4000 


0.0020 
0.0C50 

0.0323 

nil. 
0.0140 

0.0160 


0.0230 


0.0250  \ 


0.0125 

0.0500 

8.5° 
8.0° 


Microscopic  characters:  Mineral  matter;  vegetable  forms 
with  endochrome ;  large  animal  forms ;  no  organic 
debris. 


Turbidity,  due  to  very 
fine  mineral  matter,  is 
sometimes  associated 
with  pure  waters;  thus, 
minutely  divided  cal- 
cium sulphate  will  not 
subside  in  distilled  wa- 
ter. 


This  may  be  exceeded  if 
from  a  purely  mineral 
source. 

The  solids  may  be  ex- 
ceeded in  chalk  waters, 
where  they  are  mostly 
calcium  carbonate. 


The  oxygen  absorbed 
may  be  doubled  in  peat 
or  upland  surface  wa- 
ters. 


A  water  such  as  the  above  may  generally  be  used  with  confidence,  in  the  absence  of 
any  history  of  possible  pollution,  or  of  any  recent  and  appreciable  change  in  the 
amount  of  the  organic  constituents. 


104 


PEACTICAL    HYGIENE. 


2.  Usable  Water. 


Character  or  Constituents. 


Physical  characters  :  Colorless,  or  slightly  greenish  tint ; 
transparent,  sparkling,  and  well-aerated  ;  no  suspended 
matter,  or  else  easily  separated  by  coarse  filtration  or 
subsidence  ;  no  smell ;  taste  palatable. 


Chemical  Constituents. 


1.  Chlorine  in  chlorides under 

2.  Solids  in  solution  :  total . .  under 
Solids  in  solution :  volatile,  under 

3.  Ammonia,  free  or  saline,  under 
Ammonia,  albuminoid  . . .  wider 

4.  Nitric  acid  (NO3),  )  , 

.,     ,  ^'  >• under 

m  nitrates. .    . .  ) 

Nitrous  acid  (NO2),  ^ 

in  nitrites \ 

Nitrogen  in  nitrates under 

Total  combined  nitrogen,  in- 
cluding that  in  free  am- 
monia  under 

Total  nitrogen,  including  that  in 
albuminoid  ammonia  .  .under 

5.  Oxygen    absorbed    by    organic 

matter  within  half  an  hour, 
by  permanganate  and  acid, 
at  140°  F.  ((50°  C.) under 

Do.  in  fifteen  minutes,  at  80°  F. 
(27°  C.) under 

Do.  in  four  hours,  at  80°  F. 
(27'  C.) under 

6.  Hardness,  total under 

Hardness,  fixed under 

7.  Phosphoric  acid  in  phosphates. . 
Sulphuric  acid   in  sul-  /         , 

pbates J-^"'^^'' 

8.  Heavy  metals — Iron 

9.  Hydrogen     sulphide,     alkaline 

sulphides 


Grains 
per  eallon, 
1  in  T0,OUO. 


3.0000 

30.0000 
3.0000 

0.0035 
0.0070 

0.3500 

nil. 
0.0790 

w  0.0819 

I 

-  0.C876 


}   0.0700 


0.0210 

0.1050 

12.0" 

4.0° 

traces. 

2.000 

traces. 

nil. 


Centi- 
grammes 
per  litre. 
1  in  100.  UCO. 


4.2857  \ 


42.8571 

4.2857 


\ 

0.0050  j 

r 

I 

0.0100  \ 


0.5C00  ^ 

i 
I 

nil. 
0.1129 


0.1170 


0.1252 


0.1000 


0.0300   I 

0.1500  I 

17.3° 

5.7" 

traces. 

3.0000  ] 

traces. 

nil. 


Microscopic  characters  :  same  as  No.  1. 


In  some  usable  waters, 
such  as  peat  waters, 
the  color  may  be  yel- 
low or  even  brownish. 
In  some  also  the  taste 
may  be  flat  or  only 
moderately  palatable. 


This  may  be  much  larger 
in  waters  near  the  sea, 
deep  well  waters,  or 
waters  from  saline 
strata. 

The  solids  may  blacken, 
but  no  nitrous  fumes 
should  be  given  off. 

This  maj'  be  greater  in 
deep  well  waters. 

This  may  be  larger  in 
upland  surface  waters, 
peat  waters,  etc.,  when 
the  source  is  chiefly 
vegetable. 

The  amount  of  nitrates 
varies  greatly,  so  that 
an  average  is  of  doubt- 
ful value. 


The  oxygen  absorbed 
may  be  greater  (about 
double)  in  upland  sur- 
face waters,  peat  wa- 
ters, etc. 


In     some     waters     the 
amount  may  be  larger. 


A  water  such  as  the  above  will  in  most  cases  be  usable,  but  it  will  be  improved  by 
filtration  through  a  good  medium. 


WATEE. 


105 


3.  Suspicious  Water. 


Character  or  Constituents. 


Physical  characters  :  Yellow  or  strong  green  color;  turbid  ; 
suspended  matter  considerable ;  no  smell,  but  any 
marked  taste. 


Chemical  Constituents. 


1.  Chlorine  in  chlorides 

2.  Solids  in  solution  :  total 

Solids  in  solution :  volatUe  .... 

3.  Ammonia,  free  or  saline 

Ammonia,  albuminoid 

4.  Nitric  acid  (NO3),  in  nitrates  , . 

Nitrous  acid  (NOn),  in  nitrites  , . 

Nitrogen  in  nitrates  and  ni- 
trites      

Total  combined  nitrogen,  in- 
cluding that  in  free  am- 
3iionia 

Total  nitrogen,  including  that 
in  albuminoid  ammonia 

5.  Oxygen    absorbed    by    organic 

matter  within  half  an  hour, 
by  permanganate  and  acid, 
at  140=  F.  (80°  C.)   

Do.  in  fifteen  minutes,  at  80°  F. 
(27°  C.) ,. 

Do.  in  four  hours,  at  80°  F. 
(27°  C.) 

6.  Hardness,  total above 

Hardness,  fixed above 

7.  Phosphoric  acid  in  phos- 

phates   

^''phat'eT  """'^   '"^   ''^'  \   «^^^^ 

8.  Heavy  metals — iron 

9.  Hydrogen     sulphide,     alkaline 

sulphides 


Grains 
per  pallon. 
1  in  7(),0U0. 


3  to  5 

30  to  50 
3  to  5 
0.0035 
.  to 
0.0070 
0.0070 

to 
0.0087 
0.35  to 

0.70 
0.0350 
0.0870 

to 
0.1661 
0.0871 

to 
0.1718 
0.0879 

to 
0.1726 


j  0.0700 
1-   to 
0.1050 

j  0.0350  to 
I    0.0700 
j  0.1500  to 
\    0.2800 
12.0° 
4.0° 

|-   heavy 
2.000 


traces. 
nil. 


Centi- 
grammes 
per  litre. 
1  in  100,000. 


4to7  [ 

43  to  71 
4  to  7 
0.0050 

to 
0.0100 
0.0100 

to 
0.0125 

0.5  to  1.0 

0  0500 
0.1243 

to 
0.2373 
0.1247 

to 
0.2455 
0.1255 

to 
0.24G5 

0.1000 

to 
0.1500 

0.0500  to 
0.1000 

0.2000  to 

0.4000 

17.0° 

5.7° 

traces. 

3.000    ] 
traces, 
nil. 


Microscopic  characters  :  Vegetable  and  animal  forms  more 
or  less  pale  and  colorless ;  organic  debris ;  fibres  of 
clothing,  or  other  evidence  of  house  refuse. 


Where  the  impurity  is 
mostly  vegetable,  the 
color  may  be  very 
marked  in  usable  wa- 
ter. 


In  some  cases  the  chlo- 
rine may  be  greater. 


This  may  sometimes  be 
larger. 


A  water  such  as  the  above  ought  to  excite  suspicion  :  its  use  ought  to  be  sus- 
pended until  inquiries  about  it  can  be  made  ;  if  it  must  be  used,  it  ought  to  be  boiled 
and  filtered. 


106 


PRACTICAL    HYGIENE. 


4.  Impure  Water. 


Character  or  Constituents. 


Physical  characters :  Color,  yellow  or  brown ;  turbid,  and 
not  easily  purified  by  coarse  filtration ;  large  amount 
of  suspended  matter ;  any  marked  smell  or  taste. 


Chemical  Constituents. 


Chlorine  in  chlorides above 

Solids  in  solution :  total .  .above 
Solids  in  solution:  volatile,  abo7ie 
Ammonia,  free  or  saline,  .above 
Ammonia,  albuminoid. . .  .above 

Nitric  acid  (NO3U    above 

in  nitrates J 

Nitrous  acid  (NO.),  )  j^^^ 

m  nitrites ) 

Nitrogen  in  nitrates  and  ni- 
trites   above 

Total  combined  nitrcgen,  in- 
cluding that  in  free  am- 
monia   above 

Total  nitrogen,  including  that 
in  albuminoid  ammo- 
nia   above 

Oxygen  absorbed  by  organic 
matter  within  half  an  hour, 
by  permanganate  and  acid, 
at  140    F.  (60    C.^ above 

Do.  in  fifteen  minutes,  at  80^  F. 
(27^  C.) above 

Do.  in  four  hours,  at  80°  F. 
(27°  C.) above 

Hardness,  total above 

Hardness,  fixed     above 

Phosphoric  acid  in  phos- 
phates   

Sulphuric  acid  in  snl-  )  ^^^^.^ 
phates ) 

Heavy  metals 

Hydrogen  sulphide 

Alkaline  sulphides 


Grains 
per  gallon. 
1  in  70,000. 


5.0000 
50.0000 
5.0000 
0.0070 
0.0087 

0.7000 

0.0350 

i   0.1690 

0.1748 


u. 


Centi- 
grammes 
per  litre. 
1  in  100,000. 


1821 


0.1050 


0.0700 

0.2800 

20.0° 
6.0° 


Very  hea  vy  traces. 

3.000  4.2857 

Any  ex  cept  iron, 
pres  ent. 


7.1428 
71.4285 
7.1428 
0.0100 
0.0125 

1.0000 
0.C500 
0.2415 

0.2497 
0.2601 


0.1500 


0.1000 

0.4000 

28.5°' 
8.7° 


Microscopic  characters :  Bacteria  ot  any  liiTid  ;  f tin gi /  nu- 
merous vegetable  and  animal  forms  of  low  types  ;  epi- 
thelia  or  other  animal  structures ;  evidences  of  sew- 
age ;  ova  of  parasites,  etc. 


Remarks. 


Dark  colored  waters  may 
be  usable  when  the  im- 
purity is  vegetable. 


Chlorides  per  se  are  not 
hurtful,  unless  they  are 
magnesian  or  in  some 
quantity. 

Some  waters,  which  are 
organically  pure,  con- 
tain a  great  excess  of 
solids. 


In  the  absence  of  free 
ammonia,  or  much 
chlorine,  this  may  be 
due  to  vegetable  mat- 
ter. 


A  water  such  as  the  above  ought  to  be  absolutely  condemned.  Should  stress  of 
circumstances  compel  its  use,  it  ought  to  be  well  boiled  and  filtered ;  or,  better  still, 
distilled. 


WATER.  107 


SECTION  ^t:. 

SrB-SECTION    I. SE-iECH   AFTEE    WaTER. 

Occasionally  a  medical  officer  may  be  in  a  position  in  "wliicli  lie  has  to 
search,  for  water.     Few  precise  rules  can  be  laid  down. 

On  a  plain,  the  depth  at  which  water  will  be  found  will  depend  on  the 
permeability  of  the  soil,  and  the  dej^th  at  which  hai'd  rock  or  clay  will  hold 
up  water.  The  plain  should  be  well  sui-veyed  ;  and  if  any  part  seems  be- 
low the  general  level,  a  well  should  be  sunk,  or  tii;ds  made  vriih  Norton's 
tube-wells.  The  part  most  covered  "vsith  herbage  is  likely  to  have  the  water 
neai-est  the  surface.  On  a  diy  sandy  plain,  mom  in  g  mists  or  swarms  of 
insects  are  said  sometimes  to  mark  water  below.  Near  the  sea,  water  is 
generally  found  ;  even  close  to  the  sea  it  may  be  fresh,  if  a  large  body  of 
fresh  Avater  flowing  from  higher  gTound  hokls  back  the  salt  water.  But 
usually  wt ''■5  sunk  near-  the  sea  are  brackish  ;  and  it  is  necessary  to  sink 
several,  passing  farther  and  farther  inland,  till  the  point  is  reached  where 
the  fresh  water  has  the  predominance. 

Among  the  hills  the  search  for  water  is  easier.  The  hills  store  up 
water  which  mns  off  into  plains  at  theu'  feet.  Wells  should  be  sunk  at  the 
foot  of  hills,  not  on  a  spur,  but,  if  possible,  at  the  lowest  point ;  and  if 
there  are  any  indications  of  a  water-course,  as  near  there  as  possible.  In 
the  valleys  among  hills,  the  junction  of  two  long  valleys  will,  especially  if 
there  is  any  narrowing,  generally  give  water.  The  outlet  of  the  longest 
valleys  should  be  chosen,  and  if  there  is  any  trace  of  the  junction  of  two 
water-coui'ses,  the  well  should  be  sunk  at  their  imion.  In  a  long  valley  with 
a  contraction,  water  should  be  sought  for  on  the  mountain  side  of  the  con- 
traction. In  cUgging  at  the  side  of  a  valley,  the  side  with  the  highest  hill 
should  be  chosen. 

Before  commencing  to  dig,  the  country  should  be  as  carefully  looked 
over  as  time  and  opportunity  pei-mit,  and  the  dip  of  the  strata  made  out,  if 
possible.  A  httle  search  will  sometimes  show  which  is  the  direction  of  fall 
from  high  gToimds  or  a  water-shed. 

If  moist  ground  only  is  reached,  the  insertion  of  a  tube,  pierced  with 
holes,  deep  in  the  moist  gTound,  ^vill  sometimes  cause  a  good  deal  of  water 
to  be  coUected.  Norton's  American  tube-well  gave  satisfaction  in  Abyssinia, 
although  it  did  not  succeed  so  well  in  Ashantee.  A  common  pump  will 
raise  the  water  in  it  if  the  depth  be  not  more  than  2 J:  or  26  feet ;  if  deeper, 
a  special  force-pump  has  to  be  used. 

Sub-Section  II. — Speclil  Coxsideeations  ox  the  Supply  of  Watee  to 

SoLDIEPlS. 

In  barracks  and  hospitals,  and  in  all  the  usual  stations,  all  that  has  to 
be  done  is  to  make  periodical  examinations  of  the  C[uantity  and  cjuahty  of 
the  water,  to  inspect  the  cisterns,  etc.,  and  to  consider  frec|uently  if  in  any 
way  wells  or  cisterns  can  have  been  contaminated.  As  far  as  jDOSsible, 
a  record  should  be  kept  at  each  station  of  the  normal  composition  of  the 
water. 

In  transport  ships,  the  water  and  the  casks  or  tanks  should  always  be 
examined  before  going  to  sea.  Should  it  show  signs  of  putridity,  distilla- 
tion of  sea-water,  which  is  now  easily  managed,  shoulcl  be  resorted  to. 
If  the  water  distils  over  acid,  neutralize  with  carbonate  of  soda.     If  there 


108  PRACTICAL    HYGIEISTE. 

is  a  little  taste  from  organic  matter,  let  it  be  exposed  to  the  air  for  two  or 
thi'ee  days.  Crease's  tank-filters  supply  an  excellent  means  of  purifying 
water  in  large  quantities.  The  spongy  ii'on  ship-filter  is  also  an  excellent 
form  of  filter  for  the  purpose,  and  has  the  further  advantage  of  removing 
lead,  should  the  water  have  taken  any  up  during  the  process  of  distillation. 
Diu'ing  marches  each  soldier  carries  a  water-bottle.'  He  should  be 
taught  to  refill  it  with  good  water  whenever  practicable.  If  the  water  is 
decidedly  bad,  it  should  be  boiled  with  tea,  and  the  cold  tea  drunk.  The 
exhausted  leaves,  if  well  boiled  in  water,  vnl\  give  up  a  little  more  tannin 
and  coloring  matter,  and  will  have  a  good  eftect ;  and  if  a  soldier  would 
do  this  after  his  evening  meal,  the  water  would  be  ready  for  the  next  day's 

mai'ch.  Alum  and  charcoal  should  be  used. 
Small  charcoal  or  sandstone  filters  with  elas- 
tic tvibes  (Fig.  4)  at  the  top,  which  draw 
water  through  like  siphons,  or  thi-ough 
which  water  can  be  sucked,  are  useful,  and 
are  now  much  employed  by  officers.  They 
have  been  largely  used  by  the  French 
soldiers  in  Algiers,  and  some  were  issued 
to  our  troojDS  in  the  Ashantee  campaign. 
It  must  be  understood  that  these  are  all 
merely  strainers,  and  do  not  purify  the 
water  from  dissolved  substances. 
Fio.  4.  Soldiers   should   be   taught   that   there 

is  danger  in  drinking  tiu'bid  water,  as  they 
will  often  do  when  they  are  overcome  with  thirst.  Not  only  all  sorts  of 
suspended  matters  may  be  gulped  down,  but  even  animals.  On  some 
occasions,  the  French  army  in  Algiers  has  suffered  from  the  men  swallow- 
ing small  leeches,  which  brought  on  dangerous  bleeding.  The  pocket 
filters  act  fairly  well  in  removing  these  suspended  matters. 

If  water-carts  or  water-sacks  are  used,  they  shoidd  be  regularly  in- 
spected ;  evei-y  cart  should  have  a  straining  filter  of  pure  sand,  thi-ough 
which  the  water  should  pass.  The  carts  and  skins  should  be  sciiipulously 
clean.  The  water-carriers,  or  bheesties,  in  India  should  be  paraded  every 
morning,  and  the  sources  of  water  inquu-ed  into. 

"WTien  halting  ground  is  reached,  it  may  be  necessan'  to  filter  the  water. 
A  common  plan  is  to  carry  a  cask,  charred  inside,  and  pierced  with  smfill 
holes  at  the  bottom  ;  it  is  sunk  in  a  small  stream,  and  the  water  rises 
through  the  holes.  A  better  plan  still  is  to  have  two  casks,  one  inside  the 
other  ;  the  outer  pierced  with  holes  at  the  bottom  and  the  inner  near  the 
top  ;  the  space  between  is  filled  with  sand,  gravel,  or  any  filtering  medium 
that  may  be  procurable  ;  the  water  rises  through  the  gravel  between  the 
barrels,  and  flows  into  the  inner  barrel."  The  sand,  gravel,  or  other  ma- 
terial ought  to  be  frequently  turned  out,  cleaned,  or  changed.  Other  sim- 
ple jDlans  are  given  in  the  di*awings,  which  need  Httle  description.     Figs. 

'  The  Italian  water-bottle  lias  been  officially  adopted  in  oiir  army,  but  it  is  doubtful 
if  it  has  any  advantage  except  its  convenient  shape.  It  certainly  inijiarts  an  unpleas- 
ant taste  to  the  water  at  first  and  presents  difficulty  in  cleaning,  trobably  an  jron 
bottle  (coated  by  the  Bower-Barff  process),  covered  with  leather,  would  be  better. 

'^  In  the  Zulu  campaign  Surgeon-General  Woolfryes  states,  that  "to  the  large  base 
hospitals,  such  as  Fort  Pearson  and  Utrecht,  large  single  or  double  barrel  (charcoal)  filters 
made  in  Pietermaritzburg  were  furnished.  For  the  troops  barrel  (sand)  filters,  made 
on  the  spot  by  the  Royal  Engineers,  were  provided." — A.  M.  D.  Reports,  vol.  xxi.,  p. 
287. 


WATER. 


109 


5  and  6  speak  for  themselves      Fig.  7  is  a  barrel  connected  by  a  pipe  with 
a  supply  above  ;  the  water  rises  through  sand  and  charcoal,  and  is  drawn 


Fig.  5, 


FiQ.  6. 


Fig.  7. 


out  above  ;  the  barrel  is  fixed  on  a  winch,  and  the  supply  pipe  being  re- 
moved, and  the  hole  closed,  a  few  turns  of  the  handle  clears  the  sand.   Fig. 


'''-'^^-''^'''■'■^^^^ri^^^.^:,;^:^^^ 


Fig.  9. 


8  is  a  simple  contrivance,  which  may  be  made  of  wood  or  tin.     Figs.  9  and 
10  show  Crease's  field  filter  in  use,  either  as  a  hand  filter  (Fig.  10)  or  con- 


110 


PRACTICAL   HYGIENE. 


nectecl  by  an  india-rubber  tube  to  a  bucket  of  unfiltered  water  placed  in  a 
cai't  (Fig.  9).     It  acts  with  great  rapidity  and  gives  good  results.' 

In  the  held,  the  medical  officer  may  be  sent  on  to  give  a  report  of  the 
quantity  and  quality  of  any  source.  Before  the  troops  arrive  he  should 
make  his  arrangements  for  the  diiferent  places  of  supply  ;  men  and  cattle 
should  be  watered  at  different  points  ;  places  should  be  assigned  for  wash- 
and  if  removal  of  excreta  by  water  be  attempted,  the  excreta  should 


m" 


Fig.  10. 

flow  in  far  below  any  possible 
spring  ;  in  the  case  of  a  spring, 
several  resei-voirs  of  wood  should 
be  made,  and  the  water  allowed 
to  flow  from  one  to  another — the 
highest  for  men,  the  second  for 
cattle.  If  it  is  a  running  stream, 
localities  should  be  fixed  for  the 
special  pui-pose ;  that  for  the 
men's  drinking  water  should  be 
highest  uj?  the  stream,  for  ani- 
mals below,  washing  lowest ;  sen- 
tries should  be  placed  as  soon  as  fig.  ii.^ 
possible.      The     distribution   of 

water  should  be  regulated  ;  streams  are  soon  stirred  up,  made  tm-bid,  and 
the  water  becomes  undrinkable  for  want,  perhaps,  of  simple  management. 


'  In  the  Ziilu  campaign  of  1879,  Pnrs-pon-General  Woolfrve.?  reports  that  "  Crease's 
filters  were  used  in  the  farger  field  hos^pitils,  but  were  found  unsuitable  for  field  ser- 
vice, as  they  would  not  stand  the  rough  usage  incidental  to  the  march." — A.  M.  D.  Re- 
ports, vol.  xxi.,  p.  287. 

.  -'  Fig.  11 — Spongy  iron  filter,  special  hall-cock  pattern. — A,  cap  of  regulator  ;  P, 
ball-cock;  C,  perforated  lid,  covering  spongy  iron;  C,  perforated  lid,  covering  /  r>- 
pared  sriml;  C  ',  perforated  plate,  through  which  water  flows  to  regulator;  D,  cover  of 
filter  ;  F,  filtered  water ;  G,  glass  ball :  I,  spongy  iron  ;  L.  lever  of  ball-cock  ;  O,  with- 
drawing-pin  of  lever;  P,  tube  connecting  with  water-supply  or  cistern;  E,  screws  to 
fasten  ball-cock  to  filter ;  S,  pyrolusite ;  S',  sand  ;  S",  fine  gravel  (these  three  form  the 
prepared  sand) ;  T,  tap  or  stop-cock,  from  which  to  draw  the  filtered  water  ;  U,  unfil- 


I 


WATER.  Ill 

Wherever  practicable,  the  reservoii-s  or  cisterns  which  are  made  should 
be  covered  in ;  even  if  it  is  merely  the  most  flimsy  covering,  it  is  better 
than  nothing. 

In  sieges  the  same  general  rules  must  be  attended  to.  The  distribu- 
tion of  the  water  should  be  under  the  care  of  a  vigilant  medical  officer. 
Advantage  should  be  taken  of  every  rainfall ;  fresh  wells  should  be  dug 
early ;  if  necessary,  distillation  of  brackish  or  sea-water  must  be  had  re- 
coui'se  to, 

tered  water  ;  V,  screw  valve ;  X,  division  in  regulator,  from  which  X  A  may  be 
screwed  off ;  near  X  is  the  aperture  through  which  the  filtered  water  flows  into  the 
reserYoir  F. 


CHAPTER  11. 

AIR. 

It  might  be  inferred  from  the  physiological  evidence  of  the  paramount 
importance  of  proper  aeration  of  the  blood,  that  the  breathing  of  air  ren- 
dered impure  from  any  cause  is  hurtful,  and  that  the  highest  degree  of 
health  is  only  possible  when  to  the  other  conditions  is  added  that  of  a 
proj)er  supply  of  pure  air.  Experience  strengthens  this  inference.  Statisti- 
cal inquiries  on  mortality  prove  beyond  a  doubt  that  of  the  causes  of  death 
which  are  usually  in  action,  impurity  of  the  air  is  the  most  important.  Indi- 
vidual observations  confirm  this.  No  one  who  has  paid  any  attention  to  the 
condition  of  health,  and  the  recovery  from  disease  of  those  persons  who  fall 
under  his  observation,  can  doubt  that  impurity  of  the  air  marvellously 
affects  the  first,  and  influences,  and  sometimes  even  regulates  tlie  second. 
The  average  mortality  in  this  country  increases  tolerably  regularly  with 
density  of  population.  Density  of  population  usually  implies  poverty  and 
insufficient  food,  and  unhealthy  work  ;  but  its  main  concomitant  condition 
is  impvirit}'^  of  air  fi'om  overcrowding,  deficiency  of  cleanliness,  and  imper- 
fect removal  of  excreta,  and  when  this  condition  is  removed,  a  very  dense 
and  jDoor  population  may  be  perfectly  healthy.  The  same  evidence  of  the  ef- 
fect of  pru-e  and  impm-e  air  on  health  and  mortality  is  still  more  strikingly 
shown  by  horses ;  for  in  that  case  the  question  is  more  simple,  on  account 
of  the  absolute  similarity,  in  different  j)ei'iods  or  places,  of  food,  water, 
exercise,  and  treatment.  Formerly,  in  the  French  army,  the  mortality 
among  the  horses  was  enormous.  Rossignol '  states  that,  previous  to  1836, 
the  mortality  of  the  French  cavalry  horses  varied  from  180  to  197  per 
1,000  per  annum.  The  enlargement  of  the  stables,  and  the  "  increased 
quantity  of  the  ration  of  air,"  reduced  the  loss  in  the  next  ten  years  to  68 
per  1,000.'  In  1862-66  the  rate  of  death  was  reduced  to  27^  per  1,000, 
and  officers'  horses  (the  property  of  the  State)  to  20.  The  admissions  for 
lung  diseases  were,  in  1849-52,  105,  and  in  1862-66,  36  ;  for  glanders, 
1847-52,  23  ;  1862-66,  7^.^  In  the  Itahan  war  of  1859,  M.  Mouhn,  the 
chief  veterinary  surgeon,  kept  10,000  horses  many  months  in  barracks  open 
to  the  external  air  in  place  of  closed  stables.  Scarcely  any  horses  were 
sick,  and  only  one  case  of  glanders  occurred.* 

In  the  English  cavalry  (and  in  English  racing  stablesj  the  same  facts 
are  well  known.  Wilkinson  ''  informs  us  that  the  annual  mortality  of 
cavalry  horses  (which  was  formerly  great)  is  now  reduced  to  20  per  1,000, 

'  Traits  d'Hygione  Militaire.     Paris,  1857. 

■■^  Wilkinson,  Journal  of  the  Agricultural  Society,  No.  50,  p.  91  et  seq. 
3  Vital  Statistics  of  Cavalry  Horses,  by  T.  G.   Balfour,  M.D.,  F.E.S.,  Surgeon-Gen- 
eral.   Journal  of  the  Statistical  Society,  June,  1880. 

^Larrey  :   Hygiene  des  Hop.  Mil.,  1868,  p.  63.  ^Op.  cit. 


AIR.  113 

of  which  one-half  is  from  accidents  and  incurable  diseases.  Glanders  and 
farcy  have  almost  disappeared,  and  if  a  case  occurs,  it  is  considered  evi- 
dence of  neglect. 

The  food,  exercise,  and  general  treatment  being  the  same,  this  result 
has  been  obtained  by  cleanliness,  dryness,  and  the  freest  ventilation.  The 
ventilation  is  threefold — ground  ventilation,  for  drying  the  floors  ;  ceiling 
ventilation,  for  discharge  of  foul  air ;  and  supply  of  air  beneath  the  horses' 
noses,  to  dilute  at  once  the  products  of  respiration. 

In  cow-houses  and  kennels  similar  facts  ai-e  v^^ell  known ;  disease  and 
health  are  in  the  direct  proportion  of  foul  and  pure  air. 

The  air  may  affect  health  by  variations  in  the  amount  or  condition  of 
its  normal  constituents,  by  differences  in  physical  properties,  or  by  the 
presence  of  impurities.  While  the  immense  effect  of  impure  air  cannot 
be  for  a  moment  doubted,  it  is  not  always  easy  to  assign  to  each  impurity 
its  definite  action.  The  inquiry  is,  in  fact,  in  its  infancy  ;  it  is  difficult, 
and  demands  a  more  searching  analysis  than  has  been,  or  perhaps  than 
can  be  at  present,  given.  When  impure  air  does  not  produce  any  very 
striking  disease,  its  injurious  effects  may  be  overlooked.  The  evidences  of 
injury  to  health  from  impure  air  are  found  in  a  larger  proportion  of  ill 
health — i.e.,  of  daj'^s  lost  from  sickness  in  the  year — than  under  other  cir- 
cumstances ;  an  increase  in  the  severity  of  many  diseases,  which,  though 
not  caused,  are  influenced  by  impure  air  ;  and  a  higher  rate  of  mortality, 
especially  among  children,  whose  delicate  frames  always  give  us  the  best 
test  of  the  effect  both  of  food  and  air.  In  many  cases  accurate  statistical 
inquiries  on  a  large  scale  can  alone  prove  what  may  be  in  reality  a  serious 
depreciation  of  public  health. 

The  quantity  of  air  necessary  for  perfect  health  will  be  considered  in 
the  chapter  on  Ventilation.  In  the  present  chapter  the  impurities  will  be 
mentioned,  and  then  the  diseases  attributable  to  them. 

The  following  is  the  composition  of  average  pure  air  : 

Composition  of  Atmospheric  Air. 

Oxygen 209.6  per  1,000  volumes. 

Nitrogen 790.0 

Carbonic  acid  (or  carbon  dioxide) 0.4  " 

Watery  vapor Varies  with  temperature. 

Ammonia Trace. 

Organic  matter  (in  vapor  or  suspended,  ^ 
organized,  unorganized,  dead  or  living),  | 

Ozone )■   Variable. 

Salts  of  sodium | 

Other  mineral  substances J 

The  amount  of  oxygen  is  209.8  in  the  pure  mountain  air,  while  in  the 
air  of  towns  it  may  fall  to  209.0  or  208.7.'  The  mean  amount  of  ozone  is 
given  by  Levy  at  1.15   milligramme  per  100  cubic  metres  at  Montsouris.^ 

The  amount  of  watery  vapor  varies  in  different  countries  greatly,  from 
about  30  per  cent,  of  saturation  to  perfect  saturation  ;  or,  according  to 
temperature,  from  1  to  11,  or  even  12  grains  in  a  cubic  foot  of  air.  Dur- 
ing the  rains  in  the  tropics,  that  amotint  is  not  unfrequently  exceeded. 
The  best  ratio  for  health  has  not  been  determined,  but  it  has  been  sup- 

'  A.  Smith  :  Air  and  Rain,  pp.  335  et  seq.  ^  Annuaire  for  1882. 

Vol.  I.— 8 


114  PRACTICAL    HYGIENE. 

posed  it  should  be  from  65  to  75  per  cent.  ;  in  many  healthy  chmates, 
however,  it  is  much  more  and  in  some  much  less  than  this. 

The  amount  of  carbon  dioxide  in  normal  air  ranges  from  .2  to  .5  per 
thousand  (or  from  2  to  5  volumes  in  10,000)  ;  it  increases  slightly  up  to 
11,000  feet  of  elevation,  then  decreases  ;  it  is  augmented  under  certain  cir- 
cumstances ;  as  in  sea-air  by  day,  though  not  at  night  ;  the  difference 
being  between  .54:  to  .33  jier  thousand  (Lewy).  Duiiug  the  Arctic  Expe- 
dition of  1875,  Dr.  E.  L.  Moss,  of  the  Alert,  fountl  it  to  range  from  0.483 
to  0.641  per  thousand;  mean,  0.552  '  in  N.  Lat.  82°  27'. 

Fodor  ■  found  the  L'O,  at  Buda-Pesth,  druing  the  years  1877-8-9,  veiy 
constant  in  cpxantity,  the  mean  being  0.3886  per  1,000  vols.  He  gives  the 
limits  as  0.200  to  0.600,  outside  which  cases  occiu*  very  seldom,  or  depend 
upon  eiTors  ;  the  seasonal  range  is  lowest  in  winter,  an  increase  in  spiing, 
again  a  diminution  in  summer,  and  the  highest  point  is  reached  in  autumn. 
There  is  less  near  the  sea-shore  and  more  in  the  middle  of  the  continent ; 
it  ajDpeai-s  to  increase  in  snow  and  frost,  but  to  diminish  with  rain,  thaw 
and  '\\ind  ;  the  north  wind  brings  less  C0„  with  it  than  the  south.  Fodor 
attributes  the  greatest  influence  on  the  variation  of  C0„  in  the  atmosphere 
to  its  rising  from  the  gTound  air ;  the  C0„  being  always  greater  at  the 
ground  level  than  one  metre  above  it.  Le^'J'''  gives  the  mean  C0„  at  the 
Observatory  of  Moutsotu-is  at  0.302  jDer  1,000  vols,  in  a  series  of  five  yeai's' 
obsei'vations. 

Ammonia  and  org-anic  matter  ought  probably  to  be  considered  as  im- 
purities. 

SECTION  L 
IMPURITIES  IX  AIR. 

A  vast  number  of  substances,  vapors,  gases,  or  sohd  particles,  continu- 
ally pass  into  the  atmosphere.  Many  of  these  substances  can  be  detected 
neither  by  smell  nor  taste,  and  are  inhaled  without  any  knowledge  on  the 
part  of  those  who  breathe  them.  Others  are  smelt  or  tasted  at  first  ;  but 
in  a  short  time,  if  the  substance  remains  in  the  atmosphere,  the  nerves 
lose  their  dehcacy  ;  so  that,  in  many  cases,  no  warning,  and  in  other  in- 
stances, slight  warning  only  is  given  by  the  senses  of  these  atmospheric 
impimties. 

As  if  to  compensate  for  this,  a  wonderful  series  of  processes  goes  on 
ill  the  atmosphere,  or  on  the  earth,  which  keeps  the  air  in  a  state  of 
purity. 

Gases  diffuse,  and  are  canied  away  by  winds,  and  thus  become  so  diluted 
as  to  be  innocuous  ;  or  ai'e  decomposed  if  compound,  or  are  washed  down 
by  rain  ;  solid  substances  hfted  into  the  au-  by  winds,  or  by  ascensional 
force  of  evaporation,  fall  by  their  own  weight ;  or  if  organic,  are  oxidized 
into  simple  compounds,  such  as  watei',  cai'bon  dioxide,  nitric  acid  and 
ammonia ;  or  diy  and  break  up  into  impalpable  pai-ticles,  which  are 
washed  down  by  rain.     Diffusion,  dilution  by  wmds,  oxidation,  and  the 

'  Dr.  B.  Ninnis,  of  tlie  Discovery,  found  mncli  higlier  amoimts,  but  the  conditions 
may  not  have  been  quite  the  same,  or  some  accidental  error  may  have  occurred.  (See 
Report  of  the  Committee  on  the  Outbreak  of  Scurvy,  1877.) 

-  Hygienische  Untersucliungen  iiber  Luft,  Boden  u.  Wasser,  Erste  Abtheilung,  Die 
Luft.  Braunschweig,  1881.  For  further  details  from  this  important  work,  see  Report 
on  Hygiene,  Army  i>,edical  Reports,  vol.  xxiii. 

^  Auuuaire  de  Aioutsouris,  iyb2. 


AIR.  '  115 

fall  of  rain,  are  the  great  pimfiers  ;  and,  in  addition,  tliere  is  the  wonderful 
laboratory  of  the  vegetable  world,  which  keej^s  the  carbon  dioxide  of  the 
atmosphere  within  certain  limits.  If  it  were  not  for  these  counterbalan- 
cing agencies,  the  atmosj)here  would  soon  become  too  impure  for  the  human 
race.  As  it  is,  it  is  wonderful  how  soon  the  immense  impiuity,  which 
daily  passes  into  the  air,  is  removed,  except  when  the  perverse  ingenuity 
of  man  opposes  some  obstacle,  or  makes  too  great  a  demand  even  upon 
the  pimf Adng  powers  of  Nature. 

The  ail'  passing  into  the  lungs  in  the  necessaiy  and  automatic  process 
of  respii-ation,  is  dra-ma  successively  thi'ough  the  mouth  and  nose,  the  fau- 
ces, and  the  aii'-tubes.  It  may  consist,  according  to  cu'cumstances,  of 
matters  perfectly  gaseous  (as  in  pure  au'),  or  of  a  mixtui-e  of  gases  and 
sohd  particles,  mineral  or  organic,  which  have  j)assed  into  the  atmosphere. 

The  truly  gaseous  substances  will  doubtless  enter  the  passages  of  the 
lungs,  and  will  meet  there  T\dth  that  wonderful  sm-face,  covered  with  the 
most  dehcate  tufts  of  blood-vessels,  unshielded  even,  it  is  supjDosed  by 
some,  by  epithehum,  which  stand  up  on  the  sru-face  of  5,000.000  or 
6,000,000  aii'-cells,  and  thi-ough  which  the  blood  flows  mth  gTeat  velocity  ; 
there  they  vnB.  be  absorbed,  and  if,  as  has  been  calculated,  the  surface  of 
the  au'-cells  is  as  much  as  from  10  to  20  square  feet  (and  some  have 
placed  these  figou'es  much  higher),  we  can  well  understand  the  ease  and 
rapidity  ^vith  which  gaseous  substances  will  enter  the  blood. 

The  solid  particles  or  molecules  entering  with  the  air,  may  lodge  in 
the  mouth  or  nose,  or  may  jDass  into  the  lungs,  and  there  decompose,  if  of 
destructible  natui*e  ;  or  maj  dissolve  or  break  down  if  of  mineral  f  oi-mation  ; 
or  may  remain  as  soui'ces  of  initation  until  dislodged  ;  or  perhaps  become 
covered  over  with  epithehum  like  the  particles  of  carbon  in  the  miner's 
lung,  or  may  pass  into  epithehum,  and  enter  the  body  through  the  hTQ- 
phatics. 

If  such  particles  lodge  in.  the  mouth  or  nose  they  may  be  swallowed, 
and  pass  into  the  alimentary  canal,  and  it  is  even  more  j)i'obable  that  this 
should  be  the  case  with  all  except  the  lightest  and  most  finely  divided  sub- 
stances, than  that  they  should  pass  into  the  lungs.  x4Ithough  incapable  of 
present  proof,  there  is  some  reason  to  think  that  some  of  the  specific 
poisons,  which  float  about  in  an  impure  atmosphere,  such  as  those  which 
arise  from  the  typhoid  or  cholera  evacuations,  may  produce  their  fu'st 
effects,  not  on  the  lungs  or  blood,  but  on  the  alimentaiy  mucous  mem- 
brane, with  which  they  are  brought  into  contact  when  swallowed. 

Sub-Section  L — Suspe>t)ed  ]\L\ttees. 

Nature  of  Suspended  Substances. — An  immense  number  of  substances, 
organic  and  inorganic,  may  be  suspended  in  the  atmospliere.  From  the 
soil  the  winds  lift  sihca,  finely  powdered  sihcate  of  aluminium,  carbonate 
and  phosphate  of  calcium,  and  peroxide  of  iron.  Volcanoes  throw  up  fine 
particles  of  carbon,  sand,  and  dried  mud,  which,  passing  into  the  higher 
regions,  may  be  carried  over  hundi'eds  of  miles. 

The  animal  kingdom  is  represented  by  the  debris  of  the  perished  crea- 
tures who  have  hved  in  the  atmosphere,  and  also  it  would  appear  that  the 
ascensional  force  of  evaporation  will  hit  even  animals  of  some  magnitude 
from  the  sru'face  of  marsh  water. 

From  the  vegetable  world  pass  up  seeds  and  debiis  of  vegetation  ;  pol- 
len, spores  oi fungi,  mycoderms,  mucedines,  which  may  gi-ow  in  the  atmos- 
phere, and  innumerable  volatile  substances  or  odors.     Tne  germs  also  of 


116  PRACTICAL    HYGIENE. 

vibrlones,  bacteria,  and  monads  are  largely  present,  and  small  eggs  of  various 
kinds. 

From  the  sea  the  wind  lifts  spray,  and  the  chloride  of  sodium  becom- 
ing dried  is  so  diffused  through  the  atmosphere,  that  it  is  difficult,  on 
sjDectrum  analysis,  to  iiud  a  spectrum  without  the  j'ellow  Hue  of  soda. 

The  works  and  habitations  of  man,  however,  fm-nish  matters  probably  of 
much  greater  importance  in  a  hygienic  point  of  view. 

It  is  not  easy  at  present  to  give  a  complete  enumeration  of  aU  the  sub- 
stances, but  the  following  are  the  chief  facts,  divided  under  the  headings 
of  suspended  substances  in  the  external  air  ;  in  rooms  inhabited  by  healthy 
persons  ;  in  rooms  inhabited  by  sick  persons  ;  in  workshops  and  factories. 

Suspended  Substances  in  External  Air. 

1.  Duat  and  Sand  Shoivers. — In  diffei'ent  parts  of  Eui'ope  there  occur 
from  time  to  time  showers  of  dust  and  sand.  Ehrenberg  '  gives  the  micro- 
scopic examination  of  seventy  showers  ;  in  addition  to  particles  of  sand 
and  oxide  of  iron,  there  were  numerous  organic  forms,  which  are  classed 
by  Ehrenberg  imder  the  headings  oi  jjot i/gasfrica  (194  forms),  phytoUtharite 
(145  forms),  polythahnia,  etc.  In  addition  there  were  portions  of  plants 
and  fragments  of  insects.  In  a  dust  storm  of  February,  1872,  in  Sicily, 
Silvestri ''  found  four  species  of  diatoms  and  living  infusoria.  These  sand- 
storms are  sometimes  called  monsoon  showers,  but  it  would  appear  that  any 
violent  storm  of  a  cyclonic  character  may  lift  the  dust  from  sandy  wastes, 
as  from  the  African  deserts,  and  transport  it  great  distances. 

It  remains  yet  tmcertain  whether  all  dust-storms  are  entirely  of  telluric 
origin  ;  it  has  been  supposed  that  some  may  be  derived  from  meteoric 
showers,  i.e.,  may  enter  our  atmosphere  from  the  realms  of  space,  and 
there  has  been  some  speculation  as  to  whether  morpliolithes  of  peculiar 
nature  may  not  be  contained  in  such  meteoric  dust  showers.^ 

There  seems  no  doubt  that  atmospheric  dust  may  travel  to  great  dis- 
tances ;  the  air  of  Berlin  has  evidently  contained  organisms  derived  from 
the  African  deserts,  and  the  sails  of  ships  600  or  800  miles  from  Africa  are 
often  quite  i-ed  with  the  sand  which  lodges  on  them, 

2.  Independent  of  these  sand-stonns,  thei'e  are  numerous  living  crea- 
tures in  the  atmosjDhere  :  some  lifted  from  the  ground  by  winds,  others 
gi'owing  in  the  air.  Ehrenberg  has  discovered  at  least  200  forms — rhizo- 
pods,  tardigrades,  and  anguilhdce.  These  can  be  dried,  and  will  then  re- 
tain their  vitality  for  months,  and  even  years. 

When  the  external  air  is  examined  either  by  means  of  an  aeroscope  of 
some  kind,  or  by  drawing  it  through  previously  heated  glass  tubes,  siu'- 
rounded  by  a  fi-eezing  mixture,  many  of  these  oi'ganisms  can  be  found. 
Their  number  cannot  be  directly  estimated  at  present.  Indirectly  A.  Smith 
has  endeavored  to  calculate  the  amount^  fi'om  the  ammonia  in  the  air 
which  appears  to  be  derived  from  organic  matter,  and  has  supposed  that 
there  might  be  529,560  germs  (  =  .0056  grain)  in  one  cubic  foot  of  the  air 

'  Uebersiclit  der  seit  1847,  forgesetzten  Untersuchungen  iiber  das  vou  der  Atmos- 
phere unsichtbar  getragene  rieche  organische  Leben.     Berlin,  1871. 

''  Comptes  Rendus,  1872,  p.  991. 

^  Dr.  O.  Hahn  (whose  observations  are  confirmed  by  D.  D.  F.  Weiland)  is  said  to 
liave  discovered  organisms  of  a  coralline  natnre  in  the  interior  of  meteorites  of  the 
choadrite  class  (Daily  Telegraph's  Berlin  Correspondent,  May  13,  1882).  Should  this 
prove  correct,  it  opens  up  a  new  and  interesting  field  of  study,  especially  in  connection 
with  Sir  William  Thomson's  suggestion  of  the  meteoric  origin  of  life  in  this  earth. 

*  Air  and  Haiu,  p.  504. 


I 


Plate  V. 


External  Air. 


Desckiption  of  Plate  V. 


External  Air. 


Fig.  1.  Fragment  of  Pine-wood. 

V.  Epidermis  of  Hay,  with  Fungus  attached, 

2.  Linen  fibres.     N.B.  The  thick  fibres  crossing  in  lower  third  of  plate. 

3.  Epithelium  (nucleated)  from  the  mouth. 

4.  Do.        detached  from  the  skin. 

5.  Cotton  fibre. 

6'.  Feather,  or  Down. 

a.  Charred  vegetable  particles,  and  mineral  matter. 


AIR.  117 

of  a  city.  But  indirect  calculations  of  this  kind  are  of  course  doubtful. 
The  following  are  the  most  important  kinds  : 

(a)  Extremely  small  round  and  oval  cells,  appearing  in  pairs  or  ad- 
hering together.  The  cells,  described  by  Lemaire,'  Trautman,'  Bechamp, 
and  others,  ai'e  exceedingly  minute,  and  it  requires  a  power  of  600  to  1,000 
diameters  to  see  them  properly.  Trautman  states  that  they  gi'ow  faster 
when  sulphuretted  hydrogen  is  in  the  air,  and  are  checked  by  carbolic 
acid.  Lemaire  found  them  in  immense  quantities  in  the  air  of  dirty 
prison  cells,  and  in  the  sweat  of  the  prisoners  ;  they  will  occur,  however, 
in  the  open  aii'.  They  are  supposed  to  increase  rapidly  by  cleavage,  but 
their  futiu*e  development,  if  any,  is  uncertain  ;  no  effect  on  the  body  has 
been  proved  to  be  produced  by  them. 

These  bodies  probably  correspond  to  the  micrococci  or  sphoerohacteria 
of  Cohn. 

Other  bacteria  are  also  met  with,  such  as  B.  termo  (Microbacteria) 
Bacillus  and  vibrio  (Desmobacteria),  Spirillum  and  Spiroclxcete  (SjDirobac- 
teria).  Burdon-Sanderson's  observations  threv,  doubt  on  the  existence  of 
bacteria  in  the  air  as  such :  D.  D.  Cunningham  also  found  bacteria  were 
rarely  present  (that  is,  recognizable)  in  dry  atmospheric  dust,  but  they 
were  occasionaUy  found,  as  well  as  a  specimen  of  green  spirillum  ;  but  in 
the  deposit  from  the  moist  air  of  sewers  distinct  bacteria  were  fi-equently 
observed.  T'le  truth  probably  is  that,  although  they  may  be  rarely  met 
with  in  full  development,  this  depends  on  the  absence  of  proper  nutriment 
and  favorable  conditions  for  growth,  but  the  existence  of  their  spores 
(perhaps  in  some  cases  the  so-called  sjyhcej^obacteria)  appears  to  be  clearly 
proved  by  the  cultivation  experiments  of  TyndalP  and  Fodor.'* 

The  number  of  bacteria  also  varies  with  the  season  (Fodor,^  IMiqueP), 
being  greatest  in  autumn  (142)  and  in  summer  (105),  less  in  spring  (85), 
and  least  in  winter  (49  per  metre  cube).  Part  of  this  variation  is  due  un- 
doubtedly to  dryness,  for  it  is  obseiwed  that  in  rainy  weather  they  are 
little  to  be  met  mth,  but  after  some  days  of  dry  weather  become  plentiful 
(Nageli,  Fodor,  jMiquel). 

Fodor'  found  at  Buda-Pesth,  in  1878-79,  bacteria  in  522  out  of  646 
observations.  Drawing  the  air  through  a  cultivating  solution,  he  found 
numerous  kinds  of  bacteria  developed.  The  micrococci  or  sphcerobacteria 
were  the  most  frequent,  the  sjm'obacteria  tlie  rarest.  Desmobacteria  were 
comparatively  rare.  One  form  of  microbacterium  he  calls  M.  agile,  and  at- 
tributes to  it  exceptional  infective  power.     Monads  were  rare. 

{b)  Spores  of  fungi  are  not  infrequent ;  in  the  ojoen  air  they  occur  most 
commonly  in  the  summer  (July  and  August), "^  they  are  not  in  this  country 
more  frequent  with  one  wind  than  another ;  the  largest  number  found  by 
Maddox  in  ten  houi's  was  250  spores  ;  on  some  days  not  a  spore  can  be 
found.  Maddox  leaves  undetermined  the  kind  of  fungus  which  the  spores 
developed  under  cultivation  ;  the  spores  were  pale  or  olive-colored  and 
oval,  probably  from  some  form  of  smut.  Angus  Smith  found  in  water 
through  which  the  au-  of  Manchester  was  drawn  innumerable  spores.     Mr. 

'  Comptes  Eendtis  de  I'Acad. ,  Oct.,  1867,  p.  637. 

'■^  Die  Zersetzungsgase  als  TJrsache  zur  Weiter-verbreitung  der  Cholera,  1869. 

^  Floating  Matter  in  the  Air  in  Eelation  to  Putrefaction  and  Infection,  by  John 
Tyndall,  F.R.S.     Longman,  1881. 

■*  Op    cit. 

*  Annuaire  de  Montsouris,  1882,  pp.  406  et  seq. 

«  Maddox  :  Monthly  Journal  of  the  Microscopical  Society,  June,  1870,  and  Febru- 
ary, 1871. 


118  PRACTICAL    HYGIENE.  • 

Dancer  lias  calculated  that  in  a  single  drop  of  the  water  250,000  fungoid 
spores  as  well  as  mycelium  were  present,  but  as  the  water  Avas  not  ex- 
amined for  some  time  there  may  have  been  growth.  Mycelium  of  fungus 
seems  uncommon  in  the  air,  but  is  sometimes  found.  The  cells  of  the 
Protococcus  jduvialis  are  not  uncommon,  and  perhaps  of  other  aJgce. 
Blackley  '  says  the  amount  of  spores  collected  on  a  slide  in  four  hours 
amounted  to  30,000  or  40,000  per  square  inch.  Dr.  D.  D.  Cunningham' 
states  that  in  the  air  in  the  subui'bs  of  Calcutta  sj)ores  are  constantly 
present,  and  usually  in  considerable  numbers.  He  gives  a  large  number 
of  beautiful  drawings. 

Fodor^  found  by  cultivation  that  mucedines  made  their  appearances  171 
times,  sarcinae  48.  Bacteria  and  fungi  seemed  to  alternate  in  seasons  and 
years.  Thus  in  spring  bacteria  were  most  numerous  and  fungi  fewest, 
whilst  the  opposite  was  the  case  in  autumn.  Snow  and  rain  lessened  the 
quantity  of  both. 

(c)  Parts  of  flowers,  especially  jwllen*  in  the  spring  and  summer  are 
\evy  common, — cuticvdar  scales,  vegetable  fibres  and  hairs,  seed  capsules, 
globular  cells,  etc.  Near  habitations  are  also  found  bits  of  wood  often 
withered  or  burnt,  bits  of  charcoal,  starch  grains,  cotton  and  wool  fibres, 
etc.  All  these  substances  appear  fi-om  Watson's  experiments  to  be  more 
abundant  in  land  than  sea  air,  as  might,  indeed,  be  expected.^ 

[d)  Animals,  or  portions,  such  as  scales  from  the  wings  of  moths  and 
butterflies ;  portions  of  the  wings  of  insects  ;  legs  of  spiders,  bits  of  spi- 
ders' webs,  and  similar  objects,  are  not  uncommon  ;  but  sometimes  even 
living  animals  of  some  size,  apparently  rhizopods  and  amoebiform  bodies. 

((?)  Mineral  substances,  fine  particles  of  sand,  clay,  and  chalk  are  gener- 
ally met  with,  even  when  there  is  no  dust-storm,  and  are  much  more 
common  when  the  ground  is  dry  ;  rain,  indeed,  appears  not  only  to 
prevent  these  particles  from  being  lifted,  but  also  to  precipitate  those  in 
the  air. 

In  manufacturing  districts,  or  near  a  railway,  there  may  be  even  large 
particles  of  metals,  or  pottery  clay,  or  stone  in  the  external  air  ;  in  the 
dust  collected  from  a  railway  carriage  near  Birmingham,  ]Mr.  Sidebotham " 
found  many  large  jjarticles  of  iron  capable  of  attraction  by  a  magnet,  and 
being,  in  fact,  fused  particles  of  iron  often  covered  with  spikes  and  excres- 
cences. 

In  towns  with  macadamized  roads,  dust  and  remains  of  horse  drop- 
pings, finely  powdered  by  the  traffic,  pass  into  the  air,  and  as  this  is  more 
common  in  dry  weather,  the  sanitary  importance  of  watering  and  washing 
the  streets  of  great  trafiic  is  manifest. 

Mr.  Tichborne  has  published '  some  analyses  of  the  street  dust  of  Dub- 
lin ;  it  contained  from  29.7  per  cent,  of  organic  matter  (at  the  top  of  a 
pillar  134  feet  high)  to  45.2  per  cent,  (in  the  air  of  a  street) ;  the  organic 
matter  was  chiefly  stable  manure  finely  ground  ;  it  acted  as  a  ferment,  and 

'  Experimental  Researches  on  the  Causes  and  Nature  of  Catarrhus  ^stivus,  1873. 

'  Ninth  Annual  Report  of  the  Sanitary  Commissioner  with  the  Government  of 
India. 

'  Op.  cit. 

*  Blackley  (op.  cit.)  shows  that  pollen  is  in  large  quantities,  sometimes  amounting 
to  7,870  grains  per  square  inch  of  slide.  In  the  upper  strata  of  the  air  (at  400  to  500 
feet)  he  found  much  more  than  in  the  lower,  on  an  average  19  times  as  much.  Cun- 
ningham (op.  cit.)  also  found  pollen  in  large  quantity. 

''  Army  Medical  Department  Report,  vol.  xi.,  p.  529  (1871). 

«  Chemical  News,  October,  1871. 

'  Ibid.,  October,  1870. 


Description  of  Plate  VL 


Accident  Ward. 


Fig.  1'.  Epidermis  of  Hay.     1.  Do.  with  Fungus  attached. 

2.  Linen  fibre. 

2'.  Fungus  filament.     N.B.  Long  narrow  filament  in  upper  left  of 
plate. 

3.  Nucleated  Epithelium  from  the  mouth. 
3a.  Pus  cells. 

4.  Worn  EpitheKum  from  the  skin. 

4a.  Charred  vegetable  particles.     4c?.  Fungus  spores. 

5.  Cotton  fibre. 

6.  Woollen  fibre. 

7.  Fragments  of  Insects. 

8.  Pine  PoUen. 

9.  Dried-up  Pahnellaceous  Fraud. 

10.    Ciliated  spore,  probably  of  Vaucheria. 


Plate  VI 


Accident  Ward.     St.  Mary's  Hospital,  London. 


AIR.  119 

reduced  nitrate  of  potassium  into  nitrite  ;  it  had,  therefore,  a  strong-  de- 
oxidizing power.  The  plate  (No.  V.)  drawn  by  Dr.  J.  D.  Macdonald,  RN., 
F.RS.,  shows  some  of  the  substances  collected  from  the  external  air  in  the 
garden  of  St.  Mary's  Hospital,  Paddington. ' 

(/)  It  cannot  be  doubted  that  various  organic  substances  dried  in  the 
ground  and  finely  pulverized,  may  be  lifted  into  the  air  by  winds,  and  may 
be  carried  to  gTeat  distances  ;  under  the  microscope  the  particles  would 
probably  appear  formless,  and  could  not  be  referred  to  any  special  class, 
but  would  be  included  under  the  term  of  "dust,"  or  "  amorphous  matter." 
In  this  way  it  is  believed  that  some  diseases  may  be  propagated  ;  cholera, 
for  example,  by  the  particles  of  dried  excreta  lifted  and  carried  by  the  wind, 
and  small-pox  and  scarlet  fever  by  the  disintegrated  epidermis  or  dried 
discharges.^ 

Some  of  the  various  particles  of  different  kinds  thus  suspended  in  the 
air  reflect  and  scatter  the  rays  of  hght,  and  produce  the  appeai*ance  of  fine 
motes,  which  are  familiar  to  every  one,  as  seen  in  the  course  of  a  ray  of 
light  passing  through  a  dark  room,  or  when  an  electric  beam  is  transmitted 
through  a  tube.  When  the  air  is  kept  motionless  they  subside,  so  that 
most  of  them  have  some  weight,  though  some  are  so  light  as  to  float  in 
rarefied  air  (Tichborne) ;  when  heatecl,  Tyndall  has  shown  that  many  of 
them  are  burnt,  and  a  little  bluish  mist  arising  from  the  combustion  can 
even  be  perceived  ;  the  destructible  nature  proves,  of  course,  the  organic 
origin  of  those  consumed,  but  does  not  show  whether  they  are  organized 
or  not. 

Suspended  Matters  in  Enclosed  Spaces. 

1.  Booms  inhabited  by  Healthy  Persons, — In  all  inhabited  rooms  which 
ai"e  not  perfectly  ventilated,  the  presence  of  scaly  epithelium,  single  and 
tessellated  ;  round  cells  hke  nuclei,  portions  of  fibres  (cotton,  linen,  wool), 
portions  of  food,  bits  of  human  hair,  wood,  and  coal,  can  be  found  in  addi- 
tion to  the  bodies  which  are  present  in  the  external  air,  though,  as  pointed 
out  by  Watson,  mineral  matters  and  vegetable  matters  are  not  so  plentiful, 
as  the  comparative  stillness  of  the  air  allows  them  to  fall.^ 

In  some  cases  articles  of  furniture  may  furnish  certain  substances  ;  the 
flock  waU-papers,  colored  green  by  arsenical  preparations  (especially 
Scheele's  green  and  Schweinfiirth  gi-een),  give  off  little  particles  of  arseni- 
cal dust  into  the  room  ;^  and  it  has  been  shown  by  Professor  Fleck '  that 
the  arsenious  acid  in  the  Schweinfiirth  green,  when  in  contact  wdth  moist 
organic  substances,  and  especially  paste  or  size,  forms  arseniuretted  hydro- 
gen,** which  diffuses  in  the  room,  and  is  no  doubt  the  cause  of  some  of  the 
cases  of  arsenical  poisoning  from  green  papers. 

1  From  Three  Reports  on  the  Sanitary  Condition  of  St.  Mary's  Hospital,  Taddington, 
by  Surgeon-Major  F.  de  Chaumont,  M.D.,  1875-7(3. 

■■^  In  the  air  of  the  back-yard  of  another  London  hospital,  I  found  considerable  quan- 
tities of  epithelium  ;  and  In  the  "  dirty  linen  area,"  where  the  foul  linen  was  kept  in 
crates  till  washed,  I  found  not  only  epithelium,  but  even  pus  globules,  and  also  a  quan- 
tity of  fatty  crystals,  apparently  from  dressings.  There  were  also  bacteria,  both  free 
and  in  the  zooglseal  form. — [F.  de  C] 

^  Numerous  observations  on  the  air  of  barracks  and  military  hospitals  have  been 
made  by  medical  officers  of  the  army,  especially  by  Drs.  de  Chaumont,  Frank,  Hewlett 
(of  Bombay),  Stanley,  Baynes  Reed,  Venner,  Watson,  and  many  others.  (See  the 
Army  Medical  Department  Annual  Reports,  from  1860-70.) 

■*  Halley  and  many  others. 

«  Zeitsch.  fiir  Biologic,  Bd.  viii.,  p.  445  (1872). 

°  Perhaps  other  substances  are  also  formed,  such  as  cyanide  of  kakodyle,  which  is 
intensely  poisonous  (Bartlett). 


120  PRACTICAL   HYGIErrE. 

Sick-Rooms. — In  addition  to  being  vitiated  by  respiration,  the  air  of 
sick-rooms  is  contaminated  by  the  abundant  exhalations  from  the  bodies, 
and  by  the  effluvia  from  discharged  excretions.  The  quantity  of  organic 
matter  is  known  to  be  large,  but  it  is  difficult  at  present  to  give  a  quanti 
tative  statement.  Moscati,  who  (in  1818)  condensed  the  watery  vapor  of 
a  ward  at  Milan,  describes  it  as  being  slimy,  and  as  having  a  marshy 
smell.  The  peculiar  smell  of  an  hospital  is  indeed  very  remarkable,  and 
its  similarity  in  hospitals  of  different  kinds  seems  to  show  that  the  odorous 
substance  has  a  similar  composition  in  many  cases.  The  reaction  of  ozone 
is  never  given  in  such  an  atmosphere. 

Devergie  found  an  "  immense  amount "  of  organic  matter  in  the  air  in 
the  A'icinity  of  a  patient  with  hospital  gangrene. 

The  dust  of  a  ward  in  St.  Louis,  in  Paris,  examined  by  Chalvet,  was 
found  in  one  experiment  to  contain  36  per  cent,  of  organic  matter,  and  in 
another  46  per  cent.  When  burat,  it  gave  out  an  odor  of  hom.  The  dust 
collected  in  hospitals  for  diseases  of  the  skin  is  stated  by  Gailleton  to  be 
full  of  sponiles  of  Trichophyton.  They  can  be  found  in  the  air  of  the  ward 
when  condensed  by  ice. 

Much  interest  was  excited  in  1849  by  the  discovery  by  Drs.  Brittan  and 
SwajTie,  of  Clifton,  of  bodies  vei*y  hke  fungi  in  the  au'  of  a  cholera  ward  ; 
later  researches  lead  to  the  opinion  that  this  observation  was  perfectly 
con-ect,  though  the  connection  between  these  fungi  and  cholera  is  still 
quite  uncertain.  In  1849,  also,  Dr.  Dundas  Thomson  drew  the  air  of  a 
cholera  ward  through  sulphvu'ic  acid  ;  various  suspended  substances  were 
arrested,  starch,  woollen  fibres,  epithelium, /f/nyi  or  spores  oi  fungi,  and 
vibriones.  Mr.  Rainy  also  found  in  the  air  of  a  cholera  ward  in  St.  Thomas' 
Hospital,  the  spores  and  mycelium  oi.  fungi  and  bacteria.  Some  of  these 
bodies  were  found,  however,  in  the  open  air.  In  hospitals  for  skin  diseases 
Achorion  has  been  detected  in  the  air  where  there  are  patients  with/ai7<.s'; 
and  Tilbury  Fox'  has  figured  the  spores  (clustered  and  in  chains),  and  the 
myceHum  of  Trichophyton  in  a  ward  with  a  number  of  children  with  tinea 
circinata. 

In  a  w^ard  in  Netley  Hospital  (under  Bingade-Surgeon  Veale,  A.M.D.), 
where  repeated  cases  of  erysipelas  occurred,  the  air  was  found  to  be  loaded 
vnth  fungi.  The  ward  being  emptied,  and  the  fioor,  walls,  and  ceiling  be- 
ing washed  with  cai'bolic  acid,  the  disease  ceased. 

The  scaly  and  smaU  round  epithelia  found  in  most  rooms  are  in  large 
quantity  in  hospital  wards  ;  and  probably  in  cases  where  there  is  much 
exj)ectoration  or  exposui'e  of  pus  or  puriform  fluids  to  the  air,  the  quan- 
tity would  be  still  larger. 

Considering  that  the  pleuro-pneumonia  of  cattle  is  probably  propa- 
gated thi'ough  the  pus  and  epithelium  cells  of  the  sputa  passing  into  the 
au'-cells  of  other  cattle  ;  that  even  in  man  there  is  evidence  of  a  pneu- 
monic or  phthisical  disease  being  contagious,'^  the  floating  of  these  cells 
in  the  air  is  worthy  of  all  attention.  It  may  explain  some  of  those  curious 
instances  of  phthisis  being  apparently  commvmicated.  In  the  air  of  a 
phthisical  ward  at  Netley,  Dr.  Watson  not  only  found  pus-cells,  but  bodies 
which  were  not  found  in  the  external  air  or  in  the  rooms  of  healthy  per- 
sons, and  which  were  very  like  the  cells  seen  in  tuberculous  matter.  In 
military  granular  conjunctivitis  (gray  granulations),  the  remarkable  effect 
of  ventilation  in  arresting  the  spread  (Stromeyer)  seems  to  show  that  we 

'  Lancet,  Jaimary,  1872. 

*  Brjsou,  Cases  iu  the  Mediterranean  Fleet. 


AIR.  121 

have  here  a  similar  case,  and  that  ventilation  acts  by  diluting,  oxidizing, 
and  drying  the  cells  thrown  off  from  the  conjunctivse.  In  small-pox  wards, 
BakeweU  has  found  unequivocal  evidence  of  minute  scales  of  small-pox. 
matter  in  the  aii'.  It  seems  pirobable  that  the  discovery  of  suspended  mat- 
ters of  this  kind  will  lead  to  most  important  results. '  The  possibility  of  a 
dii'ect  transference  from  body  to  bod}^  of  cells  undergoing  sj^ecial  chemical 
or  vital  changes  is  thus  placed  beyond  doubt,  and  the  doctrine  of  con- 
tagion receives  an  additional  elucidation.  It  is  now  generally  admitted 
that  protophytes  like  Frotococcus  2?IuviaUs,  may  be  dried,  and  yet  retain 
their  vitality  even  for  years,  and  may  be  blown  about  in  atmospheric  cur- 
rents ;  and  should  contagion  be  proved  to  depend  upon  minute  organisms 
these  might  easily  be  carried  about  in  a  similar  way,  either  alone  or 
carried  by  epithelium  or  other  particles  thro\^-n  off  from  the  bodies  of 
patients.  The  success  which  has  sometimes  attended  the  treatment  of 
pleuro-pneumonia  in  cattle  by  means  of  carbolic  acid  (Crookes),  and  the 
apparent  advantage  of  inhaling  disinfectants  in  human  phthisis,  seem  to 
point  to  a  similar  active  cause  in  those  maladies  ;  and  this  appears  in 
some  sort  confirmed  by  the  observation  of  Koch  on  the  supposed  bacillus 
of  phthisis. 

3.  Workshops,  Factories,  and  Mines. — Grinding  of  steel  and  iron,  and 
stones  ;  making  metallic  and  pearl  buttons  ;  melting  zinc  ;  melting  solder; 
carding  and  spinning  textile  fabrics  of  all  kinds  ;  grinding  paint ;  making 
cement,  and  in  fact  almost  innumerable  trades  cause  more  or  less  dust, 
derived  from  the  fabrics  and  materials,  to  pass  into  the  air. 

Dr.  Sigerson  ^  found  a  black  dust  composed  of  carbon,  iron  (in  the 
shape  of  small  jagged  pieces  and  also  as  hollow  balls  -giyVir  of  an  inch  in 
diameter),  and  ash,  in  metal  shops.  In  the  air  of  a  printing-office  there 
was  enough  antimony  to  be  chemically  detected.  In  the  air  of  stables 
were  equine  hairs,  epithelium,  moth-cells,  ovules,  and  various  fungi. 

In  addition  to  these  suspended  matters,  which  vary  with  the  kind  of 
work,  the  air  of  workshops  is  largely  contaminated  by  respiration  and  by 
the  combustion  of  gas. 

In  mines  the  suspended  matters  are  made  up  of  the  particles  of  the 
particiolar  substance  which  is  being  worked,  or  of  rock  excavated  to  obtain 
metals,  of  sooty  matters  fi'om  lamps  and  candles,  and  of  substances  de- 
rived from  blasting. 

Sub-Section  IE. — Gaseous  Substances. 

A  great  number  of  gases  may  pass  into  the  atmosphere  either  from 
natural  causes  or  from  the  works  of  man. 

Compounds  of  Carbon. — Carbon  dioxide  (abnormal  if  exceeding  5  in 
10,000  parts),  carbon  monoxide,  carburetted  hydrogen  or  methane,  and 
peculiar  substances  (gaseous)  in  sewer  air. 

Compounds  of  Sulphur. — Sulphur  dioxide,  sulphuric  acid,  hydrogen 
sulphide,  ammonium  sulphide,  and  carbon  disulphide. 

Compounds  of  Chlorine. — Hydrochloric  acid  from  alkali  works. 

Compounds  of  Nitrogen. — Ammonia  and  ammonium  acetate,  sulphide, 

*  In  the  accident  vra,ri  of  St.  Mary's  Hospital,  Paddington,  I  found  pus-cells  in  the 
air,  near  some  beds  which  had  a  bad  reputation  for  erysipelas.  See  plate  dra-\vn  by 
Dr.  Macdonald  (Report  on  St.  Mary's,  op.  cit.V— [F.  de  C.] 

'^  British  Medical  Journal,  June,  1870,  from  Memoirs  of  the  Irish  Academy,  in  which 
publication  are  some  excellent  observations  by  the  same  writer. 


122  PEACTICAL    HYGIENE. 

and  carbonate  (normal  in  small  amount  ?),  and  nitrous  and  nitric 
acids. 

Compounds  of  Phosphorus.— Hydrogen  phosphide. 

Organic  VajMi^'^. — Of  the  exact  composition  of  the  vapors,  often  fetid, 
■which  arise  from  various  decomj)osing  animal  matters,  little  is  known. 


Sub-Section  HI. — Nature  of  Impubities  in  certain  Special  Cases. 
Air  Vitiated  by  Respiration. 

An  adult  man,  in  a  state  of  repose,  gives  off  in  twenty-four  hours  from 
12  to  16  cubic  feet  or  more,  according  to  weight,  of  carbon  dioxide,  the 
most  of  it  from  the  lungs,  although  he  also  emits  an  undetermined  quantity 
by  the  skin.  On  an  avei-age,  an  adult  man,  not  doing  excessive  work,  may 
be  considered  to  give  to  the  atmosphere  every  hour  not  less  than  .6  cubic 
foot  of  carbonic  acid.  Pettenkofer  states  the  amount  at  about  O.7.' 
Women  give  off  less,  and  children  and  old  people  also  give  oft"  a  smaller 
amount. 

The  amount  of  carbonic  acid  in  pure  air  being  assumed  to  be  on  an 
average  0.4  per  1,000,  or  four  volumes  j^er  10,000,  the  quantity  in  the  air 
of  the  rooms  vitiated  by  respiration  varies  mthiu  wide  limits,  and  many 
analyses  will  be  found  in  books.  The  following  table  is  a  part  of  the 
numerous  experiments  on  barrack-rooms  by  Dr.  de  Chaumont  on  this 
point,  and  is  especially  valuable,  because  the  amount  of  CO.,  in  the  ex- 
ternal air  was  simultaneously  determined.  The  analyses  wxre  made  at 
night,  when  the  men  were  in  the  rooms.  The  cubic  space  per  head  was 
600  feet  in  the  barracks  and  from  1,200  to  1,600  in  the  hospitals. 

The  last  column  of  the  table  shows  the  condition  of  the  ventilation  as 
measui-ed  by  the  CO^  ;  it  is  very  satisfactory  in  the  new  ban-acks  (Gosport 
and  Chelsea),  but  is  much  less  so  in  the  old  barracks  and  casemates.  The 
Herbert  and  Hilsea  mihtaiy  hospitals  show  excellent  ventilation,  while  the 
old-fashioned  Portsmouth  gamson  hospital  is  in  this  respect  very  bad.  The 
l^rison-cells  show,  in  all  cases,  a  very  high  degree  of  respiratory  impurity, 
and  this  must  be  one  of  the  depressing  influences  of  long  cell  confinement. 
WUson  ^  gives  some  important  information  on  this  point.  In  cells  (in 
Portsmouth  Con\ict  Prison)  of  614  cubic  feet,  always  occupied,  he  found 
the  C0„  =  0.720  per  1,000  ;  the  prisoners  were  healthy  and  had  a  good  color. 
In  cells  of  210  cubic  feet,  occupied  only  at  night  by  prisoners  employed  out- 
side dm-ing  the  day,  he  found  1.044  per  1,000  of  C0„ ;  the  occupants  were 
all  pale  and  anaemic. 

The  carbonic  acid  of  respiration  is  equally  diffused  through  the  air  of  a 
room  (Lassaigne,  Pettenkofer,  Eoscoe) ;  it  is  very  rapidly  got  rid  of  by 
opening  windows,  and  in  this  respect  differs  from  the  organic  matter,  and 
probably  from  the  watery  vapor ;  neither  appears  to  diffuse  rapidly  or 
equably  through  a  room. 


This  is  the  quantity  adopted  by  Roth  and  Lex  (Militar-Gesundheitspflege). 
Handbook  of  Hygiene. 


AIR. 


123 


Amount  of  Carbon  Dioxide  in  1,000  Volumes  of  Air  (de  Chaumont). 


Barracks. 

Gosport  New  Barracks 

Anglesey  Barracks 

Aldershot 

Chelsea 

Tower  of  London ' 

Fort  Elson  tCasemate) 

Fort  Brockhurst  (Casemate) 

Military  axd  Civil  Hospitals. 

Portsmouth  Garrison  Hospital 

Portsmnuth  Civil  infirmary 

Herbert  Hospital 

Hilsea  Hospital 

St.  Mary's,  Paddington , 

Military  and  Civil  Prisons. 

Aldershot  MUitary  Prison — Cells 

Gosport  Military  Prison — Cells    

Chatham  Convict  Prison — Cells 

Pentonville  Prison — Cells — Jebb's  system 


CO2  in 

External 

Air. 


.430 
.398 
.440 
.470 
.420 
.425 
.422 


.306 
.322 

.424 
.405 
.560 


.409 
.555 
.452 
.420' 


CO2  in  Room. 


Largest 
Amount 
found. 


1.846 
1.971 
1.408 
1.175 
1.731 
1.874 
1.027 


2.057 

1.309 

.730 

.741 

1.534 


3.484 
2.344 
3.097 
1.926 


Mean 
Amount. 


.645 
1.404 

.976 

.718 
1.338 
1.209 

.838 


.976 
.928 
.472 

.578 
.847 


1.051 

1.335 

1.691 

.989 


Mean 

Respiratory 

Impurity. 


.215 
1.011 
.536 
.248 
.898 
.784 
.416 


.670 
.606 

.048 
.173 

.287 


1.242 

.780 

1.239 

.569 


The  amount  of  C0„  is  often  much  greater  than  in  the  above  instances. 
In  a  boys'  school  with  67  boys,  and  4,640  cubic  feet  (  =  69  cubic  feet  per 
head),  Koscoe  found  3.1  parts  of  CO,  per  1,000.  In  Leicester,  in  a  room 
with  six  persons,  and  only  51  cubic  feet  of  space  per  head,  and  with  three 
gas-Ughts  burning,  Mr.  Weaver  ^  found  the  CO^  to  be  5.28  parts  per  1,000  ; 
while,  in  a  girls'  school-room  (70  girls,  and  10,400  cubic  feet),  or  150  cubic 
feet  per  head,  Pettenkofer  found  no  less  than  7.230  parts  per  1,000.  In 
many  schools,  work-rooms,  and  factories,  the  amount  of  respiratory  impurity 
must  be  as  great  as  this,  and  doubtless  a  constant  unfavorable  effect  is  pro- 
duced on  health.  Dr.  Hajne  (in  H.M.  ship  Doris)  found  the  CO^  to  range 
from  1.03  to  3.21  between  decks,  the  latter  quantity  being  in  the  ward- 
room with  the  scuttles  in.'  In  the  Ai-ctic  Expedition  of  1875-76,  Dr.  Moss 
found  as  much  as  4.82  in  the  ward-room  of  the  Alert,  "room  feeUng  very 
close  ;"  and  Dr.  Ninuis  found  5.57  in  the  lower  deck  of  the  Discovery. 

Gartner^  found  in  the  armored  corvette  Jackson,  about  1.0  between 
decks,  as  much  as  6.42  in  the  sick-bay,  5.54  in  the  cells,  and  no  less  than 
60  in  the  powder  magazines.^ 

In  a  horse  stable  at  the  Ecole  IMilitaire,  the  amount  was  7  per  1,000.  At 
Hilsea,  with  a  cubic  space  of  655  cubic  feet  per  horse,  the  amount  was  1.053 ; 


'  Assumed  at  .420. 

^  Mr  Weaver  gives  several  good  analyses  in  different  public  and  private  rooms  in 
Leicester.     Lancet,  July  and  August,  1872. 

^  Med.  Chir.  Trans.,"  vol.  Ivii. 

*  Deutsche  Vierteliahrschrift  fiir  Offentliche  Gesundheitspflege,  Bd.  xiii.,  p.  369, 
1881. 


124  PRACTICAL   HYGIENE. 

and  in  another  stable,  -with  1,000  cubic  feet  per  horse,  only  .593  per  1,000 
(de  Chaumont).  Miircker  found  8.5  in  a  stable  in  Gottingen,  and  no  less 
than  17.07  in  a  b^Te. 

By  the  skin  and  lungs  pass  off  from  25  to  40  ounces  of  -water  in  twenty- 
four  hoiu^,  to  maintain  which,  in  a  state  of  vapor,  211  cubic  feet  of  aii-  per 
hour  are  necessaiy  on  an  average.  Of  course,  however,  temperature  and 
the  hygrometric  condition  of  the  air  greatly  modify  this.  Organic  matter 
is  also  given  off  from  the  skin  and  lungs,  the  amount  of  which  has  never 
been  precisely  determined.  Xor  is  it  possible,  at  pi'esent,  to  estimate  it 
correctly.  This  organic  matter  must  be  partly  suspended,  and  is  made  up 
of  small  pai-ticles  of  epitheliiun  and  fatty  matters  detached  from  the  skin 
and  mouth,  and  j^artly  of  an  organic  vapor  given  off  from  the  lungs  and 
mouth.  The  organic  matter  from  the  lungs,  when  drawn  thi'ough  sulj^huiic 
acid,  dai'kens  it ;  thi'ough  j)ermanganate  of  potash,  decoloiizes  it ;  and 
through  pure  water,  renders  it  offensive.  Collected  from  the  aii'  by  con- 
densing the  watery  vapor  on  the  sides  of  a  globe  containing  ice  (as  by  Tad- 
dei  in  the  wards  of  the  Santa  Maria  Novella),  it  is  found  to  be  precipitated 
by  nitrate  of  silver,  to  decoloiize  potassium  permanganate,  to  blacken  on 
platinum,  and  to  yield  ammonia.  It  is  therefore  nitrogenous  and  oxidizable. 
It  has  a  very  fetid  smell,  and  this  is  retained  in  a  room  for  so  long  a  time, 
sometimes  for  foiu-  houi-s,  even  when  there  is  free  ventilation,  as  to  show 
that  it  is  oxidized  slowly.  It  is  probably  in  combination  with  water,  for  the 
most  hygroscopic  substances  absorb  most  of  it.  It  is  absorbed  most  by 
wool,  feathers,  damp  walls,  and  moist  paper,  and  least  by  straw  and  horse- 
hair. The  color  of  the  substance  influences  its  absorption  in  the  following 
order  :  black  most,  then  blue,  yellow,  and  white.  It  is  probably  not  a  gas, 
but  is  molecular,  and  floats  in  clouds  through  the  air,  as  the  odor  is  evi- 
dently not  always  equally  ditfiised  thi-ough  a  room.  In  a  room,  the  aii"  of 
which  is  at  first  perfectly  pui*e,  but  is  "\itiated  by  respiration,  the  smell  of 
organic  matter  is  generally  perceptible  when  the  C0„  reaches  .7  per  1,000 
volumes,  and  is  \erx  strong  when  the  CO,  amounts  to  1  per  1,000.'  From 
experiments  made  at  Gravesend,  Xetley,  Aldershot,  and  Hilsea,  by  various 
medical  ofiicers,'  it  has  been  shown  that  the  amount  of  potassium  perman- 
ganate destroyed  by  aii'  drawn  through  its  solution  is  generally  in  propor- 
tion to  the  amoimt  of  CO,  of  respii'ation. 

"VMien  the  air  of  inhabited  rooms  is  drawn  tkrough  pure  water,  and  the 
free  ammonia  got  rid  of,  distillation  with  alkahne  permanganate,  in  the 
method  of  "Wanklyn,  gives  a  perceptible  quantity  of  "albuminoid  ammonia." 
In  a  bedroom  at  9  p.m.,  A.  Smith '  fotmd  .1901  milligramme  in  1  cubic  metre 
of  ail* ;  at  7  a.m.,  there  were  .3316  milligramme  in  each  cubic  metre. 

The  average  of  eight  observations  in  the  external  air  (at  Portsmouth) 
gave  0.0935  of  free  NH,,  and  0.0886  of  albuminoid  NH^  in  milhgrammes 
per  cubic  metre.  In  the  Portsmouth  General  Hospital  the  fi-ee  NHj  was 
as  high  as  0.855,  and  the  albuminoid  1.307.^ 

The  following  is  from  Dr.  de  Chaumont's  Eeports  on  the  Ventilation 
Experiments  at  St.  Maiy's  Hospital,  Paddington  : 

'  On  this  point  see  table  at  pace  159. 

"  See  note,  p.  119. 

^  Air  and  Rain,  p.  430. — If  expressed  as  grammes  per  million  cubic  meters,  the 
amount  is  190.114  and  384.601 ;  in  grains,  in  one  million  cubic  feet,  the  numbers  are 
83.074  and  14G.210. 

•*  Moss,  Lancet,  November,  1872. 


AIR. 


125 


MUligrammes  per  Cubic  Metre. 


External  air, 

July,  1875 

Wards 

Do.  

Do 

External  air, 
August,  1876 .. . 
Wards 

Do 

Do 

Do 

Do 


Total 

Free  NH3. 

Albuminoid 

Organic 

Oxygen  for 

NH3. 

Oxygen. 

oxidizable 

matter. 

0.3574 

0.5280 

1.4300 

0.6680 

0.4710 

1.4900 

0.6669 

0.6770 

1.5100 

0.3519 

0.6915 

.... 

1.3600 

0.0163 

0.5206 

0.4444 

0.5714 

0.0497 

0.4622 

0.3747 

0.5621 

nil. 

0.2824 

0.2571 

0.5142 

0.0310 

0.3576 

0.3101 

0.3567 

0.0127 

0.5259 

0.2225 

0.4451 

0.0100 

0.3684 

0.4420 

0.6315 

j  Air    damp    and    still, 
(     wind  S.W.,  slight. 


Air    dry    and    warm, 
wind  S.  E.  by  E. ,  fresh. 


It  is  evident  that  tlie  condition  of  the  external  air,  with  regard  to  move- 
ment and  humidity,  has  a  great  deal  to  do  with  the  amount  of  organic 
matter.  The  nitrogen  acids  are  also  met  with  ;  in  one  instance,  in  the 
above  experiments,  they  reached  in  a  ward  28.484  per  metre,  of  which 
0.7392  was  nitrous,  and  the  rest  nitric  acid. 


Air  vitiated  by  Combustion. 

The  products  of  firing  pass  out  into  the  atmosphere  at  large  ;  those  of 
lighting  are  for  the  most  part  allowed  to  diffuse  in  the  room. 
Goal  of  average  quahty  gives  off  in  combustion  : 

1.  Carbon.  — About  1  per  cent,  of  the  coal  is  given  off  as  fine  carbon  and 
tany  particles. 

2.  Carbon  dioxide. — In  Manchester,  Angus  Smith  calculated  some  years 
ago  that  15,000  tons  of  carbon  dioxide  were  daily  thrown  out,  and  the 
quantity  must  now  be  stUl  larger.  In  London  over  30,000  tons  of  coal  a 
day  ai-e  consumed,  and  this  would  yield  nearly  90,000  tons  of  carbon  di- 
oxide. 

3.  Carbon  inonoxide. — The  amount  depends  on  the  perfection  of  com- 
bustion. 

4  Sulphur,  sulphur  dioxide,  and  sulphuric  acid. — The  amount  of  sul- 
phui'  in  coal  varies  from  ^  to  6  or  7  per  cent.  In  the  air  of  Manchester, 
A.  Smith  found  1  grain  of  sulphuric  acid  in  2,000  and  1,076  cubic  feet. 

5.  Carbon  disulphide. 

6.  Ammonium  sulphide  or  carbonate. 

7.  Hydrogen  sulphide  (sometimes). 

8.  Water. 

From  some  manufactories  there  poixr  out  much  greater  quantities  of 
SO,,  (coj)]Der  works),  arsenical  fumes,  hydrogen  sulphide,  carbon  dioxide, 
etc. 

For  complete  combustion  1  Bb  of  coal  demands  about  240  cubic  feet  of 
air. 

Wood  produces  carbon  dioxide  and  monoxide  and  water  in  large  quan- 
tity, but  few  compounds  of  sulphur.  1  ft)  of  dried  wood  demands  about 
120  cubic  feet  of  air  for  complete  combustion. 


126  PRACTICAL    HYGIENE. 

Coal-gas,  when  fairly  purified,  is  composed  of — 

Hydrogen 40       to     45.58 

Marsh  gas  (Hght  carburetted  hydrogen) 35       to     40 

Carbon  monoxide 3       to       6.6 

Oletiaut  gas  (ethylene  or  ethene) 3       to       4 

Acetylene  (or  ethiae) 2       to       3 

Hydrogen  sulphide 0.29  to       1 

Kitrogen 2       to       2.5 

Carbon  dioxide 3       to       3.75 

Srdphur  dioxide ) 5    to       1 

Ammonia  or  ammonium  sulphide  >■   (or  ia  the  best  cannel- 

Carbou  disvdphide )    coal  gas  only  traces). 

In  some  analyses  the  carbon  monoxide  has  been  as  high  as  11  per  cent., 
and  the  light  cai'buretted  hydrogen  56  ;  in  such  cases  the  amount  of  hydro- 
gen is  small.  As  much  as  60  gi-ains  of  sulphur  have  been  found  in  100 
cubic  feet  of  gas.'  The  parliamentaiy  maximum  is  20  grains  in  100  cubic 
feet.  In  badl}'  purified  gas  there  may  be  a  gi-eat  number  of  substances  in 
small  amount,  especially  hydrocarbons  and  alcohols,  such  as  propylene, 
butylene,  amylene,  benzole,  xylol,  some  of  the  nitrogenous  oily  bases, 
such  as  pyiTol,  picoline,  etc.'' 

\Mien  the  gas  is  partly  burnt,  the  hydrogen  and  light  and  heavj-  car- 
buretted hydrogens  are  almost  destroyed;  nitrogen  (67  per  cent.),  water 
(16i)er  cent.),  carbon  dioxide  (7  per  cent),  and  carbon  monoxide  (5  to  6 
per  cent.),  A\-ith  sulphur  dioxide  and  ammonia,  being  the  principal  result- 
ants. And  these  products  escape  usually  into  the  ah'  of  rooms.  With 
perfect  combustion  there  will  be  little  carbon  monoxide. 

According  to  the  quality  of  the  gas,  1  cubic  foot  of  gas  wiU  imite  with 
from  .9  to  1.64  cubic  foot  of  oxygen,  and  produces  on  an  average  2  cubic 
feet  of  carbon  dioxide,  and  from  .2  to  .5  grain  of  sulphm-  dioxide.  In 
other  words,  1  cubic  foot  of  gas  will  destroy  the  entire  oxygen  of  about  8 
cubic  feet  of  ah".  One  cubic  foot  of  gas  will  raise  the  temperature  of  31,290 
cubic  feet  of  air  1°  Fahr. 

0(7. — A  lamp  with  a  moderately  good  wick  burns  about  154  grains  of 
oil  per  hour,  consumes  the  oxygen  of  about  3.2  cubic  feet  of  air,  and  pro- 
duces a  little  more  than  ^  a  cubic  foot  of  cai'bon  dioxide  ;  1  ft  of  oil  de- 
mands fi'om  140  to  160  cubic  feet  of  air  for  comi^lete  combustion. 

A  candle  of  6  to  the  ft  biu-ns  per  hour  about  170  gi-ains. 

The  products  of  the  combustion  of  coal  and  wood  pass  into  the  atmos- 
phere, and  usually  are  at  once  largely  diluted.  Diffusion  and  the  ever- 
moring  air  rapidly  purify  the  atmosphere  from  carbon  dioxide. 

It  is  not  so,  however,  with  the  suspended  carbon  and  tany  matters, 
which  are  too  hea^7  to  drift  far,  or  to  ascend  high.  As  a  rule,  the  par- 
ticles of  carbon  are  not  foimd  higher  than  600  feet  ;  and  the  way  it  accu- 
mulates in  the  lower  strata  of  the  atmosphere  can  be  seen  by  looking  at 
any  lofty  building  in  London.  The  air  of  London  is  so  loaded  with  car- 
bon, that  even  when  there  is  no  fog,  particles  can  be  collected  on  Pou- 
chefs  aeroscope  when  only  a  very  small  quantity  of  air  is  dl•a'^^^l  through. 

It  is  apparently  chiefly  from  combustion,  and  in  some  cases  from 
chemical  works,  that  the  au-  of  towns  contains  so  much  acid  as  to  make 

'  Chemical  News,  March,  186.5,  p.  154 

■^  For  a  further  list  of  these  suhstances,  which  do  not  appear  very  important,  see 
Pappeuheim's  Handbuch  der  San.  Pol.,  Band  iii.,  Supp.,  p.  261. 


AIE.  127 

rain  water  acid.  In  Manchester,  in  1868,  Angus  Smith  found  the  rains  to 
contain  from  5.6  grains  to  1.4  grain  of  sulphuric  acid  (free  and  combined), 
and  from  1.277  to  .0287  grain  of  hj^drochloric  acid  per  gallon.  In  Liver- 
pool and  Newcastle  air  the  same  thing  occurs  ;  the  sulphuric  acid  is  always 
larger  in  amount  than  the  hydrochloric. 

Salphui'ous  and  sulphuric  acids  also  appear  to  be  less  rapidly  removed, 
as  Angus  Smith  found  a  perceptible  quantity  in  the  air  of  Manchester  ; 
and  the  rain  water  is  often  made  acid  from  this  cause. 

The  products  of  gas  combustion  are  for  the  most  part  allowed  to 
escape  into  rooms,  but  certainly  this  should  not  be  allowed,  when  gas  is 
burnt  in  the  large  quantities  commonly  used.  The  immense  quantity  of 
gas  often  used  causes  great  heat,  humidity  of  the  air,  and  there  is  also 
some  sulphur  dioxide,  an  excess  of  carbon  dioxide,  and,  probably,  a  little 
carbon  monoxide,  to  which  some  of  the  effects  may  be  due.  Weaver '  found 
as  much  as  5.32  volumes  of  carbon  dioxide  per  1,000  in  the  room  of  a 
frame- work  knitter  in  Leicester,  with  14  gas  lights  burning.  In  other 
work-rooms  the  amounts  were  5.28,  4.6,  down  to  2.11  volumes  per  1,000. 
This  amount  has  a  very  injurious  effect  on  health,  as  shown  long  ago  by 
Dr.  Guy.  In  a  workshop  in  Paris,  with  400  men  and  400  gas-burners,  the 
health  of  the  men  was  very  bad.  General  Morin  introduced  good  venti- 
lation, and  the  number  of  cases  of  illness  was  reduced  one-third.  The 
appetite  of  the  men,  formerly  very  bad,  gTcatly  improved.  According  to 
Dr.  Zock,''  coal-gas  gives  off  rather  more  carbon  dioxide  for  an  equal 
illuminating  power  than  oil,  but  less  than  petroleum.  Dr.  Odling  found 
for  equal  illuminating  power,  that  candles  gave  more  impurity  to  the  air 
than  gas.^     Gas  gives  out,  however,  more  water. 

In  tobacco  smoke  are  contained  particles  of  nicotine  or  its  salts 
(Heubel),  and  probably  of  picoline  bases.  There  is  also  much  carbon 
dioxide,  ammonia,  and  butyric  acid. 

Dr.  Eipley  Nichols  has  investigated  the  air  in  smoking  cars  on 
American  railways,  and  found  the  C0„  to  range  from  0.98  to  3.35  per 
1,000,  with  a  mean  of  2.278  :  in  ordinary  non-smoking  cars  the  CO^  varied 
from  1.74  to  3.67,  with  a  mean  of  2.32,  so  that  there  was  not  much  differ- 
ence as  far  as  CO.^  went.  As  regards  ammonia,  however,  the  difference  was 
great,  for  (taking  the  external  air  ratio  as  100)  he  found  in  the  smoking  car 
from  310  to  575,  whilst  in  the  ordinary  cars  it  was  only  135  to  175. 
None  of  the  peculiar  products  of  the  combustion  of  tobacco  were  found.^ 

Air  vitiated  by  Effluvia  from  Sewage  Matter  and  Air  of  Sewers. 

Air  of  Cesspools. — The  air  of  cesspools,  and  especially  of  the  cemented 
pits  which  are  still  common  in  many  continental  towns,  and  which  receive 
little  beyond  the  solid  and  liquid  excreta  and  some  of  the  house  water,  is 
generally  highly  impure.  Levy  ^  refers  to  an  extreme  case,  in  which  the 
oxygen  was  lessened  to  2  per  cent.,  the  nitrogen  being  94  and  the  CO^,  4. 
In  this  case  apparently  no  other  gases  were  present ;  but  in  most  instances 
there  is  a  variable  amount  of  hydrogen  sulphide",  ammonium  sulphide, 
nitrogen,  carbon  dioxide,  and  carburetted  hydrogen,  in  addition  to  fetid 

'  Lancet,  July,  1872.  2  Zeitsch.  fur  Biol.,  Band  ii.,  p.  117  (1866). 

^  Medical  Times  and  Gazette,  January  9,  1869. 

*  Reprint  from  the  Sixth  Annual  Report  of  the  Massachusetts  Board  of  Health. 
^  Traite  d'Hygiene,  3d  edit  ,  p.  636. 

*  Barker,  On  Malaria  and  Miasmata,  p.  245. 


128  PRACTICAL    HYGIENE. 

organic  matters.  These  organic  matters  are  in  large  amount ;  62  feet  of  the 
air  of  a  cesspool  destroyed,  in  Angus  Smith's  experiments,  as  much  potas- 
sium permanganate  as  176,000  cubic  feet  of  pure  air,  though  perhaps  some 
hydrogen  sulphide  may  have  been  also  present.  Oesterlen'  states  that 
these  gases  will  pass  easily  through  walls  ;  and  M.  Hennezel "  noticed  that 
in  the  "fosses  d'aisances"  in  Paris,  even  in  those  covered  with  stone  slabs 
and  earth,  the  wind  blowing  down  the  ventilating  tube  will  force  the  gas 
through  the  neighboring  walls,  and  then  perhaps  into  the  house. 

The  Air  of  Sewers.— In  sewers  the  products  of  decomposition  are  varia- 
ble, as  not  only  solid  and  liquid  excreta  and  house  water,  but  the  washings 
and  debris  of  the  streets,  the  refuse  of  trades,  etc.,  pass  into  the  sewers. 
As  a  rule,  the  products  of  decomposition  of  the  sewer  water  appear  to  be 
much  the  same  as  noted  above — viz.,  fetid  organic  matters,  carbo-ammoni- 
acal  substances  condensing  with  the  water  of  the  au*  on  the  cold  walls, 
carbon  dioxide,  nitrogen,  and  hydi-ogen  sulphide.^  The  proportions  of 
these  gases  are  variable ;  *  the  most  common  are  carbon  dioxide  and 
nitrogen  ;  marsh  gas  is  found  when  oxidation  is  impeded,  and  hydrogen 
sulphide  and  ammonium  sulphide,  which  form  in  the  sewer  water  in  most 
cases,  are  liberated  from  time  to  time.  The  gases,  however,  are,  as  a  rule, 
of  far  less  importance  then  the  fetid  organic  matters,  the  exact  nature  of 
which  it  would  be  most  desirable  to  examine  more  thoroughly. 

The  organic  vaj)or  is  carbo-ammoniacal ;  the  j^utrid  substance  in  the 
sewer  water  appears,  from  Odhng's  observations,  to  be  allied  to  the  com- 
pound ammonias  ;  it  contains  more  carbon  than  methylamine  (NH2(CH3)  ), 
and  less  than  ethylamine  (NH.,(C„HJ  ). 

The  composition  of  sewer  air  will,  of  course,  vary  infinitely  with  the 
amount  of  gases  disengaged  and  the  degree  of  ventilation  in  the  sewer. 
The  quantity  of  oxygen  is  sometimes  in  normal  amount  ;  it  may,  however, 
be  diminished  in  very  badly  constructed  sewers.  Parent-Duchatelet  gave 
an  analysis  of  the  air  of  a  choked  sewer  in  Paris,  which  contained  only 
13.79  per  cent,  of  oxygen,^  and  no  less  than  2.99  per  cent,  of  hydi-ogen 
sulphide.  Excluding  this  analysis,  the  greatest  impurity  in  the  old 
Parisian  sewers,  as  determined  by  Gaultier  de  Claubry,  in  19  analyses "  in 
1829,  was  3.4  per  cent,  of  carbon  dioxide  and  1.25  per  cent,  of  hydrogen 
sulphide  (in  different  samples  of  air).  The  lowest  amount  of  oxygen  was 
17.4  per  cent.  Hydi-ogen  sulphide  was  present  in  18  out  of  19  cases  ;  the 
mean  of  whole  19  cases  being  .81  jjer  cent.  The  mean  amount  of  CO^  in 
19  cases  was  2.3  per  cent  In  the  present  London  sewers  of  good  con- 
struction the  air  is  much  less  impure.  Dr.  Letheby  found  only  .532  per 
cent,  of  C0„,  a  good  deal  of  ammonia,  and  only  traces  of  hydrogen 
sulphide  and  marsh  gas.  Dr.  Miller's  experiments  in  1867  '  gave  a  mean 
of  only  0.106  per  cent,  of  CO.^  in  18  analyses,  and  .307  per  cent,  in  6  other 
instances,  the  oxygen  20.71  per  cent.  No  hydrogen  sulphide  was  present. 
Dr.  Eussell  examined  the  aii-  in  the  sewers  of  Paddington  in  August ;  the 

'  Oesterlen,  Hysriene,  1857,  p.  445. 

2  Ann.  d'Hygiene,  Oct.,  1868,  p.  178. 

^  Oesterlen,  Handb.  der  Hyg.,  2d  edition,  p.  445. 

■*  Dr.  Letheby's  experiments,  as  given  in  his  official  Report,  in  liis  article  in  the 
Encyclopaedia  Britannica,  8th  edition  (Sanitary  Science),  etc. ,  and  in  a  letter  to  Dr.  Adams 
(given  by  Dr.  Adams  in  his  pamphlet,  The  Sanitary  Aspect  of  the  Sewage  Question, 
18(38,  p.  84),  are  the  most  complete  on  this  subject. 

*  Hygiene  publ.,  t.  i.,  p.  209,  foot-note,  and  p.  390. 

*  Parent-Duchi'.telet's  Hyg.  publique,  t.  i.,  p.  389. 
'  Abstract  in  Chemical  News,  March,  1868. 


AIE.  129 

most  impure  air  contained  20.7  oxygen,  78.798  nitrogen,  and  .51  volume 
of  C0„  per  cent.  ;  there  was  very  little  ammonia,  and  no  hydrogen  sulphide. 

It  is  evident  that,  if  we  take  the  carbon  dioxide  and  hydrogen  sulphide 
as  indices,  sewer  aii"  has  no  constant  composition.  It  is  sometimes  almost 
as  pure  as  the  outside  air,  while  at  other  times  it  may  be  highly  impure. 
But  these  gases  are  probably  the  least  important  ingTedients  of  sewer  air  ; 
that  organic  matters  are  present  is  evident  from  the  pecuHar  fetid  smell, 
and  in  some  cases  they  are  in  large  amount ;  8,000  cubic  feet  of  the  air  of 
a  house  into  which  sewer  air  had  penetrated  destroyed  more  than  20  times  as 
much  potassium  permanganate  as  the  same  quantity  of  pure  air  (Angus 
Smith).  Fungi  grow  rapidly  in  such  aii",  and  meat  and  milk  soon  taint  when 
exposed  to  it.  When  the  sewer  air  passes  through  charcoal  these  substances 
are  absorbed  ;  they  may  be  j^artly  oxidized,  as  Dr.  Miller  found  some 
nitric  acid  in  the  charcoal,  but  they  also  collect  in  the  charcoal  and  can  be 
recovered  (in  part  at  any  rate)  from  it  by  distillation.' 

We  must  also  suppose,  for  facts  leave  us  no  other  explanation,  that  the 
unknown  agencies  which  produce  typhoid  fever  may  also  be  present,  and 
there  can  be  httle  doubt  that  cholera  "  may  occasionally  spread  in  the  same 
way.  The  poison  of  yellow  fever  (as  appears  hkely  from  the  epidemic  in 
Madrid)  may  also  exist  in  sewer  air.  Whether  smaU-pox,  scarlet  fever,  etc., 
can  own  a  similar  channel  of  distribution  is  uncertain,  although  they  are 
no  doubt  aggravated  by  it ;  that  dysentery  and  diarrhoea  may  also  be 
caused  by  exhalations  proceeding  from  a  fotil  sewer  we  cannot  doubt,  but 
the  precise  agency  is  here  also  unknown. 

The  experiments  of  Professor  Frankland^  show  that  solid  or  liquid 
matter  is  not  likely  to  be  scattered  into  the  air  from  the  sewage  itself  by 
any  agitation  it  is  likely  to  undergo,  until  gas  begins  to  be  generated  in  it. 
He  found  that  no  ordinary  agitation  (even  greater  than  sewer  water  is 
likely  to  meet  with)  would  scatter  particles  of  Hthia  solution  into  the  air, 
but  that  the  biu'sting  of  bubbles  of  carbon  dioxide  was  sufficient  to  effect 
it.  Hence  he  argues  (with  apparent  truth)  that  sewage  becomes  danger- 
ous in  this  way  only  after  the  setting  in  of  decomposition,  so  that  if  we 
take  proper  steps  to  carry  away  sewage  at  once  the  danger  becomes  re- 
duced to  a  minimum. 

Dr.  D.  D.  Cunningham  found  large  quantities  of  bacteria  in  the  air  of 
the  Calcutta  sewers. 

Air  of  Churchyards  and  Vaults. 

The  decomposition  of  bodies  gives  rise  to  a  very  large  amount  of  car- 
bon dioxide.  It  has  been  calculated  that  when  intramural  burial  was 
carried  on  in  London,  2|-  millions  of  cubic  feet  of  C0„  were  disengaged 
annually  from  the  52,000  bodies  then  buried.  Ammonia  and  an  ofi^ensive 
putrid  vapor  are  also  given  off.  The  air  of  most  cemeteries  is  richer  in 
CO^  (.7  to  .9  per  1,000,  Eamon  da  Luna),  and  the  organic  matter  is  per- 
ceptibly large  when  tested  by  potassium  permanganate.  In  vaults,  the 
air  contains  much  CO^,  carbonate  or  sulphide  of  ammonium,  nitrogen,  hy- 
drogen sulphide,  and  organic  matter  (Pellieux).  Waller  Lewes  foimd  ht- 
tle SH^  or  CH,  ;  or  cyanogen,  or  hydrogen  phosphide.  In  his  experi- 
ments the  gas  always  extinguished  flame. 

Fungi  and  germs  of  infusoria  abound. 

»  Miller,  Chemical  Ne'n'S,  March,  1868. 

2  A  case  in  which  sewers  probably  played  a  part  in  the  dissemination  of  cholera  is 
given  in  Dr.  Parkes'  Report  on  the  Cholera  in  Southampton  in  1806  to  the  Medical 
Officer  of  the  Privy  Council.  ^  Proceedings  of  the  Royal  Society,  1877. 

Vol.  L— 9 


130  PRACTICAL   HYGIENE. 


Air  vitiated  by  certain  Trades. 

Hydrochloric  acid  gas,  from  alkali  works. 

Sulphur  dioxide  and  sulphm-ic  acid,  from  copper  works — bleaching. 

Hydrogen  sulphide,  from  several  chemical  works,  especially  of  am- 
monia. 

Carbon  dioxide,  carbonic  monoxide,  and  hydrogen  sulphide,  from 
brick  fields  and  cement^works. 

Carbon  monoxide  (in  addition  to  above  cases),  from  iron  furnaces, 
gives  rise  to  from  22  to  25  per  cent.  (Letheby)  ;  from  copper  furnaces, 
15  to  19  per  cent.  (Letheby). 

Organic  vapors,  from  glue  refiners,  bone-bum  ers,  slaughter-houses, 
knackeries. 

Zinc  fumes  (oxide  of  zinc),  from  brass-founders. 

Arsenical  fumes,  from  copper-smelting. 

Phosphoric  fumes,  from  manufacture  of  matches. 

Carbon  disulphide,  from  some  india-rubber  works. 

Air  of  Towns. 

The  air  of  towns  may  be  vitiated  by  respiration,  combustion,  effluvia 
from  the  soil,  sewers,  and  trades.  The  movement  of  the  air  tends,  how- 
ever, to  continually  dilute  and  remove  these  impurities,  and  the  heavier 
particles  deposit,  so  that  the  air  even  of  manufacturing  towns  is  purer 
than  might  have  been  anticipated.  The  amount  of  oxygen  in  the  atmos- 
phere in  the  purest  air  near  the  surface  of  the  earth,  being  taken  as  from 
20.9  to  20.99  volumes  percent.,  and  the  carbon  dioxide  being  from  .03 
to  .045  per  cent.,  with  a  mean  of  .04,  it  would  appear,  from  Angus  Smith's 
observations,'  that  in  a  crowded  part  of  Manchester,  exposed  to  smoke,  the 
amount  of  oxygen  was  from  20.868  to  20.179  per  cent.  ;  the  average  of  the 
street  air  taken  from  the  laboratory  front  door  was,  in  Manchester,  20.943  ; 
of  the  closet,  a  midden  behind  the  laboratory,  20.70.  Li  the  London  air, 
in  the  open  spaces,  the  oxygen  amounted  to  20.95  ;  in  the  crowded  east- 
ern districts  to  20.857.'^  In  a  foggy  frost,  in  Manchester,  when  the  smoke 
was  not  moving  much,  the  amount  was  20.91.  In  Glasgow  the  average 
was  20.9092.     The  variations  are,  therefore,  within  nan-ow  hmits. 

The  percentage  lessening  of  oxygen  in  atmospheiic  air  is  partly  made 
up  by  an  increase  in  the  carbon  dioxide  ;  but  if  a  town  is  well  built,  the 
increase  is  trifling  ;  the  mean  amovmt  of  CO^  for  London,  in  Roscoe's  ex- 
periments, was  only  .037  volume  per  cent.  ;  in  Manchester,  in  usual 
weather,  A.  Smith  found  the  amount  .0403  per  cent.  ;  during  fogs,  .0679  ; 
in  the  air  above  the  middens,  .0774  per  cent.  It  is  stated  that  there  is  a 
difference  between  close  and  open  spaces  in  towns ;  thus,  in  the  open 
spaces  (parks)  in  London,  the  mean  amount  in  A.  Smith's  experiments  was 
.0301  per  cent.  ;  in  Newgate  Street  (in  the  City),  it  was  .0413  ;  in  Lower 
Thames  Street  (City),  .0428  per  cent.  It  is  not,  however,  stated  whether 
the  observations  were  made  simultaneously.^     In    Glasgow,  the   average 

'  Air  and  Rain,  p.  24.  ^  A.  Smith,  op.  cit.,  p.  30. 

3  In  the  neigliborhood  of  St.  Mary's  Hospital,  Paddington,  i  tound  the  mean  CO^ 
to  be  0.056  per  cent,  in  damp  still  weather,  July,  lb75  ;  the  same  locality  in  dry,  hot 
weather,  with  a  good  deal  of  movement  of  air,  0.0416  per  cent.  (August,  1876) ;  in  the 
neighborhood  of  University  College  Hospital,  damp  weather,  0.0786  per  cent,  in  Feb- 
ruary, 1877.— [F.  de  C] 


AIE.  131 

CO,  was  .0502,  and  in  Perth  .04136  per  cent.'  In  foreign  cities  the 
amount  is  greater,  and  surpasses  the  normal  limit  in  air.  In  Madrid, 
Eamon  da  Luna  found  .0517  as  a  mean  average,  and  in  some  cases  .08  per 
cent.  ;  in  Munich,  the  amount  is  .05  per  cent.  These  numbers  seem,  after 
all,  insignificant,  but  they  are  not  really  so,  as  the  aggregate  difference,  if 
only  .01  per  cent.,  is  considerable.  In  the  air  of  towns  which  burn  coal  the» 
are  also,  as  noted,  an  excess  of  acidity  (sulphuric  and  hydrochloric  acids), 
and  various  suspended  matters,  which  no  doubt  have  injurious  effects.'' 

The  air  of  most  towns,  in  addition  to  ammonia,  also  contains  a  nitroge- 
nous substance  which,  when  condensed  in  pure  water,  can  be  made  to  yield 
albuminoid  ammonia,  by  Wanklyn's  method.  In  various  places  in  London, 
A.  Smith^  found  the  amount  to  average  .509  milligramme  of  albuminoid 
ammonia  in  1  cubic  metre.  The  greatest  amount  was  in  a  field  two  miles 
past  Clapham  Junction  .(viz.,  .27108  miUigramme  per  cubic  metre),  and  the 
least  was  in  Westminster  Abbey  Yard  (.08555  milligTamme).  At  the  shore 
at  Innellan  (Fu-th  of  Clyde),  the  amount  was  .1378  milhgramme,  and  the 
mean  in  the  streets  of  Glasgow  was  .3049  milligramme  per  cubic  metre. 
In  the  air  of  the  Underground  Railway,  in  London,  the  amount  was  .3734 
milligramme.*  The  mean  of  INIr.  Moss's  experiments  in  the  open  air  of 
Portsmouth  was  rather  less,  viz.,  .0886  milligramme  of  albuminoid  ammonia 
per  cubic  metre.  This  ammonia  may  be  derived  from  the  li\T.ng  beings  in 
the  air,  or  from  dead  organic  matter  ;  and  to  bring  out  the  full  meaning  of 
such  researches,  the  chemical  must  be  supplemented  by  a  microscopical 
examination.  Ozone  is  genei-ally  absent  in  town  au',  but  Marie-Davy  found 
at  Montsouris  an  average  of  .0115  milligramme  per  cubic  metre. '^  This, 
however,  depends  very  much  upon  the  situation  of  the  observatory  and  the 
direction  of  the  prevailing  winds.  The  wind  blowing  from  the  open  coun- 
try is  richer  in  ozone  than  that  coming  from  the  town. " 

These  observations  prove  how  important  it  is  to  build  towns  in  such  a 
way  as  to  insure  good  perflation  and  movement  of  air  everywhere,  and  to 
provide  open  spaces  in  all  the  densely  crowded  parts.  The  great  powers 
of  nature,  winds,  and  the  fall  of  rain,  will  then,  for  the  most  part,  keep  the 
atmospheric  impurities  within  hmits  not  injurious  to  health. 

Air  of  Marshes. 

The  air  of  typical  marshes  contains  usually  an  excess  of  carbon  diox- 
ide, which  amounts,  perhaps,  to  .6  or  .8  or  more  per  1,000  volumes.  Watery 
vapor  is  usually  in  large  quantity.  Hydrogen  sulphide  is  present,  if  the 
water  of  the  marsh  contains  sulphates,  which,  in  presence  of  organic  matter, 
are  converted  into  sulphides,  from  which  SH„  is  derived  by  the  action  of 
vegetable  acids.  Marsh  gas  is  also  often  present,  and  occasionally  free 
hydrogen  and  ammonia,  and,  it  is  said,  hydrogen  phosphide.' 

*  A.  Smith,  Air  and  Rain,  p.  50  et  seq. 

'  There  ar6  also  nitrous  and  nitric  acids,  due  probably  to  the  oxidation  of  organic 
matters. 

^  Air  and  Rain,  p.  437.  The  results  are  stated  in  milligrammes  per  cubic  metre, 
instead  of  grammes  per  million  ciibic  metres. 

*In  the  garden  of  St.  Mary's  Hospital,  Paddington,  I  found  .5280  and  .5206 
mgms.  per  M.  C.  (See  page  124.)  In  the  back  yard  of  University-College  Hospital, 
.2060  and  .3675.— [F.  de  C] 

'  Annuaire  de  I'Observatoire  de  Montsouris  pour  I'an  1882. 

'  See  Fodor,  Die  Luft,  p.  84,  1881. 

'  Toropoff  (of  St.  Petersburg),  considers  malaria  poison  gaseous ;  after  removing 
water,  oxygen,  and  carbon  dioxide,  he  found  marsh  air  still  yielded  84  to  89  per  cent, 
of  gaseous  matter  ;  whilst  hill  air  gave  only  81. 


132  PE ACTIO AL    HYGIENE. 

Organic  matter  also  exists  in  considerable  quantity.  Discovered  by 
Vauquelin  (1810  and  1811,  in  the  air  coUected  over  the  Languedoc  marshes), 
by  De  Lisle,  and  again  by  Moscati  (1818,  in  the  aii*  of  a  Lombardy  rice- 
neld),  and  examined  more  recently  by  Boussingaiilt  (1829, 1839),  Gigot  (1859), 
and  Becchi  (1861),  the  organic  matter  seems  to  have  much  the  same  char- 
acter always.  It  blackens  sulphuiic  acid  when  the  aii*  is  di-awn  through  it ; 
gives  a  reddish  color  to  nitrate  of  silver  ;  has  a  flocculent  appearance,  and 
sometimes  a  pecuhar  marshy  smell,  and,  heated  with  soda-lime,  affords  e^•i- 
dence  of  ammonia.  The  amount  in  Becchi 's  expeiiments  was  .00027 
gi'amme  in  a  cubic  metre  of  air  (=.000118  grain  in  1  cubic  foot).  Ozone, 
led  thi'ough  a  solution  of  this  organic  matter,  did  not  destroy  it.  It  is 
said  to  destroy  quinine.  Besides  the  organic  matter,  various  vegetable 
matters  and  animals,  floating  in  the  air,  ai-e  aiTested  when  the  aii'  of 
mai'shes  is  di'awn  thi'ough  water,  or  siili:)huric  acid,  and  debris  of  plants, 
infusoria,  insects,  and  even,  it  is  said,  small  Crustacea  are  found  ;  the  ascen- 
sional force  given  by  the  evaporation  of  water  seems,  indeed,  to  be  sufficient 
to  lift  compai'atively  large  animals  into  the  aii'.  Dr.  M.  P.  Balestra'  has 
described  spores  and  sporangia  of  a  httle  algoid  plant  in  the  aii-  of  Rome 
and  its  vicinity,  and  the  same  plant  is  found  abundantly  in  the  water  of  the 
marshes  near  Rome.  Balestra  is  inclined  to  attribute  marsh  fever  to  this 
■widely  diffiised  "  microj)hyte  gi-anule  ;  "  whilst  the  researches  of  Klebs  and 
Tommasi-Ci-udeli  have  led  them  to  attribute  it  to  a  form  of  bacillus,  which 
they  have  called  JJ.  malarice.''  It  has  been  stated  that  ozone  is  deficient  in 
the  air  over  marshes,  but  the  observations  of  BurdeF  do  not  confiiTQ  this. 
He  often  found  as  much  ozone  as  in  other  air.  In  the  air  collected  from 
the  sui'face  of  lakes,  containing  some  aquatic  plants,  especially  Chara,  there 
is  a  large  proportion  of  oxygen,  and  this  air  gives,  near  the  surface,  the 
reaction  of  ozone  (Clemens),  while  at  some  feet  above  the  reaction  is  lost. 
This  is  usually  ascribed  to  the  oxidation  of  organic  matter,  which  rises 
simultaneously  fi'om  the  water. 

Air  in  the  Holds  of  Ships. 

The  air  in  the  holds  of  ships  is  compounded  of  exhalations  from  the 
wood,  bilge-water,  and  cargo.  Owing  to  the  comparative  immobility  of  the 
air,  it  often  becomes  extremely  foul.  The  composition  is  not  known,  but 
the  .smell  of  hydrogen  sulphide  is  very  perceptible,  and  white  paint  is 
blackened.  In  some  cases,  when  the  water-tanks  are  filled  by  condensed 
water  from  the  engines,  which  is  not  well  cooled,  the  hold  may  become  ex- 
tremely hot  (100^  to  120°  Fahr.),  and  decomposition  be  much  increased. 

Air  of  Mines. 

In  the  metalliferous  mines  the  air,  according  to  Angus  Smith,*  is  poor 
in  oxygen  (20.5  per  cent,  sometimes),  and  veiy  rich  in  carbon  dioxide  (7.85 
per  1,000  volumes  on  a  mean  of  many  exiDcriments).  It  also  contains  or- 
ganic matter,  giving,  when  burnt,  the  smell  of  burnt  feathers,  in  uncertain 
amount.  These  impurities  arise  from  respiration,  combustion  from  lights, 
and  fi'om  gunpowder  blasting.  This  latter  process  adds  to  the  air,  in  ad- 
dition to  carbon  dioxide,  caibon  monoxide,   hydrogen  and  hydrogen  sul- 

'  Comptes  Rendus,  1870,  No.  3,  July,  p.  235. 
'  Studii  suUa  Natura  della  Malaria,  Roma,  1879. 
'  Eecherches  sur  les  fievres  paludeennes,  1858. 
*  Report  on  Mines,  Blue  Book,  1864. 


AIR.  183 

phide,  various  solid  particles,  consisting  of  suspended  salts,  which  may 
amount  to  as  much  as  3  grains  in  each  cubic  foot  of  air.  These  suspended 
substances  are  principally  potassium  sulphate,  carbonate,  hyposulphite, 
sulphide,  sulphocyanide,  and  nitrate,  carbon,  sulphur,  and  ammonium  ses- 
quicarbonate. 

Much  of  this  may  hereafter  be  avoided  by  the  new  process  of  getting 
coal,  by  means  of  compressed  quickhme,  which  is  slacked  in  holes  drUled 
in  the  coal. 

SECTION  n. 

DISEASES  PRODUCED  BY  IMPURITIES  IN  AIR. 
Sub-Section  I. — Suspended  Solid  Mattees. 

1.  Dead  Substances. — The  effect  which  is  produced  on  the  respiratory 
organs  by  substances  inhaled  into  the  lungs  has  long  been  known.  Eam- 
azzini  and  several  other  writers  in  the  last  century,  and  Thackrah  fifty 
years  ago  in  this  country,  directed  special  attention  to  this  point,  and 
since  that  time  a  great  amount  of  evidence  has  accumulated, '  which  shows 
that  the  effect  of  dust  of  different  kinds  in  the  air  is  a  far  more  potent 
cause  of  respiratory  diseases  than  usually  admitted.  Affections  of  the 
digestive  organs  are  also  caused,  but  in  a  much  slighter  degree.  The 
respiratory  affections  are  frequently  recurring  catarrhs  (either  dry  or  with 
expectoration)  and  bronchitis,  with  subsequent  emphysema,  although  this 
.  sequence  appears  from  the  figures  given  by  Hirt  to  be  not  quite  so  fre- 
quent as  was  supposed,  perhaps  from  the  cough  not  being  violent.  Acute 
pneumonia,  and  especially  chronic  non-tubercular  phthisis,  are  also  pro- 
duced. The  suspended  matters  in  the  air  which  may  pi'oduce  these 
affections  may  be  mineral,  vegetable,  or  animal ;  but  it  would  seem  that 
the  severity  of  the  effects  is  chiefly  dependent  on  the  amount  of  dust,  and 
on  the  physical  conditions  as  to  angularity,  roughness,  or  smoothness  of 
the  particles,  and  not  on  the  nature  of  the  substance,  except  in  some 
special  cases.  A  large  number  of  the  unhealthy  trades  are  chiefly  so 
from  this  cause  ;  this  is  the  case,  in  fact,  with  miners  of  all  kinds.''  Mr. 
Simon^  states,  that  with  one  exception,  the  800,000  miners  in  England 
break  down  as  a  class  prematurely  from  bronchitis  and  pneumonia  caused 
by  the  atmosphere  in  which  they  live.     The  exception  is  most  important. 

The  colliers  of  Durham  and  Northumberland,  where  the  mines  are  well 
ventilated,  do  not  appear  to  suffer  from  an  excess  of  pulmonary  disease, 
or  do  so  in  a  slight  degree  only.     In  different  mines,  also,  the  amount  of 

'  The  whole  siib'ect  has  been  lately  very  carefully  investigated  by  Hirt.  Die 
Krankheiten  der  Arbeiter,  Erste  Theil,  Staubinhalations-Krankheiten,  von  Dr.  L. 
Hirt.     1871 .     See  also  Eulenberg,  Gewerbe  Hygiene,  1876. 

■■^  Thackrah  enumerates  the  following  in  his  work  on  the  Effect  of  Arts,  Trades,  and 
Professions  on  Health,  1832,  p.  63:— The  workmen  who  were  affected  injuriously  by 
the  dust  of  their  trades  50  years  ago,  and  the  same  list  will  almost  do  for  the  present 
day  :  Cornmillers,  maltsters,  teamen,  coffee-roasters,  snuff-makers,  papermakers,  ilock- 
dressers,  feather-dressers,  shoddy-grinders,  weavers  of  coverlets,  weavers  of  harding, 
dressers  of  hair,  hatters  employed  in  the  bowing  department,  dressers  of  colored  leath- 
er, workers  in  flax,  dressers  of  hemp,  some  workers  in  wood,  wire-grinders,  masons, 
colliers,  iron  miners,  lead  miners,  grinders  of  metals,  file-cutters,  machine-makers, 
makers  of  firearms,  button-makers.     Hirt  (op.  cit.)  also  gives  an  extended  table. 

3  Fourth  Report  of  the  Medical  Officer  of  the  Privy  Council,  1862,  p.  15  et  seq. 
See  also  Arlidge,  in  B.  and  F,  Med.  Chir.  Rev.,  July,  1864,  for  the  effects  of  the  pottery 
trade. 


134 


PRACTICAL    HYGIENE. 


pulmonary  disease  is  different,  apparently  according  to  the  amount  of  ven- 
tilation. 

The  following  table  is  given  by  the  Registrar-General : — ' 

Average  Annual  Deaths  per  1,000  from  Pulmonary  Disease  during  the 
Years  1860-62  inclusive. 


Metal  Miners 

Metal  Miners 

Metal  Miners 

Males,  exclu- 

Ages. 

in  Cornwall. 

in  Yorkshire. 

in  Wales. 

in  Yorkshire. 

Between  15  and  25  years, 

3.77 

3.40 

3.02 

3.97 

25    "    35      " 

4.15 

6.40 

4.19 

5.15 

35    "    45      " 

7.89 

11.76 

10.62 

3.52 

45    "    55      " 

19.75 

23.18 

14.71 

5.21 

55    "    65      " 

43.29 

41.47 

35.31 

7.22 

65    "    75      " 

45.04 

53.69 

48.31 

17.44 

The  enormous  increase  of  lung  diseases  among  the  miners  after  the  age 
of  35,  is  seen  at  a  glance. 

In  the  pottery  trade  all  classes  of  workmen  are  exposed  to  dust, 
especially,  however,  the  flat  pressers.  So  common  is  emjihysema  that  it  is 
called  "the  potters' asthma." 

So  also  among  the  china  scourers  ;  the  light  flint  dust  disengaged  in 
great  quantities  is  a  "terrible  irritant."  Dr.  Greenhow  states  that  all 
sooner  or  later  become  "  asthmatical." 

The  grinders  of  steel,  especially  of  the  finer  tools,  are  perhaps  the  most 
fatally  attacked  of  all,  though  of  late  years  the  evil  has  been  somewhat 
lessened  by  the  introduction  of  wet-grinding  in  some  cases,  by  the  use  of 
ventilated  wheel-boxes,  and  by  covering  the  work  with  linen  covers  when 
practicable.  The  wearing  of  masks  and  coverings  for  the  mouth  appears 
to  be  inconvenient,  otherwise  there  is  no  doubt  that  a  great  amount  of  the 
dust  might  be  stopped  by  vei*y  simple  contrivances." 

Button-makers,  especially  the  makers  of  pearl  buttons,  also  suffer  from 
chronic  bronchitis,  which  is  often  attended  with  haemoptysis.  So  also  pin- 
pointers,  some  electro-plate  workmen,  and  many  other  trades  of  the  like 
kind,  are  more  or  less  similarly  affected. 

In  some  of  the  textile  manufactures  much  harm  is  done  in  the  same 
way.  In  the  carding  rooms  of  cotton,  and  wool,  and  silk  spinners,  there 
is  a  great  amount  of  dust  and  flue,  and  the  daily  gi-iuding  of  the  engines 
disengages  also  fine  particles  of  steel.  Since  the  cotton  famine,  a  size 
composed  in  part  of  china  clay  (35.35  grains  of  clay  in  100  of  sizing  on  an 
average),  has  been  much  used  in  cotton  mills,  and  the  dust  arising 
seems  certainly  to  be  producing  injuiious  efi'ects  on  the  lungs  of  the 
weaver.  ° 

In  flax  factories  a  very  irritating  dust  is  produced  in  the  process  of 
hackling,  carding,  line-preparing, '  and  tow-spinning.  Of  107  operatives, 
whose  cases  were  taken  indiscriminately  by  Dr.  Greenhow,  no  less  than  79 
were  suffering  from  bronchial  imtation,  and  in  19  of  these  there  had  been 

'  Report  of  the  Commissioners  on  Mines,  Blue-book,  1864. 

'■'  See  for  further  particulars  and  much  interesting  information  Dr.  Hall's  paper 
read  at  the  Social  Science  Congress  in  186.5. 

"  G.  Buchanan's  Report  on  certain  Sizing  Processes  used  in  the  Cotton  Manufacture 
at  Todmorden.     Ordered  to  be  printed  by  the  Hovise  of  Commons.     May,  1872. 


AIR.  135 

hsemoptysis.  Among  27  hacklers,  23  were  diseased.'  In  shoddy  factor- 
ies, also,  the  same  thing  occurs.  These  evils  apj)ear  to  be  entirely  and 
easily  preventable.  In  some  kinds  of  glass-making,  also,  the  workmen 
suffer  fx'om  floating  particles  of  sand  and  felspar,  and  sometimes  potash 
or  soda-salts. 

The  makers  of  grinding-stones  suffer  in  the  same  way  ;  and  children 
working  in  the  making  of  sand-paper  are  seriously  affected,  sometimes  in 
a  very  short  time,  by  the  inhalation  of  fine  particles  of  sand  into  the 
limgs. 

In  making  Portland  cement,  the  burnt  masses  of  cement  are  ground 
down  and  then  the  powder  is  shovelled  into  sacks  ;  the  workmen  doing 
this  cough  a  great  deal,  and  often  expectorate  little  masses  of  cement. 
Some  of  them  have  stated  that  if  they  had  to  do  the  same  work  every 
day,  it  would  be  impossible  to  continue  it  on  account  of  the  lung  af- 
fection. 

The  makers  of  matches,  who  are  exposed  to  the  fumes  of  phosphorus, 
suffer  from  necrosis  of  the  jaw,  if  there  happens  to  be  any  exjDosed  part  on 
which  the  fumes  can  act.  This,  however,  is  now  obviated  by  the  use  of 
amorphous  or  red  phosjDhorus,  which  is  harmless. 

In  making  bichromate  of  j^otash,  the  heat  and  vapor  employed  carry 
up  fine  particles,  which  lodge  in  the  nose  and  cause  great  irritation,  and 
finally  ulceration,  and  destruction  of  both  mucous  membrane  and  bone. 
Those  who  take  snuff  escape  this.  The  mouth  is  not  affected,  as  the  fluids 
dissolve  and  get  rid  of  the  salt.  The  skin  is  also  irritated  if  the  salt  is 
rubbed  on  it,  and  fistulous  sores  are  apt  to  be  produced.  No  effect  is 
noticed  to  be  produced  on  the  lungs. ^  Washing  the  skin  with  subacetate 
of  lead  is  the  best  treatment. 

In  the  process  of  sulphuring  vines  the  eyes  often  suffer,  and  some- 
times (especially  when  lime  is  used  with  the  sulphur)  decided  bronchitis 
is  produced. 

In  some  trades,  or  under  special  circumstances,  the  fumes  of  metals, 
or  particles  of  metallic  compounds,  pass  into  the  air.  Brassfounders  suf- 
fer from  bronchitis  and  asthma,  as  in  other  trades  in  which  dust  is  in- 
haled ;  but  in  addition  they  also  suffer  from  the  disease  described  by 
Thackrah  as  "brass  ague,"  and  by  Dr.  Greenhow  as  "brassfounders' 
ague."  It  appears  to  be  produced  by  the  inhalation  of  fumes  of  zinc 
oxide  ;  ^  the  symptoms  are  tightness  and  oppression  of  the  chest,  with  in- 
definite nervous  sensations,  followed  by  shivering,  an  indistinct  hot  stage, 
and  profuse  sweating.     These  attacks  are  not  periodical. 

Coppersmiths  are  affected  somewhat  in  the  same  way,  by  the  fumes 
arising  from  the  partly  volatilized  metal,  or  from  the  spelter  (solder). 

Tinplate  workers  also  suffer  occasionally  from  the  fumes  of  the  solder- 
ing. 

Plumbers  inhale  the  volatilized  oxide  of  lead  which  rises  during  the 
process  of  casting.  Nausea  and  tightness  of  the  chest  are  the  first  symp- 
toms, and  then  colic  and  palsy. 

'  Mr.  Simon's  Fourth  Report,  p.  19. 

^  Chevallier,  Ann.  d'Hygi.  ne,  July,  1863,  p.  83. 

^  Some  doubt  has  been  expressed  as  to  those  symptoms  being  produced  by  pure 
zinc  fumes  ;  see  Hirt  (op.  cit.),  who  says  that  men  employed  in  making  zinc  houses, 
where  they  inhale  pure  zinc  fumes  without  copper,  never  suffer  from,  brassfounder's 
ague.  On  the  other  hand,  he  describes  very  graphically  the  effect  of  the  metallic 
fumes  (copper  ?)  on  himself.  The  workmen  think  that  drinking  large  quantities  of 
milk  lessens  the  severity  of  the  attacks. 


136  PRACTICAL    HTGTENE. 

Manufacturers  of  white  lead  inhale  the  dust  chiefly  from  the  white  beds 
and  the  packing. 

House  painters  also  inhale  the  dust  of  white  lead  to  a  certain  extent, 
though  in  these,  as  in  former  cases,  much  lead  is  swallowed  from  want  of 
cleanliness  of  the  hands  in  taking  food. 

"V\'orkers  in  tobacco  factories  suffer  in  some  cases,  and  there  are  persons 
who  can  never  get  accustomed  to  the  work  ;  yet  with  proper  care  and  ven- 
tilation it  appears  '  that  no  bad  effects  ordinarily  result. 

Workers  in  mercuiw,  silverers  of  miiTors,  and  water  gilders  (men  who 
coat  silver  with  an  amalgam  of  mercury  and  gold),  are  subject  to  mer- 
ciu'ialismus.  But  electricity  has  rendered  gilding  with  the  aid  of 
mercury  to  some  extent  obsolete  ;  and  the  making  of  miiTors  with  nitrate 
of  silver  may  perhaj^s  ultimately  abolish  all  the  hoiTors  of  mercurial  labor. 

"Workmen  who  use  arsenical  compoimds,  either  in  the  making  of  wall 
papers  or  of  artificial  flowers,  etc.,  suffer  from  slight  symj^toms  of  arsenical 
poisoning,  and  many  persons  who  have  inhaled  the  dust  of  rooms  jDapered 
with  arsenical  papers  have  suffered  from  both  local  and  constitutional 
effects, — the  local  being  smarting  of  the  gums,  eyes,  nose,  oedema  of  the 
eyelids,  and  httle  ulcers  on  the  exposed  jmrts  of  the  body  ;  the  constitu- 
tional being  weakness,  fainting,  asthma,  anorexia,  thirst,  diaiThora,  and 
sometimes  even  severe  nen-ous  symptoms.^  Arsenic  has  been  detected  in 
the  urine  of  such  jDcrsons. 

A.  Manouvi'iez^  gives  an  account  of  the  diseases  among  workmen  in 
France  employed  in  making  patent  fuel,  a  mixture  of  coal-dust  and  pitch. 
He  says  they  suffer  fi-om  melanodermy,  cutaneous  eruptions,  and  epithelial 
cancers,  affections  of  the  eyes,  ears,  and  nose  ;  bronchitis  with  pulmonary 
pseudo-melanosis  ;  and  gastro-entero-hepatic  disorders.  Hirt  also  men- 
tions some  of  the  diseases  produced  among  workmen  by  the  various  tar- 
products. 

2.  Living  Substances,  as  Infusoria,  Fungi,  Algcc,  or  their  germs,  or  Pol- 
len or  Effluvia  of  Floicers. — That  summer  cataiTh  or  hay  fever  is  produced 
in  many  persons  by  the  poUen  from  grasses  (especially  Anthoxanthum  odor- 
atum),  trees  or  flowers,  is  now  generally  admitted.  The  researches  of  Dr. 
Blackley,^  of  Manchester  (himself  a  sufferer),  have  i^laced  the  matter  beyond 
a  doubt.  In  his  case,  at  least,  it  was  pollen  that  produced  the  disease,  and 
not  the  effluvia  merely.  Coumarin  had  no  effect.  Grass-pollen  (which 
constitutes  95  per  cent,  of  the  pollen  floating  in  the  atmosphere)  and  the 
pollen  from  pine-trees  were  the  most  powerful  in  effect.  Curiously  enough, 
the  pollen  of  poisonous  jDlants,  such  as  the  Solanace.T?,  was  often  compara- 
tively innocuous.  It  is  also  known  that  the  sj^ores  of  certain /M»_r/i  in  fall- 
ing on  a  proper  soil  may  cause  disease  of  the  skin  in  men,  and  that  tinea 
and  fa c us  are  thus  sometimes  spread  seems  certain.  There  is  a  growing 
belief  in  the  connection  of  the  specific  diseases  with  low  vegetable  forms. 
Dr.  Salisbui-y,  of  Ohio,  attempted  to  trace  ague  to  a  Palmella  ;  others  have 
ascribed  it  to  the  Oscillarinece  generally  ;  Dr.  Balestra  believes  that  a 
special  alga  is  the  efficient  cause,  and  Klebs  and  Tommasi-Crudeli  attribute 
it  to  the  Bacillus  n^alarUe. 

Dr.  Salisbury  has  also  affirmed  that  the  prevalence  of  measles  in  the 
Federal  army  arose  from  fungi  from  mouldy  straw.  He  inoculated  him- 
self, his  wife,  and  foriy  other  j^ersons  with  the  fungi,  and  produced  a  dis- 

'  Hirt,  op.  cit.,  pp.  162,  163. 

-  See  paper  bv  Mr.  Jabez  Hogg,  Sanitary  Record,  April  25,  1879. 

^  Annales  d'Hygiene,  March,  1876.  ■*  Op.  cit. 


AIR.  137 

ease  like  measles  in  from  twenty-four  to  ninety-six  hours.  It  is  stated 
also  that  this  disease  was  protective  against  measles.  Dr.  Woodward 
(United  States  Army)  has  repeated  Dr.  Salisbury's  experiments,  but  does 
not  confirm  them.' 

Professor  Hallier,  of  Jena,  has  to  some  extent  adopted  the  view  that 
fu.ngi  give  rise  to  some  of  the  specific  diseases,  and  that  the  spores  float 
in  the  air,  and  are  thus  communicated,  but  the  proofs  are  not  satisfac- 
tory. " 

Di'.  D.  D.  Cunningham  says  that  he  was  unable  to  connect  any  disease, 
in  Calcutta,  with  the  occurrence  of  bacteria  or  other  bodies  in  the  air, 
either  as  regards  variation  in  kind  or  in  quantity. 

Blackley  found  that  Ghop.tonlum  elatum  (bristle  mould)  produced  nausea, 
fainting,  and  giddiness,  and  the  spores  of  penicillium  (inhaled)  brought  on 
hoarseness,  going  on  to  complete  aphonia ;  the  condition  lasted  tv/o  days, 
and  ended  in  a  sharpish  attack  of  catarrh. 

Pettenkofer,  Von  Nageli,  Fodor,  and  many  others  distinctly  attribute 
specific  diseases  to  bacteria  of  certain  kinds.  The  connection  of  the  wool- 
sorters'  disease  with  the  existence  of  bacillus  in  the  holj  of  the  patient  has 
been  established,  and  this  is  in  all  probabihty  inhaled  from  the  atmos- 
phere in  which  the  men  work. 

Koch  has  recently  demonstrated  the  presence  of  a  bacillus  in  cases  of 
phthisis,  and  has  apparently  succeeded  in  cultivating  it,  and  proj)agating 
the  disease  by  that  means. 

3.  The  Gontagia. — Under  this  head  it  will  be  convenient  to  include  the 
unknown  causes  of  the  specific  diseases.  That  these  in  some  cases  (scarlet 
fever,  small-pox,  measles,  typhus,  enteric  fever,  plague,  pertussis,  yellow 
fever,  influenza,  etc.)  reach  the  person  through  the  medium  of  air  (as  well 
as  in  some  cases  through  water  or  food)  cannot  be  doubted.  Some  of  these 
contagia  have  in  some  way  a  power  of  growth  and  multiplication  in  the 
body  of  a  susceptible  animal,  but  whether  they  can  find  nourishment,  and 
thus  grow  in  the  air,  is  yet  doubtful.  It  seems  clear,  however,  that  they 
can  retain  the  powers  of  growth  for  some  time,  as  the  small-pox  and  scar- 
let fever  poisons  may  infect  the  air  of  a  room  for  weeks,  and  cattle  plague 
and  enteric  fever  poisons  will  last  for  months,^  and  in  this  they  resemble 
Protococci  and  other  low  forms  of  life,  which  can  be  dried  for  years, 
and  yet  retain  vitality. 

The  exact  condition  of  the  agency  is  unknown  ;  whether  it  is  in  the 
form  of  impalpable  particles,  or  moist  or  dried  ejDithelium  and  pus-cells, 
is  a  point  for  future  inquiry  ;  and  whether  it  is  always  contained  in  the 
substances  discharged  or  thrown  off  from  the  body  (as  is  certainly  the 
case  in  small-pox),  or  is  produced  by  putrefactive  changes  in  those  dis- 
charges, as  is  sujDposed  to  be  the  case  in  cholera  and  dysentery,  is  also  a 
matter  of  doubt.  Bakewell  *  collected  dust  deposited  at  a  height  of  7  or 
8  feet  in  small-pox  wards,  which  contained  the  minute  scabs  with  the  epi- 
dermic scales  and  variolous  corpuscles  which  are  thrown  off  from  the  skin 

1  Camp  Diseases  in  the  U.  S.  Army,  p.  278.     The  fungus  is  a  Penirilliiim. 

^  Many  papers  on  this  subject  by  Hallier  and  others  are  contained  in  Hallier's 
Zeitschrift  fur  Parasitenkunde. 

"  The  long  retention  of  power  by  the  enteric  fever  poison  is  shown  by  a  case  related 
by  Dr.  Becher  (Army  Med.  Department  Report,  vol.  10,  p.  237).  The  typhoid  poison 
appears  to  have  adhered  to  the  walls  and  ceiling,  and  to  have  retained  its  power  to  ex- 
cite disease  in  another  person  for  a  month ;  it  was  not  destroyed  by  the  heat  of  a  very 
hot  Indian  station  (Gwalior)  in  February. 

■*Med.  Times  and  Gazette,  December  7,  1872. 


138  PRACTICAL    HYGIENE. 

in  small-pox.  Some  modern  expositors  of  the  old  doctrine  of  fomites 
would  consider  these  orj^^anic  matters  to  be  inconceivably  minute  particles 
of  li^Tng,  or  to  use  Dr.  Beale's  phrase,  bioplastic  matter,  which  is  capable, 
he  believes,  of  wonderfully  rapid  growth  under  proper  conditions.'  But 
it  is  also  probable  that  some,  if  not  all,  the  disease  poisons  are  really  living 
organisms,  a  \uew  ver}''  widely  received  now  both  in  this  country  and  else- 
where. 

The  specific  poisons  manifestly  differ  in  the  ease  with  which  they  ai'e 
oxidized  and  destroyed.  The  poison  of  typhus  exanthematicus  is  very 
readily  got  rid  of  by  free  ventilation,  by  means  of  which  it  must  be  at 
once  diluted  and  oxidized,  so  that  a  few  feet  give,  under  such  circum- 
stances, sufiicient  protection.  This  is  the  case  also  with  the  poison  of  ori- 
ental plague,  while,  on  the  other  hand,  the  poisons  of  small-pox  and 
Bcai'let  fever  will  spread  in  spite  of  very  free  ventilation,  and  retain  their 
power  of  causing  the  same  disease  for  a  long  time.  In  the  case  of  malaria, 
the  process  of  oxidation  must  be  slow,  since  the  poison  can  certainly  be 
caii-ied  for  many  hundred  yai-ds  ;  even  sometimes  for  more  than  a  mile  in 
an  upward  direction  (up  a  ravine,  for  instance),  or  horizontally,  if  it  does 
not  pass  over  the  surface  of  water.  The  poison  of  cholera  also,  some  have 
supposed,  can  be  blown  by  the  winds  for  some  distance  ;  but  the  most  re- 
cent observations  on  its  mode  of  sj^read  lead  to  the  conclusion  that  the  por- 
tability of  the  poison  in  this  way  has  been  greatly  overrated.  The  poison 
of  diphtheria  appears  also  to  be  transported  some  distance  by  wind. 

But  the  specific  poisons  are  not  the  only  suspended  substances  which 
thus  float  through  the  atmosphere. 

There  can  be  no  doubt  that  while  punilent  and  granular  ophthalmia 
most  frequently  spread  by  direct  transference  of  the  pus  or  epithelium- 
cells,  by  means  of  towels,  etc.,  and  that  erysipelas  and  hospital  gangrene, 
in  surgical  wards,  are  often  earned  in  a  similar  way,  by  dirty  sponges  and 
dressings,  another  mode  of  transference  is  by  the  passage  into  the  atmos- 
phere of  disintegrating  pus-cells  and  putrefying  organic  p^.rticles,  and 
hence  the  great  efiect  of  free  ventilation  in  military  ophthalmia  (Stro- 
meyer),  and  in  erysipelas  '  and  hospital  gangrene.  In  both  these  diseases, 
great  evaporation  from  the  walls  or  floors  seems  in  some  way  to  aid  the 
diflfusion,  either  by  giving  a  great  degree  of  humidity,  or  in  some  other 
way.  The  practice  of  frequently  washing  the  floors  of  hospitals  is  well 
known  to  increase  the  chance  of  erysipelas,  and  this  might  be  explained, 
as  Von  Nageli  suggests,  by  the  moisture  and  subsequent  drying  helping 
the  develojDment  and  subsequent  dissemination  of  minute  organisms. 

Sub-Section  II. — Gaseous  Matters. 

(a)  Carbon  Dioxide. — The  normal  quantity  of  CO.,  being  .4  volume  per 
1,000,  it  produces  fatal  results  when  the  amount  reaches  from  50  to  100 
per  1.000  volumes  ;  and  at  an  amount  much  below  this,  15  to  20  per  1,000, 
it  produces,  in  some  persons  at  any  rate,  severe  headache.  Other  persons 
can  inhale,  for  a  bi'ief  period,  considerable  ciuantities  of  carbon  dioxide 
without  injury  ;  ^  and  animals  can  be  kept  for  a  long  time  in  an  atmosphere 
highly  charged  with  it,  provided  the  amount  of  oxygen  be  also  increased. 
In  the  air  of  respiration,  headache  and  vertigo  are  produced  when  the 

■  See  chapter  on  Disinfection  for  a  fuller  notice  of  these  points. 
'  See  nij  Reports  on  St.  Mary's  Hospital,  loc.  cit. — [F.  de  C] 

^  It  is  stated  that  Sir  R.  Christison  emplo3'ed  air  containing  20  per  cent,  of  carbon 
dioxide  as  an  anaesthetic.     (Taylor's  Jurisprudence,  1865,  p.  713.) 


AIE.  139 

amount  of  CO^  is  not  more  than  1.5  to  3  volumes  per  1,000  ;  but  then  or- 
ganic matters,  and  possibly  other  gases,  are  present  in  the  air,  and  the 
amount  of  oxygen  is  also  lessened.  Well-sinkers,  -when  not  actually  dis- 
abled from  continuing  their  work  by  CO^,  are  often  aiSected  by  headache, 
sickness,  and  loss  of  appetite  ;  bi;t  the  amount  of  CO^  has  never  been  de- 
termined. 

The  effect  of  constantly  breathing  an  atmosphere  containing  an  excess 
of  C0„  (up  to  1  or  1.0  per  1,000  volumes)  is  not  yet  perfectly  known.  Dr. 
Angus  Smith  '  has  attempted  to  determine  its  effect  of,  per  se,  the  influ- 
ence of  the  organic  matter  of  respiration  being  eliminated.  He  found 
that  30  volumes  per  1,000  caused  great  feebleness  of  the  circulation,  with, 
usually,  slowness  of  the  heart's  action  ;  the  res2:>irations  were,  on  the  con- 
traiy,  quickened,  but  were  sometimes  gasping.  These  effects  lessened 
when  the  amount  was  smaller,  but  were  percej^tible  when  the  amount  was 
as  low  as  1  volume  per  1,000 — an  amount  often  exceeded  in  dwelling- 
houses.  At  the  same  time,  this  is  not  the  case  always,  for  in  the  air  of  a 
soda-water  manufactory,  when  CO,  was  2  per  1,000,  Smith  found  no  dis- 
comfort to  be  produced.  The  effects  noticed  by  Smith  have  not  been  ob- 
served in  experiments  on  animals,  by  Demarquay,  W.  Muller,  and  Eulen- 
berg,^  nor  in  other  cases  in  men,  as  in  the  bath  at  Oeynhausen,  where  no 
effect  is  produced  by  the  air  of  the  room  in  which  the  bathers  remain  for 
30  to  60  minutes,  although  it  contains  a  large  percentage.  It  has  been 
supposed  that  lung  diseases,  especially  phthisis,  are  produced  by  it ;  but 
as  this  opinion  has  been  drawn  merely  from  the  effects  of  the  air  of  respi- 
ration, which  is  other^^■ise  vitiated,  it  cannot  be  considered  to  stand  on  any 
siu'e  basis.  Hirt  finds  no  symptoms  of  chi-onic  poisoning  by  C0„,  even  in 
trades  where  acute  poisoning  occasionally  occui-s.' 

The  presence  of  a  very  large  amoujit  of  C0„  in  the  air  may  lessen  its 
elimination  fi'om  the  lungs,  and  thus  retain  the  gas  in  the  blood,  and  in 
time  j)Ossibly  produce  serious  alterations  in  nutrition. 

(b)  Carbon  Monoxide. — Of  the  immense  effect  of  carbon  monoxide, 
there  is  no  doubt.  Less  than  one-half  per  cent,  has  produced  poisonous 
symptoms,  and  more  than  one  per  cent,  is  rapidly  fatal  to  animals.  It  ap- 
pears from  Bernard's  and  fi'om  Lothar  Meyer's  obseiwations,^  that  the  gas, 
volume  for  volume,  comj)letely  replaces  the  oxygen  in  the  blood,  and  can- 
not be  again  displaced  by  oxygen,  so  that  the  person  dies  asphyxiated  ; 
but  Pokrowsky  has  shown  '  that  it  may  gradually  be  converted  into  carbon 
dioxide,  and  be  got  rid  of.  It  seems,  in  fact,  as  Hoppe-Seyler  conjectured, 
to  completely  paralyze,  so  to  speak,  the  red  particles,  so  that  they  cannot 
any  longer  be  the  carriers  of  oxygen.  The  obsei'vations  of  Dr.  Edeber  ° 
show  that,  in  addition  to  loss  of  consciousness  and  destruction  of  reflex 
action,  it  causes  complete  atony  of  the  vessels,  diminution  of  the  vascular 
pressure,  and  slowness  of  circulation,  and  finally  paralysis  of  the  heart.  A 
very  rapid  parenchymatous  degeneration  takes  place  in  the  heart  and 
muscles  generally,  and  in  the  liver,  spleen,  and  kidneys.  Hirt '  says  that 
at  high  temperatures  (2o°-32^  Cent.  =  77^^-90-  Fahi'.)  it  produces  convul- 
sions, but  not  at  low  temperatures  (8°-12°  Cent.  =  46^^-53^  Fahr.). 

(c)  Hydrogen  Sulphide. — The  evidence  with  regard  to  this  gas  is  contra- 

'  Air  and  Eain,  p   209  et  seq.  ^  Quoted  hj  Eoth.  and  Lex,  op.  cit.,  p.  1T6. 

2  Die  Krankheiten  der  Arbeiter,  Erste  Abtheilung,  2'"  Theil,  1878. 
*  De  Sanguine   Oxydo  carbonico  Infecto,  1858.     Reviewed  in  Yirchow's  Arcbiv, 
Band  xv.,  3()9.     See  also  Letheby,  Cliemical  Xews,  April,  1863. 
°  Yirchow's  Arcbiv,  Band  xxx.,  p.  525  (1864). 
» Ibid.,  Band  xxxii.,  p.  450  (1865).  *  Op.  cit. 


140  PRACTICAL    HYGIENE. 

dictory.  While  dogs  and  horses  are  affected  by  comparatively  small  quan- 
tities (1.25  and  4  volumes  per  1,000  volumes  of  air),  and  suffer  from  pm-ging 
and  rapid  prostration,  men  can  breathe  a  larger  quantity'.  Pareut-Ducha- 
telet  inhaled  an  atmosphere  containing  29  volumes  per  1,000  for  some  short 
time. ' 

When  inhaled  in  smaller  quantities,  and  more  continuously,  it  has  ap- 
peared in  some  cases  harmless,  in  others  hurtful.  Thackrah,  in  his  in- 
quiries, could  trace  no  bad  effects.  It  is  said  that  in  the  Bonnington 
chemical-works,  where  the  ammoniacal  liquor  from  the  Edinburgh  gas- 
works is  converted  into  sulphate  and  chloride  of  ammonium,  the  workmen 
are  exposed  to  the  fumes  of  ammonium  and  hydrogen  sulphides  to  such  an 
extent  that  corns  are  blackened  ;  yet  no  special  malady  is  known  to  result. 
The  same  observations  have  been  made  at  the  Britannia  metal-works,  where 
a  superficial  deposit  of  sulphide  is  decomposed  with  acids. 

Hirt  ^  has  no  doubt  of  the  occuiTence  of  chronic  poison  among  men  who 
work  among  large  quantities  of  the  gas.  The  symptoms  are  chiefly  weak- 
ness, depression,  perfect  anorexia,  slow  pulse,  furred  tongue,  nnicous  mem- 
brane of  the  mouth  pale,  as  is  also  the  face.  Sometimes  there  is  furuncu- 
loid  eruption  in  dirferent  parts  of  the  body.  Li  some  cases  there  are 
vertigo,  headache,  nausea,  diarrhoea,  emaciation,  and  head  symptoms,  "like 
a  case  of  very  slow-running  tyj^hus."  He  notices  differences  of  suscej^ti- 
bility,  which  is  also  sometimes  increased  with  custom. 

So  large  a  quantity  of  SH„  is  given  out  from  some  of  the  salt  marshes  at 
Singapore,  that  slips  of  paper  moistened  in  acetate  of  lead  are  blackened 
in  the  open  air  ;  yet  not  only  is  no  bad  effect  found  to  ensue,  but  Dr.  Little 
has  even  conjectured  (on  very  disputable  grounds,  however),  that  the  SH^ 
may  neutrahze  the  marsh  miasma. 

On  the  other  hand,  some  of  the  worst  marshes  in  Italy  are  those  in 
which  SH^  exists  in  large  quantity  in  the  air  ;  and,  in  du-ect  opposition  to 
Little,  it  has  been  supposed  that  the  highly  poisonous  action  of  the  marsh 
gas  is  partly  owing  to  the  SH,,.  Again,  in  the  making  of  the  Thames 
Tunnel,  the  men  were  exposed  to  SH„,  which  was  formed  from  the  decom- 
position of  iron  j^yrites  ;  after  a  time  they  became  feeble,  lost  theu'  appe- 
tites, and  finally  passed  into  a  state  of  great  prostration  and  anamia.  Nor, 
so  far  as  is  known,  was  there  anything  to  account  for  this  except  the  pres- 
ence of  SH^.^* 

Dr.  Josephson  and  Eawitz  ■*  have  also  investigated  in  mines  effects  pro- 
duced apparently  by  SH„  ;  two  forms  of  disease  are  produced — pure  nar- 
cotic, and  convulsive  and  tetanic  symptoms.  In  the  first  case,  the  men 
became  pale,  the  extremities  got  cold.  There  was  headache,  vertigo,  a 
small  weak  pulse,  sweating,  and  great  loss  of  strength.  On  this,  spasms 
and  tremblings  sometimes  followed,  and  even  tetanus.  These  symptoms 
were  acute,  and  not,  as  in  the  Thames  Tunnel  case,  chronic.  When  these 
attacks  occurred,  the  temperature  was  high  and  the  air  stagnant. 

The  obsei-vations  of  Clemens,  also,  on  the  development  of  boils  from 
the  passage  of  SH,  into  the  drinking  water  from  the  air,  if  not  convincing, 
cannot  be  overlooked. 

The  symptoms  produced  by  ammonium  sulphide  in  dogs  are  said,  by 

'  On  dogs,  Herbert  Barker  found  a  larger  quantity  necessary  than  that  stated  above ; 
viz.,  4.29  per  1,000  is  rapidly  fatal,  2.06  per  1,000  may  be  fatal,  but  .5  per  1,000  may 
produce  serious  symptoms. 

'■'  Op.  cit. 

3  Taylor's  Med.  Jurisp.,  1865,  p.  727. 

^  Schmidt's  Jahr.,  Band  ex.,  p.  334,  and  Band  cxvii.,  p.  85. 


AIR.  141 

Herbert  Barker/  to  differ  from  those  of  SH,.  Tliere  is  vomiting  without 
l^urging,  quickened  pulse,  and  heat  of  skin,  followed  by  coldness  and  rajDid 
sinking,  ^\^len  hychogen  and  ammonium  sulphides,  dissolved  in  water, 
are  injected  into  the  blood,"  they,  and  especially  SH„,  produce  the  same 
symptoms  as  the  injection  of  non-corpuscular  putrid'  tiuids,  viz.,  profuse 
diarrhoeal  evacuations,  with  sometimes  marked  choleraic  symptoms  and 
decided  lowering  of  the  temperature  of  the  body,  congestions  of  the  lungs, 
liver,  spleen,  and  kidneys,  initation  of  the  spine,  and  opisthotonos.  But, 
in  this  case,  a  much  larger  quantity  will  be  introduced  than  by  inhalation 
through  the  lungs. 

{d)  Carhuretted  Hydrogen. — A  large  quantity  of  carburetted  hydrogen 
can  be  breathed  for  a  short  time  ;  as  much,  perhaps,  as  200  to  300  volumes 
per  1,000.  Above  this  amount  it  produces  symptoms  of  poisoning,  head- 
ache, vomiting,  convulsions,  stertor,  dilated  pupil,  etc. 

Breathed  in  small  quantities,  as  it  constantly  is  by  some  miners,  it  has 
not  been  shown  to  produce  any  bad  effects  ;  but  there,  as  in  so  many  other 
cases,  it  is  to  be  wished  that  a  more  careful  examination  of  the  point  were 
made.  Without  producing  any  marked  disease,  it  may  yet  act  injuriously 
on  the  health.  Hirt  says  that  cases  of  chronic  poisoning  are  not  vm- 
common. 

(e)  Ammoniacal  Vapors. — An  in-itating  effect  on  the  conjunctiva  seems 
to  be  the  most  marked  effect  of  the  presence  of  these  vapors.  There  is  no 
evidence  showing  any  other  effect  on  the  health.' 

if)  Sulphur  Dioxide. — The  bleachers  in  cotton  and  worsted  manufac- 
tories, and  storers  of  woollen  ai-ticles,  are  exposed  to  this  gas,  the  amount 
of  which  in  the  atmosjohere  is,  however,  unknown.  The  men  suffer  from 
bronchitis,  and  are  frequently  sallow  and  anaemic.^ 

When  SO^  is  evolved  in  the  open  air,  and  therefore  at  once  largely 
diluted,  as  in  copper  smelting,  it  does  not  appear  to  produce  any  bad  effects 
in  men,  though  from  being  washed  down  with  rain,  it  affects  herbage,  and, 
through  the  herbage,  cattle,  causing  affections  of  the  bones,  falling  off  of 
the  hair,  and  emaciation. 

(g)  Hydrochloric  Acid  Vapors  in  large  quantities  are  very  irritating  to 
the  lungs  ;  when  poui-ed  out  into  the  air,  as  was  formerly  the  case  in  the 
alkah  manufactures,  they  are  so  diluted-  as  apparently  to  produce  no  effect 
on  men,  but  they  completely  destroy  vegetation.  In  some  processes  for 
making  steel,  hydrochloric,  sulphurous  and  nitrous  acids,  and  chlorine  are 
all  given  out,  and  cause  bronchitis,  pneumonia,  and  destruction  of  lung 
tissue,  as  well  as  eye  diseases.^ 

(h)  Carbon  Disidphide. — In  certain  processes  in  the  manufacture  of 
vulcanized  india-rubber  a  noxious  gas  is  given  off,  supjDosed  to  be  the 
vapor  of  carbon  disulphide.  It  produces  headache,  giddiness,  pains  in  the 
hmbs,  formication,  sleeplessness,  nervous  depression,  and  complete  loss 
of  appetite.  Sometimes  there  is  deafness,  dyspnoea,  cough,  febrile  attacks, 
and  even  amaurosis  and  paraplegia  (Delpech).  The  effects  seem  due  to  a 
direct  anaesthetic  effect  on  the  nervous  tissue. 

^  On  Malaria  and  Miasmata,  p.  212. 

2  Weber,  Syd.  Soc.  Tear-Book  for  1874,  p.  227. 

2  See  Schloesing,  Comptes  Rendus,  1875,  vols.  i.  and  ii. 

*  On  the  other  hand,  persons  living  in  volcanic  countries  have  sometimes  a  notion 
that  the  fumes  of  SOo  are  good  for  the  health  ;  I  have  been  told  so  by  people  in  the 
neighborhood  of  Vesuvius. — [F.  de  C] 

°  Jordan,  Canstatt's  Jahresb.  for  1863,  Band  vii, ,  p.  76. 


142  PKACTICAL    HYGIENE. 


Sub-Section  III. — Effect  of  Air  Impure  from  several  Substances 
ALWAYS  Coexisting. 

The  examination  of  the  effects  of  individual  gases,  however  important, 
can  never  teach  us  the  results  which  may  be  produced  by  breathing  air 
rendered  foul  by  a  mixture  of  impui-ities.  The  comi^osite  effect  may  possi- 
bly be  very  different  from  what  would  have  been  antici2:)ated  from  a  knowl- 
edge of  the  action  of  the  isolated  substances. 

(a)  Air  rendered  Impure  by  Iiet<piration. — The  effect  of  the  fetid  air 
containing  organic  matter,  excess  of  water  and  C0„,  produced  by  respiration 
is  very  marked  upon  many  people  ;  heaviness,  headache,  inertness,  and  in 
some  cases  nausea,  are  produced.  From  experiments  on  animals  in  which 
the  carbon  dioxide  and  watery  vapor  were  removed,  and  organic  matter 
alone  left,  Gavarret  and  Hammond  have  found  that  the  organic  matter  is 
highly  poisonous.  Hammond  found  that  a  mouse  died  in  forty-five  min- 
utes, and  cases  have  been  known  in  which  the  inhalaiion  of  such  an  atmos- 
phere for  three  or  four  hours  jDroduced  in  men  decided  febi'ile  symptoms 
(increased  temperature,  c|uickened  pulse,  furred  tongue,  loss  of  appetite, 
and  thirst),  for  even  twenty-foui-  or  forty-eight  hours  subsequently  (Parkes). 

Wlieu  the  air  is  rendered  still  more  impure  than  this,  it  is  rapidly  fatal, 
as  in  the  cases  of  the  Black  Hole  at  Calcutta  ;  of  the  prison  in  which 
300  Austrian  prisoners  were  put  after  the  battle  of  Austerlitz  (when  260 
died  veiy  rapidly) ;  and  of  the  steamer  Londonderry.  The  poisonous 
agencies  are  probably  the  organic  matter  and  the  deficient  oxygen,  as  the 
symptoms  are  not  those  of  pure  asphyxia.  If  the  persons  survive,  a  febrile 
condition  is  left  behind,  which  lasts  three  or  foiu'  days,  or  there  are  other 
evidences  of  affected  nutrition,  such  as  boils,  etc. 

When  air  more  moderately  vitiated  by  respiration  is  breathed  for  a 
longer  period,  and  more  continuously,  its  effects  become  complicated  with 
those  of  other  conditions.  Usually  a  person  who  is  compelled  to  breathe 
such  an  atmosphere  is  at  the  same  time  sedentaiy,  and,  perhajDs,  remains  in 
a  constrained  position  for  several  hours,  or  possibly  is  also  under-fed  or 
intemperate.  But  allowing  the  fullest  efiect  to  all  other  agencies,  there  is 
no  doubt  that  the  breathing  the  vitiated  atmosphere  of  respiration  has  a 
most  injurious  effect  on  the  health.'  Persons  soon  become  pale,  and  par- 
tially lose  their  appetite,  and  after  a  time  decline  in  muscular  strength 
and  spirits."  The  aeration  and  nutrition  of  the  blood  seem  to  be  inter- 
fered with,  and  the  general  tone  of  the  system  falls  below  par.  Of  special 
diseases  it  appears  pretty  clear  that  pulmonary  affections  are  more  common. 

Such  persons  do  certainly  appear  to  furnish  a  most  undue  percentage 
of  phthisical  cases  ;  that  is,  of  destnictive  lung-tissue  disease  of  some  kind. 
The  production  of  phthisis  from  inipui-e  air  (aided  most  j^otently,  as  it  often 
is,  by  coincident  conditions  of  want  of  exercise,  want  of  good  food,  and 
excessive  work)  is  no  new  doctrine.^     Baudelocque  long  ago  asserted  that 

'  See,  among  a  number  of  other  instances,  Guy's  Evidence  before  the  Health  of 
Towns  Commission,  vol.  i.,  p.  89  et  seq. ;  and  S.  Smith,  ibid.,  p.  37  et  seq. 

"^  See  Wilson's  observations  on  Prisoners,  already  cited,  page  122. 

^  The  following  statistics  (Ransom,  Sanitary  Record,  vol.  vi.)  are  instructive  :  Death- 
rate  from  diseases  of  the  respiratory  organs  for  all  England,  3.54  (1865-76) ;  for  Salford, 
5.13  ;  for  registration  district  of  Manchester,  6.10  ;  for  townshipof  Manchester  in  1874, 
7.7;  for  Westmoreland  (one  of  the  healthiest  counties),  2.27 ;  for  North  Wales,  2.51. 
For  diagrams  showing  the  effects  of  aggregation  of  population  on  the  ratio  of  respira- 
tory diseases,  see  my  Lectures  on  State  Medicine,  table  v.,  p.  48. — [F.  de  C] 


AIR.  143 

impure  air  is  the  great  cause  of  scrofula  (phthisis),  and  that  hereditary 
predisposition,  syphilis,  uncleanness,  want  of  clothing,  bad  food,  cold  and 
humid  ail",  are  by  themselves  non-effective.  Carmichael,  in  his  work  on 
scrofula  (1810),  gives  some  most  striking  instances,  where  impure  air,  bad 
diet,  and  deficient  exercise  concurred  together  to  produce  a  most  formi- 
dable mortahty  from  phthisis.  In  one  instance,  in  the  Dubhn  House  of 
Industry,  where  scrofula  was  formerly  so  common  as  to  be  thought  con- 
tagious, there  were  in  one  ward  60  feet  long  and  18  feet  broad  (height  not 
given),  38  beds,  each  containing  four  children  ;  the  atmosphere  was  so  bad 
that  in^the  morning  the  air  of  the  ward  was  unendui*able.  In  some  of  the 
schools  examined  by  Carmichael,  the  diet  was  excellent,  and  the  only 
causes  for  the  excessive  phthisis  were  the  foul  air  and  the  want  of  exercise. 
This  was  the  case  also  in  the  house  and  school  examined  by  Neil  Arnott  in 
1832.  Lepelletier '  also  records  some  good  evidence.  Professor  Ahson,  of 
Edinburgh,  and  Sii'  James  Clark,  in  his  invaluable  work,  lay  great  stress 
on  it.  Neil  Arnott,  Toynbee,  Guy,  and  others,  brought  fo?'ward  some 
striking  examples  before  the  Health  of  Towns  Commission."  Dr.  Henry 
MacCormac  has  insisted  with  great  cogency  on  this  mode  of  origin  of 
phthisis  ;  aud  Dr.  Greenhow^  also  enumerates  this  cause  as  occupying  a 
prominent  place. 

In  prisons,  the  great  mortality  which  formerly  occurred  from  phthisis, 
as  for  example  at  j\Iillbank  (Baly),  seemed  to  be  owing  to  bad  air,  conjoined 
with  inferior  diet  and  moral  depression. 

Two  Austrian  prisons,  in  which  the  diet  and  mode  of  life  were,  it  is 
beheved,  essentially  the  same,  offer  the  followiag  contrast : — 

In  the  prison  of  Leopoldstadt,  at  Vienna,  which  was  very  badly  ventilated, 
there  died  in  the  years  1834-1847,  378  jirisoners  out  of  4,280,  or  86  per 
1,000,  and  of  these  no  less  than  220,  or  51.4  per  1,000,  died  from  phthisis  ; 
there  were  no  less  than  42  cases  of  acute  miliaiy  tuberculosis. 

In  the  well-ventilated  House  of  Correction  in  the  same  city,  there  were 
in  five  years  (1850-1854)  3,037  prisoners,  of  whom  43  died,  or  14  per  1,000, 
and  of  these  24,  or  7.9  per  1,000,  died  of  phthisis.  The  comparative  length 
of  sentences  is  not  given,  but  no  correction  on  this  ground,  if  needed, 
could  account  for  this  discrejDancy.  The  great  prevalence  of  phthisis  in 
some  of  the  Indian  jails  appears  to  have  been  owing  to  the  same  cause, 
combined  with  insufficient  diet. 

The  now  well-known  fact  of  the  gTeat  prevalence  of  phthisis  in  most  of 
the  European  armies  (French,  Prussian,  Russian,  Belgian,  and  English) 
can  scarcely  be  accounted  for  in  any  other  way  than  by  supposing  the 
vitiated  atmosphere  of  the  barrack-room  to  have  been  chiefly  in  fault. 
This  is  the  conclusion  to  which  the  Sanitai'y  Commissioners  for  the  army 
came  in  their  celebrated  report.  And  if  we  must  also  attribute  some  in- 
fluence to  the  pressure  of  ill-made  accoutrements,  and  to  the  great  preva- 
lence of  s^-philis,  still  it  can  hardly  be  doubted  that  the  chief  cause  of 
phthisis  among  soldiers  has  to  be  sought  somewhere  else,  when  we  see 
that,  with  very  different  duties,  a  variable  amount  of  s}-phihs,  and  altered 
diet,  a  great  amount  of  phthisis,  has  prevailed  in  the  most  varied  stations 
of  the  army,  and  in  the  most  beautiful  chmates  ;  in  Gibraltar,  Malta,  Ionia, 
Jamaica,  Trinidad,  Bei'muda,  etc.  (see  history  of  these  stations),  in  all 
which  places  the  ooly  common  condition  was  the  vitiated  atmosphere  which 

'  Traite  Complet  de  la  Maladie  Scrophuleuse. 

'  First  Report,  1844,  vol.  i.,  pp.  52,  60,  69,  79,  etc. 

^  Report  on  the  Health,  of  tlae  People  of  England. 


14i  PRACTICAL    HYGIENE. 

oui'  barrack  system  everywliere  produced.  And,  as  if  to  clench  the  argu- 
ment, there  has  been  of  late  years  a  most  decided  decline  in  jDhthisical 
cases  in  these  stations,  -n-hile  the  only  circumstance  which  has  notably 
changed  in  the  time  has  been  the  condition  of  the  air.  So  also  the  ex- 
traordiuaiT  amount  of  consumption  which  has  prevailed  among  the  men 
of  the  Royal  and  Merchant  NaWes.  and  which,  in  some  men-of-war,  has 
amounted  to  a  veritable  epidemic,  is  in  all  probabihty  attributable  to  the 
faulty  ventilation.' 

The  deaths  from  phthisis  in  the  Royal  Navy  averaged  (3  years)  2.6  per 
1,000  of  strength,  and  the  invahding  3.9  per  1,000.  The  amount  of  consump- 
tion and  of  all  lung  diseases  was  remarkably  different  in  the  different  ships. 
These  inferences  received  the  strongest  corroboration  from  the  outbreak  of 
a  lung  disease  leading  to  the  destruction  of  lung  tissue  in  several  of  the 
ships  on  the  MediteiTanean  station  in  1860.  Dr.  Bryson  traced  this  clearly 
to  contamination  of  the  air,  and  noticed  that  in  several  cases  the  disease 
appeared  to  be  propagated  from  person  to  jDerson."  It  may  be  infeiTed 
that  pus-cells  were  largely  thrown  off  during  coughing,  and,  floating  through 
the  au",  were  received  into  the  luDgs  of  other  persons. 

The  production  of  jDhthisis  in  animals  confirms  this  view.  The  case  of 
the  monkeys  in  the  zoological  gardens,  narrated  by  Dr.  Ai-nott,  is  a  striking 
instance.  Cows  in  close  stables  frequently  die  from  jDhthisis,  or  at  any  rate 
fi'om  a  destructive  lung  disease  (not  ajDparently  pleiu'o-pneumonia) ;  while 
horses,  who  in  the  worst  stables  have  more  fi-ee  air,  and  get  a  greater 
amount  of  exercise,  are  httle  subject  to  phthisis.  But  not  only  phthisis 
may  reasonably  be  considered  to  have  one  of  its  modes  of  origin  in  the 
breathing  an  atmosphere  contaminated  by  respiration,  but  other  lung  dis- 
eases, bronchitis  and  pneumonia,  aj^pear  also  to  be  more  common  in  such 
circumstances.  Both  among  seamen  and  civihans  working  in  confined 
close  rooms,  who  are  otherwise  so  differently  cii'cumstanced,  we  find  an 
extess  of  the  acute  lung  affections.  The  only  circumstance  which  is  com- 
mon to  the  two  classes  is  the  impui-e  atmosphere.  (Compare  especially 
Gavin  ^lih-oy  and  Greenhow.)  The  favorite  belief  that  these  diseases  are 
caused  by  transitions  of  temperature  and  exposure  to  weather,  has  been 
carried  too  far. 

In  the  South  Afghanistan  field  force  the  artillery  wintered  at  Kandahar 
(1880-81)  in  tents,  and  remained  free  from  pneumonia,  whilst  the  disease 
was  prevalent  among  the  infantiy  who  were  overcrowded  in  barracks. 
The  63d.  which  was  more  crowded  than  the  other  corjDS,  suffered  most, 
having  30  cases  in  hospital  at  one  time  ;  one  company,  however,  quartered 
in  large  airy  rooms  near  the  residence  of  the  General  commanding,  had 
no  case.  On  the  2oth  of  March  a  part  of  the  regiment  was  turned  out  into 
tents  and  the  remainder  were  distributed  in  ban'acks,  so  that  each  man  had 
a  minimum  of  600  cubic  feet  of  space  ;  from  that  time  no  more  pneumonia 
occurred.  ^ 

In  addition  to  a  general  impaired  state  of  health,  arising,  probably, 
from  faulty  aeration  of  the  blood,  and  to  phthisis  and  other  lung  affections, 
which  may  reasonably  be  believed  to  have  their  origin  in  the  constant 
breathing  of  air  vitiated  by  the  organic  vapors  and  particles  arising  from 
the  person,  it  has  long  been  considered,  and  apparently  quite  correctly, 

'  Statistical  Reports  ou  fhe  Health    of  the  Xavv,  and   especially  Gavin  Milroy's 
pamphlet  on  the  Health  of  the  Royal  Navy,  1862,  pp.  44  and  54. 
■'  Trans,  of  the  Epidem.  See,  vol.  ii.,  p.  142. 
*  Report  by  Dept.  Surg. -General  Simpson. 


AIR.  145 

that  such  an  atmosphere  causes  a  more  rapid  spread  of  several  specific 
diseases,  esiDecially  typhus  exanthematicus,  plague,  small-pox,  scarlet  fever, 
and  measles.  This  may  arise  in  several  ways  ;  the  specific  poison  may 
simply  accumulate  in  the  air  so  imperfectly  changed,  or  it  may  grow  in  it 
(for  though  there  may  be  an  analogical  argument  against  such  a  process^ 
it  has  never  been  disproved,  and  is  evidently  not  impossible)  ;  or  the 
vitiated  atmosphere  may  simply  render  the  body  less  resisting  or  more 
predisposed. 

(6)  Air  rendered  Imjoure  by  Exhalations  from  the  Sick. — The  air  of  a  sick 
ward,  containing  as  it  does  an  immense  quantity  of  organic  matter,  is  well 
known  to  be  most  injurious.  The  severity  of  many  diseases  is  increased, 
and  convalescence  is  greatly  prolonged.  This  ajDpears  to  hold  true  of  all 
diseases,  but  especially  of  the  febrile.  At  a  certain  point  of  impurity, 
erysipelas  and  hospital  gangrene  appear.  The  occurrence  of  either  disease 
is,  in  fact,  a  condemnation  of  the  sanitary  condition  of  the  ward.  It  has 
been  asserted  that  hospital  gangrene  is  a  precursor  of  exanthematic  t}'- 
phus,'  but  probably  the  introduction  at  a  particular  time  of  the  specific 
poison  of  tyiDhus  was  a  mere  coincidence.  But,  doubtless,  the  same  foul 
state  of  the  air  which  aids  the  spread  of  the  one  disease  would  aid  also 
that  of  the  other. 

When  hosjjital  gangrene  has  appeared,  it  is  sometimes  extremely 
difficult  to  get  rid  of  it.  Hammond"  states  that  in  a  ward  of  the  New 
York  City  Hospital,  where  hospital  gangrene  had  appeared,  removal  of  the 
furniture  and  patients  did  not  prevent  fresh  patients  being  attacked. 
Closing  the  ward  for  some  time  and  whitewashing  had  no  effect.  The 
plastering  was  then  removed,  and  fresh  plaster  applied,  but  still  cases  re- 
curred. At  last  the  entire  walls  were  taken  down  and  rebuilt,  and  then  no 
more  cases  occurred. 

It  is  now  well  known  that  by  the  freest  ventilation,  i.e.,  by  treating 
men  in  tents  or  in  the  open  air,  hospital  gangrene  can  be  entirely  avoided."* 
The  occurrence  of  hospital  gangrene  in  a  tent  is  a  matter  of  the  rarest 
occui'rence. 

(c)  Air  rendered  Impure  by  Combustion. — Of  the  products  of  combustion 
which  pass  into  the  general  atmosphere,  the  carbon  dioxide  and  monoxide 
are  so  largely  and  speedily  diluted  that  it  is  not  likely  they  can  have  any 
influence  on  health.  The  particles  of  carbon  and  tarry  matter,  and  the 
sulphur  dioxide,  must  be  the  active  agents  if  any  injury  results.  It  has 
been  supposed  that  the  molecular  carbon  and  sulphur  dioxide,  instead  of 
being  injurious,  may  even  be  useful  as  disinfectants,  and  we  might  a  priori 
conclude  that  to  a  certain  extent  they  must  so  act ;  but  certainly  there  is 
no  evidence  that  the  smoky  ah'  of  our  cities,  or  of  our  colliery  districts,  is 
freer  from  the  poisons  of  the  chief  specific  diseases  than  the  air  of  other 
places.  It  has  been  supposed,  indeed,  that  the  air  of  large  cities  is  partic- 
ularly antagonistic  to  malaria,  and  it  is  true  that  they  have  less  diphtheria, 
in  this  countr}^,  than  the  rural  districts,  but  there  are  probably  other  causes 
acting  in  those  cases.  The  solid  particles  of  carbon,  and  the  sulphur  diox- 
ide, may,  on  the  other  hand,  have  injurious  eifects.  It  is  not  right  to  ig- 
nore the  mechanical  effect  of  the  fine  powder  of  coal  so  constantly  di-awn 

^  See  Guillemin,  Recueil  de  Memoires  de  Med.  Ch.  and  Pharm.  Militaires,  No.  159, 
1874. 

'■'  On  Hygiene,  p.  173. 

2  See  Vol.  II. ,  chapter  on  Hospitals,  and  Professor  Jtingken's  Address  on  Pyaemia, 
in  the  Sydenham  Society  Year-Book  for  1862,  p.  213  ;  and  Report  on  Hygiene,  by  Dr. 
Parkes  in  the  Army  Medical  Report  for  1862  (vol.  iv.}. 
Vol.  I.— 10 


146  PRACTICAL    HYGIENE. 

into  the  lungs,  and  even  the  possibihty  of  irritation  of  the  lungs  from  sul- 
j/hur  dioxide.  Certain  it  is,  that  persons  -s^ith  bronchitis  and  emphysema 
often  feel  at  once  the  entrance  into  the  London  atmosphere  ;  and  individual 
experience  will  probably  lead  to  the  opinion  that  such  an  atmosphere  has 
some  effect  in  oiigfinating  attacks  of  bronchitis,  and  in  delaying  recoverv-. 
But  statistical  evidence  of  the  etfect  of  smoky  town  atmospheres  in  pro- 
ducing lung  affections  on  a  large  scale  cannot  be  given,  so  many  are  the 
other  conditions  which  complicate  the  problem.  There  is,  however,  no 
doubt  of  the  evil  effect  of  the  London  atmosphere  during  dense  fogs  ; 
witness  the  effect  upon  the  animals  at  the  cattle  show  at  Islington  in 
December,  1873,  and  the  increased  mortahty  fi-om  lung  diseases  duiing 
foggy  weather. 

The  effect  of  breathing  the  products  of  combustion,  of  gas  especially,  is 
more  easily  determined.  In  proportion  to  the  amount  of  contamination  of 
the  air,  many  persons  at  once  suffer  from  headache,  heaviness,  and  oppres- 
sion. 

Bronchitic  affections  are  frequently  produced,  which  are  often  attributed 
to  the  change  from  the  hot  room  to  the  cold  air,  but  are  really  probably 
owing  to  the  influence  of  the  imjDure  air  of  the  room  on  the  lungs. 

The  effects  of  constantly  inhahug  the  j^roducts  of  gas  combustion  may 
be  seen  in  the  case  of  workmen  whose  shops  are  dark,  and  who  ai'e  com- 
jDelled  to  bum  gas  during  a  large  j^ai't  of  the  day  :  the  pallor,  or  even 
ana?niia  and  general  want  of  tone  which  such  men  show,  is  owing  to  the 
constant  inhalation  of  an  atmosphere  so  impure. 

(d)  Air  rendered  Impure  by  the  Gas  and  Effluvia  from  Seicers  and  House 
Drains. — Cases  of  asph^-xia  from  hydi-ogen  sulphide,  ammonium  suljDhide, 
carbon  dioxide,  and  nitrogen  (or  possibly  rapid  poisoning  from  organi'^ 
vapors),  occasionally  occur  both  in  sewers  and  fi'om  the  opening  of  old 
cesspools.  In  a  case  at  Clapham,  the  clearing  out  of  a  pri^y  produced  in. 
twenty-three  childi-en  violent  vomiting  and  piu'ging,  headache,  and  great 
prostration,  and  con\-ulsive  twitchings  of  the  muscles.  Two  died  in  twenty- 
f oui-  hours. ' 

These  are  instances  of  mephitic  poisoning  in  an  intense  degree  ;  but  when 
men  have  breathed  the  air  of  a  newly  opened  drain  in  much  smaller 
amounts,  marked  effects  are  sometimes  produced  ;  languor  and  loss  of 
appetite  are  followed  by  vomiting,  dian-hoea,  coHc,  and  prostration.  The 
eltiuria  which  have  produced  these  sj'mj^toms  are  usually  those  arising  from 
a  drain  which  has  been  blocked  for  some  time.  When  the  an*  of  sewers 
penetrates  into  houses,  and  especially  into  the  bed -rooms,  it  certainly  causes 
a  greatly  impau'ed  state  of  health,  especially  in  children.  They  lose  ap- 
petite, become  pale  and  languid,  and  suffer  from  diarrhoea  ;  older  persons 
suffer  fi-om  headaches,  malaise,  and  feverishness  ;  there  is  often  some  de- 
gree of  anjemia,  and  it  is  clear  that  the  process  of  aeration  of  the  blood  is 
not  perfectly  cai-ried  on."' 

In  some  cases  decided  febiile  attacks  lasting  three  or  four  days,  and 
attended  with  great  headache  and  anorexia,  have  been  known.  Houses 
into  which  there  has  been  a  continued  e.scape  of  sewer  air  have  been  so 
notoriously  imhealthy  that  no  persons  would  live  in  t^em,  and  this  has 
not  been  only  from  the  prevalence  of  fever,  but  from  other  diseases. 
Brigade-Surgeon  Marston,  in  his  excellent  paper  on  theJ'ever  of  Malta,  ^ 

'  Health  of  Towns  Report,  vol.  i.,  p.  139. 

'  Ibid.  See  especially  the  evidence  of  Rigbv,  vol.  i.,  p.  151,  and  of  Aldis,  vol.  i., 
p.  11.5. 

3  Army  Med.  Report  for  1861,  p.  486. 


AIR.  147 

tells  us  tliat  wlien  typhoid  fever  broke  out  at  the  Fort  of  Lascaris,  from  the 
opening  of  a  drain,  other  affections  were  simultaneously  developed,  viz., 
"  diarrhoea,  dysentery,  slight  pyrexial  disorders,  and  diseases  of  the  primaiy 
assimilative  organs."  A  close  examination  and  analysis  of  the  affections 
produced  by  the  inhalation  of  sewer  air,  would  probably  much  enlarge  this 
list ;  and  the  class  of  affections  resulting  from  this  cause,  to  which  it  may 
be  difl&cult  to  assign  a  nosological  name,  will  be  found  to  be  essentiaUy 
connected  with  derangement  of  the  digestive  rather  than  with  the  pul- 
monary system. 

Dr.  Herbert  Barker '  has  attempted  to  submit  this  question  to  experi- 
ment by  conducting  the  air  of  a  cesspool  into  a  box  where  animals  were 
confined.  The  analysis  of  the  air  showed  the  presence  of  CO.^,  hydrogen 
sulphide,  and  ammonium  sulphide.  The  reaction  of  the  gas  was  usually 
neutral,  sometimes  alkaUne.  The  gas  was  sometimes  offensive,  so  that 
organic  vapors  were  probably  j^resent ;  but  no  analysis  appears  to  have 
been  made  on  this  point.  Three  dogs  and  a  mouse  Avere  experimented  on  ; 
the  latter  was  let  down  over  the  cesspool,  and  died  on  the  fifth  day.  The 
three  dogs  were  confined  in  the  box  ;  they  all  suffered  from  vomiting,  purg- 
ing, and  a  febrile  condition,  which.  Dr.  Barker  says,  "resembled  the 
milder  forms  of  continued  fever  common  to  the  dirty  and  ill- ventilated 
homes  of  the  lower  classes  of  the  community."  But  the  effects  required 
some  time,  and  much  gas  for  their  production.  Dr.  Barker  attributes  the 
results,  not  to  the  organic  matter,  but  to  the  mixture  of  the  tlu-ee  gases, 
and  specially  to  the  latter  two. 

The  effect  on  the  men  who  work  in  sewers  which  are  not  blocked,  or 
temporarily  impure  from  exceptional  disengagement  of  hydrogen  sulphide 
from  any  cause, ^  has  been  subject  to  much  debate.  The  air  in  many  sewers 
in  London  is  not  very  impure  ;  the  analyses  of  Letheby  and  Miller  have 
shown  that  generally  the  amount  of  CO^  is  very  little  in  excess  of  that  in 
the  external  air,  and  that  there  is  hardly  a  trace  of  hydrogen  sulphide  or 
of  fetid  organic  effluvia.  The  air  in  the  house  drains  is  often,  in  fact,  more 
impure  than  that  of  the  main  sewers.  This  is  the  case  also  in  the  other 
places,  and  is  to  be  accounted  for  by  the  numerous  oj)enings  in  the  sewers, 
from  the  porosity  of  the  walls,  from  the  continual  ventilation  produced  by 
the  air  being  drawn  into  houses,  and  from  the  amount  of  water  in  the 
sewers  being  often  so  great,  and  its  flow  so  rapid,  as  to  materially  lessen 
the  chances  of  generation  of  gas.  The  evidence  is,  on  the  whole,  opposed 
to  the  view  that  sewer-men  suffer  in  health  in  consequence  of  their  occupa- 
tion. Thackrah  states  ^  that  sewei'-men  are  not  subject  to  any  disease 
(apart  from  asphyxia),  and  are  not  short-lived.  He  cites  no  evidence. 
Parent-Duchatelet  ^  came,  on  the  whole,  to  the  same  conclusion  as  regards 
the  sewer-men  of  Paris  in  1836.  He  says  that  there  are  some  men  so 
affected  by  the  air  of  sewers  that  they  can  never  work  in  them  ;  but  those 
who  can  remain  suffer  only  from  a  little  ophthalmia,  lumbago,  and  perhaps 

'  Malaria  and  Miasmata,  1863,  p.  176  et  seq. 

^  Fatal  cases  have  occurred  both,  in  London  and  Liverpool  sewers  from  the  rapid 
evolution  of  SHo,  either  from  gas  liquid,  or,  in  Liverpool,  from  the  action  of  acids 
passing  into  the  sewers,  and  meeting  with  sulphide  of  calcium  in  the  refuse  derived 
from  alkaline  manufactories. 

^  The  Effects  of  Arts,  Trades,  and  Professions  on  Health,  1832,  p.  118. 

^  Hygiene  Publique,  vol.  i. ,  p.  247  (1836).  The  conclusions  of  Parent-Duchatelet 
are  not  entirely  justified  by  his  evidence.  The  number  of  men  he  examined  was  small, 
and  many  of  them  had  been  employed  for  a  short  time  only  in  the  sewers  ;  it  also  ap- 
peared that  a  considerable  number  had  actually  suffered  from  bilious  and  cerebral 
afEections.     (See  the  former  editions  of  this  work.) 


148  PRACTICAL    HYGIENE. 

sciatica.  They  consider  otherwise  their  occupation  not  only  innocent,  but 
as  favorable  to  health.  The  only  fact  adverse  to  this  seemed  to  be  that 
the  air  of  the  sewer  gi-eatly  aggravated  venereal  disease,  and  those  who 
persisted  in  working  with  disease  on  them  inevitably  perished.  The  work- 
ing in  deep,  old  sewage  matter  produced  an  eruj)tiou  on  the  parts  bathed 
by  the  mud,  which  resemblecl  itch  sometimes,  or  was  phlyctenoid  in 
character. 

A  more  recent  inquirj'  conducted  into  the  health  of  the  sewer-men  in 
London  did  not  detect  any  excess  of  disease  among  them, '  and  in  Liver- 
pool also  the  sewer-men  are  said  to  have  good  health.  The  workmen  em- 
ployed at  the  various  sewage  outfalls,  who,  though  not  in  the  sewers,  breathe 
the  effluvia  arising  from  the  setthng  tanks,  do  not  find  it  an  imhealthy 
occupation. 

It  does  not  appear,  therefore,  that  at  jiresent  the  workmen  connected 
with  fairly  ventilated  sewers  show  any  excess  of  disease  ;  at  the  same 
time,  it  must  be  allowed  that  the  inquiry  has  not  been  very  rigorously 
prosecuted,  and  that  the  length  of  time  the  men  work  in  sewers,  their 
average  yearly  mortality,  discharge  from  sickness,  loss  of  time  from  sick- 
ness, and  the  effect  produced  on  their  expectation  of  life,  have  not  been 
perfectly  determined. 

The  air  of  sewers  passing  into  houses  aggravates  most  decidedly  the 
severity  of  all  the  exanthemata— erysipelas,  hospital  gangrene,  and  puer- 
peral fever  (lligby)  ;  and  it  has  probably  an  injurious  effect  on  all  diseases. 
That  pneumonia  may  be  produced  is  shown  by  the  case  of  the  East  Sheen 
School. 

Two  special  diseases  have  been  supposed  to  arise  from  the  air  of  sewers 
and  fecal  emanations,  viz.,  diarrh<pa  and  tyijhoid  (enteric)  fever. 

With  regard  to  the  production  of  diarrhoea  from  fecal  emanations,  it 
would  seem  that  the  autumnal  diaiThoea  of  this  countiw  is  intimately  con- 
nected with  temperatui-e,"  and  usually  commences  when  the  thermometer 
is  persistently  above  60°,  and  when  there  is,  at  the  time,  a  scarcity  of 
rainfall.  It  is  worst  in  the  badly  sewered  districts,  and  is  least  in  well- 
drained  districts,  and  in  wet  years.  It  has  been  checked  in  London  by 
a  heavy  fall  of  rain.  All  those  points  seem  to  connect  it  with  fecal  eman- 
ations reaching  a  certain  rapidity  of  evolution  in  consequence  of  high 
temperature,  deficient  rain,  and  perhaps  relative  dryness  of  the  atmosjihere. 
At  the  same  time,  there  is  a  connection  between  this  disease  and  impure 
water.  It  may  own  a  double  origin,  and  in  a  diy  season  both  cases  may 
be  in  operation. 

That  enteric  fever  may  arise  from  the  effluvia  from  sewers  is  a  doctrine 
very  generally  admitted  in  this  country,  and  is  supported  by  strong  evi- 
dence. There  are  several  cases  on  record  in  which  this  fever  has  con- 
stantly prevailed  in  houses  exposed  to  sewage  emanations,  either  from  bad 
sewers  or  from  want  of  them,  and  in  which  proper  sewerage  has  com- 
pletely removed  the   fever.  ^      Many  of  these  cases   occurred  before  the 

'  In  reference  to  this  point,  however,  a  writer  in  the  Lancet  (April,  1872)  very  jnstly 
pointed  out  that  the  statistics  are  very  imperfect,  in  taking  no  notice  of  men  who  have 
been  discharged  or  who  have  died. 

-  Ransom  and  Vernon,  Influence  of  Atmosph.  Changes  on  Lis.,  p.  3. 

2  In  Healtli  of  Towns  Reports  and  Evidence,  Mr. ^Simon's  Eeports,  Dr.  Lethehy's 
Reports,  Dr.  Acland's  Reports  on  Fevers  in  Agricultural  Districts,  and  the  Reports  of 
the  Medical  Officer  to  the  Privy  Council,  will  be  found  abundant  evidence  in  support 
of  this  assertion.  Many  provincial  towns  in  England  could  give  similar  evidence,  as 
Norwich.     (See  Dr.  Richardson's  Report,  Medical  Times  and  Gazette,  January,  1862.) 


AIR.  149 

water-carriage  of  tj^hoid  was  recognized,  but  yet  the  connection  between 
the  sewage  emanation  and  the  fever  seems  undoubted. 

This  evidence  is  supported  by  cases  in  which  the  opening  of  a  drain 
has  given  rise  to  decided  typhoid  fever/  as  well  as  to  a  vei-y  fatal  disease 
(probably  severe  typhoid),  in  which  coma  is  a  marked  symptom.  So  also 
in  some  instances"^(Windsor  and  Worthing),'  the  spread  of  enteric  fever 
has  evidently  been  OA^dng  to  the  conveyance  of  efSu^-ia  into  houses  by  the 
agency  of  unventilated  sewers.  In  a  case,  fi-om  private  information,  an 
outbreak  of  enteric  fever  in  a  training-school  was  locaKzed  in  certain  parts 
of  the  school  (whereas  the  drinking-water  was  common  to  all),  and  was 
traced  to  imperfection  of  traps  in  those  parts  of  the  house  which  were 
affected.  In  this  case  the  drains  led  down  to  a  large  tank  at  some  dis- 
tance, and  at  a  much  lower  level,  and  the  smell  of  the  effluvia  was  so  slight 
that  at  first  it  was  not  believed  that  the  drains  could  be  out  of  order.  A 
very  good  case  is  given  by  Surgeon  Page,^  late  6th  Dragoons,  in  his 
descrij)tion  of  an  outbx'eak  of  tj-phoid  fever  at  Newbridge,  following  dis- 
continuance of  the  use  (on  account  of  repairs)  of  a  ventilating  shaft  for  the 
sewers.  Sewer-gas  got  into  the  barracks,  and  several  cases  (some  fatal)  of 
typhoid  fever  occurred.  Other  possible  causes  were  carefully  inquired 
into  and  eliminated.^  These  two  classes  of  fact  seem  decidedly  to  show  a 
causal  connection  between  the  effluvia  from  sewers  and  excreta  and  enteric 
fever,  and  they  are  supported  by  the  statistical  evidence  which  proves  that 
the  prevalence  of  typhoid  fever  stands  in  a  close  relation  to  the  imperfec- 
tion with  which  sewage  matters  are  removed.  The  army  statistics  give 
excellent  instances  of  this,  and  the  evidence  produced  by  Dr.  Buchanan  of 
the  prevalence  of  typhoid  fever  before  and  after  sewerage  of  a  town  is  to 
the  same  effect.^ 

The  persistent  existence  of  enteric  fever  at  Eastney  barracks,  Ports- 
mouth, appears  to  have  been  traceable  to  sewer  air  driven  back  into  the 
quarters  by  the  tide,  there  being  no  traj)s  or  ventilating  openings.  Since 
October,  1878,  when  the  drains  were  put  in  better  order,  and  better  flushed 
and  ventilated,  there  has  been  no  fever." 

German  wiiters  have  lately  commented  much  upon  the  view  that  there 
is  a  connection  between  sewer  air  and  enteric  fever,  and  reference  may 
be  especially  made  to  the  papers  of  Soyka,  Eenk,  A.  de  Rozsahegyi  and 
Lissauer.'  Their  contention  is  that  enteric  fever  is  not  due  to  the  influ- 
ence of  sewer  au',  because  it  is  rare  that  such  air  gets  into  houses,  and 
experiments  are  cited  to  prove  this.  It  is,  however,  admitted  and  demon- 
strated by  Soyka  in  the  tables  which  he  gives,  that  a  similar  improvement 

The  case  of  Calstock,  in  Devonsliire,  may  be  also  noted.  It  used  to  be  always  liable  to 
outbreak  of  typhoid  fever,  but  after  the  drainage  of  the  place  the  fever  disappeared. 
(Bristowe,  in  Trans,  of  Epid.  Soc,  vol.  i.,  p.  396.)  Murchison  not  only  adopted  this 
view,  but  even  proposed  to  give  the  term  "pythogenic  fever  "  to  typhoid. 

'  For  references  to  illustrative  cases,  see  5th  edition  of  this  work,  p.  128,  note. 

-  Ninth  Report  of  the  Medical  Officer  to  Privy  Council,  p.  44. 

"*  Army  Medical  Eeport,  vol.  xv. ,  p.  301. 

*  An  outbreak  at  Kinsale,  apparently  due  to  sewer  effluvia,  is  narrated  by  Surgeon- 
Major  Wallace,  Army  Med.  Eeports,  vol.  xvii.,  p.  55.  The  inquiry  seems  to  have  been 
very  carefully  made. 

=  Ninth  Report  of  Medical  Officer  to  the  Privy  Council,  p.  44.  In  twenty-one  Eng- 
lish towns  the  average  reduction  of  typhoid  mortality  after  sewage  was,  45.4  per  cent. 
In  many  of  the  towns  an  improved  water  supply  was  introduced  at  the  same  time,  but 
the  purification  of  the  air  by  sewage  and  cleanliness  has,  it  is  believed  by  Buchanan, 
'"been  most  uniformly  followed  by  a  fall  in  the  prevalence  of  typhoid." 

"  See  "  Report  on  Hygiene,"  A.M.D.  Eeports,  vol.  xx.,  p.  222. 

'  Deutsche  Vierteljaiirschrift  fiir  OfFentliche  Gesundheitspflege,  1881. 


150  PRACTICAL    HYGirXE. 

in  the  health  of  to-svTis  has  followed  the  introduction  of  proper  drainage  in 
the  cities  of  Germany  as  has  been  observed  in  this  country.  This  is  at- 
tributed to  the  cleansing  of  the  soil  and  the  atmosphere  by  the  removal  of 
the  sewage  matter,  although  they  still  insist  upon  the  essentially  local  or 
topical  character  of  the  disease.  Von  Niigeli '  positively  denies  the  pos- 
sibility of  specific  disease  being  conveyed  through  emanations  from  drains 
or  cesspools. 

Although  it  seems  difficult  not  to  admit  that  the  effluvia  from  the 
sewers  will  produce  typhoid,  there  are  yet  some  remarkable  facts  which 
can  be  cited  on  the  other  side. 

It  has  been  denied  by  Parent-Duchatelet  and  by  Guy  ^  that  typhoid 
fever  is  more  common  among  sewer-men  than  others,  and  later  inquiries 
among  the  sewer-men  of  London  seem  to  bear  out  the  assertion.  But,  as 
ah'eady  stated,  the  air  of  London  sewers  is  really  tolerably  pure  ;  and  some 
of  the  men  may  be  protected  by  pre\'ious  attacks,  for  typhoid  fever  is  a  most 
common  disease  among  the  poorer  children  in  London.  Murchison  ^  and 
Peacock  have  also  stated,  on  the  other  side,  that  enteric  fever  is  not  uncom- 
mon among  sewer-men.     This  argument,  therefore,  is  not  of  great  weight. 

The  evidence  is  very  strong  that  the  men  employed  at  the  sewage 
tanks  and  on  the  sewage  farms,  and  their  families,  do  not  show  an  un- 
usual amount  of  typhoid  ;  nor  do  the  persons  living  in  adjacent  houses. 
Now,  if  sewage  emanations  can  cause  typhoid  fever,  it  might  be  expected 
that  we  should  by  this  time  have  had  plenty  of  evidence  of  this  special 
effect.  Again,  in  our  rural  villages,  and  in  many  farm-houses,  the  excreta 
of  men  and  animals  literally  cover  the  ground,  and  it  might  have  been 
anticipated  that  enteric  fever  would  never  be  absent.  If  this  is  the  case 
in  this  country,  it  is  still  more  so  in  China,  where  the  excreta  are  so  care- 
fully stored  and  applied  to  land.  In  a  report  made  by  various  medical 
officers,  the  writers  state  that,  in  Chinese  villages  suiTounded  with  ex- 
creta, where  the  contamination  of  the  air  by  feecal  emanations  is  very 
great,  there  is  no  typhoid  fever.  And  as  typhoid  is  well  known  in  other 
parts  of  China,  the  absence  is  not  owing  to  any  peculiai'ity  of  climate  pre- 
venting the  appearance  of  the  fever.* 

We  have,  then,  counterfacts  which  must  be  allowed  to  be  of  consider- 
able weight.  Any  explanation,  to  be  satisfactory,  must  not  ignore  one  set 
of  facts,  but  must  impartially  include  both. 

The  possibility  that  the  adult  persons  submitted  to  sewage  emanations 
may  have  had  typhoid  fever  in  early  life,  and  are  therefore  insusceptible, 
may  explain  some  cases  of  escape,  even  when  fsecal  emanations  are  con- 
stantly breathed.  But  it  would  be  impossible  to  extend  this  argument  to 
the  cases  of  immunity  in  children,  unless  we  suppose  that  typhoid  fever  in 
childi'en  is  constantly  overlooked,  and  is  as  common  as  measles,  which 
seems  unlikely. 

It  has  been  supposed  that  there  is  an  essential  difference  when  animal 
and  vegetable  substances  are  decomposing  in  covered  places  and  in  the 
open  air."     It  is  evident  that  the  physical  conditions  will  be  widely  dif- 

'  Die  Niederen  Pilze,  1877,  p.  215  et  seq. 

'  Journal  of  the  Statistical  Society,  1848. 

^  On  Fevers,  p.  453. 

*  See  Reports  by  Drs.  Miller  and  Manson,  for  Shanghai  and  Amoy,  in  the  Customs 
Gazette  of  China,  July  to  September,  1871. 

'  This  is  the  view  taken  in  the  Second  Report  of  the  State  Board  of  Health  of 
Massachusetts.  From  an  inquiry  in  most  of  the  large  cities  of  that  State,  the  con- 
clusion is  drawn  that  it  is  putrefaction  of  animal  and  vegetable  substances,  under 
cover,  which  gives  typhoid. 


AIR.  151 

ferent  in  the  two  cases.  In  tindergTouncl  channels  there  is  greater  mean 
temperature,  more  moisture,  and  a  more  stagnant  atmosphere.  In  the 
open  ail-,  while  there  may  be  heat  from  the  sun's  rays,  this  may  restrain 
putrefaction  ;  while  the  coldness  of  the  nights  and  the  much  greater 
movement  and  dryness  of  the  au-,  may  hinder  the  formation  or  lessen  the 
chance  of  reception  of  any  fever-causing  substance  developed  during  the 
putrefaction.  At  first  sight,  there  appeal's  to  be  much  in  favor  of  this 
view,  and  it  would  explain  the  greater  chance  there  appears  to  be  of  efflu- 
via coming  from  sewers  causing  typhoid  fever  than  when  the  effluvia  came 
from  excreta  in  the  open  air.  But  it  does  not  meet  two  undoubted  facts, 
viz.,  that  there  are  cases  in  which  sewer  air  is  breathed  without  causing 
typhoid,  and  the  occasional  severe  outbreaks  of  typhoid  in  villages  with- 
out sewers,  and  where  there  is  no  putrefaction  under  cover. 

That  the  importation  of  typhoid  fever  into  places  previously  fi'ee  for 
years  is  followed  by  outbreak^  is  quite  certain.  In  many  of  these  cases, 
as  in  the  excellent  instance  at  Steyning,  recorded  by  Whitley,'  all  the  con- 
ditions of  accumulated  sewage,  etc.,  which  are  sujDposed  to  produce 
typhoid  fever,  were  present  for  years,  and  yet  no  fever  resulted.  Then  a 
patient  came  from  a  distance  with  typhoid  fever,  and  the  disease  spread 
through  the  village,  either  through  the  medium  of  the  water  (as  is  perhaps 
most  common),  or  through  the  air.  These  instances  are  so  numerous  that 
the  entrance  of  a  fi'esh  agent  must  be  admitted,  and  if  so,  the  series  of 
events  becomes  quite  intelligible. 

The  doctrine  that  a  specific  cause  is  necessary  for  the  production  of 
typhoid  fever  ;  that  this  cause  is  present  in  the  intestinal  discharges,  and 
that  sewei's  and  fsecal  effluvia,  and  ftecal  impregnation  of  water,  are 
thereby  the  channels  by  which  this  specific  cause  reaches  the  body  of  a 
susceptible  person  (i.e.,  of  a  jDerson  who  has  not  previously  had  the 
disease),  will  be  found  to  explain  almost  all  the  events  which  have  been 
recorded  in  connection  with  the  origin  of  typhoid  fever. 

There  are,  however,  still  some  difficulties.  There  are  instances  in 
which  t^'phoid  fever  arises  from  sewer  air  without  any  possibility  of  tra- 
cing the  entrance  of  a  person  with  the  disease.^  Sometimes,  as  in  the  case 
of  an  isolated  house  in  the  country,  it  seems  most  difficult  to  believe  that 
any  such  entrance  could  have  taken  place.  It  must,  however,  be  remem- 
bered that  the  carriage  of  the  "  contagion  "  takes  place  in  so  many  wa}'^, 
that  it  is  impossible  always  to  trace  it.  In  the  case  of  typhoid  fever,  the 
stools  are  not  only  infectious  during  the  height  of  the  disease,  but  prob- 
ably during  the  early  period  of  recovery ;  and  the  disease  itself  is  also 
often  so  slight  that  persons  move  about,  and  believe  they  have  only  an 
attack  of  diarrhoea.  Again,  the  frequent  journeying  from  place  to  place 
exposes  all  persons  to  a  greater  chance  of  inhaling  the  typhoid  effluvia, 
and  the  real  soui'ce  of  the  disease  may  be  far  removed  from  the  place 
which  is  actually  suspected. 

There  are,  again,  cases  in  which  typhoid  fever  occurs  in  persons  who 
have  not  been  exposed  apparently  to  sewer  air,  or  fiscal  emanations,  or  to 
the  charge  of  any  tyi^hoid  contagion.  Dr.  Gordon  Hardie  has  recorded 
two  cases  of  this  kind  of  soldiers  attacked  during  imprisonment.  Such 
cases  can  only  be  explained  either  by  supposing  an  incubative  period  of 

'  The  cases  recorded  sixty  years  ago  by  Bretonneau  liave  been  confirmed  by  many 
observations  since. 

-  From  the  Report  of  the  Medical  Officer  to  the  Privy  Council,  p.  43. 

•"'  Eanke  admits  the  possibility  of  spontaneous  origin  of  typhoid,  but  thinks  it 
spreads  more  frequently  through  air  than  any  other  way. 


152  PRACTICAL    HYGIEXE. 

extraordinary  length,  or  an  origin  apart  altogether  either  from  fsecal  ema- 
nations or  a  prior  case  of  the  disease. 

Admittmg,  however,  that  there  are  still  difficulties  to  be  explained  by 
future  obsei-vation,  it  seems  clear  that  the  theoiT  of  a  specific  cause  repro- 
ducing itself  in  the  intestines  and  contained  in  the  discharges,  and 
naturally  therefore,  connected  more  or  less  closely  with  excreta  and 
sewers,  and  sometimes  with  drinking-water,  is  that  which  best  meets  the 
facts  which  have  been  most  faithfully  reported  in  outbreaks  of  tyi^boid 
fever.  The  evidence  of  the  carriage  of  a  cause  of  this  kind  in  water 
strongly  supports  this  riew. 

(e)  Emanations  from  Faecal  Matter  thrown  on  the  Ground. — Owing, 
doubtless,  to  the  rapid  movement  of  the  air,  there  is  no  doubt  that  the 
excreta  of  men  and  animals  thrown  on  the  ground  and  exposed  to  the 
open  air  are  less  hurtful  than  sewer  air,  and  probably  in  proportion  to  the 
dilution. 

When  there  are  accumulations  in  close  courts,  small  back-yards,  etc., 
the  same  effects  are  produced  as  by  sewer  air,  and  many  instances  are 
recorded  in  the  Health  of  Towns  Report.  "SVhen  fpecal  matters  are  used  for 
manure,  and  are  therefore  sj^eedily  mixed  with  earth,  they  seldom  pro- 
duce bad  effects.  Owing,  doubtless,  to  the  great  deodorizing  and  absorb- 
ing powers  of  earth,  efilu^-ia  soon  cease  to  be  given  off.  An  instance  is, 
however,  on  record  in  which  two  cases  of  typhoid  were  supposed  to  arise 
from  the  manviring  of  an  adjacent  field.  Dr.  Cloxiston  has  also  shown  by 
evidence,  which  seems  very  sti'ong,  that  dysentery  was  produced  jn  an 
asylum  by  the  exhalations  from  sewage,  which  was  sj)read  over  the  ground 
(a  stiff  brick  clay  subsoil)  about  300  yards  from  the  asylum.  The  case 
seems  a  veiy  conrincing  one,  as  the  possibility  of  the  action  of  other  causes 
(impui'e  water,  bad  food,  etc.)  was  excluded.  This  is  a  point  on  which 
more  eridence  is  desfrable.  It  is  stated  in  some  works  that  disease  is 
frequently  produced  by  the  manui-uig  of  the  gi'ound,  but  there  seems  to  be 
no  satisfactoiy  eridence  of  this.  On  the  other  hand,  Dr.  A.  Cai-jDcnter 
shows,  from  the  histoiy  of  Beddington  sewage  faiTn,  that  no  harm  to  the 
neighborhood  has  accrued  from  the  iiingation  with  the  Croydon  sewage 
during  twenty  years. '  It  has  been  said  that  if  the  sewage  matter  can  be 
apphed  while  perfectly  fresh  to  the  gi'ound,  no  hann  results ;  but  if  decom- 
position has  fully  set  in,  it  is  not  so  comjiletely  deodoiized  by  the  ground,'' 
In  China,  where  faecal  matter  is  so  constantly  apphed  in  agiiculture,  the 
air  is  often  filled  M-ith  veiy  pungent  efiluria,  yet  no  bad  effect  is  pro- 
duced.^ 

if)  Emanation  from  Streams  2^oUuted  by  Fcecal  Matter.  — The  evidence 
on  this  point  is  contradictoiy.  Parent-Duchatelet,  in  1822,^  investigated 
the  effect  produced  on  the  health  of  the  inhabitants  of  the  Faubourg  St. 
IMarceau,  in  Paris,  by  the  almost  insupportable  effluvia  ai'ising  from  the 
Eiviere  de  Bievi-e,  which  received  a  large  portion  of  the  sewage  of  the 
quarter.  He  asserts  that  the  health  was  not  at  all  damaged,  though  he 
admits  that  there  is  ti-uth  in  the  old  tradition  at  the  Hotel  Dieu,  that  the 
cases  from  St.  Marceau  were  more  severe  than  from  any  other  place. 

Dr.  M'WiUiam  foiind  that  the  emanations  fr-om  the  Thames  in  1859-60 

'  The  Utilization  of  Town  Sewage  bv  Surface  trigation,  by  A.  Carpenter,  M.D., 
Trans.  Internat.  Medical  Congress,  London,  1881,  vol.  iv. 

^  See  chapter  on  Sewage,  Vol.  II. 

^  Dr.  A.  Jamieson's  "Report  on  the  Health  of  Shanghai  for  the  Half-year  ending 
September,  1870,"  China  Customs  Gazette  for  1870 ;  Shanghai,  1871. 

*  Hygiene  Publique,  p.  98. 


AIR.  153 

had  no  deleterious  effect  on  the  health  of  the  Custom-House  men  employed 
on  the  river.     The  amount  of  diarrhoea  was  even  below  the  average. 

]\Ir.  Rawhnson  states  '  that  a  careful  house-to-house  visitation  had  been 
made  in  some  of  the  worst  districts  of  Lancashii-e  (in  Manchester,  on  the 
banks  of  the  Medlock,  for  instance)  mthout  finding  any  great  excess  of, 
disease. 

On  the  other  hand,  in  the  reports  of  Sir  H.  De  la  Beche  and  Dr.  Lyon 
Plai^'fair,"  is  some  strong  evidence  that  the  general  health  of  the  people 
suffered  from  the  emanations  of  the  putrid  streams  of  the  Frome,  and  the 
tributaries  of  the  L'k  and  Medlock  ;  that  they  were  pale,  in  many  cases 
dyspeptic  ;  that  fevers  (t}'phoid)  prevailed  on  the  banks  is  asserted  by  some 
observers,  but  rather  doubted  by  others  ;  but  none  seem  to  have  any  doubt 
that  the  fevers,  when  they  occurred,  were  much  worse.  Cholera  in  Manchester 
was  severe  along  the  banks  of  some  of  these  streams,  but  that  might  have 
been  from  the  water  being  drunk.  In  1858  also,  Dr.  Ord  ^  observed  that  a 
large  number  of  the  men  employed  on  the  Thames  were  affected  by  the 
effluvia  ;  the  symjDtoms  being  languor  and  depression,  followed  by  nausea 
and  headache,  aching  of  the  eyeballs,  and  redness  and  swelling  of  the 
throat.  Diarrhoea  was  rare.  In  1859  these  symptoms  were  not  obseiwed, 
though  the  state  of  the  river  was  worse.  Were  they  then  really  caused  by 
the  effluvia  in  1858  ? 

It  is  very  likely  that  the  discrepancy^  of  evidence  may  arise  fi'om  the 
amount  of  water  which  dilutes  the  faecal  matter  being  much  greater  in  some 
cases  than  others.  In  the  case  of  the  Thames,  the  dilution  was  after  aU 
very  great,  and  this  was  the  case,  in  part  at  any  rate,  in  the  Bievre,  as  the 
stream  was  in  some  places  6  and  7  feet  deep.  The  evaporation  from  such 
a  body  of  water,  however  offensive  it  may  be,  must  be  a  very  different 
thing  from  the  effluvia  coming  off  from  the  masses  of  organic  matter  laid 
bare  by  the  almost  complete  drying  up  of  streams  into  which  quantities  of 
ffecal  matter  are  discharged.  ^\Tien  sewage  matter  is  pom-ed  into  the 
sea,  and  washed  back  by  the  tide,  it  becomes  a  source  of  danger. 

(g)  Effect  of  Manure  Manufactories. — The  manure  manufactories  at  pres- 
ent existing  in  this  country  do  not  appeal'  to  produce  any  bad  effects. 
They  are  generally  at  some  httle  distance  from  to's\'ns,  and  the  effluvia  are 
soon  dUuted.  The  Secretary  of  the  Hyde  Manure  Company  stated  that 
while  the  works  were  in  oj)eration  no  bad  effects  were  observed.  But  if 
situated  in  towns  they  are  nuisances,  and  may  be  hiu-tful.  In  1847  evi- 
dence was  given  to  show  that  a  manure  manufactory  situated  iu  Spital- 
fields,  and  about  100  feet  from  the  workhouse,  caused  bad  dian'hcea  when- 
ever the  wind  blew  in  that  direction,  and  12  cases  of  "  spontaneous  gan- 
grene "  (!)  which  had  appeared  among  children  were  attributed  to  it.  The 
cases  of  disease  in  the  workhouse  infirmary  also  acquired,  it  was  said,  a 
malignant  and  intractable  character.^  In  France  the  workmen  engaged  in 
the  making  of  "  poudrette  "  do  not  in  any  way  suffer,  except  from  slight  oph- 
thalmia. ^     Parent-Duchatelet  ^  (on  very  sKght  evidence  indeed)  thought  the 

'  Eeport  of  Committee  on  Sewage,  1864,  p.  174,  Question  3997. 

°  Second  ReiDort  of  the  Health  of  Towns  Commission,  pp.  261  and  347. 

^  Trans.  Social  Science  Association,  1859,  p.  571. 

*  Medical  Gazette,  December,  1847. 

*  Parent-Duch'.telet ;  Patissier.  See  also  Tardieu,  Diet.  d'Hygiene,  t.  iv.,  p.  453. 
Tardien,  in  1862,  writes :  "We  do  not  hesitate  to  affirm  that  the  exhalations  from  these 
manufactories  (voiries)  exercise  no  injurious  action  either  on  man  or  vegetation." 
But  it  must  be  remembered  that  these  places  are  excellently  conducted ;  ventilation  is 
good,  and  the  f^cal  matter  is  soon  subjected  to  processes  wliich  prevent  its  decom- 
position. *  Hi'g.  Publique,  t.  ii.,  p.  276. 


154  PRACTICAL    HYGIENE. 

emanatioBS  were  even  Ijeneficial  in  some  diseases,  and  Tardieu  seems  inclined 
to  support  this  opinion.  AYlien  the  poudrette  is  decomposing,  and  lai-ge 
quantities  ai'e  brought  into  smnll  spaces,  as  on  board  ship,  serious  conse- 
quences may  certainly  result.  Parent-Duchatelet  records  tvo  cases  of  out- 
breaks on  board  shij^s  carrsing  poudrette  which  fermented  on  the  voyage  ; 
one  ve.ssel,  the  "  Ailhui-,"  lost  half  her  crew  (n timber  not  known),  and  the 
rest  were  in  a  state  of  deplorable  health  ;  the  men  who  unloaded  the  cai-go 
were  also  affected.  The  s^Tnptoms  are  not  recorded  ;  but,  in  a  smaller  ves- 
sel, where  all  ou  board  (5)  were  similarly  affected,  the  disease  put  on  the 
appearance  of  "an  adynamic  fever."  There  was  intense  pain  of  the  head 
and  of  all  the  hmbs,  vomiting,  gi-eat  prostration,  and  in  two  cases  severe 
dian'hoea.  These  symptoms  are  very  similar  to  those  already  mentioned 
as  produced  in  the  children  at  Clapham  by  the  opening  of  a  privy.  In 
bone  manure  factories  it  has  been  shown  that  arsenic  is  given  off  in  the 
fumes  in  considerable  quantity,  arising  from  the  use  of  impiu-e  sulphuric 
acid. ' 

(h)  The  Air  of  Graveyards. — There  is  some  evidence  that  the  disturb- 
ance of  even  ancient  places  of  sepulture  may  give  rise  to  disease.  Yicq 
d'Azjr  refei-s  to  an  epidemic  in  Auvergne  caused  by  the  ojDening  of  an  old 
cemetery  ;  the  removal  of  the  old  burial-jDlace  of  a  convent  in  Paris  pro- 
duced illness  in  the  inhabitants  of  the  adjoining  houses.'^  Li  India,  the 
cantonment  at  Sukkur  was  jilaced  on  an  ancient  Mussulman  bui-ial-ground, 
and  the  station  was  most  imhealthy,'  especially  from  fevers. 

The  effect  of  effluvia  from  comparatively  recent  putrefying  human  bod- 
ies has  been  obsei-ved  by  many  writers.  Rammazzini  *  states  that  sextons 
entering  places  where  there  are  putrefying  corpses  are  subject  to  malignant 
fevers,  asph^-xia,  and  suffocating  catarrhs  ;  Fourcroy  remarks  that  there  are 
a  thousand  instances  of  the  pernicious  effects  of  cadaveric  exhalations  ;  and 
Tardieu  ^  has  collected  a  very  considerable  number  of  cases,  not  only  of 
asphyxia,  but  of  several  febrile  affections  produced  by  exhumations  and  dis- 
turbance of  bodies.  Mr.  Chadwick,"  and  the  General  Board  of  Health,' 
also  summed  up  eridence  which  showed  that  in  chvu'chyards  thickly 
crowded  with  dead,  vapors  were  given  off  which,  if  not  productive  of  any 
specific  disease,  yet  increased  the  amount  both  of  sickness  and  mortahty. 
In  some  instances  this  might  have  been  from  contamination  of  the  diink- 
iug-M'ater  ;  but  in  other  cases,  as  in  the  houses  bordering  the  old  city 
graveyards,  where  the  water  was  supplied  by  j^ublic  companies,  the  aii'  also 
must  have  been  in  fault.  In  the  houses  which  closely  bordered  the  old 
city  yards,  which  were  crowded  TN-ith  bodies,  cholera  was  very  fatal  in 
1849",  and,  according  to  some  practitioners,  no  cases  recovered.  All 
other  diseases  in  these  localities  were  said  to  have  assumed  a  very  riolent 
and  unfavorable  t^i^e.  Hirt  says,  on  the  other  hand,  that  when  grave- 
diggers  are  protected  from  the  acute  effects  of  carbon  dioxide,  theu'  call- 
ing is  not  unhealthy  ;  their  death-rate  he  gives  at  17  per  1,000,  and  their 
mean  duration  of  hfe  at  58-60  years.  This,  however,  is  in  Germany,  where, 
as  he  admits,  there  is  less  crowding  of  gi-aveyards  than  in  England  or 

'  On  the  Presence  of  Arsenic  in  the  Vapors  of  Bone  Manure,  bv  James  Adams,  M.D. 
1876,  etc. 

-'  Tardieu,  Diet.  d'Hygiene,  t.  i  ,  p.  517. 

^  Norman  Chevers,  European  Soldiers  in  India,  p.  404. 

*  Maladies  des  Artizans,  p.  71.  ^  Diet.  d'Hygiene,  1862,  t.  iii.,  p.  468  et  seq. 
'  Report  on  Interments  in  Towns.  '  Report  on  Extramural  Sepulture,  18o0. 

*  S.  Smith  and  Sutherland's  Reports  on  Extramural  Interment,  p.  12.  See  also 
Sutherland's  Report  on  Cholera,  1850,  p.  27. 


AIR.  155 

France.  Nageli,  arguing  probably  from  similar  data,  thinks  that  grave- 
yards may  exist  in  the  midst  of  towns  without  danger  to  health,  provided 
precautions  be  taken  with  reference  to  the  drainage  and  ventilation  of  the 
soil. 

[i)  Effluvia  from  Deconi2JOsing  Animals.- — On  this  point  there  is  some 
discrepancy  of  evidence. 

In  1810,  Deyeux,  Parmentier,  and  Pariset  gave  evidence  to  show  that 
the  workmen  in  knackeries  are  in  no  way  injured.  Parent-Duchatelet, 
from  his  examination  of  the  health  of  the  men  employed  at  the  knackery 
and  slaughter-house  at  Montfaucon,  came  also  to  the  conclusion  that  their 
health  was  not  affected.  It  should  be  mentioned  that  this  knackery  is  re- 
markably well  placed  for  ventilation,  and  is  excellently  conducted  ;  putrid 
remains,  in  the  proper  sense  of  the  word,  do  not  now  exist  in  any  knackery 
in  or  near  Paris  ;  the  workmen  are  well  paid  and  well  fed,  and  are  there- 
fore prepared  to  bear  the  effect  of  any  injurious  efHuvia.  It  has  been  stated, 
however,  that  in  the  Hotel  Dieu,  the  patients  used  to  suffer  when  the  wind, 
loaded  with  effluvia,  blew  from  Montfaucon  (Henry  Bennet).  Tardieu, 
from  a  late  re-examination  of  the  question,  confirms  Parent's  conclusions,' 
except  as  regards  glanders  and  malignant  pustule,  touching  which  Parent- 
Dachatelet's  evidence  was  as  usual  negative.  Tardieu,^  however,  states 
that  many  examples  occur  in  the  French  knackeries  of  the  transmission  of 
these  diseases,  though  glanders  and  farcy  are  less  frequently  caught  in 
knackeries  than  in  stables.  No  analysis  has  yet  been  made  of  the  air  of 
knackeries. 

Parent-Duchatelet  ^  is  also  often  quoted,  as  having  proved  that  the  ex- 
posure of  the  remains  of  4,000  horses,  killed  in  the  battle  of  Paris  in  1814, 
produced  no  bad  effects.  These  horses  were  killed  on  March  30th,  and 
were  burnt  on  the  10th  and  12th  of  April.  They  gave  out  "  une  odeur  in- 
fecte,"  which  produced  no  bad  results  on  those  who  collected  the  bodies. 
Parent-Duchatelet  inquired  particularly  whether  typhus  was  produced  by 
effluvium,  and  proved  that  it  was  not ;  a  conclusion  conformable  to  our 
present  doctrine.  He  did  not,  however,  do  more  than  examine  the  regis- 
ters of  deaths  of  the  three  years  before,  during,  and  after  the  battle,  and 
found  no  evidence  for  increased  mortality.  The  utmost  this  observation 
shows  is,  that  no  typhus  was  produced ;  and  that  the  amount  of  decompo- 
sition, caused  by  eleven  days  of  hot  weather,  did  not  affect  those  concerned 
in  collecting  and  burning  the  bodies. 

On  the  other  hand,  the  experience  of  many  campaigns,  where  soldiers 
have  been  exposed  to  the  products  of  an  advanced  putrefaction  of  horses, 
shows  that  there  is  a  decided  influence  on  health.  Pringle  especially  no- 
ticed this  ;  and  in  many  subsequent  campaigns  this  condition  has  been 
one  of  the  causes  of  insalubrity.  Diarrhoea  and  dysentery  are  the  princi- 
pal diseases  ;  but  all  affections  are  increased  in  severity.  At  the  siege  of 
Sebastopol,  where,  in  the  Fi'ench  camp,  a  great  number  of  bodies  of  horses 
lay  putrefying  on  the  ground,  Reynal  *  describes  the  effect  as  disastrous, 
and  even  conjectures  that  the  spread  of  typhus  was  connected  with  this 
condition,  though  this  is  unlikely. 

(k)  Air  of  Brickfields  and  Cement  Wor^ks. — The  peculiar  smell  of  brick- 
fields cannot  be  owing  to  carbon  dioxide  or  monoxide,  or  to  hydrogen  sul- 
phide or  sulphur  dioxide  (the  gases  evolved  from  the  kilns)  ;  but  its  exact 
cause  is  not  known.     The  air,  at  its  exit  from  the  chimney  of  furnaces  and 

»  Diet.  d'Hygiene,  t.  iv.,  p.  468.  ^  Op.  cit.,  t.  iv.,  p.  468. 

2  Die.  d'Hygiine,  t.  i.,  p.  47.  *  Tardieu,  Diet.  d'Hygiene,  t.  ii.,  p.  221. 


156  PRACTICAL    HYGIENE. 

kilns,  is  rapidly  fatal  ;  but  so  rapid  is  its  ascension,  dilution,  and  diffusion, 
that  at  a  little  distance  it  is  respirable.  In  almost  all  the  actions  against 
the  owners  of  brickfields  nothing  more  than  a  nuisance  has  been  estab- 
lished, and  this  not  in  the  legal  sense.  The  smoke  and  gases  from  cement 
works,  however,  destroy  neighboring  vegetation.  The  smell  can  be  per- 
ceived for  several  hundi'ed  yards. '  In  the  north  of  France  it  is  ordered 
that  no  kihis  shall  be  N\-ithin  50  metres  (54^  yardsj  of  a  public  road  ;  and 
the  kilns  are  lighted  only  at  night. 

(/)  Air  of  Taliow-makers,  Bone-burners,  etc. — In  many  trades  of  this 
kind  large  quantities  of  very  disagreeable  animal  vapors  are  jDroduced, 
which  spread  for  a  long  distance,  and  are  most  disagreeable.  Although 
a  nuisance,  it  is  difficult  to  bring  forward  positive  evidence  of  insalubrity. 
But  the  odor  is  so  bad  that  in  France  rules  are  in  force  to  oblige  the 
vapors  to  be  condensed  or  consumed,"  and  if  in  the  process  any  water  is 
contaminated  with  fatty  acids,  it  is  neutrahzed  with  lime.  M.  Foucon  has 
iigui-ed  an  apparatus  which  completely  bui-ns  the  animal  vapors.^ 

(;»)  Air  of  3Iarshes. — It  seems  scarcely  necessary  to  allude  to  this 
point,  except  to  notice  that  in  addition  to  paroxysmal  fevers,  it  has  been 
supposed  that  serous  diarrhoea  (a  sort  of  dysenteria  incnienta)  and  time 
bloody  dysentery,  are  produced  by  malaria.  Also  that  there  is  peihaj^s 
some  connection  with  malaria  and  liver  abscess  (?).  The  breathing  of 
marsh  air  also  may  j^roduce  au  imperfect  condition  of  nutrition,  in  which 
enlarged  spleen  plays  a  prominent  jpart,  and  the  mean  duration  of  life  is 
shortened. 

(n)  Unknown  Conditions  of  the  Atmosjjhei'e. — Occasionally,  outbreaks 
of  disease  occur  from  uupiu-ities  of  the  atmosj^here,  the  nature  of  which  is 
not  kno%vn,  though  the  causes  giring  rise  to  them  ma}'  be  obrious.  Dr. 
Majer  records  a  case  of  a  school  at  Ulm,  of  sixty  or  seventy  boys,  where 
the  greater  number  were  suddenly  affected,  on  a  warm  day  in  May,  Avith 
similar  symptoms— giddiness,  headache,  nausea,  shivering,  trembling  of 
the  hmbs,  sometimes  fainting.  The  attack  occun-ed  again  the  next  day,  and 
a  common  cause  was  certain.  The  room  was  enclosed  by  walls,  in  a  narrow 
space,  w^here  the  snow  had  lain  all  the  winter  ;  the  wall  was  covered  with 
fungous  vegetation,  and  with  salts  from  the  mortar.  From  the  sudden  en- 
trance of  wann  w'eather,  fermentation  had  set  in,  and  a  strong  marshy 
smell  was  produced  ;  the  substances  of  whatever  kind  generated  in  this  way 
accumulated  in  the  narrow,  ill-ventilated  space.  Removal  to  a  healthier 
locality  at  once  cured  the  disease. 

'  At  Southampton  the  smell  is  perceptible  at  a  distance  of  two  miles. 

-  Vernois,  Hygiene  Indus.,  t.  ii.,  p.  00. 

*  Pappenheim's  Beit,  der  Sauitat.  Pol.,  Heft  ii. 


CHAPTER  III. 

VENTILATION.' 

The  term  ventilation  is  not  always  iised  in  the  same  sense.  By  some  it  is 
applied  to  the  dilution  and  removal  of  all  impuiities  ■wliicli  can  collect  m 
the  ah'  of  inhabited  rooms.  The  most  common  causes  of  such  impurities 
are  the  respu'ation  and  cutaneous  transpiration  of  men,  the  products  of 
combustion  of  hghts,  the  effluvia  of  simple  uncleanliness  of  rooms  or 
persons,  the  products  of  the  sohd  or  fluid  excreta  retained  in  the  room,  or, 
in  hosjDital,  dischai'ges  from  the  body  or  from  dressings.  In  addition 
there  may  be  special  conditions  vrhich  allow  impui'e  au-  to  flow  into  a 
room,  as  fi'om  the  basement  of  a  house,  from  imperfectly  trapped  soil  and 
waste  pipes,  or  from  other  impurities  outside  a  house. 

It  will  be  desu'able,  however,  to  restiict  the  term  ventilation  to  the  re- 
moval or  dilution,  by  a  stipj^ly  of  pure  au',  of  the  pulmonary  and  cutaneous 
exhalations  of  men,  and  of  the  products  of  combustion  of  hghts  in  ordinary 
dwellings,  to  which  must  be  added,  in  hospitals,  the  additional  effluvia 
which  proceed  fi-om  the  persons  and  discharges  of  the  sick.  All  other 
causes  of  impurity  of  air  ought  to  be  excluded  by  cleanliness,  proper  re- 
moval of  sohd  and  fluid  excreta,  and  attention  to  the  conditions  siiiTound- 
ing  dwellings. 

The  subject  of  ventilation  may  be  conveniently  considered  rmder  the 
following  heads  : — 

1.  The  quantity  of  fresh  aii'  required  for  the  purposes  defined  above. 

2.  The  mode  in  which  this  quantity  may  be  supphed. 

3.  The  method  of  examining  whether  ventilation  is  sufficient  or  not  ; 
in  other  words,  ascertaining  that  the  air  of  inhabited  rooms  is  pui'e  accord- 
ing to  a  certain  standard.     This  will  form  the  subject  of  a  separate  chapter. 


SECTION  I. 

QUANTITT  OF  AIR  REQUIRED. 

1.       QrAXTITT  EEQriRZD  TO  DILUTE  OE  EEMOVE  THE  EESPrRATOET  DtlPURITIES 
CAUSED  BY  HEALTHY  PERSOXS. 

The  impuiities  added  to  the  air  by  respiration  have  been  ah'eady 
enumerated. 

The  CO,  which  a  human  being  adds  to  the  au-  he  dwells  in,  is  not  in 
itself  an  important  impurity,  the  amount  being  too  small  to  exercise  much 
influence  on  health  ;  but  it  is  practically  in  a  constant  ratio  with  the  more 
important  organic  matter  of  respiration  ; — and,  as  it  is  readily  detenu ined 


^  For  Annj  Regulations  on  Ventilation,  see  Vol.  IL,  Book  n..  Chap.  n. 


l^S  PRACTICAL    HYGIENE. 

with  sufficient  accuracy  for  practical  pvu'poses,  it  is  taken  as  a  convenient 
index  to  the  amount  of  the  impui-ities. ' 

Pettenkofer,  whose  experiments  are  still  the  most  trustworthy,  ascer- 
tained that  a  man  of  twenty-eight  years  of  age,  weighing  132  ib  avoir., 
evolved  per  hour  at  night  during  I'epose  0.56  of  a  cubic  foot  of  CO^,  and 
0.78  in  the  day-time,  using  very  moderate  exertion  ;  during  hard  work  the 
same  man  evolved  1.52  per  hour.     These  amounts  give  the  following  : — 

In  repose 0.00424  cub.  ft.  of  CO^  per  lb  of  body  weight. 

In  gentle  exertion ... .     0.00591  "  "  " 

In  hard  work 0.01227 

These  figures  are  nearly  in  the  ratio  of  2,  3,  and  6,  and  this  may  serve 
as  a  guide  to  the  proportions  of  fresh  air  required.  If  now  we  take  the 
average  weight  of  adult  males  at  150  lb  to  160  lb,  adult  females  at  100  ib 
to,  120  lb,  and  children  at  60  lb  to  80  lb,  we  should  have  the  following 
amounts  of  C0„  evolved  per  hour  in  repose  : — ■ 

Adult  males 0. 036  to  0.678  cubic  foot. 

Adult  females 0.424  to  0.509 

Children 0.254  to  0.339 

The  estimate  for  children  is  jDi'obably  too  little,  as  tissue  change  is  more 
active  in  their  case. 

For  a  mixed  community  a  general  average  of  0.6  of  a  cubic  foot  per 
hour  may  be  adopted  ;  but  for  adult  males,  such  as  soldiers,  it  is  advisable 
to  adopt  0.7  to  0.72. 

Taking  the  CO,  as  the  measure  of  the  impurity  of  the  air  vitiated  by 
respiration  and  transpiration,  in  short  from  the  person  in  any  way,  we 
have  to  ask.  What  is  to  be  considered  the  standard  of  ixirity  of  air  in 
dwelling-rooms  ?  We  cannot  demand  that  the  air  of  an  inhabited  room 
shall  be  absolutely'  as  pure  as  the  outside  air  ;  for  nothing  short  of  breath- 
ing in  the  open  air  can  insure  joerfect  purity  at  every  respiration.^  In 
every  dwelhng-room  there  will  be  some  impurity  of  au*. 

The  practical  limit  of  purity  will  depend  on  the  cost  which  men  are 
wilhng  to  jDay  for  it.  If  cost  is  disregarded,  an  immense  volume  of  air  can 
be  supplied  by  mechanical  contrivances  ;  but  there  are  comparatively  few 
cases  in  which  this  could  be  allowed. 

Without,  however,  attempting  too  much,  it  may  be  fairly  assumed  that 
the  quantity  of  air  supplied  to  every  inhabited  room  should  be  great 
enough  to  remove  all  sensible  impurity,  so  that  a  person  coming  directly 
from  the  external  air  should  perceive  no  trace  of  odor,  or  difference  be- 
tween the  room  and  the  outside  air  in  point  of  freshness.  This  is  now 
pretty  generally  admitted  as  the  most  convenient  practical  standard,  pre- 
cautions being  taken  that  the  air-space  be  entered  directly  from  the  ex- 
ternal air,  or  as  nearly  so  as  possible,  for  the  sense  of  smell  is  rapidly 
duUed. 

'  One  of  the  earliest  observers  to  recognize  the  value  of  carbonic  acid  as  an  index  of 
purity,  appears  to  have  been  F.  de  Blanc,  whose  memoir,  llccherches  sur  la  Compo- 
sition de  I'Air  Confine  (1842),  is  cited  by  General  Morin.  He  appears  to  have  liad 
clearer  notions  as  to  the  amount  of  air  necessary  than  most  of  his  contemporaries 

"Thus  the  carbonic  acid  in  the  air  being  taken  at  .04  per  cent. ,  and  tlie  carbonic 
acid  of  resjiiration  being  placed  at  .6  cubic  feet  in  an  hour,  a  man  placed  in  a  room  of 
1,000  cubic  feet  of  air  must  receive  no  less  than  1,000,000  cubic  feet  of  outside  air  in 
an  hour  to  reduce  the  carbonic  acid  to  the  standard  (nearly  .0401  per  cent.)  of  the  fresh 
air.  — "On  Ventilation  and  Cubic  Space,"  by  Dr.  de  Chaumont,  Assistant  Professor  of 
Hygiene,  Army  Medical  School,  Edinburgh  Med.  Jour.,  May,  1867. 


VENTILATI02T. 


159 


In  a  paper  by  Dr.  de  Cliaimiont/  it  is  shown,  from  a  large  number  of 
observations  (473  analyses),  that  the  sense  of  smell  carefnlly  employed 
gives  a  very  fair  idea  of  the  amount  of  impurity  in  an  au'-space.  In  those 
experiments  the  amount  of  C0„  in  the  external  air  was  determined  at  the 
same  time,  so  that  the  respiratory  impurity  was  accurately  knov.-n.  Drdd- 
ing  the  observations  into  groups,  the  following  results  were  obtained  : — 


1.  Fresh,  or  not  2.  Eather  close, 
differing-  sensi-  Organic  matter 
bly    from    the'     becoming  per- 

.    outer  air.  |     ceptible. 


3.  Close. 

Organic     matter 

disagreeable. 


4.  Very  close. 
Organic  matter  of- 
fensive   and   op- 
pressive ;  limit  of 
differentiation 
by  the  senses. 


Mean  COo  per  1,000  vols,  re-  1 
duced  to  0"-  Cent  (=32"  ,' 
F.),  due  to  respiratory  im-  f 
purity I J 


0.4132 


0.6708 


0.9054 


It  will  thus  be  seen  that  the  smeU  of  organic  matter  is,  on  an  average, 
perceptible  to  the  sense  of  smell  when  the  coincident  CO.,,  due  to  resxDh'ator\- 
(or  personal)  impiuity,  reaches  0.1943  per  1,000  ;  and  that  when  it  exceeds 
t).90o4,  smeU  is  no  longer  able  to  detect  shades  of  difference.  TVe  may 
therefore  take  0.2  per  1,000  in  round  numbers  as  the  maximum  amount  of 
respiratory  imjDuiity  admissible  in  a  properly  ventilated  ah'-space. 

Adopting,  then,  this  standard  as  the  measure  of  the  permissible  maxi- 
mum of  impui'ity,  the  next  point  is  the  quantity  of  pure  external  aii'  which 
should  pass  through  the  air  of  a  room,  vitiated  by  respii'ation,  per  head 
per  hour,  in  order  to  keep  the  CO.,  at  this  ratio,  assuming  a  general  average 
of  0.6  of  a  cubic  foot  per  head  per  hour  to  be  given  out.  The  foUowing 
table  gives  the  answer  to  this  question,  under  different  conditions  of  cubic 
space : — 

Table  to  sTiow  the  Degree  of  Cordaminatioji  of  the  Air  {in  terms  of  CO:::)  hy  Eespiration, 
and  tM  Amount  of  Air  necessriry  to  dilute  to  a  given  Standard  of  .%  per  l.UOO  I  olurnes  of 
Air,  exclusive  of  the  Amount  originally  present  in  the  Air. 


Amount    of    cubic    space 
(=  breathing  space)  for 
one  man  in  cubic  feet. 

Batio  per  1,000  of  CO2  from 
respiration  n  t  the  end  of 
one  honr.  if  there   has 
been  no  change  of  air. 

Amount  of  air  necessary  to 
dilute  to  standard  of  .2 
during  the  first  hour. 

Amount  necessary  to  di- 
lute to  the  given  .stand- 
ard every  hour  after  the 
first. 

100 

6.00 

2,900 

3.000 

200 

3:00 

2,800 

3,000 

300 

2.00 

2,700 

3,0C0 

400 

1.50 

2,600 

3.0C0 

500 

1.20 

2,500 

3,000 

600 

1.00 

2.400 

3,000 

700 

0.86 

2,300 

3,000 

800 

0.75 

2.200 

3,000 

900 

0.67 

2,100 

3.000 

1,000 

0.60 

2,000 

3.000 

For  the  sake  of  simphcity,  the  C0„  naturally  ia  the  au'  has  been  dis- 
regarded, but,  of  course,  there  would  be  actually  in  the  air  from  .3  to  .4 


1  "  On  the  Theory  of  Ventilation,"  Proceedings  of  the  Eoyal  Society,  2so.  168,  p. 
187,  1875,  and  Xo.  l"71,  1876. 


ICO  PRACTICAL    HYGIENE. 

volumes  per  1,000  more  from  this  source.  Thus  (if  we  take  it  at  0.4),  in 
the  room  of  100  cubic  feet,  there  would  be  at  the  end  of  an  hour  (.04  +  . 6) 
.64  volume,  or  6.4  per  1,000,  and  in  the  room  of  200  cubic  feet  there  wovild 
be  .34  volume  per  cent.,  or  3.4  per  1,000.  The  above  table  is  calculated 
from  this  formula.' 

P 
where  p,   =  Eespiratoiy  impui-ity  per  1,000  volumes  existing  in  the  au'-space 
c,  stated  in  terms  of  C0„. 
p  =  Admissible  limit  of  respiratory  impujity,  that  is,  0.2  per  1,000 

volumes. 
c  =  Aii'-space,  in  cubic  feet. 
d  =  Amount  of  fi-esh  air  requii'ed,  in  cubic  feet. 
Thus  the  difference  between  the  actual  ratio  of  vitiation  and  the  admis- 
sible limit,  multiphed  by  the  capacity  of  the  aii'-space  and  divided  by  the 
admissible  hmit,  gives  the  amount  of  fresh  aii*  required. 

1-2 

Example:  Let  p,  =  1.  and  c  =  600 :  then  — '—  '—  =  4,  and  4  x  600  = 

2,400  cubic  feet  of  air  required. 

This  formula  is,  however,  inconvenient  in  fonn,  and  gives  to  cubic  sjyace 
an  apparent  importance  which,  as  we  shall  see  fiu-ther  on,  it  does  not 
possess.     The  follo^ving  is  therefore  better,  as  it  is  of  general  aj^jDlication. 

l=d 

P 
where  e  —  the  amount  of  CO,  exhaled  by  one  individual  in  an  hour,  p  = 
the  Hmit  of  admissible  impuiity  (stated  per  cubic  foot),  and  d  —  the  re- 
C[uired  delivery  of  fresh  aii-  in  cubic  foot  per  hour*.  If  p  be  expressed  per 
1,000  volumes,  then  d  must  be  taken  to  represent  the  number  of  thousands 
of  cubic  feet  of  aii*.  If  now  we  take  e  at  the  general  average  of  0.6  of  a 
cubic  foot,  then : 

0.6    o  (\(\(\  0.6 

Q  QQQo  ~  ^>^^^  oi*  7^  =  3  =  number  of  thousands  of  cubic  feet  of  air  re- 
quired. 

This  formula  may  also  be  used  conversely,  in  order  to  find  from  the 
condition  of  the  air  the  average  amount  of  fresh  air  which  has  been  hither- 
to supphed  and  utihzed.  For  this  piu-pose  we  simply  substitute  for  p  (the 
admissible  hmit)  p,,  the  observed  ratio.  Thus,  let  us  suppose  that  p^,  the 
observed  ratio  of  vitiation,  was  0.7  per  1,000  vols.,  we  should  have  : 

0.6 

jY^  =  0.857  =  number  of  thousands  of  cubic  feet, 

or  857  cubic  feet  of  air  per  head  per  hour  had  been  supphed  and  utilized 

duiing  the  time  of  occupation. 

We  can  also  calculate  the  probable  condition  of  an  au--space  in  which  a 

e 
given  quantity  of  aii*  is  supphed  :  thus,  -r  —  p^;  taking  the  amount  directed 

for  soldiers  in  baiTacks,  viz.,  1,200  per  hour,  we  have  (assuming  that  e 
represents  in  this  case  0. 7) 
0.7 
1  200  "^  0.000583  CO,  per  cubic  foot,  or  0.583  per  1,000  vols. 

'  Spe  Dr.  F.  de  Chaumont's  papers  in  the  Lancet,  September,  1866,  and  Ediu.  Med. 
Journal,  May,  lj^67  ;  also  Professor  Donkin's  Memorandum  in  the  Blue  Book  of  the 
Committee  on  the  Cubic  Space  oirthe  Metropolitan  Workhouses  (1867). 


VENTILATION-.  161 

Where  the  quantity  e  is  less  than  the  above  amounts,  as  for  instance  in 

the  case  of  children,  we  should  have,  assuming  children  to  evolve  0.4  of  a 

cubic  foot,         0.4  7      /.      1  .    „ 

vr-n  =  2  =  number  of  thousands  of  cubic  feet  of  air  required. 

For  a  long  time  after  this  subject  first  attracted  attention  the  amount  of 
fresh  air  supposed  to  be  necessary  was  put  at  too  low  a  figure.  Even  the 
figures  of  General  Morin,'  which  were  a  great  advance  at  the  time,  are 
insufficient.  He  proposed  2,118  cubic  feet  (60  cubic  metres)  for  barracks  at 
night,  and  Eanke  adopts  the  same  figures. 

Koth  and  Lex^  adopt  the  maximum  of  total  impurity  at  .6  per  1,000, 
which  includes  0.4  of  initial  CO^ ;  and  as  they  estimate  the  expired  CO^  as 
20  litres,^  or  .706  cubic  feet  (Eng.)  per  hour,  they  give  the  hourly  quantity 
of  air  as  100  cubic  metres,  or  3,533  cubic  feet. 

It  is  highly  desirable  that  some  general  agTeement  should  be  come  to 
as  to  the  amount  of  air  necessary,  even  if  it  be  admitted  that  the  desired 
amount  cannot  always  be  obtained.  If  we  adopt  the  following  amotmts  of 
C0„  as  being  evolved  during  repose,  we  shall  not  be  far  from  the  probable 
truth- 

AdrJt  males  (say  160  lb  weight) 0.7  of  a  cubic  foot 

"  females  (  "    120  lb       "      ) 0.6 

ChUdren        (  "      80  lb      "      ) 0.4 

Average  of  a  mixed  community 0.6  " 

Under  those  conditions  the  amount  of  fresh  aii*  to  be  supphed  in  health 
during  repose  ought  to  be — 

For  adult  males 3,500  cubic  feet  per  head  per  hour. 

"       "      females 3,000 

"    childi-en 2,000  "       . 

"    a  mixed  community  . .  .  3,000  "  "  " 

The  amount  for  adult  males  as  above  given  is  just  100  cubic  metres,  or 
if  we  take  it  at  3,600  cubic  feet,  it  is  just  one  cubic  foot  per  second.  These 
numbers  are  easy  to  remember. 

When  we  have  to  deal  with  places,  the  inmates  of  which  are  actively 
employed,  such  as  workshops  and  the  like,  the  amount  of  air  supplied  must 
be  proportionately  increased.  We  have  seen  that  in  light  work  the  CO^ 
evolved  per  hour  is  nearly  0.006  of  a  cubic  foot  per  fib  of  body  weight,  and 
in  hard  work  at  least  double  that  amount, — so  that  for  a  man  of  160  lb 
weight  we  should  have — 

In  hght  work 0.95  of  a  cubic  foot  of  CO.,  evolved  per  hour. 

In  hard  work 1.96 

This  would  argue  a  dehvery  of  fresh  air  as  follows  : — 

In  light  work 4,750  cubic  feet. 

In  hard  work 9,800 

It  was  stated  long  ago,  from  extensive  observations,  that  in  mines,  if  it 
was  wished  to  keep  up  the  gTeatest  energies  of  the  men,  no  less  than  100 
cubic  feet  per  man  per  minute  (  =  6,000  per  hour)  must  be  given  ;  if  the 

'  Rapport  de  la  Commission  sur  le  Chauffage  et  la  Ventilation  des  Batimens  dii 
Palais  de  Justice,  Paris,  1860  ;  also  Manual  Pratique  du  Chauffage  et  de  la  Ventilation, 
1874. 

-  Op.  cit.,  p.  221. 

2  This  amount  is  also  adopted  by  General  Morin. 
Vol.  I.— 11 


162  PRACTICAL    HYGIENE. 

quantity  were  reduced  to  one-third,  or  one-half,  there  was  a  serious  dimi- 
nution in  the  amount  of  work  done  by  the  men.  This  amount  included, 
of  course,  all  the  air  wanted  in  the  mine  for  horses,  lights,  etc' 

TJie  amount  for  animah  is  an  important  question  which  has  been  httle 
studied.     Marcker  °  gives  the  following  from  experiments  : — 

For  large  cattle  (viz.,  oxen,  etc.)  30  to  40  cubic  metres  per  hour  for 
every  1,000  lb  weight,  or  1  to  1^  cubic  foot  for  every  lb  weight. 

For  amall  cattle  (viz.,  sheep,  etc.)  40  to  50  cubic  metres  j^er  hour  for 
every  1,000  tti  weight,  or  l^to  If  cubic  foot  for  every  lb  weight  ;  the  higher 
quantity  being  given  on  account  of  the  more  rapid  tissue  change  in  the 
smaller  animals.  These  quantities  seem  absurdly  small,  and  the  chief  reason 
for  so  limiting  them  seems  to  have  been  the  fear  of  lowering  the  temperature 
too  far.  This  is  an  erroneous  view  :  animals  proj)erly  fed  will  thrive  better 
in  a  well-ventilated  place  at  a  low  temperatiire  than  in  a  warmer  place  ill- 
ventilated.  There  seems  no  reason  why  the  same  rule  should  not  apply  to 
animals  as  to  man,  in  which  case  something  like  20  to  25  cubic  feet  per 
hour  per  lb  of  body  weight  ought  to  be  supplied.  A  horse  or  a  cow  ought, 
therefore,  to  have  fi'om  10,000  to  20,000  cubic  feet  per  hour, — in  short,  it 
ought  to  be  practically  in  the  open  air. 


2.     ON    THE   QUANTITY    OF    AIK    REQUIRED   FOR   LIGHTS,    IF    THE    AIR   IS    TO    BE   KEPT 

PURE   BY    DILUTION. 

Air  must  be  also  supplied  for  lights  if  the  products  of  combustion  are 
allowed  to  pass  into  the  room.  Wolpert  has  calculated  that,  for  every  cubic 
foot  of  gas,  1,800  cubic  feet  of  air  must  be  introduced  to  dilute  properly  the 
products  of  combustion  ;  and  this  is  not  too  much  if  we  remember  that  a 
cubic  foot  of  good  coal  gas  produces  about  2  cubic  feet  of  carbon  dioxide, 
and  that  sulphur  dioxide  and  other  substances  may  be  also  formed.  A 
common  small  gas  burner  will  burn  nearly  3  feet  per  hour,  and  wiU  con- 
sume 10  or  jDrobably  12  cubic  feet  in  an  evening  (4  hours),  and  therefore 
from  18,000  to  21, GOO  cubic  feet  of  air  must  be  introduced  for  this  pur- 
pose alone  in  the  4  hours,  unless  the  products  of  combustion  are  removed 
by  a  special  channel.^  The  power  of  illumination  being  equal,  gas  does 
not  produce  more  CO,,  than  candles  (Odling),  but  usually  so  much  more 
gas  is  burnt  that  the  air  is  much  more  deteriorated  ;  there  is  also  greater 
heat  and  more  watery  vapor.  The  products  should  never  be  allowed  to 
escape  into  the  air  of  the  room.  Weaver  has  shown  how  important  a 
source  of  impurity  this  is  ;  and  the  bad  effects  of  breathing  the  products 
of  gas  combustion  are  well  known. 

One  lb  of  oil  demands,  for  complete  combustion,  138  cubic  feet  of  air  ; 
and  to  keep  the  air  perfectly  pure,  nearly  as  much  air  must  be  introduced 
for  1  ft)  of  oil  as  for  10  feet  of  gas.  In  mines,  60  cubic  feet  per  hour  are 
allowed  for  each  light  ;  the  lights  generally  are  dim,  and  the  amount  of 
combustion  is  slight  ;  but  this  seems  an  extremely  small  amount. 

If  gas  is  not  burnt  in  a  room,  or  in  a  very  smaU  amount,  or  if  only 
candles  or  oil  lamps  are  used,  it  is  seldom  necessai-y  to  take  them  into  ac- 
count in  estimating  the  amount  of  air. 

'  Proceedings  of  the  Civil  Engineers,  vol.  xii.,  pp.  298  and  308. 

"^  Op.  cit. 

^  See  an  elaborate  table  by  M.  Layet,  Eevue  d'Hygiene,  vol.  ii.,  pp.  1096-7. 


VENTILATION.  163 


3.    ON     THE     QUANTITY     REQUIRED     FOR     THE     RESPIRATION     AND    DILUTION    OF    THE 
EMANATIONS    OF    SICK   MEN. 

In  making  differential  experiments  among  tlie  healtliy  and  the  sick,  it 
has  been  found  '  that  among  the  former  the  smell  of  organic  matter  was 
still  imperceptible  when  the  air  contained  0.208  per  1,000  of  respiratory 
impurity  as  CO^  ;  but  in  hospitals  containing  ordinary  cases  it  was  quite 
distinct  when  the  CO^  reached  0.166.  From  this  we  may  conclude  that 
the  minimum  amount  of  fresh  air  for  hospitals  ought  to  exceed  that  re- 
quired in  health  by  at  least  one-fourth.  If  3,000  cubic  feet  per  hour  be 
admitted  as  a  general  average  in  health,  we  may  demand  in  round  numbers 
4,000  in  sickness  ;  and  if  we  have  to  deal  with  adult  males  only,  such  as 
soldiers,  4,500  per  head  per  hour.  When  we  have  to  deal  with  serious 
cases,  a  still  greater  amount  must  be  given,  reaching  5,000,  6,000,  or  even 
more  if  possible, — in  fact,  the  supply  should  be  unlimited.  These  views 
are  in  accordance  with  the  results  of  experimental  inquiry  (Grassi  in  Paris  ; 
Sankey  in  London  ;  Sutherland). 

In  some  diseases,  so  much  organic  substance  is  thrown  off,  that  scarcely 
any  ventilation  is  sufficient  to  remove  the  odor.  In  some  of  the  London 
hospitals  Dr.  de  Chaumont  found  that  there  was  still  a  close  smell  when 
5,000  cubic  feet  and  even  more  were  supplied,  but  the  distribution  was  not 
perfect.  Even  when  3,600  feet  were  supplied  and  utilized  (as  calculated 
from  the  C0„)  the  ward  was  not  free  from  smell.  The  best  surgeons  now 
consider  an  almost  complete  exposure  of  pyaemia  patients  to  the  open  air 
the  best  treatment ;  and  it  is  well  known  that  in  typhus  fever  and  (to  a 
less  extent)  in  typhoid,  and  also  in  small-pox  and  plague,  this  complete  ex- 
posure of  patients  to  air  is  the  first  important  mode  of  treatment,  before 
even  diet  and  medicines.  Even  temperature  must  be  sacrificed  to  a  con- 
siderable extent,  in  order  to  obtain  fresh  air,  if  a  choice  requires  to  be 
made  between  the  two. 

Humidity. — The  condition  of  the  air  as  regards  humidity  is  a  matter  of 
some  importance,  but  has  not  hitherto  been  much  considered.  In  Dr.  de 
Chaumont's  experiments  the  mean  humidity,  in  rooms  having  less  than  0.2 
per  1,000  of  respiratory  impurity  (reckoned  as  CO  J,  was  73  per  cent.,  at  a 
temperature  of  63°  Fahr.  This  might  be  taken,  provisionally,  as  a  stand- 
ard,^ at  least  for  climates  like  our  own.  In  drier  climates,  however,  as  in 
America,  such  a  condition  would  not  be  attainable  in  many  cases,  when 
the  external  air  has  a  mean  humidity  of  40  or  even  30  per  cent.  In  Ger- 
many 50  per  cent,  is  looked  upon  as  an  average  humidity,  whilst  in  Eng- 
land this  would  indicate  an  exceptionally  dry  atmosphere. 

'  The  Theory  of  Ventilation,  by  Dr.  de  Chaumont,  Proc.  Roy.  Soc. ,  loc.  cit. 

'■^  From  the  state  of  the  air  as  regards  humidity,  information  may  sometimes  he 
obtained  which  might  take  the  place  of  the  COo  determination,  in  the  absence  of 
means  for  carrying  out  the  latter.  For  instance,  at  St.  Mary's  Hospital,  the  air  of  the 
wards  was  found  to  have  78  per  cent,  of  humidity,  or  5.8  per  cubic  foot ;  to  reduce  it 
to  73  per  cent.,  or  5.5  grains  per  cixbic  foot,  while  the  external  air  contained  5.3,  we 

5  8—5  5        0  8 
should  have     '  — '-   =   —    —  1,  or  we  should  require  to  add  to  the  existing  delivery 

5.5— 5. /i         O.o 
of  air,  at  least  as  much  more  per  hour  as  would  equal  the  total  cubic  space.     In  the 
case  referred  to  this  was  about  2256  cubic  feet.     The  actual  supply  was  2080,  total  483(5 
per  head,  or  about  the  quantity  demanded  for  proper  hospital  ventilation. 


104  PRACTICAL    HYGIENE. 


SECTION  n. 


THE  MODE   IN  WHICH   THE   NECESSARY   QUANTITY   OF   FRESH 
AIR  CAN   BE   SUPPLIED. 

This  is  an  engineering  problem,  and  there  can  be  no  doubt  that  in 
time  to  come  it  will  be  as  carefully  considered  by  engineers  as  the  supply 
of  "water,  or  the  removal  of  the  solid  and  fluid  excreta.  Ventilation  is, 
in  fact,  the  problem  of  the  removal  of  the  gasiform  excreta  of  the  lungs 
and  skin. 

Sub-Section  I. — Preliminary  Considerations. 

1.  Cubic  Space.^ — A  certain  amount  of  fresh  air  has  to  pass  through  a 
given  air-space  in  a  fixed  time  in  order  to  maintain  a  certain  degree  of 
purity  ;  the  amount  has  been  fixed  at  3,000  cubic  feet  for  each  healthy 
person  in  an  hour ;  before  considering  the  appliances  for  moving  this  air, 
we  must  consider  what  should  be  the  minimum  size  of  the  air-space 
through  which  the  fresh  air  has  to  pass. 

This  will  entirely  depend  on  the  rate  at  which  air  can  be  taken  through 
the  space  without  the  movement  being  perceptible  or  injurious.  The  size 
of  the  si^ace  is  of  consequence,  chiefly,  in  so  far  as  it  affects  this  condition. 
The  larger  the  air-space  the  less  is  the  necessity  for  the  frequent  renewal 
of  air,  and  the  less  the  chances  of  draught.  Thus  a  space  of  100  cubic 
feet  must  have  its  air  changed  thirty  times  in  an  hour,  if  3,000  cubic  feet 
of  air  are  to  be  given,  while  a  space  of  1,000  cubic  feet  need  only  have  it 
changed  three  times  in  an  hour  for  an  equal  ventilation. 

When  the  most  perfect  mechanical  means  are  employed,  the  air  of  even 
a  small  air-si:)ace  can  be  changed  sufficiently  often  without  draught.  Thus, 
in  Petteukofer's  experimental  room  at  Munich,  the  air-space  is  424  cubic 
feet,  and  2,G40  cubic  feet  can  be  drawn  through  by  a  steam  engine  in  an 
hour  without  perceptible  movement  ;  in  other  words,  the  change  is  six 
times  per  hour  nearly.  With  the  best  mechanical  contrivances,  and  with 
disregard  of  cost,  we  are  therefore  certain  that  a  cubic  space  of  GOO  feet 
would  be  sufficient,  and  there  is  every  probability  that  engineers  could 
ventilate  even  a  smaller  space  without  perceptible  movement. 

But  if  the  mechanical  contrivances  are  of  an  inferior  kind,  and  par- 
ticularly if  natural  ventilation  is  used,  the  difficulties  of  ventilating  a 
small  space  are  considerable,  and  are  caused  not  so  much  by  the  rate  of 
movement  of  the  greater  part  of  the  air  in  the  room,  as  by  the  rate  at  the 
openings  where  the  fresh  air  comes  in  very  quickly,  and  causes  currents 
in  the  room.     Suppose,  for  example,  a  space  of  500  cubic  feet  with  a  man 

'  In  the  metropolitan  lodging-houses,  30  superficial  and  240  cubic  feet  are  allowed  ; 
in  the  section-houses  of  the  metropolitan  police  50  superficial  and  450  cubic  feet  are 
given.  The  Poor-law  Board  allows  BOO  cubit  feet  for  every  healthy  person  in  dormi- 
tories, and  from  850  cubic  feet  and  upward,  according  to  circumstances,  as  far  as  1,200 
subic  feet  for  every  sick  person.  In  Dublin,  an  allowance  of  300  cubic  feet  is  re- 
quired in  the  registered  lodging-houses. — (From  an  excellent  pamphlet,  entitled  Essen- 
tials of  a  Healthy  Dwelling,  p.  13. )  In  the  Prussian  army  the  allowance  is  495  cubic  feet 
(Prussian  measurement,  which  is  nearly  the  same  as  English),  the  superficial  space 
being  42-45  square  feet ;  in  the  old  Hanoverian  army  the  cubic  space  was  700  to  800 
cubic  feet  (Prussian).  The  London  School  Board  have  given,  in  a  general  school- 
room, 10  square  feet  per  scholar,  and  in  graded  schools  9  square  feet;  the  height  was 
ordered  to  be  13  feet — making  130  and  117  cubic  feet  respectively.  This  seems  very 
small. 


VEi!?^TILATIOI«".  165 

in  it,  who  has  to  be  supplied  -with  3,000  cubic  feet  in  an  hour  ;  if  the  iulet 
opening  be  12  square  inches,  the  rate  of  movement  through  it  would  be 
10  feet  per  second,  or  nearly  7  miles  ^ev  hour ;  if  24  square  inches,  it 
would  be  five  feet,  or  about  3.4  miles  per  hour.  In  either  case,  in  such  a 
small  room,  the  air  could  not  be  properly  distributed  before  reaching  the 
person,  and  a  draught  would  be  felt.  If  instead  of  500  cubic  feet  1,0(30  be 
given,  the  problem  is  easier,  for  the  small  cui-rent  of  fresh  air  mixing  with 
the  larger  volume  of  aii'  in  the  room  is  more  easily  broken  up,  and  the 
man  being  further  from  the  opening,  the  movement  is  less  felt.  The 
question,  in  fact,  turns  in  great  measure  on  the  power  of  introducing  the 
air  without  draught. 

If  the  renewal  of  air  is  carried  on  by  what  is  termed  natural  ventila- 
tion, under  the  ordinaiw  conditions  of  this  climate,  a  change  at  the  rate 
of  six  times  per  hour,  as  in  Pettenkofer's  room,  could  not  be  attempted. 
Even  five  times  per  hour  would  be  too  much  ;  for,  in  bai-racks  with  600 
cubic  feet  per  head,  the  rooms  are  cold  and  draughty,  when  anything  ap- 
proaching to  3,000  cubic  feet  per  head  per  hour  are  passing  through  ;  that 
is  a  change  of  five  times  per  hour  for  each  GOO  cubic  feet  of  air-space.  A 
change  equal  to  three  times  per  hour-  is  generally  all  that  can  be  borne 
under  the  conditions  of  warming  in  this  country,  or  that  is  practically 
attainable,  and  if  this  be  correct,  from  1,000  to  1,200  cubic  feet  should  be 
the  minimum  allowance  of  the  initial  air-space. 

With  good  warming  and  an  equable  movement,  which,  however,  is  not 
always  easy  to  get,  there  might  be  larger  inlets  and  therefore  more  easy 
distribution  and  a  smaller  au'-siDace  to  begin  with.  If  the  inlets  are  48 
square  inches,  the  rate  through  them  to  supjDly  a  space  of  500  cubic  feet 
with  3,000  cubic  feet  j)er  hour  would  be  only  '2^  feet  per  second  ;  and  if, 
as  should  be  the  case  in  artificial  ventilation,  the  inlet  is  72  or  80  square 
inches  in  size,  the  rate  would  only  be  a  httle  over  1-|  foot  per  second, 
which  would  be  imperceptible  even  at  the  orifice.  But  there  is  an  argu- 
ment against  a  small  cubic  space,  even  with  good  mechanical  ventilation, 
viz.,  that  if  anything  arrests  the  mechanism  for  a  time,  the  ratio  of  impurity 
from  respiration  increases  much  faster  in  a  small  than  in  a  lai-ge  space.' 

The  wainnth  of  the  moving  au'  influences  the  sensation  of  the  persons 
exposed  to  it.  At  a  temperatui-e  of  55'  or  60",  a  rate  of  1 J  foot  per  second 
( =:  1  mile  per  hoiu-  nearly)  is  not  perceived  ;  a  rate  of  2  to  24-  per  second 
(1.4  and  1.7  miles  per  hoiu-j  is  imperceptible  to  some  j)ersons  ;  3  feet  per 
second  (2  miles  per  houi*  nearly)  is  jDerceptible  to  most  ;  a  rate  of  3^  feet 
is  perceived  by  all  persons  ;  any  greater  speed  than  this  vciR  give  the  sen- 
sation of  draught,  especially  if  the  enteiTtig  air  be  of  a  drfferent  temperature, 
or  moist.     If  the  air  be  about  70'  Fahr.,  a  i-ather  greater  velocity  is  not  per- 

'  Experimental  data  on  many  of  these  points  are  still  -wanting.  In  prisons,  -with 
cells  for  separate  confinement  and  artificial  ventilation,  tlie  amount  of  space  is  seldom 
nnder  750  to  SOO  cubic  feet,  and  practically  this  is  found  to  be  too  small. 

In  Pentonville  Prison,  on  Jebb's  system,  the  air -was  hardly  ever  changed  three 
times  in  the  hour,  during  my  experiments,  although  the  cells  are  nearly  feuO  feet  in 
capacity.  The  mean  supply  of  air  per  hour -was  about  1,0.56  cubic  feet.  In  Gosport 
military  prison,  also  on  Jebb's  principle  (but  not  perfectly  carried  out),  the  mean 
supply  vras  about  800  cubic  feet,  but  the  cells  are  only  about  600  in  capacity.  In  Alder- 
shot  military  prison  (not  on  Jebb's  principle)  -vrith  cells  about  600  cubic  feet  in  size,  the 
mean  supply  -sras  under  500.  And  in  Chatham  convict  prison,  -where  the  cells  are 
only  200  the  mean  supply  -was  about  480.  Wilson  (Hand-book  of  Hygiene)  appears  to 
have  found  the  air  changed  in  the  large  cells  at  Portsmouth  convict  prison  about  three 
times  in  the  hour,  and  in  the  small  about  four  times  ;  this,  ho-wever,  is  certainly  not 
the  rule.— (F.  de  C.) 


166  PRACTICAL    HYGIENE. 

ceived,  while  if  it  be  still  higher  (80°  to  90°  Fahr.),  the  movement  becomes 
again  more  perceptible,  and  this  is  also  the  case  if  the  temperatiire  be  be- 
low 40^  Fahr.  If  the  aii-  coiild  be  warmed  to  a  certain  point  in  a  cold  ch- 
mate,  or  if  the  climate  be  warm,  there  may  be  a  much  more  rapid  cun-ent, 
and  consequently  a  smaller  cubic  space  might  be  given.  The  subject  of 
ventilation  is  in  cold  climates  connected  inseparably  with  that  of  warming, 
for  it  is  impossible  to  have  efficient  ventilation  in  cold  weather  without 
warming  the  air. 

The  amount  of  cubic  space  thus  assigned  for  healthy  persons  is  far  more 
than  most  people  aro  able  to  have  ;  in  the  crowded  rooms  of  the  artisan  class, 
the  average  entire  space  would  probably  be  more  often  200  or  250  cubic  feet 
per  head  than  1,000.  The  expense  of  the  lai-ger  rooms  would,  it  may  be 
feared,  be  fatal  to  the  chance  of  such  an  ideal  standard  being  generally  carried 
out  ;  but,  after  all,  the  question  is,  not  what  is  likely  to  be  done,  but  what 
ought  to  be  done  ;  and  it  is  an  encouraging  fact  that  in  most  thuigs  in  this 
world,  when  a  right  course  is  recognized,  it  is  somehow  or  other  eventually 
carried  out. 

So,  in  the  case  of  soldiers,  the  amount  of  authorized  regulation  space 
(600  cubic  feet),  is  below  the  standard  now  given,  bvit  still  the  space  is  as 
much  as  can  be  demanded  at  present,  as  it  has  been  found  veiy  difficult, 
without  incurring  greater  expense  than  the  country  would  bear,  to  give 
every  man  even  the  600  cubic  feet. 

For  sick  persons  the  cubic  space  shovdd  be  more  than  for  healthy  per- 
sons. We  are  to  remember  that  there  are  other  impurities  besides  those 
arising  from  respiration  and  transpiration,  and  that  immediate  dilution  and 
as  speedy  removal  as  can  be  managed  are  essential. 

Very  much  the  same  considei*ations  apply  to  sick  as  to  healthy  men,  ex- 
cept that  the  allowance  of  air  in  all  cases  of  acute  diseases  mvist  be  gTeater ; 
and,  therefore,  especially  if  natiu-al  ventilation  be  employed,  the  cubic  space 
has  to  be  enlarged  also,  to  insvu-e  good  distribution  without  draught,  for 
siu'face  chilling  must  be  carefully  avoided. 

Admitting  that,  in  hospitals,  a  minimum  of  4,000  cubic  feet  of  fresh  air 
per  patient  jjer  hour  should  be  supj^lied,  if  the  change  of  air  is  to  be  three 
times  per  hour,  as  the  best  available  rate  of  movement,  the  cubic  space  must 
be  about  1,300  cubic  feet.  A  consideration  of  another  kind  may  aid  in  de- 
termining the  question  as  regards  sick  men.  In  hospitals  a  certain  amoimt 
of  floor-space  is  indispensably  necessary  ;  first,  for  the  lateral  separation  of 
jDatients  ;  secondly,  for  convenience  of  attendance.  For  the  first  object, 
the  gi-eater  floor-sj^ace  the  better  ;  and  in  respect  of  the  second,  Dr.  Acland 
has  clearly  showoi  that  the  minimum  floor-space  for  convenient  nursing 
should  be  72  square  feet  per  bed.'  In  a  ward  of  12  feet  in  height  this 
would  give  only  864  cubic  feet,  which  is  much  too  small. 

Considering,  however,  the  immense  benefit  to  patients  of  pure  air,  and 
the  practical  experience  of  hospital  physicians,  it  is  very  desirable  not  to  fix 
the  floor  and  cubic  space  of  hospital  wards  at  the  minimum  of  what  may 
suffice.  The  clesu'e  of  most  hospital  physicians  and  surgeons  is  to  obtain 
for  their  patients,  if  they  can,  a  floor-space  of  100  to  120  square  feet,  and  a 
cubic  space  of  1,500  to  2,000  cubic  feet,  and  in  this  they  are  right. 

It  must  be  distinctly  understood  that  a  minimum  of  floor-space  must  be 
insisted  upon  in  all  cases,  not  less  than  -j"^  of  the  cubic  space. '^ 

'  See  Report  of  the  Committee  appointed  to  inquire  into  the  cubic  space  of  Metro- 
politan Workhouses,  18G7,  p.  12. 

-  On  this  subject  see  further  in  Vol.  II.,  chapter  on  Habitations. 


VENTILATIOT^-.  1G7 

A  notion  prevails  among  many  people,  that  cubic  space  may  take  the 
place  of  change  of  air, — so  that  if  a  larger  cubic  space  be  given,  a  certain 
amount  of  change  of  air  may  be  dispensed  with,  or  less  fresh  aii-  be  requii-ed. 
This  is  quite  erroneous  :  even  the  largest  space  can  only  provide  sufficient 
air  for  a  limited  time,  after  which  the  same  amount  of  fi'esh  au'  must  be 
supphed  hourly,  whether  the  space  be  large  or  small  This  is  shown  by  the 
table  on  page  149,  and  may  also  be  mathematically  demonstrated  by  the 
foi-mula  given  below.'  Even  in  a  space  of  10,000  cubic  feet  per  head  the 
hmit  of  admissible  impurity  would  be  reached  in  a  little  over  3  hours,  after 
which  the  same  homiy  supply  of  3,000  feet  would  be  as  necessary  as  in  a 
space  of  100  cubic  feet." 

Cubic  Space  required  for  Animals. 

The  amount  of  cubic  space  for  animals  has  not  been  very  carefully  ex- 
amined. If  we  followed  the  rule  for  men  and  gave  one  third  of  the  quan- 
tity of  air  supphed  per  hour,  tliis  would  give  for  horses  and  cattle  from 
3,000  to  7,000  cubic  feet.  This,  however,  is  probably  not  necessary,  be- 
cause change  of  air  can  be  carried  on  more  freely  than  in  human 
habitations,  and  animals  cannot  close  ventilators  as  men  will  often  do.  A 
floor-space  of  100  to  120  square  feet  would  probably  be  sufficient,  giving 
a  space  of  1,200  to  f,800  cubic  feet,  according  to  the  height  of  the  building. 
If  this  could  be  secirred  there  is  every  probability  that  the  results  would  be 
excellent.  We  might  put  the  estimate  roughly  at  2  cubic  feet  of  space  for 
every  ft  avds.  the  animal  weighs, — the  floor-space  being  not  less  than  y^  of 
the  cubic  capacity. 

At  present,  the  Army  Keg-ulations  allow,  in  new  stables,  each  horse  1,605 
cubic  feet,  and  100  square  feet  of  floor-space  ; '  and  the  means  of  ventila- 
tion, as  will  be  presently  noticed,  ai-e  ample.  ^  In  the  Army  Horse  Infir- 
maries, the  superficial  area  is  to  be  137  square  feet,  and  the  cubic  space 
1,900  feet  per  horse. 

In  the  stables  of  cattle  there  is  often  excessive  over-crowding,  and  it  is 
well  known  that  there  is  a  vast  amount  of  disease  among  them,  which, 
however,  is  seldom  allowed  to  go  far,  as  they  are  sent  to  the  butcher.  Dr. 
Ballard,  who  paid  great  attention  to  the  cattle  plague  in  Islington,  recom- 
mended that  at  least  1,000  cubic  feet  should  be  allowed  per  animal. 

2.  Source  of  the  Air  supplied. — In  order  that  the  object  of  the  ventila- 
tion shall  not  be  defeated,  it  is  necessary  that  the  air  entering  a  room 

1  pi  =  ^V  *  0  J,  where  pi  =  ratio  of  respiratory  impurity  at  the  time  (7i),  (e)tlie 
amount  of  impurity  involved  during  (li),  {d)  the  supply  of  fresh  air,  (e)  the  exponential 
function,  viz.,  2.718,  and (c)  the  capacity  of  the  air  space.     Soon  after  the  first  hour  the 

coefficient  6~7"  practically  vanishes,  and  with  it  vanishes  also  the  small  influence 
the  cubic  space  exercises. 

-  For  further  remarks  on  this  point,  see  my  Lectures  on  State  Medicine  ;  also 
"Hvgiene  "  in  Sanitary  Record,  1874-75.  In  a  pamphlet  by  General  Morin,  Note  sur 
r  espace  cubique,  etc.,  a  table  is  given  that  might  be  misleading,  without  explanation. 
It  really  shows  the  amount  of  air  necessary  to  dilute  a  certain  amount  of  jmpurity 
evolved"  in  a  certain  cubic  space,  and  is  sirailar  to  the  table  given  on  page  159  of  this 
work.  For  continuous  ventilation  the  necessary  supply  in  any  ordinary  space  of  the 
first  hour,  is  a  constant  quantity.  This  can  be  shown  by  asymptote  lines  also.  See 
paper  by  C.  Herscher,  Socicte  de  Medecine  Publique,  in  Kevue  d'Hygiene,  vol.  iii.,  p. 
207.— (F.  de  C.) 

3  Report  of  the  Barrack  and  Hospital  Improyement  Commission  on  the  Ventilation 
of  Cavalry  Stables,  1866,  p.  10. 

•*  See  Book  II.,  Vol.  II. 


16S  PRACTICAL   HYGIENE. 

shall  be  pure.  The  air  must  he  the  pure  external  air,  and  not  he  derived 
from  places  where  it  has  stagnated  and  taken  up  impurities  ;  if  it  is  drawn 
along  jDassages  or  tubes,  and  through  louvres  or  basements,  these  should 
be  capable  of  inspection  and  cleansing.  All  air-shafts  should,  if  possible, 
be  short  and  easily  cleaned.  This  is  an  imjDortant  rule,  and  should  lead 
to  the  rejection  of  all  plans  in  which  the  air-shafts  are  long  and  inacces- 
sible. Several  instances  have  occurred  of  air  being  distributed  by  costly 
appliances,  but  drawn  from  an  impure  source,  or  allowed  to  be  contami- 
nated on  its  passage.  Listead  of  perforated  bricks,  there  should  be  slid- 
ing panels,  or  hinged  flaj^s,  so  that  the  tube  may  be  easily  reached.  In 
towns  it  may  be  necessary  to  filter  the  air,  which  is  often  loaded  with  the 
products  of  combustion  and  other  impurities. 

3.  Wai'ming  or  Cooling  of  the  Ai7\—Th.e  air  may  require  to  be  Avarmed 
to  G0°  or  G5°  Fahr.,  or  cooled  according  to  the  season  or  locality.  The 
warming  in  cold  and  temperate  climates  is  a  matter  of  necessity,  as,  if  dis- 
comfort is  caused  by  cold  draughts,  ventilation  openings  are  certain  to  be 
closed. 

4.  Distribution. — The  distribution  in  the  rooms  should  be  perfect,  that 
is,  there  should  be  uniform  diffusion  of  the  fresh  air  through  the  rooms. 
The  best  way  of  ascertaining  this  is  to  compare  the  amount  of  air  utilized, 
as  calculated  from  the  observed  CO^,  with  the  actual  movement  of  air, 
as  measured  with  the  air-meter.  If  the  distribution  is  good,  the  two 
quantities  ought  not  to  difl'er  materially.  Much  difficulty  is  found  in  prop- 
erly managing  uniform  diffusion,  and  it  requires  careful  arrangement  of 
the  various  openings.  The  distributing  plans  should,  if  possible,  prevent 
the  chance  of  breathed  air  being  rebreathed,  especially  in  hospitals. 
As  the  ascent  of  respired  air  is  raj^id,  on  account  not  only  of  its  tempera- 
ture, but  from  the  force  with  which  it  is  propelled  upward,  the  jDoint  of 
discharge  for  patients  in  bed  should  be  above. 

By  some  it  has  been  argued  that  it  is  better  that  the  foul  air  should 
pass  off  below  the  level  of  the  person,  so  that  the  products  of  respiration 
may  be  immediately  di'awn  down  below  the  mouth,  and  be  replaced  by  de- 
scending pure  air.  But  the  resistance  to  be  overcome  in  drawing  down 
the  hot  air  of  respiration  is  so  great  that  there  is  a  considerable  waste  of 
power,  and  the  obstacle  to  the  discharge  is  sometimes  sufficient,  if  the  ex- 
tracting force  be  at  all  lessened,  to  reverse  the  movement,  and  the  fresh 
air  forces  its  way  in  through  the  pipes  intended  for  discharge.  This  plan, 
in  fact,  must  be  considered  a  mistake.  The  true  principle  is  that  stated 
long  ago  by  D'Ai'cet.  In  the  case  of  vapors  or  gases  the  proper  place  of 
discharge  is  above  ;  but  heavy  powders,  arising  in  certain  arts  or  trades, 
and  which  from  their  weight  rapidly  fall,  are  best  drawn  out  from  below. 

Sub-Section  II. — Means  by  which  Air  is  set  in  Motion. 

These  are  : — 1st,  the  forces  continually  acting  in  nature,  which  produce 
what  has  been  termed  natural  ventilation.  2d,  the  forces  set  in  action 
by  man,  which  produce  the  so-called  artificial  ventilation. 

The  division  is  convenient,  but  not  strictly  logical,  as  the  forces  which 
act  in  natural  do  so  also  in  artificial  ventilation  to  a  certain  extent. 

Natural  Ventilation— General  Statements. 

Three  forces  act  in  natural  ventilation,  \\z.,  diffusion,  winds,  and  the 
difference  in  weight  of  masses  of  air  of  unequal  temperature. 


VENTILATION.  169 


1.    DrFTUSION. 

As  every  gas  diffuses  at  a  certain  rate,  viz.,  inversely  as  the  square  root  of 
its  density,  there  is  a  constant  escape  of  any  foreign  gas  into  the  atmosphere 
at  large.  From  every  room  that  is  not  air-tight  Pettenkofer  and  Eoscoe  have 
shown  that  diffusion  occurs  through  brick  and  stone,  and  Pettenkofer  be- 
Ueves  that  one  of  the  e\T.ls  of  a  newly  built  and  damp  house  is  that  diffusion 
cannot  occur  through  its  walls.  But  the  ordinary  plastered  and  papered 
walls  reduce  diffusion  to  a  most  insignificant  amount.  Through  chinks 
and  openings  produced  by  imperfect  carpentry  the  air  diffuses  fast,  and 
Eoscoe  found  that  when  he  evolved  carbonic  acid  in  a  room  the  amount 
had  decreased  one-half  from  that  cause  in  90  minutes. 

The  amount  of  purification  produced  by  diffusion  under  ordinary  cir- 
cumstances is  shown  by  observation  to  be  insufficient  ;  and,  in  addition, 
organic  substances,  which  are  not  gaseous,  but  molecular,  ai-e  not  affected 
by  it.     As  a  general  ventilating  power,  it  is  therefore  inadequate. 

2.    THE   ACTION    OF   THE   WINDS. 

The  wind  acts  as  a  ^^owerful  ventilating  agent,  and  in  various  ways.  If 
it  can  pass  freely  through  a  room,  with  open  doors  and  windows,  the  effect 
it  produces  is  immense.  For  example,  air  moving  only  at  the  rate  of  2 
miles  an  hour  (which  is  almost  imperceptible),  and  allowed  to  pass  freely 
through  a  space  20  feet  wide,  wiU  change  the  air  of  the  space  528  times 
in  one  hour.  No  such  powerful  action  as  this  can  be  obtained  in  any 
other  way. 

The  wind  will  pass  through  walls  of  wood  (single -cased),  and  even  of 
porous  bricks  or  stone  ;  and  perhaps  this  will  account  for  the  fact  that 
such  houses,  though  cold,  are  healthy  habitations.  By  covering  a  brick 
with  wax,  or  inclosing  a  portion  of  a  brick  wall  in  an  air-tight  box,  Petten- 
kofer has  shown  that  the  force  of  the  breath  will  drive  air  through  the 
brick  and  will  blow  out  a  candle  on  the  other  side  if  the  current  of  air  be 
collected  in  a  small  channel.  The  force  required  to  drive  the  air  through 
is,  however,  really  considerable,  as  the  air  in  the  brick  must  be  brought 
into  a  state  of  tension. 

Marcker '  has  given  the  following  as  the  amount  of  air  passing  in  one 
hour  through  a  square  metre  of  wall  space,  when  the  difference  of  tem- 
perature is  1°  C.  : — Sandstone,  1.69  ;  limestone,  2.32  ;  brick,  2.83  ;  tu- 
faceous  limestone,  3.64  ;  and  loamy  brick,  5.12  cubic  metres  of  air.  The 
little  porosity  of  sandstone  depends  on  the  amount  of  moisture  it  holds. 
The  moisture,  in  fact,  greatly  influences  the  transit.  Plaster,  however,  ap- 
pears to  arrest  wind,  if  it  be  true,  as  stated,  that  in  the  interior  of  some 
thick  walls,  after  man}'  years,  lime  has  been  found  still  caustic ;  and  Marcker 
also  notices  the  obstructive  effects  of  mortar. 

There  ar^  two  objections  to  winds  as  ventilating  agents  by  perflation. 

(1)  The  air  may  be  stagnant.  In  this  country,  and,  indeed,  in  most 
countries,  even  comparative  quiescence  of  the  air  for  more  than  a  few  hours 
is  scarcely  known.  Air  is  called  "  still  "  when  it  is  really  moving  1  or  1| 
mile  an  hour.  The  average  annual  movement  of  the  air  in  this  country  is 
from  6  to  12  miles  per  hour  ;  but  it  varies,  of  course,  greatly  from  day  to 
day,  and  in  different  places.     The  mean  movement  at  Netley  (average  of 

1  Untersuch.  iiber  nat.  et  kiinstliche  Ventilation.     Gottingen,  1871. 


170  PRACTICAL    HYGIETs^E. 

13  years)  is  about  10^  miles  per  hour  ;  at  Aldershot  it  is  12|  iniles  per 
hour  (mean  of  5  years). 

(2)  A  much  more  serious  e^il  is  the  uncertainty  of  the  movement,  and 
the  difficulty  of  regidation.  "VMien  the  velocity  reaches  5  or  6  feet  per 
second,  unless  the  air  be  wann,  no  one  will  bear  it.  The  "wind  is  therefore 
excluded,  or,  if  aUowed  to  enter  du-ectly  through  small  openings,  is  badly 
disti-ibuted.  Passing  in  with  a  gi-eat  velocity,  it  forces  its  way  like  a 
foreign  body  through  the  air  in  the  room,  causing  di-aughts,  and  escajDing,  it 
may  be,  by  some  opening  without  proper  mixing.  A  current  entering  in 
this  way  may  be  measui-ed  for  many  feet. 

But  the  wind  acts  in  another  way.  A  moving  body  of  au*  sets  in  motion 
all  air  in  its  vicinity.  It  di'ives  air  before  it,  and,  at  the  same  time,  causes 
a  partial  vacuum  on  either  side  of  its  own  jDath,  toward  which  all  the  aii-  in 
the  vicinitv-  flows  at  angles  more  or  less  approaching  right  angles-.  In  this 
way  a  small  cun-ent  moving  at  a  high  velocity  will  set  in  motion  a  large 
body  of  air. 

The  wind,  therefore,  blowing  over  the  tops  of  chimneys,  causes  a  cur- 
rent at  right  angles  to  itself  up  the  chimney,  and  the  unequal  draught  in 
furnaces  is  owing,  in  part,  to  the  vaiiation  in  the  velocity  of  the  wind. 
Advantage,  therefore,  can  be  taken  of  this  aspirating  power  of  the  wind, 
to  cause  a  movement  of  aii'  up  a  tube.  The  wind,  however,  may  impede 
ventilation  by  obstmcting  the  exit  of  aii'  from  any  particular  opening,  or 
by  blowing  down  a  chimney  or  tube.  This  is,  in  fact,  one  reason  of  the 
failure  of  so  many  systems  of  ventilation  ;  they  may  work  well  in  a  still 
atmosphere,  but  the  immense  resistance  of  the  wind  has  not  been  taken 
into  account.  At  3  miles  an  hour-,  the  pressiu-e  of  the  wind  is  f  of  an  ounce 
on  each  square  foot  ;  it  is  1  ounce  at  3^  miles ;  2  ounces  at  5  miles  ;  4 
ounces  at  7  miles  ;  -h  lb  at  10  miles  ;  and  1  lb  at  14  miles.  At  Xetley  the 
average  2:)ressure  is  a  little  over  ^  lb  j^er  square  foot. 

In  some  systems  of  ventilation  the  pei-flating  power  of  the  wind  has 
been  used  as  the  chief  motive  agent.  In  Eg^pt  the  Mind  is  allowed  to 
blow  in  at  the  top  of  the  house  thi'ough  large  funnels.  This  plan  has  been 
in  use  from  time  immemorial  This  was  the  case  in  'Mx.  Sylvester's  plan, 
which  was  used  at  Derby  and  Leicester  fifty  or  sixty  years  ago.  A  large 
cowl,  tiu-ning  toward  the  wind,  was  pLaced  in  a  convenient  sjDot  near  the 
building  to  be  ventilated— a  little  above  the  ground  if  in  the  country,  or 
at  some  height  if  in  a  town.  The  wind  blowing  do"s^Ti  the  cowl,  j^assed 
thi'ough  an  under-gi'ound  channel  to  the  basement  of  the  house,  and 
entered  a  chamber  in  which  was  a  so-called  cockle-stove  or  calorifere  of 
metal  plates  or  water  or  steam  pipes,  by  which  the  air  was  warmed.  It 
then  ascended  through  tubes  into  the  rooms  above,  and  passed  out  by  a 
tube  or  tubes  in  the  roof,  which  were  covered  by  cowls  tiu-ning  from  the 
wind.  So  that  the  asj^ii-atory  power  of  the  aii'  was  also  used.  This  plan 
is  extremely  economical,  but  the  movement  of  the  air  is  unequal,  and  it  is 
difficult  to  regulate  it.  It  has  been  proposed  to  place  a  fan  in  the  tunnel 
to  move  the  aii-  in  periods  of  calm,  and  the  plan  then  becomes  identical  in 
principle,  and  almost  in  detail,  with  the  method  of  Yan  Hecke. 

Mr.  Ritchie  '  has  employed  a  similar  plan  in  the  ventilation  of  a  dwell- 
ing-house. The  air  is  wai'med  in  winter  to  about  70"  Fahr.  ;  every  room 
has  a  longitudinal  openiug  over  each  door,  concealed  by  the  architrave, 
and  regulated  by  valves,  and  through  this  the  warm  aii'  from  the  staircase 
enters  the  rooms,  and  then  passes  up  the  chimney,  and  up  outlet  au--flues 

'  Treatise  on  Ventilation,  by  Robert  Ritchie,  C.E.,  1862,  p.  89. 


VENTILATIOlsr.  171 

placed  in  the  walls,  commencing  at  the  ceiling,   and   ending  at  the  wail- 
heads  under  the  roof. 

Dr.  Arnott  ventilated  the  Field  Lane  Ragged  School  on  this  principle 
with  excellent  effect.  In  that  case,  as  in  aU  others,  the  movement  was  also 
in  part  carried  on  by  the  thh'd  cause  of  motion  in  air,  viz., 
the  effect  of  unequal  density  of  masses  of  air. 

In  the  ventilation  of  ships,  the  wind  is  constantly  used  ; 
and  by  windsails  and  tubes  with  cowls  turning  toward  the 
wind,  air  is  driven  between  the  decks  and  into  the  hold. 

In  using  the  wind  in  this  way,  the  difficulty  is  to  distri- 
bute the  air  so  that  it  shall  not  cause  draughts.  This  is 
best  done  by  bending  the  tubes  at  right  angles  two  or  three 
times,  so  as  to  lessen  the  velocity,  by  enlarging  the  channel 
toward  the  opening  in  the  interior  of  the  vessel,  and  by 
placing  valves  to  partially  close  the  tubes,  if  necessary,  and 
by  screens  of  wire  gauze.  ^ 

In  all  cases  in  which  the  air  of  a  room,  as  in  a  base- 
ment story,  or  in  the  hold  of  a  ship,  perhaps,  is  likely  to 
be  colder  than  the  external  air,  and  when  artificial  means  fig.  12.— nia^ 
of  ventilation  cannot  be  employed,  the  wind  should  be  upc'^stcowi!^^^ 
taken  advantage  of  as  motive  agent. 

The  aspiratory  power  of  the  wind  can  be  secui-ed  by  covering  air- 
shafts  with  cowls  such  as  that  shown  in  Fig.  12,  which  aid  up  currents  and 
prevent  down  di-aughts. 

3.    MOVEMENTS    PRODUCED    BY   UNEQUAL    WEIGHTS    OP    AIR. 

The  wind  itself  is  caused  by  this  power  ;  but  it  is  necessary,  in  discus- 
sing ventilation,  to  look  upon  this  as  if  it  were  an  independent  force.  If 
the  air  in  a  room  be  heated  by  fire,  or  the  presence  of  men  or  animals,  or 
be  made  moister,  it  endeavors  to  expand  ;  and  if  there  be  any  means  for  it 
to  escape,  a  portion  of  it  will  do  so,  and  that  which  remains  wiU  be  lighter 
than  an  equal  bulk  of  the  colder  aii-  outside.  The  outer  air  wiU  then  rush 
into  the  room  by  everj'  orifice,  until  the  equahty  of  weight  outside  and 
inside  is  re-estabHshed.  But  as  the  fresh  air  which  comes  in  is  in  its  turn 
heated,  the  movement  is  kept  uj)  in  a  constant  stream,  cold  air  entering  by 
one  set  of  orifices,  and  hot  air  escaping  by  another. 

We  have  now  to  inquire  how  the  rate  of  this  constant  stream  of  air  may 
be  calculated.^  The  mode  most  generally  used  is  based  on  two  well-known 
laws  : — first,  that  the  velocity  in  feet  per  second  of  falling  bodies  is  equal 
to  (nearly)  8  times  the  square  root  of  the  height  through  which  they  have 
fallen  ;  and,  second,  that  fluids  pass  through  an  orifice  in  a  partition  with 
a  velocity  equal  to  that  which  a  body  would  attain  in  faUing  through  a 
height  equal  to  the  difference  in  depth  of  the  fluid  on  the  two  sides  of  the 


'  As  the  use  of  perforated  zinc  plates  and  of  wire-gauze  is  very  common  in  ventila- 
tion, it  is  necessary  to  bear  in  mind  that  these  screens  very  soon  get  clogged  with  dirt. 
In  all  cases  they  should  be  so  arranged  as  to  be  easily  inspected  and  cleaned  ;  and  it 
should  be  a  matter  of  routine  duty  to  see  that  they  are  constantly  kept  clean.  It 
should  also  be  understood  that  the  delay  by  friction  through  the  fine  wire-gauze  is 
exceedingly  great. 

^  Many  of  these  points  are  given  in  Hood's  Treatise  on  Warming  and  Ventilation, 
and  in  Wolpert  (Principien  der  Vent,  und  Luftheizung),  and  a,re  also  discussed  in 
Peclet  (Traite  de  la  Chaleur,  third  edit.),  and  by  General  Morin  (Etudes  sur  la  Ventila- 
tion, Paris,  1863,  t.  ii.),  to  which  reference  is  made  for  those  who  wish  to  enter  mto 
the  mathematical  part  of  the  inquiry. 


172  PRACTICAL    HYGIENE. 

partition. '     The  press\ire  of  air  upon  any  surface  may  be  represented  by 

the  weight  of  a  cohimn  of  air  of  uniform  density  of  a  certain  height.     Thus 

the  pressure  of  the  atmosphere  at  the  surface  of  the  eiu'th  is  nearly  15  ft* 

on  the  square  inch,  and  this  would  be  the  weight  of  a  column  of  aii-  of 

about  5  miles  in  height.     Aii*,   therefore,   rushes  into  a  vacuum  with  a 

velocity  equal  to  that  which  a  hea\-y  body  would  acquire  in  falling  from  a 

height  of  5  miles,  ^iz.,  1,304:  feet  per  second.     But  if,  instead  of  rushing 

into  a  vacuum,  it  rush  into  a  chamber  in  which  the  air  has  less  pressiu-e 

than  outside,  its  velocity  vnR  be  that  due  to  a  height  which  represents  the 

difference  of  pressui'e  outside  and  inside.     In  ordinary  cases  this  difference 

of  pressure  cannot  be  obtained  by  dii-ect  observation,  but  must  be  inferred 

from  the  difference  of  temperature  of  the  outer  and  inner  aii".     Aii'  is  dilated 

one  part  in  491  of  its  volume  for  every  degree  of  Fahrenheit  (or  1  in  273 

for  every  degi'ee  of  centigrade)  that  its  temperature  is  raised,  consequently 

the  difference  of  pressui'e  outside  and  inside  will  be  as  follows : — 

The  height  from  the  aperture  at  which  air  enters  to  that  fi"om  which  it 

escapes,  multiplied  by  the  difference  of  temperature  between  outside  and 

inside,  and  divided  by  491. 

If  the  height  be  20  feet,  and  the  difference  of  temperature  15  degrees,  we 

20  X  15 
have  the  height  to  produce  velocity  of  inflowing  current  =     .„.. — =  0. 61  of 

a  foot,  and  the  velocity  =  8  V^=:8  x  .781  =  6.248.  This,  however,  is  the 
theoretical  velocity.  In  j)ractice  an  allowance  must  be  made  for  friction 
of  ^th,  id,  or  even  ^,  according  to  circumstances.  The  deduction  of  ifh 
would  leave  4.686  linear  feet  per  second  as  the  actual  velocity.  If  this  be 
multiplied  by  the  area  of  the  opening,  in  feet,  or  decimals  of  a  foot,"  the 
amount  of  air  is  expressed  in  cubic  feet  per  second,  and  multiplying  by  60 
will  give  the  amount  per  minute. 

A  table  is  given  at  page  194,  in  which  this  calculation  has  been  made 
for  all  probable  temperatures  and  heights  ;  but  it  must  be  remembered 
that  the  movement  is  greatly  influenced  by  the  wind. 

This  cause  of  movement  is,  of  course,  constantly  acting  when  the  tem- 
perature of  the  air  changes.  It  will  alone  suffice  to  ventilate  all  rooms  in 
which  the  air  is  hotter  than  the  external  air,  but  will  not  answer  when 
the  air  to  be  changed  is  equal  in  temperature  to,  or  colder  than,  the  exter- 
nal air. 

As  its  action  is  equable,  imperceptible,  and  continuous,  it  is  the  most 
useful  agency  in  natural  ventilation  in  cold  climates,  in  inhabited  and 
warm  rooms  ;  and  in  all  habitations  arrangements  should  be  made  to  allow 
it  to  act.  As  the  action  increases  with  the  difference  of  temperature,  it  is 
most  powerful  in  winter,  when  rooms  are  artificially  wanned,  and  is  least 
so,  or  is  quite  arrested  in  summer,  or  in  hot  climates,  when  the  internal 
and  external  temperatures  are  identical. 

4.    LOSSES    PRODUCED   BY   FRICTION    FROM   VARIOUS    CAUSES. 

This  aspect  of  the  question  has  hardly  received  the  attention  it  de- 
serves, and  its  neglect  is  apt  to  lead  to  failure  and  disappointment.  The 
chief  causes  of  loss  are  the  following : — 

'  Tliis  is  freqiaently  called  the  rule  of  Montgolfier.  The  formula  is  r  =y/2gli  ;  q 
beine  the  acceleration  of  velocity  in  each  second  of  time,  viz.,  32.18  feet,  and  H  the 
height  of  the  descent. 

-  It  will  be  found  alwavs  easier  to  take  the  area  in  decimals  of  a  foot  instead  of 
inches  ;  biat  if  it  be  taken  in  inches,  multiply  the  linear  discharge  by  the  number  of 
square  inches,  and  divide  by  144. 


VENTILATION.  1 73 

1.  Length  of  Tube  or  Shaft. — Here  with  equal  sectional  areas  the  loss 
is  directly  as  the  length,  so  that  if  "\ve  take  a  shaft  of  30  feet  as  a  standard, 
a  shaft  of  40  feet  long  "would  have  an  increased  friction  of  one-third. 

2.  Size  of  Opening. — For  similar  sections  the  fi'iction  is  inversely  as 
the  diameter.  Thus  for  two  openings,  respectively  1  and  2  feet  in  diame- 
ter, the  fiiction  at  the  smaller  opening  will  be  twice  that  of  the  larger. 
In  this  way  dividing  ujd  an  ojDening  into  a  number  of  smaller  openings, 
the  aggregate  of  which  is  equal  to  the  original  opening,  jiroduces  a  loss  by 
friction  in  the  direct  ratio  of  the  diameters.  An  opening  of  1  square  foot 
divided  into  four  openings  of  {-  of  a  square  foot  loses  in  the  ratio  of  1 : 
^,  being  respectively  the  diameters  of  the  openings.  "When  the  shapes  of 
the  openings  are  noL  similar,  the  ratio  may  be  stated  as  that  of  the  square 
roots  of  the  areas.  Thus  1  square  foot  divided  into  nine  openings,  each 
equal  to  \  of  a  square  foot,  will  lose  in  the  ratio  of  1 :  ^,  the  square  roots 
of  the  respective  areas.' 

3.  Shape  of  Opening. — A  circular  opening  may  be  taken  as  the  stand- 
ard, that  being  the  figTU'e  which  includes  the  greatest  area  within  the 
smallest  periphery.  The  loss  sustained  from  any  other  shape  being  used 
will  be  proportionate  to  its  difference  from  a  circle  enclosing  a  similar 
area.  Thus,  if  we  have  two  openings,  each  of  1  square  foot  area,  the  one 
being  a  cii'cle  and  the  other  a  square,  the  length  of  periphery  of  the  latter 
will  be  4  square  feet,  of  the  former  3-J- ;  therefore  the  velocity  of  the  cur- 
rent through  the  square  opening  will  be  -\^  or  -^-  of  that  through  the  cir- 
cular opening.^ 

4.  Angles  in  the  Tube  or  Shaft. — This  is  a  most  serious  cause  of  loss. 
The  exact  formida  has  not  been  distinctly  determined,  but  it  may  be 
accepted,  as  in  accordance  with  experiment,  that  every  right  angle  dimin- 
ishes the  current  by  one-half,  so  that  two  right  angles  in  a  tube  would  re- 
duce it  to  4-,  and  so  on.^  Yet  it  is  no  uncommon  thing  to  find  tubes  and 
shafts  bent  recklessly  at  numerous  angles  to  fit  a  cornice  or  architrave,  to 
save  expense  and  appearance. 

5.  The  presence  of  dust,  soot,  or  dirt  of  any  kind  seriously  interferes 
with  the  current,  but  this  may  of  course  be  obviated  with  a  moderate 
amount  of  care  and  attention. 

It  is  obvious  that  attention  to  the  above  points  is  necessary  to  obtain 
success  in  any  scheme  of  ventilation.  To  take  an  examj^le  ;  let  us  sup- 
pose a  straight  shaft  30  feet  long,  sectional  area  circular,  of  1  square  foot, 
— the  current  through  this  giving  a  sufficient  amount  of  air  for  the  pur- 
pose required.  Let  it  be  necessary  to  produce  a  similar  amount  of  ven- 
tilation in  another  place,  but  to  use  smaller  shafts,  square  in  section,  area 
of  each  ^  of  a  square  foot, — each  shaft  being  40  feet  long,  and  having  one 
right  angle  in  its  coui'se  ;  what  would  be  the  relative  amoimts  of  air 
available,  other  things  being  equal  ?  Taking  the  circular  shaft,  we  have 
length  of  shaft  30,  length  of  periphery  Sh,  total  331  =  friction.  In  the 
four  smaller  shafts  we  have  length  40,  length  of  periphery  of  each  2,  which 
multiplied  by  4  =  8,  total  48 :  the  right  angle  doubles  the  friction,  so  that 

^  See  General  Morin's  Observations. 

-  For  a  table  of  friction  due  to  form  of  sectional  area,  see  "  Hygiene,"  in  Sanitary 
Record,  1875,  by  Dr.  F.  de  Chaiimont. 

^  The  formula  expresses  tbe  condition  approximately  between  0°  and  90'; 

1  -h  sin-5 

but  1  -{-  cos  e    .g  of  more  general  application,  including  any  angle  between  0'  and  180". 
In  either  case  90°  shows  a  loss  of  one-Tudf. 


174  PRACTICAL    HYGIENE. 

48  X  2  =  96  as  compared  to  33^.  Thus  the  result  would  be  nearly  as  3 
to  1  in  favor  of  the  single  shaft.  It  would  be  obviously  necessary  to 
treble  either  the  number  of  the  smaller  shafts  or  the  size  of  each  of  them. 

It  is  advisable  generally  to  widen  shghtly  the  openings  of  shafts,  es- 
pecially if  they  ai-e  of  small  diameter,  as  the  evu-reut  tends  to  be  contracted 
and  obstructed  at  that  point.  At  every  change  of  dii'ection  the  same  thing- 
takes  place.  Hence  the  desirability  of  rounding  off  angles  as  much  as 
possible,  where  they  cannot  be  altogether  avoided. ' 

It  is  generally  best  to  have  the  sections  of  shafts  circular  or  elliptical 
instead  of  rectangular,  for  not  only  is  there  less  loss  by  friction  originally, 
but  there  is  less  chance  of  lodgement  of  dust,  etc.,  and  they  can  be  more 
easily  and  thoroughly  cleaned. 

5.  PEACTICAI,  APPLICATION  OF  THE  GENERAL  STATEMENTS  OF  NATURAL 
VENTILATION." 

1.  No  particular  arrangements  are  necessary  to  allow  diffusion  to  act, 
except  that  there  shall  be  communication  between  two  atmospheres. 

2.  To  obtain  the  perflation  of  the  wind,  windows  should  be  placed,  in  all 
cases  Avhere  it  can  be  managed,  at  opposite  sides  of  a  room.  The  windows 
should  open  at  the  top,  and  in  case  the  wind  has  a  high  velocity,  means 
should  be  taken  to  distribute  it.  This  can  be  done  by  sloping  the  window 
inward  when  it  opens,  or  a  board  may  be  placed  obliquely  upward  from 
the  top  sash  of  the  window,  when  it  opens  in  the  usual  way  ;  then  the  air 
striking  against  the  board  is  thrown  up  toward  the  ceiling.  Or,  wu-e-gauze 
may  cover  the  space  left  when  the  window  is  open.  The  velocity  of  the 
Avind  is  checked  by  the  gauze,  and  the  current  is  minutely  divided.  The 
gauze,  however,  must  be  kept  clean. 

Various  plans  have  been  proposed  by  different  persoos.  The  panes  of 
glass  may  be  made  double,  spaces  being  left  at  the  bottom  of  the  outside 
pane  and  at  the  top  of  the  inner  one,  so  that  the  wind  is  obliged  to  pass 
up  between  the  two  panes  before  it  enters  the  room.  Or,  the  lower  sash 
being  raised,  and  a  piece  of  wood  placed  below  it,  the  air  is  allowed  to 
pass  through  the  space  left  between  the  upper  and  lower  sashes  (Hinekes 
Bird).  Or,  glass  louvres,  which  can  be  more  or  less  closed,  are  placed  in 
one  of  the  j^anes  of  the  window ;  or  a  number  of  holes  are  obliquely 
bored  thi'ough  the  panes,  through  which  the  air  may  pass  up  toward 
the  ceiling  before  it  intermixes  with  the  air  of  the  room.  In  Lockhead's 
ventilator  there  is  a  frame  over  the  glass  Iou-stc,  with  a  regulator  in  the 
centre.  In  Cooper's  ventilator  a  movable  plate  of  glass  can  be  brought  by 
a  movable  handle  over  the  opening. 

StaUard  has  proposed  to  ventilate  workshops  and  factories  by  having  a 
double  ceiling  ;  the  lower  ceiling  is  to  be  made  of  zinc  or  oiled  paper,  per- 
forated with  very  numerous  srnaU  holes ;  and  the  space  between  the  two 
ceilings  is  to  be  fi'eely  open  to  the  air  on  all  sides  ;  thus  there  would  be 
almost  open-air  breathing,  as  the  communication  with  the  external  air 
would  be  constant  and  at  all  parts  of  the  room. 

Besides  windows,  special  openings  may  be  provided  for  the  wind  to 

'  On  this  question  see  Wolpert,  Theorie  u.  Praxis  der  Ventilation  u.  Heizung  (1879), 
p.  210  et  seq. 

"  A  very  good  account  of  the  various  plans  in  natural  ventilation  will  be  found  in 
Mr.  Edward's  work,  On  the  Ventilation  of  Dwelling-Houses,  1868,  in  which  figures  of 
the  plans  are  given;  see  also  Eassie,  "  Dictionary  of  Sanitary  Appliances, "  Sanitary 
Kecord,  1880-8i. 


VENTTLATIOI^f.  175 

blow  through,  as  in  the  plans  ali*eacly  referred  to  of  Stir.  Sylvester  and  Dr. 
Arnott. 

In  all  warm  chmates,  where  no  chill  can  be  produced  by  wind,  it  is  a 
good  plan  to  make  the  walls  entii-ely  pervious.  Nothing  can  be  better  than 
the  ventilation  of  the  bamboo  matted  houses  in  Burmah.  The  wind  blows 
through  them,  but  it  is  so  broken  up  into  cun-ents  that  it  is  not  in  the  least 
unpleasant.  Even  in  colder  parts  of  India,  the  upper  pai-ts  of  the  walls 
might  be  made  thus  pervious,  provision  being  made  to  cover  them,  if 
necessary,  in  the  cold  season. 

Cowls  have  been  a  good  deal  recommended  as  aids  to  ventilation,  but 
the  labors  of  the  Committee  of  the  Sanitaiy  Institute  of  Great  Britain, 
though  not  yet  completed,  have  shown  that  the  majority  of  them  have  no 
superiority  over  the  open  tube.  The  only  form  which  seemed 
faii'ly  good  was  the  common  lobster-backed  cowl.  For  general 
use,  however,  this  would  requii-e  to  revolve,  and  this  is  objec- 
tionable, as  all  revohing  an'angements  are  hable  to  get  out  of 
order.  A  fixed  cowl,  consisting  merely  of  a  cone  as  a  cap  and  a 
similar  flange  roimd  the  rim  of  the  pipe,  insures  a  fairly  con- 
stant up  draught  (Fig.  12),  A  reversed  arrangement  (Fig.  13) 
insures  a  constant  down  draught. 

Another  plan  for  utilizing  the  action  of  the  wind  is  by  the 
use  of  "  Ellison's  conical  bricks,"  which  are  pierced  with  conical 
holes,  about  ^\  of  an  inch  diameter  externally  and  1^  in.  inter- 
nally, depth  4^  in.  The  wind  blomng  on  them  is  so  distributed 
as  to  be  imj^erceptible  as  a  draught  in  the  room.  ^>,g  -^g  _jjj_ 

3.  The  movement  produced  by  the  difference  of  weight  of  agram  of  a 
unequally  heated  bodies  of  air  will,  of  coiarse,  go  on  thi'ough  ct/.sz  tube, 
open  windows  and  doors  and  through  all  the  contrivances  just  ^^ith  trumpet 

•  TT-.  •  TTT  -T  T    -I  mouthandin- 

mentioned.  But  as  m  cold  chmates  "onndows  and  doors  must  verted  coni- 
sometimesbeshut,  no  room  of  any  kind  should  be  ^rithout  addi-  ^'^^'^^p- 
tional  openings,  which  may  permit  this  movement  h'om  uneqaal  tempera- 
tiu'e  to  go  on.  The  great  difficulty  here  is  to  exclude  the  action  of  the 
wind ;  and,  in  fact,  it  is  impossible  to  do  so  ;  but,  as  far  as  possible,  the 
openings  should  be  protected  from  the  perflating  influence  of  the  wind,  so 
that  only  its  aspii-ating  force  should  be  acting.  They  should  be  capable  of 
being  lessened  in  size,  when  the  difference  of  the  external  and  internal 
temjoeratures  is  gxeat.  As  long  as  there  are  openings,  movement  will  go 
on  ;  and  it  does  not  really  matter,  as  long  as  there  is  proper  distribution, 
where  the  air  comes  in  or  goes  out,  or  whether  its  direction  is  constant.  In 
fact,  it  scarcely  ever  is  constant,  so  liable  is  the  direction  to  be  altered  by 
winds,  by  the  action  of  the  srm  heating  one  side  of  a  room,  by  the  une- 
qual distribution  of  heat  in  the  room,  etc.  Still  it  seems  desirable,  as  far 
as  it  can  be  done,  to  make  such  arrangements  as  shall  give  the  movement 
of  air  a  certain  dii-ection ;  and  therefore,  in  most  systems,  some  of  the 
openings  are  intended  for  the  admission  of  fresh  air,  and  are  called  inlet, 
entrance,  or  adduction  openings ;  others  are  intended  for  the  discharge  of 
impure  au- — and  are  termed  outlet,  exit,  or  abduction  openings. 

Total  size  of  all  the  Special  Openings,  ichether  intended  for  Inlets  or  Outlets. 
— As  the  movement  of  air  increases  with  temperature,  the  size  of  the  aper- 
tures can  only  be  fixed  for  a  certain  given  temperature ;  and  as  the  efflux  of 
hot  air  increases  with  the  height  of  the  column  (supposing  the  tempera- 
ture is  equal  thi'oughout),  a  difterent  size  has  also  to  be  fixed  for  diiferent 
heights. 

This  causes  a  clifficvdty  in  fi:xiag  the  proper  size  for  ventHatiag  openings 


176  PRACTICAL    HYGIENE. 

in  the  case  of  natural  ventilation,  as  the  conditions  are  so  variable.  The 
theoretical  size  for  any  requu'ed  change  of  au-,  supposing  the  conditions 
were  constant,  may  be  obtained  from  the  table  at  page  194,  which  is  cal- 
culated from  Montgolfier  s  formula,  with  a  deduction  of  ^th  for  friction. 

Thus,  say  that  the  height  of  the  heated  column  is  20  feet,  and  the  dif- 
ference of  temperature  between  the  air  in  the  room  and  that  outside  is  20° 
F.,  the  huear  rate  of  discharge  as  stated  by  the  table  (allowance  being  made 
for  friction)  is  322  feet  jDer  minute,  or  19,320  feetj^er  hour.  If  the  opening 
were  1  square  foot  this  would  give  19,320  cubic  feet  per  hour.  But  if 
3,000  cubic  feet  per  hour  are  wanted  for  one  person,  the  orifice  of  1  square 
foot,  or  144  square  inches,  is  too  large,  and  must  be  lessened  in  the  propor- 

3000  X 144 
tiou  of  3,000  to  19,320      ^,.  .j^-,,.     =  22  square  mches   (round  numbers), 

i.e.,  reduced  to  22  square  inches.  There  must  be  a  corresponding  space 
for  entry,  making  the  total  ventilating  oj)ening  44  square  inches. 

To  take  another  example  ;  let  us  say  the  heated  column  is  15  feet,  the 
difference  of  temperature  10°  F.,  and  the  required  suj)ply  for  one  person 
2,000'cubic  feet.  The  table  gives  the  hnear  rate  as  197  feet  per  minute,  or 
11,820  per  hour  ;  an  orifice  of  144  square  inches  would  then  give  11,820, 

/2,000  X  144  \ 

and  an  orifice  of  24  square  inches  would  give  2,000  ;  I — Ji  uon —  —  ^^j- 

But  if  in  the  above  conditions  3,000  cubic  feet  hourly  supply  were  wanted, 
the  Oldening  must  be  36  square  inches.  These  examples  show  how  impos- 
sible it  is  to  fix  any  size  which  shaU  meet  all  conditions,  even  if  the  influence 
of  v.dnd  could  be  completely  excluded,  which  is  impossible.  The  only  way 
is  to  adojDt  a  size  which  will  meet  most  cases,  and  suj)ply  means  of  altering 
the  size  according  to  circumstances.  In  this  country,  a  size  of  24  square 
inches  per  head  for  inlet,  and  the  same  for  outlet,  seems  calculated  to  meet 
common  conditions  ;  but  arrangements  should  be  made  for  enabling  this 
to  be  lessened  or  closed  in  very  cold  weather,  or  if  the  influence  of  strong- 
winds  is  too  much  felt.'     Moreover,  the  size  must  be  in  part  deiDcndent  on 

"  The  following  formula  proposed  by  Dr.  de  Chaumont  can  be  used  instead  of  the 
table  at  page  194.  It  is  based  on  Montgolfier's  formula,  with  the  discharge  calculated 
for  the  hour  and  for  square  inches,  instead  of  for  the  minute  and  the  linear  discharge, 
as  in  the  table. 

Let  h  be  the  height  of  the  heated  column  of  air  ;  t  its  temperature  ;  t'  the  tempera- 
ture of  the  external  air;  .002  the  ratio  of  expansion  of  air  for  each  degree  of  Fahr. ; 
100  a  constant ;  and  /'the  coefficient  of  friction.  Let  D  be  the  delivery  required  per 
hour,  and  *  the  total  inlet  and  outlet  area  in  square  inches.     Then  to  find  *  : 

D 

100/(v//t{<  -  t'y+^2)  ~ 
Example  :   Suppose,  as  in  the  text,  that  the  heated  column  be  20  feet,  its  mean  tem- 
perature 65°,  and  that  of  the  outer  air  45"',  and  the  required  delivery  be  3,000  cubic  feet 
per  hour  ;  let/ also  equal  |  or  .75. 

3000 

: =44.4 

100  X  .75  (y  20(65'  -  45'^  x  .002) 

square  inches  for  inlet  or  outlet,  or  22.2  for  inlet  alone. 

A  converse  formula  by  Dr.  de  Chaumont  may  be  also  useful.  If  the  area  of  the 
inlet  opening  (*')  is  known,  to  find  the  delivery  per  hour  under  conditions  h,  t,  and  t . 

200/ (v/  /r(<  -  t)    xT002)  *'=  D. 
The  constant  200  is  obtained  by  multiplying  3,600  (seconds  per  hour)  by  twice  the 
square  root  of  16.09  (=  8  nearly),  and  dividing  by  144  square  inches.     By  halving  this 
constant  we  get  the  number  for  both  inlet  and  outlet  together. 


VENTILATION".  177 

the  size  of  the  room,  because  in  a  small  room  with  many  people  it  is  im- 
possible to  have  the  size  so  great  as  it  wotild.  be  if  each  person's  area  of 
ventilation  opening  were  48  squai-e  inches,  unless  some  portion  of  the  ah: 
were  warmed. 

Belative  Size  of  the  Inlets  and  Outlets. — It  is  commonly  stated  that,  as  the 
heated  air  exj)ands,  the  outlets  should  be  larger  than  the  inlets,  and  the 
great  disproportions  of  5  to  4  and  10  to  9  have  been  given.  As,  however, 
the  average  difference  of  temperature  is  only  about  10"  to  15^  Fahi-.  in  this 
country,  the  dispro2:)ortion  is  much  too  gTeat,  as  a  cubic  foot  of  an*  only 
expands  to  1.020361  cubic  foot  with  an  increase  of  10^.  Even  if  the  differ- 
ence is  3U°  Fahi'.,  a  cubic  foot  of  au-  only  becomes  1.061  cubic  foot,  which 
is  equal  to  an  increase'  of  about  jyth.  The  difference  is  so  shght  that  it 
may  be  neglected,  and  the  inlets  and  outlets  can  be  made  of  the  same  size. 

It  is  desii-able  to  make  each  individual  inlet  opening  not  larger  than  48 
to  60  square  inches  in  area,  or  enough  for  two  or  thi'ee  persons  ;  and  to 
make  the  outlet  not  more  than  1  square  foot,  or  enough  for  six  persons. 
Distribution  is  more  certain  with  these  small  openings. 

Position  and  Description  of  the  Inlet  and  Outlet  Tubes. — 1.  Inlets. — The 
air  must  be  taken  from  a  j)ure  source,  and  there  must  be  no  chance  of  any 
effluvia  passing  in.  As  a  iiile,  the  inlet  tubes  should  be  short,  and  so  made 
as  to  be  easily  cleaned,  other-^ise  dii-t  lodges,  and  the  au'  becomes  imj)iu'e. 
Inlets  should  not  be  lai'ge  and  single,  but  rather  numerous  and  small  (from 
48  to  60  inches  superfcial),  so  that  the  air  may  be  properly  distributed. 
They  should  be  conical  or  tramjDet-shaped  where  they  enter  the  room,  as 
the  entering  an*,  after  perhaps  a  slight  contraction,  spreads  out  fan-hke,  and 
a  slight  back  curi'ent  from  the  room  down  the  sides  of  the  funnel  facihtates 
the  mixing  of  the  entering  air  with  that  of  the  room.  To  lessen  the  risk 
of  immediate  down-draught  they  should  tui-n  upward,  if  they  ai'e  placed 
above  the  heads  of  the  persons.  Externally  the  inlets  should  be  partly 
protected  from  the  wind  ;  otherwise  the  wind  blows  through  them  too 
rapidly,  and,  if  the  current  be  strong,  draughts  are  felt ;  an  overhanging 
shelf  or  hood  outside  wiU  answer  pretty  well.  Valves  must  be  provided  to 
partially  close  the  openings  if  the  wind  blows  in  too  strongly,  or  if  the 
change  of  air  is  too  rapid  in  cold  weather.  If  covered  with  whe-gauze,  it 
must  be  frequently  cleaned. 

Sometimes  an  inlet  tube  must  be  can-ied  some  distance  to  an  inner 
room,  or  to  the  opposite  side  of  a  lai-ge  room  which  is  unprovided  with 
cross-ventilation.  In  this  case  the  heat  of  the  room  so  warms  the  tube  that 
the  wind  may  be  permitted  to  blow  thi'ough  it. 

The  j)osition  of  the  inlets  is  a  matter  of  some  difficulty.  If  there  are 
several,  they  should  be,  of  course,  equally  distributed  through  the  room, 
so  as  to  insure  proper  mixing  of  the  air.  They  should  not,  however,  be 
placed  too  near  an  outlet,  or  the  fi-esh  air  may  at  once  escape  ;  theoretically, 
their  proper  place  of  entrance  is  at  the  bottom  of  the  room,  but  if  so,  the 
air  must  in  this  climate  be  warmed  ;  no  person  can  bear  the  cold  ah*  flow- 
ing to  and  chilling  the  feet.  The  au-  can  be  warmed  easily  in  various  ways, 
viz. : — 

{a)  The  air  may  pass  through  boxes  containing  coils  of  hot- water  j)ipes, 
or  (in  factories)  of  steam  pipes.  This  is  the  best  mode  of  wai'ming.  The 
coils  may  be  close  to  the  outside  wall,  or  in  the  centre,  or  in  hospitals  in 
boxes  under  the  beds  communicating  with  the  exterior  au-,  and  opening 
into  the  ward. 

(6)  The  au'  may  pass  into  air-chambers  behind  or  round  grates  and 
stoves,  and  be  there  wai-med,  as  in  the  present  baiTack  and  hospital  grate. 
Vol.  I.— 13 


ITS  PRACTICAL    HYGIENE. 

contrived  by  Captain  Galton  ;  or  as  in  the  Meissner  or  Bohm  stoves  of 
Germam- ; '  or  as  in  the  terra-cotta  stove,  in  the  Herbei-t  Hospital  at  Wool- 
wich. 

(c)  The  ail-  may  be  -n-armed  in  a  tube  passing  through  the  stove,  as  in 
Georges  calorigen,  or  by  the  method  of  Bond's  euthermic  stove. 

If  the  au"  cannot  be  warmed,  it  must  not  be  admitted  at  the  bottom  of 
the  room  ;  it  must  be  let  in  above,  about  9  or  10  feet  from  the  floor,  and 
be  dii-ected  toward  the  ceHing,  so  that  it  may  pass  up  and  then  fall  and  mix 
gi-adually  -n-ith  the  aii*  of  the  room.  The  13aiTack  Commissioners  have 
adopted  this  plan  with  half  the  fresh  ah-  brought  into  a  baiTack-room. 
The  other  half  is  wanned.     It  answers  fairly  well. 

In  towns  or  mauufactimng  districts  the  air  is  so  loaded  with  particlec 
of  coal,  or,  it  may  be,  other  jDOwders,  that  it  must  be  filtered.  Nothing 
answers  better  for  this  than  mushn  or  thin  porous  flannel,  or  paperhangers' 
canvas,  spread  over  the  ojjeniug,  which  then  should  be  made  larger.  This 
covering  can  be  moistened  if  the  incoming  air  be  too  dry. 

The  tubes  proposed  by  ]\Ii'.  Tobin,  of  Leeds,  proride  for  the  introduction 
of  ail'  from  the  outside  at  the  floor  level  and  then  up  a  vertical  tube,  about 
4  feet  in  height ;  this  gives  a  vertical  du-ection  to  the  cuiTent,  which  is  re- 
tained for  several  feet  further  before  it  begins  to  spread  and  descend.  The 
action  of  such  a  tube  is,  of  course,  much  affected  by  the  dii'ection  of  the 
Mind,  and  in  some  instances  it  is  reversed  altogether.  The  method  is, 
however,  useful  in  some  cases,  2:>articularly  for  introducing  aii*  into  places 
which  could  only  be  reached  ^ith  difficulty  by  otlier  means.  It  has  been 
tried  on  a  large  scale  at  St.  Mary's  Hospital,  Paddington,  with  fair  success.^ 
In  some  fonns  (as  made  by  the  Sanitary  Engineering  Company),  there  is 
an  arrangement  for  washing  the  air  and  arresting  impiuities.  An  ingen- 
ious contrivance  for  warming  the  aii*  for  the  upright  tube  by  means  of  a 
gas-jet  has  been  suggested  by  ]\Ir.  Lawson  Tait  ;  it  also  provides  an  outlet 
for  foul  au-.  A  modification  for  bedrooms  and  other  rooms  in  private 
houses  is  also  recommended  by  IMi*.  Tobin,  -viz.,  to  cut  out  slits  be- 
tween the  sashes  of  the  windows,  so  that  the  air  enters  vertically,  even 
when  the  window  is  shut.  This  is  similar  in  piinciple  to  other  modifica- 
tions of  window  ventilation  ah-eady  refeiTed  to,  but  it  is  only  adapted  for 
compai-atively  small  rooms,  and  is  quite  inapj)licable  to  a  hosjiital  ward  or 
the  like. 

2.  Outlets. — The  place  for  the  outlets  is  a  most  important  consideration, 
as  it  wiU  determine  in  gi-eat  measure  the  position  of  the  inlets.  If  there 
are  no  means  of  heating  the  air  passing  through  them,  they  should  be  at 
the  tojD  of  the  room  ;  if  there  are  means  of  heating  them,  they  may  be  at 
any  point.  If  not  artificially  warmed,  the  highest  outlet  tube  is  usually  the 
point  of  gi-eatest  discharge,  and  sometimes  the  only  one. 

(a)  Outlet  Tubes  uithout  Artificial  Heat. — They  should  be  placed  at  the 
highest  point  of  the  room  ;  should  be  inclosed  as  far  as  possible  within 
walls  so  as  to  jorevent  the  air  being  cooled  ;  should  be  straight  and  with- 
perfecth'  smooth  internal  surfaces,  so  that  friction  may  be  reduced  to  a 
minimum.  In  shape  they  may  be  round  or  square,  and  they  may  be 
covered  above  with  some  appai-atus  which  may  aid  the  asjDirating  power  of 
the  wind,  and  prevent  the  passage  of  rain  into  the  shaft. 

The  causes  of  down-draught  and  down-gusts  in  outlet  tubes  are  these  : 

'  The  Germans  appear  to  be  now  making  great  use  of  these  ventilating  stoves  in 
hospitals,  and  even  in  private  houses.  For  a  good  account,  see  Roth  and  Lex,  loc.  cit., 
p.  248  et  seq. 

-*  See  Dr.  de  Chaumont's  Report,  op.  cit. 


VENTILATIOlSr.  179 

the  Tvind  forces  down  tlie  air,  rain  gets  in,  and,  by  evaporation,  so  cools 
the  air  that  it  becomes  heavier  than  the  air  in  the  room  ;  or  the  air  be- 
comes too  much  cooled  by  passage  through  an  exposed  tube,  so  that 
it  cannot  overcome  the  weight  of  the  superincumbent  atmosphere  ;  or 
another  outlet  shaft,  with  greater  discharge,  reverses  the  current. 

Arrangements  should  be  made  to  distribute  the  down-draught,  if  it  oc- 
curs ;  flanges  placed  at  some  httle  distance  below,  so  as  to  tlu'ow  the  air 
upward  again  before  it  mixes  with  the  air  of  the  room,  or  simple  contriv- 
ances of  a  similar  kind,  may  be  used.  Valves  should  be  also  fixed  to  lessen 
the  area  of  the  outlet  when  necessary.  If  there  are  several  outlet  tubes  in 
a  room,  all  should  commence  at  the  same  distance  from  the  floor,  be  of  the 
same  height  (or  the  discharge  will  be  unequal),  and  have  the  same  expos- 
ure to  sun  and  wind. 

Simple  ridge  openings  may  be  used  in  one-storied  buUdings  with  slant- 
ing roofs  ;  they  ventilate  most  thoroughly,  but  snow  sometimes  diifts  in. 
Rain  may  be  prevented  entering  by  carrj-ing  down  the  sides  of  the  over- 
hanging ridge  for  some  httle  distance.  A  flange  j)laced  some  little  distance 
below  will  throw  any  down-draught  toward  the  walls. 

(6)  Outlets  with  Artificial  Warmth. — The  dischai'ge  of  outlets  is  much 
more  certain  and  constant  if  the  air  can  be  warmed.  The  chimney  with 
open  fii-e  is  an  excellent  outlet — so  good  that  in  dwelling-houses,  if  there 
are  proper  inlets,  no  other  outlet  need  be  made,  except  when  gas  is  used. 
When  rooms  are  large,  and  more  crowded,  other  outlets  are  necessaiy  ; 
the  heat  of  the  fire  may  be  further  utilized  by  shafts  round  the  chimney, 
opening  at  the  top  of  the  room,  or,  in  other  words,  by  sruTOunding  the 
smoke-flue  with  foul-au*  shafts. 

Gas,  if  used,  should  in  all  cases  be  made  to  warm  an  outlet  tube,  both 
to  caiTy  off  the  products  of  combustion,  and  to  utilize  its  heat.  The  best 
an-angement  appears  to  be  to  place  over  the  gas-jet  a  pipe  to  caiTy  off  the 
products  of  combustion,  and  to  case  the  pipe  itseh  with  a  tube,  the  open- 
ing of  which  is  at  the  ceihng  ;  the  tube  carrying  off  the  gas  products  is  hot 
enough  to  cause  a  very  considerable  cbaught  in  its  casing,  and  thus  two 
outlet  cuiTents  are  in  action,  one  over  the  gas,  and  one  from  the  cehing 
round  the  gas-tube.  A  modification  of  the  lamp  proposed  in  1846  by  ]Mr. 
Eutter  answers  very  well,  and  is  in  use,  as  arranged  by  Mr.  Eicketts.  A 
good  form  is  also  made  by  Messrs.  Sugg. 

In  various  other  ways  the  heat  of  fire  and  lights  may  be  taken  advan- 
tage of. 

There  will  seldom  be  any  difficulty  in  arranging  the  inlets  and  outlets, 
and  in  obtaining  a  satisfactory'  result,  if  these  principles  are  borne  in  miad, 
viz.,  to  have  the  fresh  air  pui-e,  to  distribute  it  properly,  and  to  adopt 
everj'  means  of  securing  the  outlets  fi'om  cold  or  of  artificially  waiTaing 
them,  and  of  distributing  the  air,  which,  in  spite  af  all  precautions,  wUl 
occasionally  jDass  down  them. 

In  hot  climates,  when  outlet  shafts  are  run  up  above  the  general  level 
of  the  building,  it  would  be  of  advantage  to  make  them  of  biick  work,  and 
to  color  them  black,  so  that  they  may  absorb  and  retain  heat. 

6.    PLANS    OF    TUBES    iJNTD    SHAFTS    WHICH   HAVE   BEEN   PROPOSED. 

In  most  of  the  j^lans  which  have  been  proposed,  the  inventors  have  not 
distinctly  seen  that  the  influence  of  the  ^inds  and  of  the  movement  of  air 
produced  by  unequal  temperatui-es  must  be  carefully  distingviished,  and, 
as  far  as  can  be  done,  provided  for. 


180 


PRACTICAL    HYGIENE. 


jy:5£2OTH3aii 


\ 


1.  openings  at  once  to  the  Outer  Air  for  Inlets,  the  Chimney  being  relied 

on  for  the  Outlets  or  Special  Tabes  fixed  in. — Perforated  or  air  bricks  are 

let  into  the  walls.     A  usual  size  is  9  x  3  inches,  and  the  united  area  of  all 

the  several  openings  in  one  brick  is  about  11^  square  inches.     Another 

common  size  is  10x6  inches,  with  an  oj)eu  area  of 

about  24  square  inches.     The  Avind  blows  freely 

through  them,  and  draughts  are  produced. 

The  Sheringham  valve  is  a  great  improvement 
on  this  :  the  air  passes  through  a  perforated  brick 
or  iron  jilate,  and  is  then  directed  upward  by  a 
valve  ojDening,  which  can  be  closed,  if  necessary, 
PiQ  14  by  a  balanced  weight  (Fig.  14).     The  size  of  the 

internal  oj^ening  is,  in  the  usual  sized  valve,  9 
inches  by  3,  and  the  area  is  27  inches.  These  valves  are  usually  placed 
toward  the  upper  part  of  the  room.  The  wind  blows  through  them,  and 
the  movement  is  therefore  variable.  They  are  often  outlets  ;  it  will,  in 
fact,  depend  upon  circumstances  whether  they  are  inlets  or  outlets.  Very 
little  draught  is,  however,  caused  by  them,  unless  with  a  high  wind ;  on 
the  whole,  they  are  the  best  inlets  of  this  kind. 

An  oj)en  iron  frame  of  the  size  of  a  brick  covered  with  perforated  zinc, 
and  with  a  valve  to  close  it,  if  necessary,  is  a  still  simpler  j:)lan,  and  the  air 
is  pretty  well  distributed.     The  gauze  should  be  cleaned  frequently.     Mr. 

Boyle,  of  Ijondon,  uses  a  round  plate  woi'king 
on  a  screw,  which  can  be  brought  nearer  or 
farther  from  a  corresponding  opening  in  the 
wall ;  the  air  entering  strikes  on  the  plate,  and 
then  spreads  circularly  over  the  wall,  and  is 
then  drawn  gently  into  the  room.  Some  in- 
genious forms  of  inlet  and  outlet  have  also  been 
introduced  by  Mr.  Richard  Weaver,  C.E.,  and 
by  Messrs.  Ellison,  of  Leeds. 

2.  Tubes  of  Different  Kinds. — A  single  tube 
has  been  sometimes  used  for  inlet  and  outlet,  a 
double  current  being  established.  This  is,  how- 
ever, a  rude  plan,  as  there  are  no  means  of  dis- 
tributing the  air,  and  as  the  intermingling  of 
Fio.  15.  the  ciuTent  and  the  friction  of  the  meeting  air 

is  sometimes  so  great  as  to  impede,  or  even  for 
a  time  stop,  the  movement. '  To  avoid  these  inconveniences,  Watson  pro- 
posed to  place  a  partition  in  the  tube  (Fig.  15),  and  Muir  suggested  the 
use  of  a  double  partition  running  from  corner  to  x;orner,  so  as  to  make 
four  tubes.  He  covered  his  divided  tube  Avith  a  lou\Te  so  as  to  make  use 
in  some  degree  of  the  aspiratory  jjower  of  the  wind  on  one  side. 

In  these  tubes,  accidental  circumstances,  such  as  the  sun's  rays  on  one 
side,  the  wind,  the  fire  in  tlie  room,  etc.,  will  determine  which  is  outlet  and 
which  is  inlet.  They  are  so  far  better  than  the  single  tube,  that  the  partition 
divides  the  currents  and  prevents  friction,  but  there  is  the  same  irregular 
action  and  changing  of  currents  from  accidental  circumstances,  so  that  the 

. ^ : ■■ -\ 

'  The  model  ofWatson's  ventilating  tube  is  well  adapted  for  showing'how  opposing 
currents  of  air  block  each  other.  Although  the  tube  is  of  good  size,' a  candle  placed 
in  a  bell  glass,  into  the  top  of  which  the  tube  is  fixed,  soon  goes  out ;  a  partition  being 
then  inserted  into  the  tube  the  currents  are  at  once  divided — one  passes  up,  one  down, 
the  sides  of  the  tube,  and  the  candle  biarns  again. 


VENTILATIOTSr. 


181 


direction  of  the  currents  and  tlieii*  rate  are  variable.     The  distribution  of 
the  enteiing  air  is  also  not  good. 

Much  better  than  these  plans  is  M'Kinnell's  circular  tube.  It  consists 
of  two  cylinders, one  encircling  the  other,  the  area  of  the  inner  tube  and 
encii'cling  ring  being  equal  ^  The  inner  one  is  the  outlet  tube  ;  it  is  so  be- 
cause the  casing  of  the  other  tube  maintains  the  temperature  of  the  air  in 
it ;  and  it  is  also  always  made  rather  higher  than  the  other ;  above  it  is 
protected  by  a  hood,  but  if  it  had  a  cowl,  lihe  that  at  Fig.  12,  it  would  be 
better.  The  outer  cylinder  or  ring  is  the  inlet  tube  ;  the  air  is  taken  at  a 
lower  level  than  the  toj^  of  the  outlet  tube  ;  when  it  enters  the  room,  it  is 
thrown  up  toward  the  ceiHng,  and  then  to  the  walls  by  a  flange  placed  on 
the  bottom  of  the  inner  tube  ;  the  air  then  passes  from  the  walls  along  the 
floor  toward  the  centre  of  the  room,  and  upward  to  the  outlet  shaft. 
(Figs.  16  and  17.)     Both  tubes  can  be  closed  by  valves.     If  there  is  a  fire 


<*?> 


Fig.  16.  Fig.  17. 

in  the  room,  both  tubes  may  become  inlets  ;  to  prevent  this  the  outlet 
tube  should  be  closed ;  if  doors  and  windows  are  open,  both  tubes  become 
outlets. 

The  movement  of  air  by  this  plan  is  imperceptible,  or  almost  so  ;  it  is 
an  admirable  mode  for  square  or  round  rooms,  or  small  churches  ;  for  very 
long  rooms  it  is  less  adaj^ted. 

The  tube  is  made  of  aU  sizes,  from  6  inches  in  diameter,  which  is 
adapted  for  a  sitting-room,  up  to  7  or  8  feet,  which  is  the  size  used  in  some 
churches.  The  two  tubes,  after  passing  out  of  the  room,  may  be  taken  in 
different  directions,  care  being  taken  that  the  inner  tube  is  always  the 
longest,  and,  if  possible,  with  the  fewest  curves. 

If  the  two  tubes  can  be  kept  together  for  some  distance,  an  advantage 
would  perhaps  be  gained,  as  the  hot  aii*  would  transmit  a  portion  of  its  heat 
to  the  ah-  in  the  outer  tube,  which  would  enter  the  room  at  a  higher  tem- 
perature than  would  othen\dse  be  the  case  ;  some  loss  of  movement  would 
result,  but  this  would  be  triflinof. 

Dr.  Arnott's  chimney  ventilator  is  a  valved  opening  at  the  top  of  the 
room,  leading  at  once  into  the  chimney,  and,  like  Dr.  Chowne's  siphon,  has 


'  It  would  be  advisable  to  make  the  outer  ring  larger,  seeing  that  the  friction  to  he 
overcome  is  about  double  that  of  the  inner  tube. 


182  PRACTICAL    HYGIENE. 

the  gi'eat  advantage  of  di-awing  the  air  from  the  toj^  of  the  room  :  it  has 
heen,  and  is,  much  used,  but  has  the  inconvenience  of  occasionally  allowing 
the  reflux  of  smoke. 

Mr.  Boyle  has  altered  this  chimney  ventilator  by  hanging  small  talc 
plates  at  a  certain  angle  ;  a  very  sUght  pressure  closes  them  and  prevents 
reflux. 

Of  these  various  plans,  M'Kinnell's  should  be  chosen,  if  the  air  must  be 
admitted  at  the  top  of  the  room  ;  and  they  are  well  adapted  for  guai'd- 
rooms,  cells,  and  rooms  of  small  dimensions,  when  it  is  desii-ed  to  have  the 
ventilating  appai-atus  out  of  reach.  Watson's  di%-ided  tube  can  also  be  used, 
but  is  less  useful  than  the  others. 


System  of  Ventilation  adopted  in  the  Army. 

On  Home  Service. — The  official  plan  now  in  use  was  arranged  about 
twenty-two  yeai's  ago  by  the  Baii-ack  Improvement  Commission  ;  it  is  ap- 
pHed  in  most  of  the  new  baiTacks,  and  in  several  old  ones.  It  has  answered 
extremely  well,  and  it  is  much  to  be  desired  that  it  should  be  carried  out 
evervwhere.  It  is  based  on  the  plan  of  natural  ventilation,  and  consists 
of— 

1.  One  outlet  shaft,  or  more  if  required,  proceeding  from  the  highest 
point  of  the  room  ;  the  exact  position  in  the  room  varies  ;  it  is  sometimes 
at  the  comer,  or  at  one  side,  according  to  cii'cumstances.  This  shaft  is 
carried  straight  up  inside  the  wall,  and  about  4  to  G  feet  above  the  roof, 
and  is  covered  \^-ith  a  louvre.  It  is  made  of  wood,  is  very  smooth  inside, 
and  is  provided  with  a  flap  for  paitly  closing  it  below.  Its  size  is  regulated 
by  that  of  the  room  and  by  the  number  of  inmates,  but  it  is  not  made 
larger  than  1  square  foot ;  if  more  outlet  is  requii-ed,  another  shaft  is 
put  up.  The  relation  between  its  size  and  that  of  the  room  varies  ■nith 
the  position  of  the  room.  In  a  thi-ee-storied  baiTack  the  nile  is  as 
follows : — 

1.  On  the  ground  floor,  1  square  inch  of  section  area  of  outlet  shaft  for 

eveiy  60  cubic  feet  of  room-space,  or  for  each   man  10  square 
inches  of  area. 

2.  On  the  first  floor,  1  square  inch  for  every  55   cubic  feet  of  room- 

space,  or  for  each  man  10.9  (say  11)  square  inches. 

3.  On  the  second  floor,  1  square  inch  for  ever}'  50  cubic  feet  of  room- 

space,  or  for  each  man  12  squai-e  inches. 

In  a  one-storied  ban'ack  the  amount  should  be  the  same  as  the  second 
floor,  or,  in  other  words,  12  men  would  have  a  shaft  of  1  square  foot.  In 
addition,  there  is  the  chimney,  which  gives  a  section  area  per  head  of 
about  six  square  inches.  The  total  outlet  area  per  man  is  therefore  16  to 
18  inches,  according  to  cii'cumstances. 

2.  Inlets. — The  amoiuit  of  inlet  is  a  trifle  more  than  1  square  inch  to 
every  60  cubic  feet  of  room. 

Half  the  inlet  air  is  wai*med  in  all  the  new  bai-racks  and  many  old  bar- 
racks by  being  taken  through  air  chambers  behind  thefii-e  (Galton's  stove) 
(area  of  tube  =  6  square  inches  per  head),  and  the  other  half  comes  direct 
fr'om  the  outer  afr  into  the  rooms  thi'ough  Sheiingham  valves.  Ai'ea  of 
outer  opening  =  5  square  inches,  making  altogether  11  square  inches  of 
inlet  opening  per  man. 

The  cold  air  inlets  (Sberingham  valves)  are  placed  at  the  sides  near  the 


VENTILATION". 


183 


ceiling,  about  9  feet  from  the  floor,  and  are  not  opposite  each  other.  Fig. 
18  shows  a  usual  arrangement.  The  outlet  space  is  thus  seen  to  be  rather 
larger  than  the  inlet,  but  as  the  doors  and  windows  seldom  fit  close,  it  is 
probable  that  practically  this  is  of  little  consequence. 

The  movement  of  air  through  these  openings  is  tolerably  regular — ^a 
regular  as  it  ever  can  be  in  natural  ventilation.  The  discharge  of  air  through 
the  chimney  and  outlet  shaft  averages 
about  1,200  cubic  feet  per  head  per  hour, 
with  a  range  from  700  to  1,500  or  1,600, 
according  to  the  amount  of  fire,  the  warmth 
of  the  room,  and  the  movement  of  the  ex- 
ternal air.  The  usual  upward  current 
through  the  outlet  shafts  at  night,  is  from 
3  to  5  feet  per  second.  Sometimes  the 
chimney  and  outlet  counteract  each  other 
a  little  ;  a  strong  chimney  draught  may 
stop  the  current  in  the  outlet  shaft,  but 
there  is  seldom  any  down-draught  unless 
rain  beats  into  the  louvre  and  trickles 
down  the  inside  of  the  shaft.  The  ven- 
tilation of  barracks  has  been  wonderfiilly 

improved  by  this  plan,  and  the  average  CO^  ranges  from  .7  to  1  per  1,000 
volumes,   according  to  the  rapidity  of  movement  of  the  air. 

The  hospital  system  is  precisely  the  same,  except  that  the  dimensions 
are  nearly  doubled. 

3Iediterranean  Stations. — The  same  system  is  directed  to  be  carried  out 
whenever  practicable  at  Malta  and  Gibraltar,  only  the  sizes  of  the  inlets  and 
outlets  are  trebled  ;  for  example,  there  is  1  square  inch  of  outlet  for  every 
20  cubic  feet  of  space  instead  of  60  as  at  home  ;  great  care  is  ordered  to 
be  taken  to  remove  all  outside  obstacles  to  the  movement  of  the  wind. 

The  Tropics  and  India. — The  same  system  in  principle  is  now  directed 
to  be  used  in  India. 


Fig.  18. 


SECTION  m 

ARTIFICIAL  VENTILATION. 

Artificial  ventilation  is  accomplished  in  two  ways :  either  the  air  is 
drawn  out  of  a  building  or  room  (the  method  by  extraction),  or  it  is  driven 
in,  so  as  to  force  out  the  air  already  in  the  room  (the  method  by  propiilsion). 


Sub-Section  I. — Ventilation  by  Extraction. 

This  is  produced  by  the  application  of  heat,  so  as  to  cause  an  upward 
current,  or  by  the  steam- jet,  or  by  a  fan  or  screw,  which  draws  out  the 
air. 

1.  Extraction  by  Heat.^-The  common  chimney  is  a  well-known  example 
of  this.  There  is  a  constant  current  up  the  chimney,  when  the  fire  is  burn- 
ing, in  proportion  to  the  size  of  the  fire  and  of  the  chimney.  The  usual 
current  up  a  common  sitting-room  chimney,  with  a  fair  fire,  is,  as  measured 
by  an  anemometer,  from  3  to  6  feet  per  second,  A  very  large  fire  wiU 
bring  it  up  to  8  or  9  feet.  The  movement  caused  by  a  kitchen  or  furnace 
fire  is,  of  course,  greater  than  this.  If  the  area  of  the  section  where  the 
anemometer  is  placed  be  known,  the  discharge  can  be  stated  in  cubic 
feet. 


184  PRACTICAL    HYGIENE. 

'\Mieii  the  air  enters  equably,  and  is  well  distributed,  the  movement  of 
air  is  from  the  inlets  gently  toward  the  fireplace  ;  there  is  also  said  to  be 
a  movement,  from  above  the  fireplace,  along  the  ceiling  and  down  the  walls, 
and  then  along  the  floor  to  the  chimney.' 

In  the  wards  of  Foi-t  Pitt  the  cuiTent,  with  a  good  fire,  is  about  3^  to  4^ 
feet  per  second  ;  and  as  the  section  area  of  the  thi'oat  is  .5  square  foot,  the 
average  discharge  is  about  7,200  cubic  feet  per  hour.  In  the  barracks  of 
Chiitham,  Dr.  Fytfe  found  the  discharge  by  the  chimney  to  be  9,080  cubic 
feet  per  hour  (average  of  six  observations).  In  the  barracks  at  Gravesend, 
Messrs.  Hewlett,  Stanley,  and  Reid  found  the  discharge  to  be  6,120  cubic 
feet  per  hour  (average  of  twenty  obsen-ations).  At  Chelsea  New  BaiTacks, 
with  a  fire  alight  but  low,  the  velocity  was  14.6  per  second,  or  :2l,038  cubic 
feet  per  horn- ;  and,  with  the  fire  out,  11.9  per  second,  or  17,088  per  hour.'' 
In  the  experiments  of  the  Barrack  Commissioners,^  the  chimney  discharge 
ranged  from  5,300  to  16,000  cubic  feet  per  hour,  the  mean  of  twenty-five 
experiments  being  9,904  cubic  feet.  Even  in  summer,  without  a  fire, 
there  is  genei-ally  a  good  up-current.*  It  may  be  concluded  that,  with  an 
ordinary  fire,  a  chimney  gives  a  discharge  sufficient  for  foui-  or  five  persons. 
If  then,  moi-e  than  this  number  of  persons  habitually  live  in  the  room,  an- 
other outlet  must  be  provided. 

As  the  cun-ent  up  the  chimney  is  so  great  when  the  fire  is  lighted,  all 
other  openings  in  a  room,  if  not  too  many,  become  inlets  ;  and,  in  this  way, 
down-draughts  of  air  may  occur  from  tubes  intended  as  outlets.  There  is 
no  remedy  for  this  ;  and  if  too  much  enters,  the  outlets  must  be  more  or 
less  closed. 

If  the  room  be  without  openings,  so  that  no  air  can  reach  the  fu'e,  air  is 
drawn  down  the  chimney,  and  a  double  current  is  estabhslied,  by  which  the 
fire  is  fed.  The  down-cui-rent  coming  in  puffs  is  one  cause  of  smoky  chim- 
neys, and  may  be  at  once  cured  by  making  an  inlet. 

The  chimney  and  fire  is  a  type  of  a  number  of  other  similar  modes  of 
ventilation  by  extraction. 

The  ventilation  of  mines  is  carried  on  by  Hghting  a  fire  at  the  bottom 
of  a  shaft  (the  upcast  or  return  shaft),  or  half  a  shaft,  if  there  be  only  one. 
The  air  is  di-awn  doAvn  the  other  or  downcast  or  intake  shaft,  or  half  the 
shaft,  and  is  then  made  to  ti-averse  the  galleries  of  the  mine,  being  directed 
this  way  or  that  by  partitions.  Double  doors  ai"e  used,  so  that  there  is  no 
back  or  side  iiish  of  the  air.  The  cuiTent  passes  thi-ough  the  upcast-shaft  at 
the  rate  of  from  8  to  10  feet  per  second  ;  it  flows  thi-ough  the  main  galleries 
at  the  rate  of  from  4  to  6  feet  per  second,  or  even  more,  and  from  1,000  to 
2,000  cubic  feet  per  liead  per  hour  are  supphed  in  good  mines.  In  fire- 
damp mines  much  more  than  this  is  given,  even  as  much  as  6,000  cubic  feet 
per  man  per  hour-.  ^  If  the  quantity  of  air  be  reduced  too  low  there  is  a 
serious  diminution  in  the  amount  of  work  performed  by  the  men.  A  horse 
is  allowed  2,466  cubic  feet,  and  a  hght  59  ciibic  feet  per  hoiu-.  All  these 
quantities  are  too  small.  It  may  easily  be  conceived  how  skilfully  the  air 
must  be  directed,  so  as  to  traverse  the  most  remote  workings  ;  in  some 
mines  a  portion  of  aii-  makes  a  cu'cuit  of  from  30  to  40  miles  before  it  can 

'  Reid  and  Stewart,  quoted  by  the  Barrack  Commissioners. 

'^  Dr.  F.  de  Chaumont's  Reports,  Army  Med.  Reports,  vol.  ix. 

'  Report,  1861,  p.  73. 

■•  In  August,  1869,  I  found  at  Fort  Elson  the  velocity  to  be  on  one  occasion  7.5  per 
second,  and  at  Gosport  Xew  Barracks,  8.4.  The  velocity  generally  ranges  from  1^  foot 
to  3  feet  per  second,  althoiigh  it  is  often  more. — (F.  de  C.) 

'  Proceedings  of  Civil  Engineers,  vol.  xii.,  p.  308. 


VENTILATIOlSr.  185 

arrive  at  the  upcast-shaft.  The  size  of  the  shafts  in  a  colliery  varies  from 
8  to  11  or  12  feet  in  diameter ;  the  sectional  area  of  a  shaft  of  the  former 
size  would  be  50  square  feet.  A  current  of  8  feet  per  second  in  the  up- 
cast-shaft would  give  a  dischai'ge  of  1,440,000  cubic  feet  per  hour,  which 
would  give  720  men  2,000  cubic  feet  per  hour. 

The  sectional  area  and  height  of  the  extracting  shaft,  and  of  the  tubes 
running  into  it,  have  been  fixed  by  Peclet ;  the  principle  is  to  give  to  the 
shaft  the  greatest  height  which  can  be  allowed,  and  the  largest  section 
which  can  be  given,'  without  permitting  the  temperature  of  the  contained 
air  to  fall  so  low  as  to  be  unable  to  overcome  the  resistance  of  the  atmos- 
■phere  at  the  top  of  the  shaft,  or  the  action  of  the  winds.  ^ 

In  large  buildings  the  same  plan  is  often  used  ;  a  chimney  (cheminee 
d'appel  of  the  French)  is  heated  by  a  fire  at  the  bottom,  and  into  the  bot- 
tom of  this  shaft,  close  to  the  fire,  run  a  niimber  of  tubes  coming  from  the 
different  rooms.  Several  Pi'euch  and  Enghsh  hospitals,  and  many  other 
buildings,  are  ventilated  in  this  way.  Dr.  Reid  for  some  years  ventUated 
the  Houses  of  Parhament  in  the  same  manner,  and  so  powerful  was  his 
up-draught,  that  he  could  change  the  entire  air  in  the  building  in  a  few 
minutes. 

In  dweUing-houses  it  has  been  proposed  to  have  a  central  chimney,  into 
which  the  chimneys  of  all  the  fires  shall  open,  and  to  sun-ound  this  with 
au'-shafts  connected  with  the  tops  of  the  rooms.  It  is  supposed  that  if 
other  inlets  exist,  there  will  be  a  current  both  up  the  chimney  and  up  the 
shaft  mnning  beside  it. 

In  all  these  cases  it  requires  that  the  workmanship  shall  be  very  exact, 
so  that  air  shall  not  reach  the  extracting  shaft  except  through  the  tubes. 

It  is  now  more  than  a  hundred  and  twenty  years  ago  since  Dr.  Mead 
brought  before  the  Royal  Society  Mr.  Sutton's  plan  of  ventilating  ships  on 
the  same  principle.  Tubes  running  from  the  hold  and  various  cabins 
joined  together  into  one  or  two  large  tubes  which  opened  into  the  ashpit 
beneath  the  cooking  fires.  If  the  doors  of  the  ashjoits  were  kept  closed, 
the  fires  drew  the  air  rapidly  from  all  parts  of  the  ship.  Unfortunately, 
this  plan  never  came  into  general  use.  The  same  plan  was  adopted  by 
Dr.  Mapleton  for  the  ventilation  of  the  hospital  ships  employed  in  the  last 
(1860)  China  War.  The  arrangement  requires  some  watching  to  prevent 
careless  cooks  fi'om  allowing  air  to  reach  the  fires  in  other  ways. 

On  the  same  principle  some  men-of-war  are  now  being  ventilated.^  The 
funnel  and  upper  part  of  the  boiler,  and,  as  far  as  possible,  all  the  steam 
apparatus,  are  inclosed  in  an  ii'on  casing,  so  that  a  space  is  left  of  some  3 
or  4  feet  between  the  casing  and  the  funnel.  When  the  fires  are  hghted, 
there  is  of  course  a  strong  cuiTcnt  up  this  space,  and  to  supply  this  the  air 
is  drawn  down  through  all  the  hatchways  toward  the  f menace  doors.  The 
temjDerature  of  the  stokehole  is  reduced  from  130°  or  140°  Fahr.,  to  60° 
and  70°  ;  and  the  draught  to  the  fires  is  so  much  more  perfect,  that  more 
steam  is  obtained  from  the  same  amount  of  fuel.  This  plan,  devised  by 
Mr.  Baker,  has  been  ingeniously  apphed  by  Admiral  Fanshawe,  late  super- 
intendent at  Chatham  dockyard,  to  the  ventilation  of  every  part  of  the 
ship  where  there  are  no  water-tight  compartments.     Edmonds'  plan  com- 

'  De  la  Chaleur,  3d.  ed.,  1861,  t.  iii.,  p.  66  et  seq. 

■-*  The  amount  of  the  resistance  given  to  the  movement  of  air  through  the  tubes 
leading  to  the  sh?it,  and  in  the  shaft  itself,  can  be  calculated  from  the  formula  given 
by  Peclet  at  p.  47  (t.  iii.),  but  which  it  is  unnecessary  to  introduce  here. 

3  In  the  new  ironclads  it  is  f oimd  necessary  to  use  large  fans  driven  by  special  en- 
gines to  effect  thorough  change  of  air  below. 


186  PRACTICAL    HYGIENE. 

bines  with  this  the  ventilation  not  only  of  the  hold,  but  of  the  timbers  of 
the  ship. 

Sometimes,  instead  of  a  fire  at  the  bottom  of  the  chimney,  it  is  placed  at 
the  top  ;  but  this  is  a  mistake,  as  there  is  a  great  loss  of  heat  fi-om  the  im- 
mediate escape  of  the  heated  ah* ;  the  proper  plan  is  to  heat,  as  much  as 
possible,  the  whole  column  of  air  in  the  chimney,  which  can  only  be  done 
by  placing  the  fire  below.  Sometimes,  as  in  Jebb's  method  for  cell-prisons, 
the  shaft  is  too  shoi-t  for  the  work  it  has  to  do. 

Frequently,  instead  of,  or  in  addition  to  a  fire,  heat  is  obtained  in  the 
shaft  by  means  of  hot-water  or  steam  pipes.  This  plan  has  long  been  in 
use  in  England,'  and  has  since  been  introduced  into  France,  and  improved 
by  M.  Leon  Duvoir.  Wai'ming,  as  well  as  ventilation,  is  accomplished  by 
this  method,  which  is  in  action  at  the  Hospitals  Lariboisiere  (in  one-half) 
and  Beaujon.  It  appears  to  be  at  once  effectual  and  economical,  though 
it  has  been  shaii^ly  criticised  by  Grassi  and  Peclet.  After  a  veiy  long  in- 
vestigation into  the  merits  of  all  rival  plans,  it  was  adopted  by  a  French 
commission  for  the  warming  and  ventilation  of  the  Palais  de  Justice  at 
Paris,  and  has  since  been  adopted  in  other  pubUc  buildings,  chiefly  from 
the  advocacy  of  General  Morin.^  The  plan  at  the  Hospital  Lariboisiere  is 
simply  this  :  an  extracting  shaft  contains  in  the  lower  part  a  boiler,  from 
which  two  spiral  hot-water  tubes  run  up  to  the  requisite  height  in  the 
shaft,  and  then,  lea%T.ng  it,  pass  downward  and  enter  the  wards,  in  which 
they  are  coiled  so  as  to  form  hot-water  stoves,  and  then  leaving  the  wards, 
they  pass  dowTi  aud  re-enter  the  boiler.  There  is  a  continual  circulation 
of  hot  water,  and  in  the  shaft  there  is  necessarily  an  upward  cun-ent  of  air. 
But  as  the  air  is  continually  increasing  in  temperature  toward  the  jDoint 
of  discharge,  there  is  a  loss  of  power,  just  as  in  the  case  of  the  fire  being- 
placed  at  the  top  instead  of  the  bottom  of  the  shaft.  From  the  bottom  of 
the  wards  air-conduits  or  tubes  run  into  the  extracting  shaft,  and  thus  the 
vitiated  air  is  drawn  out  of  the  wards.  The  fresh  ah'  is  admitted  du-ectly 
from  the  outside  into  the  wards,  and  is  warmed  by  being  admitted  through 
the  coils  of  the  hot-water  tubes.  In  the  summer  the  water  is  shut  off 
from  the  water-stoves,  but  the  temperatiu-e  of  the  extracting  shaft  is  still 
maintained. 

It  is  certainly  time  that  the  ventilation  by  this  plan  is  irregidar  ;  ^  and 
also,  that  in  the  Hospital  Lariboisiere,  a  much  greater  quantity  of  air 
passes  through  the  extracting  shaft  than  enters  thi-ough  the  hot- water 
stoves. 

In  the  summer,  when  there  is  ventilation  without  warming,  the  outflow 
of  air  from  the  wards  varied  from  84.4  cubic  metres  (2,980  cubic  feet)  to 
55.3  cubic  metres  (1,952  cubic  feet)  per  head  per  hour.^ 

In  the  winter,  when  there  are  both  ventilation  and  warming,  the  out- 
flow of  air  fi'om  the  wards  was  82.2  cubic  metres  (or  2,902  cubic  feet)  per 
head  per  hom*.  Of  that  amount,  only  35  cubic  metres  (1,235  cubic  feet) 
entered  by  the  water-stoves,  the  rest  came  in  by  doors  and  windows  and 
other  openings — an  objectionable  point,  as  the  air  might  press  in  from  the 
closets.  Yet,  in  spite  of  this,  the  temperature  was  maintained  pretty  well 
up  to  the  hmit  fixed  in  the  agreement,  viz.,  15"^  Cent,  or  59°  Fahr. 


'  It  is  in  use  in  the  Circuit  Court-House  in  Glasgow,  and  in  the  Police  Buildings  at 
Edinburgh  (Ritchie),  and  in  many  other  buildings. 

^  Two  excellent  reports  have  been  made  by  this  Commission,  of  which  General 
Morin  was  reporter.  Their  titles  are  given  further  on.  Much  information  is  also  given 
in  General  Morin's  work  on  ventilation.  Etudes  sur  la  Ventilation,  Paris,  18G3,  2  vols. 

^  Peclet,  Traite  de  la  Chaleur,  1861,  t.  iii.,  p.  267.         •*  Grassi,  op.  cit.,  pp.  35-37. 


VENTILATION^.  187 

Oil  lias  been  used  in  some  cases  instead  of  "svater,  for  circulating  in  the 
heating  appai'atus. 

Very  frequently,  instead  of  a  fwe  or  hot-water  vessels,  lighted  gas  is 
used  to  cause  a  current,  and  if  the  gas  can  be  apphed  to  other  uses,  such 
as  lightmg,  cooking,  or  boiling  water,  the  plan  is  an  economical  one. 

In  theatres  the  chandehers  have  long  been  made  use  of  for  this  pur- 
pose. !^L  D'Arcet  proposed  this  for  several  of  the  old  theatres  in  Paris, 
and  the  Commission  '  appointed  to  determine  the  mode  of  ventilation  to  be 
adopted  in  the  Theatres  L^Tique  et  du  Cu-que  Imperial,  determined,  after 
much  consideration,  that  this  plan  was  the  best  adapted  for  theatres.  Gen- 
eral i\Iorin,  from  numerous  experiments,  found  that  1  cubic  metre  of  gas 
caused  the  discharge  of  1,000  cubic  metres  of  aii',  or  1  cubic  foot  would 
cause  the  discharge  of  1,000  cubic  feet  of  au-." 

The  advantage  of  extraction  by  heat,  especially  in.  the  case  of  theatres 
and  buildings  where  gas  can  be  brought  into  play,  ai-e  obvious,  but  the 
growing  use  of  the  electric  hght  will  necessarily  modify  the  arraugements 
for  ventilation. 

There  are  some  objections  to  extractions  by  the  fire  and  hot-au-  shaft. 

(1)  The  inequahty  of  the  di'aught.  It  it  almost  impossible  to  keep  the 
fire  at  a  constant  height.  The  same  quantity  of  combustible  material 
should  be  consumed  in  the  same  time  every  day,  and  the  heat  should  be 
kept  in  by  large  masses  of  masonry.  Still,  with  these  precautions,  the  at- 
mospheric influences,  and  changes  in  the  quality  of  the  combustibles,  can- 
not be  avoided. 

(2)  The  inequality  of  the  movement  from  different  rooms.  From 
rooms  nearest  the  shaft,  and  with  the  straightest  connecting  tubes,  there 
may  be  a  strong  ciuTent,  while  from  distant  rooms  the  friction  in  the  con- 
duits is  so  gi'eat  that  Httle  air  may  pass.  This  is  weU  seen  in  cell  prisons, 
ventilated  on  Jebb's  principle.  The  gTcatest  care  is  therefore  necessary  in 
calculating  the  resistance,  and  in  apportioning  the  area  of  the  tubes  to  the 
resistance.  This  plan  is,  iadeed,  best  adapted  for  compact  buildiugs.  Oc- 
casionally, if  the  friction  be  great,  from  too  small  size,  or  the  angular 
arrangement  of  the  conduits  leading  to  the  hot-shaft,  there  may  be  no 
movement  at  all  in  the  conduits,  but  a  down-current  to  feed  the  fire  is 
established  in  the  shaft  itself — a  state  of  things  which  was  discovered  by 
Dr.  Sanderson  to  exist  in  the  ventilation  of  St.  Maiy's  Hospital  in  London. 

(3)  The  possibUity  of  reflux  of  smoke,  and  perhaps  of  au',  from  the 
shaft  to  the  rooms,  is  another  objection  of  some  weight. 

(4)  The  impossibihty  of  properly  controUing  the  places  where  fresh  air 
enters.  It  will  flow  in.  from  all  sides,  and  possibly  from  places  where  it  is 
impure,  as  from  closets,  etc. ;  au'  is  so  mobile  that  with  every  care  it  is 
difficult  to  bring  it  under  complete  control — it  will  always  press  in  and  out 
at  the  point  of  least  resistance. 

2.  Extraction  by  the  Steam-jet. — The  moving  agent  here  is  the  force  of 
the  steam-jet,  which  is  aUowed  to  i^ass  into  a  chimney^  The  cone  of  steam 
sets  in  motion  a  body  of  air  equal  to  217  times  its  own  brdk.  Tubes  pass- 
ing from  different  rooms  enter  the  chimney  below  the  steam-jet,  and  the 
air  is  extracted  from  them  by  the  strong  upwai-d  current.  This  plan  is 
best  adapted  for  factories  with  spai'e  steam.  It  was  employed  for  some 
time  in  the  ventilation  of  the  House  of  Lords,  but  was  finally  abandoned. 

1  Eapport  de  la  Commission  sur  la  Chauffage  fet  la  Ventilation  du  Theatre  Lyrique 
et  du  Tlieatre  du  Cirque  Imperial,  Rapporteur  le  General  Morin,  Paris,  1861. 
^  Etudes  sur  la  Vent. ,  t.  ii. ,  p.  720. 


188  PRACTICAL    HYGIENE. 

3.  Extraction  by  a  Fan  or  Screw. — An  extracting  fan  or  Arcliimedean 
screw  has  been  used  to  throw  out  the  aii\  Several  difiereut  kinds  have 
been  proposed  by  Messrs.  Combes,  Letoret,  Glepia,  and  Lloyd,  and  have 
been  used  in  coal-mines  in  Belgium,  and  in  some  of  the  English  mines. 
At  the  Abercarn  mine,  in  South  Wales,  a  fan  is  used  of  13|  feet  diameter ; 
the  vanes,  eight  in  number,  are  3  J  feet  wide  by  3  feet  long  ;  at  GO  revolu- 
tions per  minute  the  velocity  of  the  au*  is  782  linear  feet  per  minute,  and 
45,00U  cubic  feet  are  extracted  ;  the  velocity  at  the  cu-cumference  of  the 
fan  is  2,545  feet  per  minute  ;  the  theoretical  consumption  of  coal  per  hour 
is  17.4  ft).' 

'Mi:  Van  Hecke  formerly  used  a  fan  for  this  pui-pose,  in  his  system  of 
ventilation  of  buildings,  but  he  has  fovmd  it  better  to  abandon  it,  and  sub- 
stitute a  propeUing  fan. 

Sub-Section  II. — Ventilation  by  Propulsion. 

This  plan  was  proposed  by  Desaguliers,  in  1734,''  when  he  invented  a 
fan  or  Avheel  inclosed  in  a  box.  The  air  passed  in  at  the  centre  of  the  fan, 
and  was  thrown  by  the  revolving  vanes  into  a  conduit  leading  fi'om  the 
box.  In  some  form  or  other  this  fan  has  been  used  ever  since,  and  the 
conduits  leading  from  it  are  now  generally  made  large,  so  that  the  fan  may 
move  slowly,  and  deliver  a  large  quantity  of  au*  at  a  low  velocity.  The 
fan,  if  small,  is  worked  by  hand ;  if  larger,  by  horse,  water,  or  steam 
power.     It  is  largely  used  in  India,  under  the  name  of  the  Thermantidote. 

The  fans  are  often  made  with  six  or  eight  rays,  each  caiTying  vanes  at  the 
end,  which  should  be  as  close  as  possible  to  the  enveloj)ing  box.  In  size, 
the  length  of  the  vanes  should  be  more  than  half  the  length  of  the  rays  ; 
the  number  of  rays  should  augment  with  the  diameter  of  the  orifice  of 
access.' 

The  amount  of  air  delivered  can  be  told  by  timing  the  speed  of  revolu- 
tion of  the  extremities  of  the  fan  per  second,  or  jDer  minute  ;  the  eflective 
velocity  is  equal  to  f  ths  of  this,  and  this  is  the  rate  of  movement  of  the  air. 
If  the  section  area  of  the  conduit  be  known  the  number  of  cubic  feet  dis- 
charged per  second,  minute,  or  hour,  can  be  at  once  calculated. 

The  power  of  this  plan  is  very  considerable.  AVith  a  fan  of  10  feet 
diameter,  revolving  sixty  tunes  per  minute,  the  effective  velocity  is  1,414 
feet  per  minute.  The  rate  of  movement  in  the  main  channel  should  not 
be  more  than  4  feet  per  second  ;  the  conduits  must  gradually  enlarge  in 
calibi'e  ;  and  the  movement,  when  the  air  is  delivered  into  the  rooms,  should 
not  be  more  than  1^  foot  per  second.  At  the  Hospital  Lariboisiere  in 
Paris,  it  is  stated  that  150  cubic  metres  (=  4,296  cubic  feet)  have  been 
delivered  per  head  per  hoiu',  in  the  wards  ventilated  by  the  propelhng  fan 
of  MM.  Thomas  et  Laurens.  It  must,  however,  be  remembered,  that  the 
later  observations  of  General  Morin  showed  that  much  of  the  movement 
ascribed  to  the  fan  was  really  owing  to  natural  ventilation. 

This  plan  is  very  well  adapted  for  those  cases  in  which  a  large  amount 
of  air  has  to  be  suddenly  supplied,  as  in  crowded  music  halls  and  assembly 
rooms.     St.  George's  HaU  at  Liverpool  is  ventilated  in  this  way.     The  air 

'  Ure's  Dictionary,  1875,  art.  Ventilation,  vol.  iii.  p.  1069. 

'  Course  of  Experimental  Philosophy,  vol.  ii.,  p.  564.  The  wheel  was  shown  to  the 
Eoval  Society  in  1734 

"^  Peolet,  be  la  Chalenr,  3d  edition,  1868,  t.  i.,  pp.  259,  263.  Numerous  kinds  of  fans 
for  propulsion  and  extraction  are  figured,  and  detailed  accounts  of  construction  and 
amount  of  work  are  given. 


VENTILATION.  189 

is  taken  from  tlie  basement ;  is  washed  by  being  drawn  througb  a  thin 
film  of  water  thi'own  up  by  a  fountain  ;  is  passed  into  caloriferes  (in  the 
winter),  where  it  can  be  moistened  by  a  steam-jet,  if  the  difference  of  the 
dry  and  wet  bulb  be  more  than  four  to  six  degrees,  and  is  then  propelled 
along  the  channels  which  distribute  it  to  the  hall.  In  summer,  it  is  cooled 
in  the  conduits  by  the  evaporation  of  water. 

At  the  Hopital  Necker  in  Pai'is,  and  in  many  other  places,  the  plan  of 
Van  Hecke  is  in  use.  A  fan,  worked  by  an  engine,  drives  the  air  into 
smjdl  chambers  in  the  basement,  where  it  is  warmed  by  cockle  stoves,  and 
then  ascends  into  the  rooms  above  and  passes  out  by  outlet  shafts  con- 
stinicted  in  the  walls.  The  system  is  effective  and  economical,  though  it 
is  only  just  to  say  that,  the  use  of  the  fan  excepted,  it  is  precisely  similar 
in  principle  to  Sylvester's. 

The  fans  employed  by  ]VIM.  Verity,  of  London,  seem  to  be  very  power- 
ful. 

In  addition  to  the  fan,  other  appliances  have  been  used.  Soon  after 
Desaguliers  proposed  the  fan,  Dr.  Hales  employed  large  bellows  for  the 
same  pui-pose,  and  they  were  used  for  some  time  on  board  some  men-of- 
war,  and  in  various  buildings.  They  were  worked  by  hand  ;  and  probably 
this,  and  their  faulty  consti'uction,  led  to  their  being  disused.  Theii'  use 
was  revived  and  their  form  modified  and  improved  by  Dr.  Arnott.'  Dr. 
Arnott  showed  that  Hales  lost  much  poAver  by  forcing  his  air  through  small 
openings  ;  and,  by  some  ingenious  alterations,  made  an  effective  machine. 
The  hydraulic  air-pump,  sometimes  used  in  mines,  is  usefiil  on  a  small 
scale. ^ 

The  punkah  used  in  India  is  another  mechanical  agent  with  a  similar 
though  more  imperfect  action.  AMien  a  punkah  is  pulled  in  a  room  open 
on  all  sides,  it  will  force  out  a  portion  of  air,  the  jDlace  of  which  will  be  at 
once  sujDjolied  by  air  rushing  in  with  greater  or  less  rapidity  from  all  points. 
If  the  punkah  can  be  moistened  in  any  way,  its  cooUng  effect  is  consider- 
able. In  Moorsom's  jDimkah  a  wheel  timied  by  a  bullock  both  moves  the 
punkah  and  elevates  water,  which  then  passes  along  the  top  of  the  punkah, 
and  flows  down  it. 

The  advantages  of  ventilation  by  propulsion  are  its  certainty,  and  the 
ease  with  which  the  amount  thrown  in  can  be  altered.  The  stream  of  air 
can  be  taken  from  any  point,  and  can,  if  necessai-y,  be  washed  by  passing 
through  a  thin  film  of  water,  or  thi'ough  a  thin  screen  of  moistened  cotton, 
and  can  be  warmed  or  cooled  at  pleasure  to  any  degi'ee.  In  fact,  the 
engineer  can  mtroduce  into  this  operation  the  precision  of  modern  science. 

The  disadvantages  are  the  great  cost,  the  chances  of  the  engine  breaking 
down,  and  some  difficulties  m  distribution.  If  the  air  enter  thi-ough  small 
openings,  at  a  high  velocity,  it  will  make  its  way  to  the  outlets  without 
mixing.     The  method  requires,  therefore,  great  attention  in  detail. 

'  On  the  Smokeless  Fireplace,  by  Nell  Axnott,  M.D.,  F.R.S.,  etc.,  1855,  p.  163  ;  and 
in  other  publications. 

^  Ure's  Dictionary,  1875,  vol.  iii. ,  p.  1064. 


190  PRACTICAL   HYGIEKE. 

SECTION  IV. 

RELATIVE  VALUE  OF  NATURAL  AND  ARTIFICIAL  VENTILATION. 

Circumstances  differ  so  widely,  that  it  is  impossible  to  select  one  system 
tn  preference  to  all  others.  In  temperate  climates,  in  most  cases,  especially 
for  dweUing-houses,  baiTacks,  and  hospitals,  natural  ventilation,  with  such 
powers  of  extraction  as  can  be  got  by  utilizing  the  sources  of  warming  and 
lighting,  is  the  best.  Incessant  movement  of  the  air  is  a  law  of  natiire. 
We  have  only  to  allow  the  air  in  our  cities  and  dwellings  to  take  share  in 
this  constant  change,  and  ventilation  will  go  on  uninteiTuptedly  without 
oiu'  care. 

In  some  circumstances,  however,  as  in  the  tropics,  with  a  stagnant  and 
warm  air ;  and  in  temperate  climates  in  certain  buildings,  where  there  are 
a  great  number  of  small  rooms,  or  where  sudden  assemblages  of  people 
take  place,  mechanical  ventilation  must  be  used.  So  much  may  be  said 
both  for  the  system  of  extraction  and  propulsion  under  certain  cii'cum- 
stances,  that  it  is  impossible  to  give  an  abstract  preference  to  one  over  the 
other.  In  fact,  it  is  evident  that  the  special  conditions  of  the  case  must 
determine  the  choice,  and  we  m'ust  look  more  to  the  amount  of  air,  and  the 
method  of  distribution,  than  to  the  actual  source  of  the  moving  j^ower.  But 
in  either  case  the  greatest  engineering  skill  is  necessary  in  the  aiTangement 
of  tubes,  the  supply  of  fresh  air,  etc.  The  danger  of  contamination  of  air 
as  it  passes  through  long  tubes,  and  the  immense  friction  it  meets  with, 
must  not  be  overlooked.  For  hospitals,  natural  ventilation  certainly  seems 
the  proper  plan.  The  cost  of  the  various  plans  will  depend  entii'ely  on 
circumstances,  the  nature  of  the  building,  the  price  of  materials,  coal,  etc. 
On  the  whole,  the  plans  of  ventilating  and  warming  by  hot-water  jDipes, 
and  Van  Hecke's  plan,  are  cheaper  than  the  method  by  propulsion  by 
means  of  a  large  fan  ;  but  the  latter  gives  us  a  method  which  is  more  under 
engineering  control,  and  is  better  adapted  for  hot  climates  when  it  is 
desired  to  cool  the  air. 


CHAPTEE  IV. 

EXAMINATION  OF   AIR  AND  OF  THE  SUFFICIENCY  OF 

VENTILATION. 

The  sufficiency  of  ventilation  should  be  examined — 

1st,  By  determining  the  amount  of  cubic  space  assigned  to  each  person, 
and  the  amount  of  movement  of  the  air,  or,  in  other  words,  the  number  of 
cubic  feet  of  fresh  air  which  each  person  receives  per  hour. 

2d,  By  examining  the  air  by  the  senses,  and  by  chemical  and  mechanical 
methods,  so  as  to  determine  the  presence,  and,  if  possible,  the  amounts  of 
suspended  matters,  organic  vapor,  carbon  dioxide,  hydrogen  sulphide,  and 
watery  vapor. 

SECTION  I. 
MEASUREMENT  OF  CUBIC  SPACE.' 

The  three  dimensions  of  length,  breadth,  and  height  are  simply  multi- 
plied into  each  other.  If  a  room  is  square  or  oblong,  with  a  flat  ceihng, 
there  is,  of  coui'se,  no  difficulty  in  doing  this,  but  frequently  rooms  are  of 
irregular  form,  with  angles,  projections,  half-circles,  or  segments  of  circles. 
In  such  cases  the  rioles  for  the  measurement  of  the  areas  of  cu'cles,  seg- 
ments, triangles,  etc.,  must  be  used.  By  means  of  these,  and  by  dividing  the 
room  into  several  parts,  as  it  were,  so  as  to  measure  fii'st  one  and  then  another, 
no  difficulty  will  be  felt.  After  the  room  has  been  measured,  recesses  con- 
taining air  should  be  measured,  and  added  to  the  amount  of  cubic  space  ; 
and,  on  the  other  hand,  solid  projections,  and  soHd  masses  of  furniture, 
cupboards,  etc.,  must  be  measured,  and  their  cubic  contents  (which  take  the 
place  of  air),  deducted  from  the  cubic  space  already  measured.  The  bed- 
ding also  occupies  a  certain  amount  of  space  ;  a  soldier's  hospital  mattress, 
pillow,  three  blankets,  one  coverlet,  and  two  sheets,  will  occupy  almost  10 
cubic  feet,  about  7  if  tightly  rolled  up.  It  is  seldom  necessary  to  make  any 
deduction  for  tables,  chairs,  and  iron  bedsteads,  or  small  boxes,  or  to  reduce 
the  temperature  of  the  air  to  standard  temperature,  as  is  sometimes  done. 

A  deduction  may  be  made,  however,  for  the  bodies  of  persons  li\ing  in 
the  room  ;  a  man  of  average  si^ie  takes  the  place  of  about  2^  to  4  cubic  feet 
of  air  (say  3  for  the  average).^ 

In  linear  measurement,  it  is  always  convenient  to  measure  in  feet  and 
decimals  of  a  foot  and  not  in  feet  and  inches.  ^  If  square  inches  are  meas- 
ured, they  may  be  turned  into  square  feet  by  multiplying  by  .007, 

'  For  tables  of  useful  measures,  see  Appendix  B,  Vol.  II. 

^  The  weight  of  a  man  in  stones,  divided  by  4,  gives  the  cubic  feet  he  occupies. 
Thus  a  man  weighing  12  stones  occupies  8  cubic  feet. 
3  The  following  table  may  be  found  convenient : 

Inches. 

12 

11 

10 


Decimal  parts  of 
a  foot. 

Inches. 

Decimal  parts  of 
a  foot. 

Inches. 

Decimal  parts  of 
a  foot. 

1.00 

8 

=: 

0.67 

4 

=         0.33 

0.92 

7 

= 

0.58 

3 

=         0.25 

0.83 

6 

= 

0.50 

2 

=         0.17 

0.75 

5 

= 

0.43 

1 

=        0.08 

1^2  PEACTICAL    HYGIENE. 

■R-ci^zs—Area  or  Superficies. 

A         r   ■    1^  =D'  X   .7854. 

/rmo/arcZe  ......................     ^^,  ^    ^^gg 

Circumference  of  circle =D  ^  3.1416. 

Diximtter  of  circle ^  ^  Multiply 'the  procluct^of^  the 

Area  of  ellipse —  |      \y;o  diameters  by  .7854. 

(  Half  sum  of  the  two  diame- 
Circumference  of  ellipse =  '^      ters  by  3.1416. 

C  Squai-e  one  of  the  sides,  or 
J.           ^^  =}      multiply    any    two    sides 

Areaofasquare |     into  each  other. 

_  j  Multiply  two  sides  perpen- 
Areaofa  rectangle —  ^      dicular  to  each  other. 

_  j  Base      X  h  height,  or 
Area  of  a  triangle —  ^  Height  x  ^  base. 


Fig.  I'J. 

Area  of  a  parallelogram 


Fig.  20. 


Any  figure  bounded  by  right  lines. 


=  Divide  into  two  triangles  by 
a  diagonal,  and  take  sum 
of  the  areas  of  the  two 
triangles. 


=  Divide  into  triangles,  and 
take  the  sum  of  their 
areas. 


Fig.  21. 

Area  of  segment  of  circle 


FIG.  22. 


=  To  I  of  product  of  chord 
and  height  add  the  cube 
of  the  height  divided  by 
twice  the  chord. 

(Ch  X  H  X  I)  +  2^j^ 

Cubic  Capacity  of  a  Cube  or  a  Solid  i?.dfln^/e. -Multiply  together  the 
three  dimensions,  length,  breadth,  and  height. 

CiT Capacity  of  a  Solid  Triangle. -Ai-ea  of  section  (triangle)  multiphed 

^^  ^Cub^c  Capacity  of  a  Cone  or  Pyramid.-Axe^ol  base  x  i  ^eight 

Cubic  Capacity  Sf  a  Dome.-Tv^o-ihird,soi  the  product  of  the  aiea  of 

the  base  multipUed'bv  the  height  (area  of  base  x  height  x  3). 
Cubic  Capacity  of  a  Cylinder.— Ai-eaoi  base  x  height. 
Cubic  Capacity  of  a  Sphere.— T>'  x  .o-2^G.  .,.     f  ^  „^.no 

The  cubic  capacity  of  a  bell-tent  may  be  taken  as  that  of  a  cone. 


EXAMINATIOlSr    OF    AIR    AND    VENTILATION.  193 

The  cubic  capacity  of  an  hospital  marquee  must  be  got  by  dividing  the 
marquee  into  several  parts — 1st,  into  body  ;  and  2d,  roof : — 

1,  Body,  as  a  sohd  rectangle,  with  a  half  cylinder  at  each  end. 

2.  Roof,  solid  triangle,  and  two  half  cones. 

The  total  number  of  cubic  feet,  with  additions  and  deductions  aU  made, 
must  then  be  divided  by  the  number  of  persons  living  in  the  room  ;  the 
result  is  the  cubic  space  per  head. 

SECTION  II. 

MOVEMENT  OF   AIR   IN  TBE   ROOM. 
The  direction  of  movement  must  first  be  determined,  and  then  its  rate. 

1.    DIRECTION    OF   MOVEMENT. 

First  enumerate  the  various  openings  in  the  room — doors,  windows, 
chimney,  special  openings,  and  tubes — and  consider  which  is  likely  to  be 
the  direction  of  movement,  and  whether  there  is  a  possibility  of  thorough 
movement  of  the  air.  Then,  if  it  is  not  necessary  to  consider  further  any 
movement  through  open  doors  or  windows,  close  all  these,  and  examine 
the  movement  through  the  other  openings.  This  is  best  done  by  smoke 
disengaged  from  smouldering  cotton-velvet,  and  less  perfectly  by  small 
balloons,  hght  pieces  of  paper,  feathers,  etc.  The  flame  of  a  candle,  which 
is  often  used,  is  only  moved  by  strong  currents.  It  may  be  generally  taken 
for  granted  that  one  half  the  openings  in  a  room  will  admit  fresh  air,  and 
half  will  be  outlets.  But  this  is  not  invariable,  as  a  strong  outlet,  like  a 
chimnej'',  may  draw  air  through  an  inlet  of  far  greater  area  than  itself,  or 
may  draw  it  through  a  much  smaller  area,  with  an  increased  rapidity. 

2.    RATE   OF   MOVEMENT. 

The  direction  being  known,  it  is  only  necessary  to  measure  the  dis- 
charge through  the  outlets,  as  a  corresponding  quantity  of  fresh  air  must 
enter. 

By  the  Anemometer. — This  is  best  done  by  an  anemometer,  orairrmeter, 
of  which  there  are  several  in  the  market.  The  one  commonly  used  is  in 
principle  that  invented  by  Combes  in  1838  :  four  little  sails,  driven  by  the 
moving  air,  tvirn  an  axis  with  an  endless  screw,  which  itself  turns  some 
small-toothed  wheels,  which  indicate  the  number  of  the  revolutions  of  the 
axis,  and  consequently  the  sjDace  traversed  by  the  sails  in  a  given  time,  say 
one  minute.  M.  Neumann,  of  Paris,  modified  this  anemometer  by  omitting 
most  of  the  wheels,  and  introducing  a  dehcate  watchmaker's  spring,  which 
opposes  the  force  of  the  wind,  and  when  it  equals  it,  brings  the  sails  to  a 
stand-stiU.  By  a  careful  graduation  (which  must  be  done  for  each  instru- 
ment), the  rate  per  second  is  detei-mined,  and  is  indicated  by  a  small  dial 
and  index. 

Mr.  Casella,  of  Holborn,  at  the  suggestion  of  the  late  Dr.  Parkes,  modi- 
fied and  improved  this  instrument,  and  adapted  it  to  EngHsh  measures.  A 
very  beautiful  instrument  is  thus  available  by  which  the  movement  of  air 
can  be  measured  approximatively  very  readily. 

Casella's  air-meter  is  thus  used  : — Being  set  at  the  zero  point,  it  is 
placed  in  the  current  of  the  air  ;  if  it  is  placed  in  a  tube  or  shaft,  it  should 
bo  put  well  in,  but  not  quite  in  the  centre,  as  the  central  velocity  is  always 
greater  than  that  of  the  side  ;  a  point  about  two-fifths  from  the  sides  of 
the  tube  will  give  the  mean  velocity.  The  time  when  the  sails  begin  to 
move  is  accurately  noted,  and  then,  after  a  given  time,  the  instnmient  is 
Vol.  L— 13 


194 


PRACTICAL    HYGIENE. 


removed,  and  the  movement,  in  the  time  noted,  is  given  by  the  dial.  A 
coiTection  is  then  made,  and  the  hnear  dischai'ge  is  obtained.'  If  this 
lineal'  discharge  is  multipUed  by  the  section-area  of  the  tube  or  opening 
(expressed  in  feet  or  decimals  of  a  foot),  the  cubic  discharge  is  obtained. 
If  the  current  varies  in  intensity,  the  movement  should  be  taken  several 
times,  and  the  mean  calculated  ;  and  if  the  tube  is  so  small  that  the  sails 
approach  closely  to  the  cii'cumference,  the  results  cannot  be  depended  on. 
If  jjlaced  at  the  mouth  of  a  tube,  it  often  indicates  a  much  feebler  ciu'rent 
than  really  exists  in  the  tube. 

Table  to  show  the  Velocity  of  Air  in  linear  feet  per  minute.  Calculated  from  Mont- 
golfkr^s  formula  ;  the  expansion  of  air  being  taken  as  0. 002  for  each  degree  Fahren- 
heit., and  one  fourth  being  deducted  for  friction.     {Round  nunibers  have  been  taken.) 


o  a 
■«  E 

•?  3 


88 

m 

100 
104 
108 
111 
115 

18  ill8 

19  1121 


DlFFEBENCB  BETWEEN   iNTEBNAL  AMD  EXTEBNAI,  TeMFEBATITBE. 


345678910  11  13  13   14  15|16  17   18  19la0  31  33  3334  35  30 


26  142 

27  1145 

28  i]4~ 

29  1511 

30  153 

31  jl55 

32  ;158 

33  |160 

34  1 1(52 

35  105 

3(i  ivn 

37  1170 

38  172 

39  174 

40  176 
45  187 
50  197, 


102!ll4  125 
107  119  131 
111  125  130 
116  1.30  140 
120,135  147 
125  139  153 
129  144  158 
133  148  lh2 
136  153  167 
140  157  172 
144  161  176 
147  165  181 
151  169  1-5 
154  173  189 
158  176  193 
161,180  197 
164  183  201 
167  187  205 
170  190  2u7 
173  194  212 
l';6  197  216 
170  20U  21'.( 
182  204  22i 
185  207  226 
188  210  230 
190  213  2:a 
193  216  2:^6 
196  219  240 
198  222  243 
201  225  246 
204  228  249 
216  241  264 
228  254  279 


169  176  1&3 
177  185  192 
185  193  201 
192  201  209 
200  209  217 
207  216  225 
213  223  2;« 
220  2;i0  239 
226  'iSTi  246 
233  243  253 
2:^9  249  259 
245  255  i  266 
250  261  272 
256  267  278 
261  273  284 
267  279  290 
272  284  296 
277  290  302 
282  295  307 
287  300  312 
292  305  31  Si 
297  310  323: 
302  315  328: 
307  320  333, 
311  325  338' 
316  330  343 
320  334  348 
325  339  353 
329  344  358 
33^  348  362 
338  353  3(i7 
358  374  389 
377  394  4011 


190 
200 
209 
217 
225 
233 
241 
248 
255 
262 
269 
276 
282 
289 
295 
301 
307 
!313 
,319 
324 
i330 
i335 
:341 
,346 
■351 
356 
1 361 
;,66 
371 
376 
381 
404 
426 


233  239 
245  250 
255  261 
£66  272 
276  282 
286  292 
295  £02 
304  311 
313  320 
321  329 
330:338 
3381346 
3461354 
£54  362 
361  370 
369  378 
376  385 
383:392 
390  >  399 
£97^407 
404  414 
411, '420 
4171427 
424,434 
430  440 
4:-:6  447 
442  453 
448  459 
454  465 
461  471 
467'477 
495  506 
522,534 


244  249 
256  261 
267  273 
278  284 
289  295 
299  305 
319  315 
318;  25 
327  335 
386  344 
345  353 
354  361 
362  370 
370  378 
378  £86 
386  394 
394  402 
'401  410 
408  417 
416  425 
423  432 
430  4;:-9 
437  446 
443  453 
450  460 
457  407 
463  473 
470  AiO 
476  486 
482  ^92 
488  499 
518  529 
546  558 


254  279 
267  292 

279  305 
290  318 
301  330 
312  341 
322  363 
332  363 
342  374 
351  384 
360  394 
369  404 
378  414 
366  423 
394  432 
402  441 
410  450 
418  458 
426  467 
433  475 
441  483 
448  491 
455  499 
462  £06 
469  514 
476  522 
483  529 
490  5:  6 
4i  6  543 
5C3c51 
509  558 
540  591 
569  C23 


I  3  I  4  I  5  I  6  I  7  :  8  I  9  |10    11  13|l3|l4;15|  16il7,18   iy|30  3li33la3|34  35|30 

To  use  the  table,  determine  the  heiglit  of  the  warm  column  of  air  from  the  point 
of  entrance  to  the  point  of  discharge.  Ascertain  the  difference  between  its  temperature 
and  that  of  the  external  air.  Take  out  number  from  table,  and  multiply  by  the  sec- 
tion-area of  the  discharge-tube  or  opening,  in  feet  or  decimals  of  a  foot.  The  result  is 
the  discharge  in  cubic  feet  per  minute,  multipl}'  by  60 — result,  discharge  per  hour. 
Example. — Height  of  column,  32  feet ;  difference  of  temperature  between  internal  and 
external  air,  17  deg.  Looking  in  the  table,  we  find,  opposite  to  32  and  under  17,  375 
feet.     That  would  be  for  an  area  of  1  square  foot. 

r     375         ^ 
.75 


But  supposing  our  air  opening  to  be  only 
\  of  a  foot,  we  must  multiply  375  by  \ 
or  0. 75  of  a  foot. 


Therefore  we  get  281  feet 
(per  minute),  multiplied  by 
(jO  =  10,860  feet  per  hour. 


'  All  instruments  require  correction,  as  they  never  give  the  whole  of  the  velocity. 
Great  care  must  be  taken  to  ascertain  that  the  correction  has  been  accurately  deter- 
mined, and  they  should  be  frequently  compared  with  a  standard  instrument. 


EXAMINATION    OF   AIR    AND    VENTILATION.  195 

Tlie  cubic  discharge  per  minute  being  known,  the  amount  per  hour  is 
got  by  multiplying  by  60,  and  this,  divided  by  the  number  of  men  in  the 
room,  gives  the  discharge  per  head  for  that  particular  apertiu-e. 

An  anemometer  on  a  larger  scale  is  fixed  in  some  of  the  large  outlets  of 
the  Paris  hospitals,  showing  the  movement  at  every  moment  by  means  of 
an  index  and  dial, ' 

By  the  Manometer. — Dr.  Sanderson  has  made  an  ingenious  alteration 
of  a  manometer  described  by  Peclet,  which  can  also  be  employed  to  meas- 
ure the  pressure,  and  by  calculation  the  velocity,  of  the  air.  The  ciUTent 
of  air  is  allowed  to  impinge  on  a  surface  of  water,  and  the  height  to  which 
the  water  is  driven  up  a  tube  of  known  inclination  and  size  gives  at  once 
a  measure  of  force.  But,  as  necessitating  a  little  calculation,  this  instru- 
ment is  less  useful  than  the  anemometer,  though  it  is  adapted  for  cases 
where  the  anemometer  cannot  be  used,  as  it  may  be  connected  by  a  long 
tube  with  a  distant  room,  and  probably  would  be  well  fitted  to  measure 
constantly  the  velocity  in  an  extraction  shaft. 

In  measuring  the  movement  of  the  air  in  chimneys,  or  places  w^here 
either  the  heat  or  the  dust  would  injure  the  air-meter,  a  manometer  must 
be  used.     Mr.  Fletcher  describes  what  appears  to  be  a  good  one.^ 

By  Calculation. — Supposing  the  external  air  is  tranquil,  and  that  the 
only  cause  of  movement  is  the  unequal  weights  of  the  external  colder  and 
the  internal  warmer  air,  the  amount  of  discharge  may  be  appro ximatel}^ 
obtained  by  the  law  of  Montgolfier,  already  given.  There  is  a  fallacy,  how- 
ever, as  the  amount  of  friction  can  never  be  precisely  known.  Still,  as  an 
approximation,  and  in  the  absence  of  an  anemometer,  the  rule  is  useful ; 
and  the  accompanying  table  (p.  194)  has  therefoi'e  been  calculated. 

On  testing  this  table,  however,  by  the  air-meter,  it  has  been  found 
to  give  too  much  when  the  tubes  are  long,  on  account  of  the  great  friction, 
and  it  is  therefore  advisable  to  make  a  further  deduction  of  |-th  when  the 
shaft  or  tube  is  long,  and  is  at  the  same  time  of  small  diameter.  If  the 
tube  has  any  angles,  or  is  curved,  this  table  is  too  imperfect  to  be  used, 
unless  attention  be  paid  to  the  correction  for  friction  already  noted. 

If  the  movement  of  the  external  air  influences  the  movement  in  the 
room,  as  when  the  wind  blows  through  openings,  calculation  is  useless, 
and  the  anemometer  only  can  be  depended  on. 


^SECTION  m. 

EXAMINATION  OF  THE  AIR. 
1.    BY   THE    SENSES. 

Many  impurities  are  quite  imperceptible  to  smell,  but  it  so  happens 
that  animal  organic  matters,  whether  arising  in  respiration  or  in  disease, 
have,  for  the  most  part,  a  peculiar  fetid  smell,  which  is  very  perceptible  to 
those  trained  to  observe  it  when  they  enter  a  room  from  the  open  air. 
This  is,  in  fact,  a  most  dehcate,  as  well  as  a  ready  way  of  detecting  such 
fetid  impurities,  and,  with  a  httle  trouble,  the  sense  of  smell  may  be  cul- 
tivated to  the  point  of  extreme  acuteness.  Only,  it  must  be  remembered, 
that  in  a  short  time  the  impression  is  lost,  and  is  not  at  once  regained  even 
in  the  open  air.     For  a  detailed  consideration  of  this  question,  see  Dr.  de 

'  Peclet,  De  la  Chaleur,  t.  i.,  p.  171,  where  the  description  will  be  found. 
^  Fifth  Annual  Report  of  the  Inspector  under  the  Alkali  Act,  Blue  Book. 


196  PRACTICAL    HYGIENE. 

Chaumont'a  papers  in  the  Proceedings  of  the  Royal  Society,  1875  and  1876. 
Among  other  points,  it  is  shown  that  the  humidity  of  the  air  has  a  very 
marked  influence  in  rendering  the  smell  of  organic  matter  perceptible, 
even  moi*e  powerful  than  a  rise  in  temperature.  Thus  the  effect  of  an  in- 
crease of  one  per  cent,  in  the  humidity  is  as  great  as  a  rise  of  4.18^  Fahr.  in 
temperatui-e,  calculated  from  the  mean  of  458  fully  recorded  observations. ' 
As  the  evidence  of  the  senses,  however  practically  useful,  is  always 
liable  to  be  challenged,  a  more  thorough  examination  of  the  air  must  in 
many  cases  be  made. 

2.    MICROSCOPICAL    AND    CHEIVnCAL    EXAMINATION. 

The  points  which  should  be  examined  are — * 

1.  The  existence  and  character  of  suspended  matters  as  judged  of  by 

the  microscope,  both  by  immediate  observation  and  after  cultiva- 
tion in  prepared  nutrient  fluids.^ 

2.  The  amount  of  CO^,  which  is  taken  as  a  convenient  measure  of  all 

impuiities. 

3.  The  amount  of  the  free  or  sahne  ammonia. 

4.  The  ammonia  formed  by  the  action  of  alkaline  pennanganate  on 

nitrogenous  substances  floating  in  the  air  (albuminoid  ammonia).* 

5.  The  amount  of  oxidizable  substances,  as  judged  of  by  the  amount 

of  oxygen  given  off  by  a  standai'd  solution  of  potassium  perman- 
ganate.^ 

6.  Amount  of  nitrous  and  nitric  acids. 

7.  The  amoimt  of  watery  vapor. 

8.  The  presence  of  H„S,  or  other  offensive  gases  and  vapors. 

9.  The  presence  or  absence  of  ozone. 

Microscopical  Examination. 

1.  Suspended  Matters. " — It  is  probable  that  the  microscopical  examina- 
tion of  air  will  give  us  in  future  more  important  information  even  than 
the  chemical  examination.  It  is,  of  conrse,  a  merely  qualitative  test,  as 
there  are  no  means  of  jiroperly  estimating  the  amount  collected. 

The  suspended  matters  may  be  collected  very  simply  by  Pouchet's 
aeroscope.  A  small  funnel  is  drawn  into  a  small  point,  below  which  is  a 
slip  of  glass  moistened  with  glycerine.  The  end  of  the  funnel  and  a  slip 
of  glass  are  inclosed  in  an  air-tight  chamber,  from  which  a  small  glass 
tube  passes  out  and  is  connected  by  india-rubber  tubing  with  an  aspirator. 
As  the  water  runs  out  through  the  aspirator,  air  passes  down  the  funnel 
and  impinges  on  the  glycerine,  which  an-ests  any  solid  particles. 

As  it  is,  however,  desirable  to  avoid  glycerine,  which  may  (in  spite  of 
previous  careful  examination)  contain  foreign  particles,  a  still  better  plan 

'  Supplementary  Note  on  the  Theory  of  Ventilatipn,  Proceedings  of  the  Royal  So- 
ciety, ]^ovember  17,  1876. 

■^  The  amounts  of  oxygen  and  nitrogen  can  also  be  determined  ;  but  very  numerous 
observations  have  shown  that  the  oxygen  often  varies  within  extremely  narrow  limits, 
even  when  there  is  no  doubt  of  the  presence  of  considerable  impurity  in  the  air,  so 
that  as  far  as  present  knowledge  gives,  the  determination  of  its  amount  is  no  good  guide 
as  a  general  rule. 

^  On  this  question,  see  Tyndall  on  Floating  Bodies  in  the  Atmosphere  ;  Miquel, 
Annuaire  de  Montsouris,  1882  ;  and  Fodor,  Die  Luft,  op.  cit. 

*  For  these  two  processes  the  determination  of  the  organic  nitrogen  and  carbon,  by 
Frankland's  method,  may  be  substituted,  if  practicable. 

*  See  page  1U3  for  an  account  of  the  suspended  matters  in  air. 


EXAMHSTATION    OF   AIR    ATH)    VENTILATION.  197 

is,  to  take  a  small  bent  tube,  wash  it  tlioroughlv,  diy  it,  and  heat  it  to 
redness  ;  when  cool,  it  should  be  placed  in  a  freezing  mixture,  an  india- 
rubber  tube  be  fixed  on  one  end,  and  air  slowly  drawn  through ;  the  water 
of  the  ail*  condenses  in  the  tube,  and  many  of  the  solid  particles  fall  -oith 
it.  A  drop  is  then  taken  by  a  perfectly  clean  glass  rod,  iDreviously  heated 
to  redness,  placed  on  a  clean  glass,  and  looked  at  mth  an  immersion  lens, 
as  soon  after  collection  as  possible. 

Or  air  may  be  di'awn  through  piu-e  distilled  water,  a  di-op  of  which  is 
then  examined. 

The  late  Dr.  Watson  (Staff- Surge  on),  in  his  examination  of  the  au'  at 
Netley,'  used  fine  glass  thi-eads  soaked  in  pui-e  glycerine,  or  dry,  and 
crushed  glass  ;  after  the  au'  was  drawn  through,  he  washed  the  glass 
threads  with  pure  water,  and  then  examined  the  water.  These  glass  threads 
form  good  traps  for  the  larger  particles.'^  For  thorough  investigation, 
however,  it  is  necessary  to  caiTy  out  cultivation  experiments,  by  can-^ing 
the  au-  through  a  sterilized  solution,  and  watching  carefully  the  develop- 
ment of  the  different  organisms.  Fodor  recommends  a  solution  of  isin- 
glass, 1^  to  2  j)arts  in  300  to  400  of  pure  distilled  water,  thoroughly  boiled, 
and  decanted  or  filtered. 

IMiquel  has  employed  a  variety  of  media,  some  proving  more  convenient 
than  others  for  different  purposes. 

An  aspirator,  to  draw  au-  through  the  tubes,  is  very  easily  made  ;  a 
square  tin  vessel,  with  a  tap  below,  and  a  small  opening  above  to  receive 
the  india-rubber  tube,  is  all  that  is  necessary  ;  fill  this  with  water,  and 
let  it  run  down,  and  measure  the  total  quantity  (in  a  pint  vessel)  dis- 
charged without  tilting  the  vessel.  An  imperial  pint  contains  34.659 
cubic  inches,  and  one  fluid  ounce  1.733  cubic  inch.  A  cubic  foot  is  very 
nearly  1,000  fluid  ounces,  and  the  ounce  may  be  taken  as  1.728  cubic 
inch.^  The  exact  delivery  of  the  aspu-ator  is,  therefore,  easily  deter- 
mined ;  the  air  should  be  di-awn  slowly  through  the  bent  tube  in  the 
freezing  mixtiu-e  or  through  the  aeroscoj)e,  so  that  no  particles  can  es- 
cape. The  use  of  a  large  glass  or  earthenware  vessel  is  perhaps  better, 
as  being  less  liable  to  error  ;  a  piece  of  india-rubber  with  a  clamp  or  ^^inch 
cock,  and  a  double-tubed  india-rubber  cap,  are  ah.  that  are  recj^uii'ed. 

Chemical  Examiimtion. 
2.  Estimation  of  Carbon  Dioxide. — For  our  pui-pose  the  method  pro- 
posed by  Pettenkofer  is  the  best.  A  glass  vessel  is  taken  capable  of  hold- 
ing a  gallon,  or  4^  htres.  The  capacity  is  determined  by  filhng  it  with 
water,  and  by  measuring  the  contents  by  means  of  a  litre  or  pint  measure 
.  (1  oz.  =28.4  cubic  centimetres).  Angus  S  nith  recommends  extracting 
the  ah'  from  the  bottle  by  means  of  bellows.  But  the  most  convenient 
way  is  simply  to  fill  tlie  vessel  with  water  in  the  place,  the  air  of  which  is 
to  be  examined,  and  then  to  let  it  di'ain  for  a  little.  When  this  is  done 
60  CO.  of  clear  lime  or  baiyta  water  are  put  in,  and  the  mouth  is  closed 
with  an  india-rubber  cap.^     The  vessel  is  agitated  so  that  the  lime-water 

'  Army  Medical  Department  Report,  vol.  xi. ,  p.  529. 

^  I  have  found  carrying  the  air  through  a  succession  of  hottles  containing  pure  dis- 
tilled water  the  best  plan,  for  the  sediment  is  examined  by  the  microscope,  and  the 
liquid  part  can  be  used  for  chemical  examinations  for  organic  matter. — (F.  de  C.) 

^  These  numbers  are  exact  at  39'  Fahr.,  or  the  maximum  density  point  of  water. 

■*  Should  an  india-rubber  cap  not  be  available,  a  cork  or  a  bung  may  be  used,  tied 
over  with  leather  or  oil-skin  ;  in  that  case  the  second  alkalinity  of  the  lime-water  (if 
this  be  used)  should  be  determined  as  soon  after  the  six  or  eight  hours  as  possible, 
certainly  within  twenty-four  hours. 


198  PRACTICAL    HYGIENE. 

may  run  over  the  sides,  and  then  it  is  left  to  stand  for  not  less  than  six  or 
eight  hours  if  lime  water  be  used  ;  if  baryta  water  be  used,  the  experiment 
may  be  completed  in  a  much  shorter  time,  less  than  one  hova:  The  CO, 
is  absorbed  by  the-  lime  or  bar>-ta  water,  and  consequently  the  causticity 
of  these  fluids  is,  j^ro  tanto,  lessened.  If  the  causticity  of  the  lime  or  ba- 
ryta is  known  before  and  after  it  has  been  placed  in  the  vessel,  the  difference 
wiU  give  the  amount  of  hme  or  barj-ta  which  has  become  united  with  C0„. 
The  causticity  of  lime  is  determined  by  means  of  a  solution  of  crystal- 
lized oxalic  acid,'  1  C.C.  of  wliich  exactly  neutralizes  1  milhgi-amme  (.001 
gramme)  of  lime  ;  30  C.C.  o_  lime-water  are  taken,  and  exactly  neutralized  ; 
good  tunneric  paper  is  the  best  plan  that  is  usually  available  for  determin- 
ing the  exact  point  of  neutralization,  and  the  mai-gin  of  the  drop  gives  the 
most  dehcate  indication.  EosoUc  acid  has,  however,  been  recommended, 
and  also  the  solution  of  phenolphthaleine  ;  the  latter  gives  very  exact  indi- 
cations. The  amount  of  lime  in  the  30  C.C.  is  then  equal  to  the  number 
of  C.C.  of  oxalic  acid  used;  it  is  always  somewhere  between  34  and  41 
milligrammes.^ 

After  the  lime  has  absorbed  the  CO,  of  the  air  in  the  vessel,  30  C.  C.  of 
the  solution  are  taken  out  and  tested  "uith  the  oxalic  acid  solution  as  be- 
fore ;  the  diflference  shows  the  milligrammes  of  lime  precipitated  by  the 
CO,.  Muhiply  the  difference  by  0.795,  the  result  is  the  C.C.  of  CO,  in  the 
quantity  of  au-  examined.  Deduct  60  C.C.  from  the  total  capacity  of  the 
jar  (to  account  for  the  space  occupied  by  the  hme-water  put  in),  and 
state  the  capacity  in  litres  and  decimals  ;  divide  the  C.C.  of  C0„  obtained 
by  the  coiTected  capacity  of  the  jar  ;  the  quotient  is  the  C.C.  of  CO,  per 
1,000  volumes  of  air. 

Example. — The  first  alkalinity  of  lime-water  )        qq  r     SO  C  C 

was ....    [ 

After  exposure  to  the  air  in  the  ]         qq  h 

]ar  it  was ) 

Difference,  being  milligrammes  )  6.  precipitated  by  CO, 

of  hme f  in  jar. 

Multiply  by  factor 0.795 

4770  =  Total  CO,  in  jar 
in  C.C. 

Capacity  of  jar 4,385  C.C. 

Deduct  60  C.C.  for  space  taken  up  by  lime- 
water  60 

Net  capacity =4,325  C.C.  =  4.325  litrea 

Then  4.770V  4.325  =  1.103  C.C.  of  CO,  per  htre,  or  volumes  per  1,000. 
The  factor  0.795  is  obtained  as  follows: — The  difference  between  the  two 
alkalinities  expresses  milhgi-ammes  of  lime  i:)recipitated  by  C0„ ;  from  this 
the  milligrammes  of  CO,  can  be  got,  by  caleiilating  from  the  ratios  of  the 
equivalents,  thus  : 

CaO.  COj.  Mgm.      CaO.      Mgm.  of  CO3. 

56        :        44       \\       a        :         x         :      .• .     x  =  a  x  ■^. 
As  1  C.C.  of  CO,  at  32°  Fahr.  (0°  Cent.)  weighs  1.9767  miUigrammes, 

'  See  Appendis  A,  Vol.  II. 

'  The  amoun:;  varies  with  the  temperature,  lime  being  less  soluble  in  hot  than  cold 
water  ;  at  60.7"  the  amount  is  38.6;  with  a  difference  of  +0.1  for  every  degree  below 
that,  and  —0.1  for  every  degree  above  (Fahr.). 


EXAMINATION    OF    AIR    AND    VENTILATION.  199 

the  ratio  between  weight  and  volume  is  -.  nnaj  =  0.506  ;   .  • .  x  x  0.506  = 

C.C.  of  COj,  coiTesponding  to  the  milligrammes  by  weight.     As  60  C.C.  of 
lime-water  were  put  into  the  jar,  and  only  30  C.C.  taken,  the  result  must 

44 

be  multipHed  by  2.    Therefore  the  factors  combined  are  :  ^  x  0.506  x  2  = 

0.795,  and  this,  multiphed  by  a,  the  difference  between  the  two  all^ahnities, 
gives  X,  the  total  C.C.  of  CO.,  in  the  jar. 

If  baryta  be  used  instead  of  lime,  it  must  be  free  from  traces  of  potash 
and  soda  ;  a  much  smaller  quantity  of  liquid  may  be  employed,  as  it  is  so 
much  more  soluble  than  Hme  ;  the  calculation  is  the  same. 

A  correction  for  the  temperature  of  the  air  examined  must  be  made, 
the  standard  being  32°  Fahr.,  or  0°  C,  the  freezing-point  of  water.  If  the 
temperature  be  above  this  (as  it  will  generally  be,  at  least  in  buildings) 
the  air  will  be  expanded,  and  a  smaller  quantity,  by  weight,  consequently, 
will  be  operated  on.  On  the  other  hand,  below  32°  the  air  will  be  con- 
tracted, and  a  larger  quantity,  by  weight,  operated  on  than  at  the  standard 
tempei'ature.  This  can  be  corrected  by  adding  0.2  per  cent,  to  the  result* 
for  every  degree  above  32^^,  and  subtracting  it  for  every  degree  below  ;  the 
reason  being  that  air  expands  or  contracts  0.2  per  cent,  for  every  degree 
(or  1  per  cent,  for  every  5  degrees)  it  deviates  from'  the  standard. 

Example. — In  the  preceding  example  the  CO^  was  found  to  be  1.103 
per  1,000.  Suppose  the  temperature  to  have  been  60°  Fahr.,  then  60-32 
=  28°  to  be  corrected  for  ;  28  x  0.2  =  5.6  per  cent,  to  be  added  on  to  result, 
or  the  result  must  be  multiplied  by  1  +  . 056  =  1.056,  .-.  1.103  x  1.056  = 
1 154  per  1,000,  the  corrected  result.  Suppose  the  temperature  had  been 
25°Fahr.,  then  32-25  =  7°  to  be  corrected  f  or  ;  7  X  0.2  =  1.4  per  cent,  to  be 
deducted,  or  the  resultmustbe  multiplied  by  1.00-. 014=0.986, .-.  1.103  X 
0.986=1.087,  the  corrected  result. 

A  correction  for  pressure  is  not  necessary,  unless  the  place  of  obser- 
vation be  much  removed  from  sea-level ;  in  that  case,  the  barometer  must 
be  observed,  and  a  rule  of  three  stated. 

As  standard  height  of  bar :  )    j  observed  height } 
(=29.92   in.  =760   mm.) :  j    ]  of  bar:  y-  ■  a  :  x. 

It  must  be  understood  that  none  of  the  methods  hitherto  used  for  the 
determination  of  CO,  in  the  air  give  quite  accurate  results,  but  the  above 
is  the  most  convenient  for  ordinary  use  and  is  sufficiently  accurate  for 
practical  purposes.  The  results  differ  considerably  if  the  quantities  of  air 
treated  vary,  therefore  uniformity  in  this  point  is  desirable. 

Dr.  W.  Hesse  (of  Schwarzenberg)  has  devised  an  ingenious  portable 
apparatus  for  determination  of  C0„,  l3ut  the  quantities  of  air  treated  seem 
rather  too  small.  The  apjDaratus  includes  the  various  apparatus  necessary 
for  measuring  cubic  space,  determining  air  currents,  ascertaining  the  CO^, 
and  observing  the  humidity  (by  Wolpert's  hygrometer). 

3  and  4.  Estimation  of  Free  Ammonia  and  of  the  Nitrogenous  Matter  in 
Air  by  Conversion  into  Albuminoid  Ammonia. — The  nitrogenous  matter  ex- 
isting in  air  may  be  in  the  form  of  dead  or  living  matter  of  very  various 
kinds.  Its  determination  may  be  useful  as  showing  that  one  or  other  of 
these  classes  of  substances  exists  in  the  air  in  proportions  greater  than  in 
pure  air.  The  amount  of  nitrogen  may  be  estimated  in  a  similar  man- 
ner to  that  proposed  by  Wanklyn  and  Chapman  for  water.  The  late  Mr. 
Chapman,'  finding  that  water  did  not  sufficiently  absoi'b  the  nitrogenous 

1  Chemical  News,  February  11,  1870. 


200  PEACTICAL    HYGIENE. 

substances  in  air,  proposed  to  heat  finely  powdered  pumice-stone  to  red- 
ness, to  moisten  it  with  pure  water,  and  then  to  place  it  over  some  coarse 
pieces  of  pumice-stone  supported  on  wire  in  a  funnel ;  a  definite  quantity 
of  air  (say  100  litres)  is  then  drawn  through  the  funnel ;  the  pumice-stone 
is  transferred  to  a  retort  containing  water  freed  fi'om  ammonia,  and  dis- 
tilled as  in  the  determination  of  the  albuminoid  ammonia  of  water.  Dr, 
Angus  Smith '  takes  a  bottle  of  about  2,000  C.C.  capacity,  places  in  it  SO- 
SO  C.C.  of  the  purest  water,  draws  into  it  the  air  to  be  examined,  and  then 
agitates  the  water  in  the  bottle,  and  proceeds  as  in  Wanklyn's  and  Chap- 
man's water  test.  The  most  convenient  way  is  to  draw  the  air  by  means 
of  a  measured  aspirator,  through  a  succession  of  wash  bottles,  each  con- 
taining 100  C.C.  of  water,  perfectly  free  from  ammonia,  and  then  to  de- 
termine the  free  and  albuminoid  Nllg  by  Wanklyn's  method. 

Another  plan  is  to  lead  a  definite  quantity  of  air  through  a  clean  curved 
tube,  suri'ouuded  by  a  freezing  mixture  ;  the  water  of  the  air  condenses, 
and  with  it  much  of  the  organic  matter ;  the  tube  is  then  washed  out  with 
pure  water,  the  washings  are  put  into  a  retort  with  ammonia-free  water, 
,and  distilled  as  usual.  After  passing  through  the  tube  the  air  should  be 
led  through  piire  water  to  arrest  the  portion  of  organic  matter  that  always 
escapes  condensation. 

The  amount  of  ammonia  (free  and  albuminoid)  is  determined  as  in 
water  analysis.  The  mere  presence  of  free  ammonia  may  be  determined  by 
exposing  strips  of  filtering  paper,  dipped  in  Nessler's  solution  or  in  ether- 
ial  solution  of  the  alcoholic  extract  of  logwood  ;  the  former  becomes  yel- 
low, the  latter  jDurple. 

The  quantity  of  air  drawn  through  must,  of  course,  be  accurately  de- 
termined by  a  properly  arranged  aspirator,  and  the  results  then  calculated 
in  milligrammes  j)er  cubic  metre,  ^ 

5.  Estimation  of  the  Oxidizable  Matters  in  the  Air  in  terms  of  Oxygen. — 
In  this  case  a  definite  quantity  of  air  is  drawn  through  a  solution  of  per- 
manganate of  potassium  of  known  strength,  and  the  amount  of  undecom- 
posed  permanganate  is  determined  by  oxalic  acid.  Or  part  of  the  water 
through  which  the  air  has  been  draAvn  for  the  ammonia  determinations 
may  be  examined  in  the  same  way  as  in  the  case  of  drinking  water.  The 
permanganate  acts  upon  various  matters  in  the  air,  besides  the  putrescible 
organic  matters,  such  as  hydrogen  sulphide,  nitrous  acid,  tarry  matters, 
etc.  The  presence  or  absence  of  H„S  may  be  determined  qualitatively  by 
means  of  acetate  of  lead  papers,  ammonium  sulj^hide  by  pajoer  dipped 
in  niti'oprusside  of  sodium  ;  whilst  tarry  matters  would  generally  be  re- 
cognized by  the  smell  of  the  water,  or  its  turbidity.  In  the  absence  of 
these  the  difference  between  the  permanganate  determinations,  before  and 
after  boiling  with  sulphuric  acid,  may  be  calculated  as  nitrov;s  acid,  as  in 
the  case  of  drinking  water  ;  whilst  the  result  after  boiling  may  be  reckoned 
as  the  oxygen  for  oxidizable  organic  matter  only.^ 

6.  The  Nitrous  and  Nitric  Acids  may  also  be  determined,  in  the  same 
way  as  in  drinking  water,  from  the  w^ashings  of  the  air  obtained  as  above. 

All  these  determinations  should  be  made,  when  opportunities  ofier,  as 
the  results  may  prove  hereafter  of  some  value. 

7.  Watery  Vapor. — The  hygi'ometric  condition  of  the  air  is  ascertained 
in  various  ways,  especially  by  the  dry  and  wet  bulb  thermometer,  or  by 

'  Air  and  Rain,  p.  421. 

2  One  cubic  metre  equals  1,000  litres,  or  1,000.000  C.C. 

2  See  Reports  on  St.  Mary's  Hospital,  by  Dr.  F.  de  Chaumont. 


EXAMINATION^    OF    AIR    AND    VENTILATION.  201 

Dines'  direct  hygrometer.     The  hau'  hygrometer  of  Saussure  is  also  a  use- 
ful instrument  for  this  joui-pose,  as  it  marks  the  degree  of  humidity  yeiy 
quickly.     Wolpert's  horse-haii'  hygrometer  may  also  be  used. 
8.   The  presence  of  H.-,S,  etc.,  has  been  referred  to  above. 


SECTION  TV. 

SCHEME  FOR  THE  APPLICATION  OF  THE  FOREGOING  RULES. 

When  a  ventilation  inquiiy  is  about  to  be  made,  everything  ought  to 
be  got  ready  beforehand.  A  number  of  bottles  (about  4  to  4^  litres),  or 
glass  jars,  ought  to  be  carefully  measured,  and  the  capacity  in  C.C.  (less 
60  C.C.  to  account  for  the  lime-water)  marked  upon  them  ;  each-  bottle 
ought  also  to  have  a  closely  fitting  india-rubber  cap  and  a  distinctive 
number.  These  bottles  are  to  be  used  for  collecting  the  samples  of  air 
for  Co,.  Charges  of  lime-water  (or  baryta-water)  (each  60  C.C.)  ought  to  be 
carefully  measured  off  with  a  burette,  or  graduated  pipette,  into  small 
stoppered  bottles.  Two  or  more  sets  of  wet  and  dry  bulb  thermometers' 
ought  to  be  ready,  and  two  or  more  series  of  not  less  than  six  bottles, 
each  containing  about  100  C.C.  of  pure  distilled  water,  connected  together 
vfith  glass  tubes  and  india-rubber  caj^s  ;  also  four  or  more  asph-ators  foi 
drawing  the  aii-  through  the  bottles.  One  of  CaseUa's  small  air-meters, 
with  a  long  pole  in  joints,  intu  which  it  can  be  screwed,  a  measui'ing  ta23e 
and  foot-rule,  a  pocket-compass,  some  pieces  of  cotton-velvet,  a  note-book, 
are  also  necessary. 

When  a  room  has  to  be  examined,  enter  it  after  being  some  time  in  the 
open  air,  and  notice  if  there  be  any  smell ;  record  the  sensation  at  once 
in  your  notes.  Hang  up  the  wet  and  diy  biilb  thermometer  (if  it  has  not 
been  placed  there  before),  and  then  proceed  to  take  samples  of  the  aii"  for 
C0„  ;  fin  the  jars  with  water,  empty  them,  and  allow  them  to  di-ain  ;  then 
pour  into  each  jai'  the  hme-water  fi'om  one  of  the  small  bottles,  put  on  the 
india-rubber  cap,  and  shake  it  up.  Always  take  tico  samples  at  least,  and 
more  if  a  large  room.  Xote  the  numbers  of  the  bottles.  Take  the  wet 
and  dry  bulb  readings.  Ai-range  the  set  of  bottles  with  distilled  water  in 
some  convenient  place,  and  attach  them  to  one  of  the  aspirators,  which 
may  be  allowed  to  flow  into  another  below  it.  When  the  upper  one  is 
empt}'  it  may  be  changed  for  the  lower  one,  and  so  the  stream  of  air  may 
be  carried  on  for  any  length  of  time,  as  seems  necessary, — the  number  of 
times  the  aspirators  are  changed  should  be  duly  noted.  In  determiniug 
the  carbon  dioxide,  put  out  all  the  lights,  or  have  only  sufficient  for  work- 
ing ptu'poses  ;  allow  no  smoking,  and  have  no  person  in  the  room  but 
those  who  are  sleeping  there.  The  aspu-ators  may  be  allowed  to  go  on 
continuously,  but  the  examination  of  the  air  for  CO.,  ought  to  be  repeated 
at  intervals,  the  exact  time  of  observations  being  noted.  At  the  same  time, 
similar  observations  ought  to  be  made  in  the  open  au-,  as  nearly  as  possible 
simultaneously  with  those  inside.  At  some  convenient  time  the  measure- 
ments of  the  room  and  the  ventilators,  the  velocities  of  the  currents  of  air, 
etc.,  should  be  taken  on  some  such  plan  as  the  following  : — Measiu'e  the 
cubic  space,  then  consider  the  jDossible  sources  of  entrance  and  exit  of  air  ; 
if  there  are  only  doors  and  windows,  notice  the  distance  between  them, 
how  they  open,  on  what  external  place  they  open  ;  whether  there  is  free 
passage  of  air  from  side  to  side  ;  whether  it  is  hkely  the  air  ■v\-ill  be 
properly  distributed.     On  all  these  points  an  opinion  is  soon  ai-iived  at. 


202  PRACTICAL   HYGIENE. 

If  there  are  other  openings,  measure  them  all  carefully,  so  as  to  get  their 
supei'ficies  ;  the  chimney  must  be  measured  at  its  throat  or  smallest  part. 
Determine  then  the  du-ection  of  movement  of  air  through  these  openings 
by  smoke,  noting  the  apparent  rapidity.  The  doors  and  windows  should 
be  closed.  When  the  inlets  have  been  discovered,  consider  whether  the 
air  is  drawn  from  a  jDiu-e  external  source,  and  whether  there  is  proj^er  dis- 
tribution in  the  room.  Then  measure  the  amount  of  movement  in  both 
inlets  and  outlets  with  the  anemometer,  or  calculate  by  the  table  if  it  seems 
safe  to  do  so. 

If  the  ventilation  of  the  room  is  influenced  by  the  wind,  the  horizontal 
movement  of  the  external  air  should  be  determined  by  Robinson's  anemo- 
meter, or  the  little  air-meter  by  Casella  may  be  also  used  for  this  purpose, 
unless  the  wind  be  very  strong. 

In  recording  the  velocity  of  the  air  at  any  openings  it  is  convenient  to 
mark  an  incoming  cuxTcnt  with  apZws  sign  and  an  outgoing  with  a  minus, 
thus  :  +  75  would  mean  an  incoming  current  at  the  rate  of  75  feet  per 
minute  ;  while  —  63  would  mean  an  outgoing  current  at  63  feet  per  minute. 

When  the  final  analyses  are  made,  and  the  amoimt  of  CO^  determined, 
the  amount  of  air  per  head  per  hour,  supplied  and  utilized,  ought  to  be 
calculated  out  (as  before  explained),  and  compared  with  the  amount  of 
movement  determined  with  the  aii'-meter.  If  the  quantities  accord  fairly, 
the  distribution  may  be  considered  good ;  on  the  other  hand,  if  they  differ, 
an  excess  by  the  air-meter  shows  bad  distribution,  w^iilst  a  deficiency  indi- 
cates some  other  source  of  incoming  air  noi.  yet  observed. 

The  water,  through  which  the  air  has  been  passed  by  the  aspirator, 
ought  to  be  examined  at  once,  if  practicable  ;  if  not,  the  bottles  ought  to 
be  carefully  stoppered,  and  the  stoppers  tied  down  \\dth  leather  or  strong 
linen, — when  convenient,  the  sediment  should  be  examined  microscopically, 
and  the  water  (when  the  sediment  has  subsided)  chemically  ws  before 
explained.  The  sediment  or  a  portion  of  the  water  should  be  put  into  a 
cultivating  solution  for  further  investigation,  if  opportunity  affords. 


CHAPTER  V. 
FOOD. 

SECTION  I. 

GENERAL   PRINCIPLES   OF  DIET. 

Is  the  widest  acceptation  of  the  term,  Food  includes  every  thing  ingested, 
which  goes  directly  or  indirectly  to  the  growth  or  repair  of  the  body,  or  to 
the  production  of  energy  in  any  form.  In  this  way  it  would  include  not 
only  those  organic  and  mineral  solids  and  the  usual  beverages  recognized 
as  dietetic,  but  also  water  and  aii'.  For  it  is  Cjuite  obvious  that  without 
water  no  function  of  the  living  body  would  be  possible,  whilst  the  produc- 
tion of  energy  is  mainly,  if  not  entu-ely,  caused  by  the  union  of  the  atmos- 
pheric oxygen  with  the  organic  matter  of  the  food  or  the  tissues  of  the 
body  itself.  Although  these  facts  are  distinctly  recognized,  it  has  generally 
been  the  practice  to  restrict  the  term  "food"  to  those  substances  which 
are  capable  of  oxidation,  or  those  which  act  as  directors  cr  regulators  of 
nutrition,  to  the  exclusion  of  air  and  water  ;  these  two  last  being  usually 
considered  under  separate  heads.  No  one  group  even  of  this  rough  classi- 
fication is  capable  of  sustaining  healthy  life  alone,  and  a  combination  of 
aU,  or  nearly  all,  the  different  constituents  of  diet  is  required  to  accom- 
plish the  best  results.  It  is  also  necessary  to  hmit  the  appellation,  "food," 
so  as  to  exclude  generally  medicines  and  poisons,  which,  on  the  one  hand, 
either  act,  or  are  intended  to  act,  upon  processes  of  unhealthy  nutiition,  or, 
on  the  other  hand,  prevent  the  processes  of  healthy  nutrition,  and  so  induce 
unhealthy  nutrition,  and  ultimately  dissolution.  Even  here  the  line  can- 
not be  too  strictly  drawn,  for  in  many  cases  it  is  a  question  more  of  quan- 
tity than  kind  that  determines  the  dii-ection  of  the  action. 

The  enumeration  and  classification  of  the  foods  or  aliments  necessaiy 
to  maintain  human  life  in  its  most  perfect  state  have  been  usually  based  on 
the  deduction  of  Prout,  that  milk  contains  all  the  necessaiy  ahments,  and 
in  the  best  form.  The  substances  in  milk  are — 1st,  the  nitrogenous  mat- 
ters, viz.,  the  casein  princijDally,  and  in  smaller  quantities,  albumin,  lacto- 
protein,  and  perhaps  other  albuminous  bodies  ;  2d,  the  fat  and  oil ;  3d, 
sugar  in  the  form  of  lactin  ;  4th,  water  and  salts,  the  latter  being  espe- 
cially combinations  of  magnesium,  calcium,  potassium,  sodium,  and  iron, 
vdth  chlorine,  phosphoric  acid,  and  in  smaller  quantities  sulj)huric  acid. 

In  addition  to  their  occun'ence  in  milk,  which  is  admitted  to  be  a  i^er- 
fect  food  for  the  young,  this  enumeration  of  ahments  appears  to  be  justi- 
fied by  two  considerations.  First,  that  the  different  members  of  each  class, 
inter  se,  have  a  remarkably  similar  composition,  while  there  are  broad  lines 
of  physical  and  chemical  demarcation  between  the  classes  ;  and  secondly, 
that  the  different  classes  appear  to  serve  different  pui-poses  in  nutrition, 
and  are  all  necessaiy  for  perfect  health. 

The  first  point,  the  similarity  of  composition  among  the  different  mem- 


204  "  PRACTICAL    HYGIENE. 

bers  of  the  same  class,  is  obvious  enough.  The  nitrogenous  ahments  are 
blood-fibrin,  muscle  fibrin  or  syntonin,  myosin,  vegetable  fibrin,  albumin 
in  its  various  forms,  casein  (in  its  animal  and  vegetable  forms),  and  globu- 
lin. Their  conjposition,  etc.,  are  remarkably  uniform  ;  they  contain  be- 
tween 15.4  and  1G.5  per  cent,  of  nitrogen,  and  may  be  conveniently  distin- 
guished by  the  common  term  of  albuminates.  They  can  replace  each  other 
in  nutrition.  There  are  some  other  nitrogenous  bodies,  such  as  gelatin 
and  chondrin,  and  the  substances  classed  under  keratin  or  elastin,  which, 
though  approaching  in  chemical  characters  to  the  other  substances,  ai-e 
not  their  nutritive  equals. 

The  second  class  consists  of  the  various  animal  and  vegetable  fats,  wax, 
etc.,  the  composition  of  which  is  very  uniform,  and  the  chief  nutritive 
differences  of  which  depend  on  physical  conditions  of  form  or  aggregation, 
which  conditions  cause  some  fats,  when  acted  upon  by  the  aHmentary  fluids, 
to  be  moi-e  easily  absorbed  than  others. 

The  group  of  the  starchy  and  saccharine  substances  (the  carbo-hydrates), 
or  of  their  alhes  or  derivatives  (dextrin,  pectin),  is  equally  well  character- 
ized by  chemical  resemblances,  inter  se,  and  differences  from  the  other 
groups.  The  several  dietetic  starches,  sugars,  including  lactin,  cellulose 
(whose  want  of  nutritive  power  is  dejoendeut  on  form  and  aggregation,  and 
which  requires  for  digestion  a  more  elaborate  apparatus  than  some  animals 
possess),  and  the  various  derivatives  of  the  starches,  are  all  closely  aUied. 
There  has  been  some  doubt  whether  pectin  sliould  be  classed  chemically 
vrith  the  sugar  and  starch  group,  as  the  oxygen  and  hydrogen  are  not  in 
the  proportions  to  form  water,  but  this  is  perhaps  no  objection  to  its  asso- 
ciation in  a  dietetic  classification. 

The  foui-th  class,  consisting  of  the  salts  already  noted  and  of  water, 
needs  no  comment. 

The  physiological  evidence  that  these  classes  of  ahments  serve  different 
purposes  in  nutrition  is  not  so  complete  as  that  of  their  chemical  diff"er- 
ences. 

A  broad  distinction  must,  of  course,  be  drawn  between  the  nitrogenous 
and  non-nitrogenous  substances.  Late  researches,  w^hich  have  much  modi- 
fied our  opinion  of  the  direction  in  which  the  potential  energy  of  the  diet- 
etic princijiles  may  be  manifested  (as  heat,  or  electricity,  or  mechanical 
movement),  and  of  the  mode  in  which  the  nitrogenoiis  substances  in  par- 
ticular, aid  or  restrain  this  transformation,  do  not  impeach  the  proposition 
that  the  presence  of  nitrogen  in  an  organized  structure,  and  its  participa- 
tion in  the  action  going  on  there,  is  a  necessary  condition  for  the  manifes- 
tation of  any  energy,  or  any  chemical  change.  Whether,  when  energy  is 
manifested,  the  nitrogenous  framework  of  any  nitrogenous  structure  is  a  mere 
stage  on  which  other  actors  play,  or  whether  it  in  used  up  and  destroyed, 
or  is,  on  the  other  hand,  built  up  or  renovated  during  action,  is,  so  far  as 
classification  of  food  is  concerned,  a  matter  of  no  consequence. 

The  following  considerations  seem  to  prove  the  necessary  participation 
of  the  nitrogenous  structures  in  manifestations  of  energy.  Every  structiire 
in  the  body  in  which  any  form  of  energy  is  manifested  (heat,  mechanical 
motion,  chemical  or  electrical  action,  etc.)  is  nitrogenous.  The  nerves,  the 
muscles,  the  gland-cells,  the  floating  cells  in  the  various  liquids,  the  semen 
and  the  ovarian  cells,  are  all  nitrogenous.  Even  the  non-celhilar  Uquids 
passing  out  into  the  alimentary  canal  at  various  points,  which  have  so  gTcat 
an  action  in  preparing  the  food  in  different  ways,  are  not  only  nitrogenous, 
but  the  constancy  of  this  implies  the  necessity  of  the  nitrogen,  in  order  that 
these  actions  shall  be  performed ;  and  the  same  constancy  of  the  presence 


FOOD.  205 

of  nitrogen,  when  function  is  performed,  is  apparently  traceable  through 
the  whole  world.  Surely  such  constancy  proves  necessity.  Then,  if  the 
nitrogen  be  cut  off  from  the  body,  the  various  functions  languish.  This 
does  not  occur  at  once,  for  every  bod}'  contains  a  store  of  nitrogen,  but  it 
is  at  length  inevitable.  Again,  if  it  is  wished  to  increase  the  manifestation 
of  the  energies  of  the  various  organs,  more  nitrogen  must  be  supj^lied. 
The  experiments  of  Pettenkofer  and  Voit  show  that  the  nitrogenous  sub- 
stances composing  the  textures  of  the  body  determine  the  absoi-ption  of 
oxygen.'  The  condensation  of  the  oxygen  from  the  atmosphere,  its  con- 
version into  its  active  condition  (ozone),  and  its  application  to  oxidation, 
are  according  to  their  experiments  entirely  under  the  control  of  the  nitro- 
genous tissues  (fixe'd  and  floating),  and  are  apparently  proportional  to  their 
size  and  vigor, ^  and  to  changes  occurring  in  them.  The  absorption  of 
oxygen  does  not  determine  the  changes  in  the  tissues,  but  the  changes  in 
the  tissues  determine  the  absorption  of  oxygen.  In  other  words,  without 
the  participation  of  the  nitrogenous  bodies,  no  oxidation  and  no  manifesta- 
tion of  energy  is  possible.  The  experiments  show  that  the  absorption  of 
oxygen  by  the  lungs  (blood-composition,  and  physical  conditions  of  pres- 
sure, etc.,  remaining  constant)  is  dependent  on  its  disposal  in  the  body, 
and  that  this  disposal  is  in  direct  relation  with  the  absolute  and  relative 
amount  and  action  of  the  nitrogenous  structures.  Mechanical  motion, 
electricity,  or  heat  may  be  owing  to  oxidation  of  fat  or  of  starch,  or  of 
nitrogenous  substance  ;  but  whatever  be  the  final  source,  the  direction  is 
given  by  the  nitrogenous  structures. 

The  next  point  is  not  quite  so  clear.  Are  the  non-nitrogenous  bodies, 
the  fats  and  the  starches,  to  be  again  broadly  separated  into  two  groups, 
which  cannot  replace  each  other  ;  or,  are  these  nutritively  convertible  ?  It 
is  now  certain  that  fat  may  arise  from  albuminates,  so  that  the  nitrogenous 
substance  plays  two  parts — first,  that  of  the  organic  framework,  i.e.,  of  tlie 
regulator  of  oxidation  and  of  transformation  of  energy;  and,  second,  it 
may  form  a  non-nitrogenous  substance  which  is  oxidized  and  transformed. 

The  experiments  of  Edward  Smith,  Fick  and  Wislicenus,  Haughton, 
and  others,  on  muscular  action,  prove  that  we  must  look  for  the  main  source 
of  energy  which  is  apparent  during  muscular  action  in  the  oxidation  of 
non-nitrogenous  substances,  but  no  experiments  have  yet  shown  whether 
these  are  fatty  or  saccharine.  It  seems  to  be  inferred  that  it  is  fat  which 
is  thus  chiefly  acted  upon  ;  but  this  opinion  is  rather  derived  from  a  refer- 
ence to  the  universal  presence  of  fat  when  energy  is  manifested,  to  the 
known  necessity  of  it  in  diet  (for  though  the  dog  and  the  rat  (Savory)  can 
live  on  fat-free  meat  alone,  man  cannot  do  so),^  and  from  the  large  amount 
of  energy  its  oxidation  can  produce,  than  from  actual  observation.  If  it 
were  true,  a  broad  distinction  would  be  at  once  drawn  between  fatty  and 
starchy  food,  but  it  is  not  experimentally  proved.  If,  on  the  other  hand, 
it  were  certain  that  the  starchy  aliments  formed  fat  in  the  human  body  as  a 
rule,  this  would  be  a  reason  for  drawing  no  distinction  between  the  groups. 
Independent  of  the  argument  drawn  from  bees  fed  on  sugar  alone  and 
forming  wax,  from  the  fattening  of  ducks  and  geese,  and  the  older  experi- 

^  Zeitsch.  fiir  Biologie,  Band  ii.,  p.  457.  See  especially,  tlie  summary  of  their 
opinion  at  page  571. 

^  When  to  a  diet  of  meat,  which  causes  a  certain  absorption  of  oxygen,  fat  or  sugar 
is  added,  the  absorption  of  oxygen  lessens  (Ranke,  Phys.  des  Menschen,  1868,  p.  145) ; 
80  that  it  is  relative  as  well  as  absolute  amount  which  comes  into  play. 

^  Ranke  could  not  maintain  himself  in  perfect  nutrition  on  meat  alone. — Physiol, 
des  Menschen,  1868,  p.  149. 


206  PRACTICAL    HYGIENE. 

ments  on  pigs,  the  later  experiments  of  Lawes  and  Gilbert '  seem  to  show 
clearly  that  the  fat  stored  up  in  fattened  pigs  cannot  be  derived  from  the 
fat  given  in  the  food,  but  must  have  been  produced  partly  from  nitrogenous 
substances,  but  chiefly  from  the  carbo-hydrates.  So  also  it  seems  now 
probable  that  the  fat  in  milk  is  not  derived  at  once  from  blood,  but  fi-om 
changes  of  albumin  in  the  lacteal  gland-cells.  There  seems  no  reason  why 
we  should  not  extend  the  inference  to  man.  If  so,  a  man  could  live  in 
perfect  health  on  a  diet  composed  only  of  fat-free  meat  and  starch,  with 
salts  and  water,  just  as  he  can  certainly  live  (though  perhaj^s  not  in  the 
highest  health)  on  meat,  fat,  salts,  and  water.  The  carbo-hydrates  would 
then  be  proved  to  be  able  to  replace  fats.  The  experiment  has  not  yet 
been  performed  or  at  least  recorded,  but  it  seems  important  it  should  be. 

Grouven's  exjDeriments  also  suggest  that  in  cattle  the  carbo-hydrates 
may  split  up  in  the  alimentary  canal  into  glycerine,  lactic  and  butyric 
acids,  and  cai'bon  dioxide  and  marsh  gas.  If  this  be  true,  in  the  herbivora 
the  starches  would  be  merely  another  form  of  fat. 

An  argument  against  the  fats  and  carbo-hydi-ates  being  mutually  re- 
placeable under  ordinary  conditions  in  the  diet  of  men  is  drawn  from  a 
consideration  of  the  diets  used  by  all  nations.  In  no  case  in  which  it  can 
be  obtained  is  an  admixture  of  starch,  in  some  form,  with  fat  omitted. 
Moreover,  in  all  cases  (except  in  those  nations,  like  the  Eskimos,  who  are 
under  particular  conditions  of  food),  we  find  that  the  amount  of  fat  taken 
is  comparatively  small  as  compared  with  that  of  starches.  The  fats  when 
taken  into  the  iDody  enter  hke  the  albuminates  into  the  structure  of  the 
tissues,"  of  which  fat  forms  in  probably  all  cases  an  essential  part.  The 
carbo-hydrates,  on  the  other  hand,  in  the  human  body  do  not  appear  to  be 
parts  of  the  tissues,  though  they  are  contained  in  the  fluids  which  bathe 
them,  or  are  contained  in  them.  The  sj)ecial  direction  which  the  chemical 
changes  in  the  carbo-hydrates  take  in  the  body,  seem  also  to  point  to 
special  duties.  Thus,  the  formation  of  lactic  and  other  acids  of  the  same 
class  must  arise  from  carbo-hydrates  chiefly  or  solely.  But  the  formation 
of  these  acids  is  certainly  most  important  in  nutrition,  for  the  various 
reactions  of  the  fluids,  which  ofi"er  so  striking  a  contrast  (the  alkalinity  of 
the  blood,  tbe  acidity  of  most  mucous  secretions,  of  the  sweat,  mine,  etc.), 
must  be  chiefly  owing  to  the  action  of  lactic  acid  on  the  phosphates,  or 
the  chlorides,  and  to  the  ease  with  which  it  is  oxidized  and  removed.  If 
the  direction  of  the  changes  which  the  carbo-hydrates  undergo  within  the 
body  is  different  from  that  of  the  fats,  the  products  of  these  changes  must 
be  inferred  to  play  dissimilar  parts. 

"Without  jDushing  these  ai'guments  too  far,  and  with  the  admission  that 
the  subject  is  still  obscure,  we  are  fairly  entitled  to  assert  that  the  two 
groups  of  fats  and  carbo-hydrates  are  not  so  immediately  and  completely 
convertible  as  to  permit  us  to  place  them  together  in  a  classification  of  diets. 

In  the  second  question  to  which  reference  was  made,  "viz.,  that  of  a 
nitrogenous  substance  fiu'nishiiig  fat,  or  a  carbo-hydrate,  the  case  is  simpler. 
The  experiments  of  Voit,  and  of  Lawes  and  Gilbert  as  well  as  other  con- 
siderations, prove  that  the  fat  of  tissues  may  be  derived  from  nitrogenous 

'  On  the  Sources  of  the  Fat  in  the  Animal  Body,  Phil.  Mag  ,  December,  1866. 

"^  The  fats  appear  to  pass  into  the  body  directly  and  alter  saponification,  which  ren- 
ders absorption  easy.  The  soap  is  then,  according  to  Radziejevvski's  experiments  (Vir- 
chow's  Archiv,  Band  xliii. ,  p.  26b),  reconverted  into  fat.  It  has  been  supposed  that  the 
greater  part  of  the  tissue  fat  (fat  cells)  is  not  derived  in  this  way,  but  from  the  tissue 
albuminates;  but  Hofmann's  experiments  and  reasonings  (Zeitsch.  fiir  Biol.,  Band  viii., 
p.  153)  seem  to  show  that  the  ingested  fats  are  stored  up  largely.  Clinical  observa- 
tions certainly  support  this  view. 


FOOD.  207 

substances,  and  there  are  reasons  to  believe  that  a  glycogenous  substance 
may  also  be  derived  from  albuminates.'  It  is  also  probable,  though  not 
proved,  that  these  non-nitrogenous  derivatives  may  be  burnt  up  in  the 
muscles  and  other  parts,  as  Fick  conjectures.^  But  this  cannot  allow  us 
to  consider  an  albuminate  as  an  aliment  which  may  replace  fat  or  starch  in 
the  case  of  man.  The  digestive  system  of  man  is  framed  so  differently 
from  that  of  the  carnivora,  that  fat  must  be  taken  in  its  own  form,  for  it 
either  cannot  be  formed  in  sufficient  quantity  from  albuminates,  or  the 
body  is  poisoned  by  the  excess  of  nitrogen  which  is  necessarily  absorbed  to 
supply  it. 

With  regard  to  the  necessity  of  all  four  classes  of  aliments,  it  can  be 
affirmed  with  certainty  that  (putting  scurvy  out  of  the  question)  men  can 
live  for  some  time  and  can  be  healthy  with  a  diet  of  albuminates,  fat,  salts, 
and  water.  But  special  conditions  of  life,  such  as  great  exercise,  or  ex- 
posure to  very  low  temperature,  appear  to  be  necessary,  and  under  usual 
conditions  of  life,  health  is  not  very  perfectly  maintained  on  such  diet.  It 
has  not  yet  been  shown  that  men  can  hve  in  good  health  on  albuminates, 
carbo-hydrates,  salts,  and  water,  etc.,  without  fat.^ 

The  exact  effect  produced  by  the  deprivation  of  any  one  of  these  classes 
is  not  yet  known.  An  excess  of  the  albuminates  causes  a  more  rapid  oxi- 
dation of  fat  (and  in  dogs  an  ehmination  of  water),  while  an  excess  of  fat 
lessens  the  absorption  of  oxygen,  and  hinders  the  metamorphosis  of  both 
fat  and  albuminate  tissues.  The  carbo-hydrates  have  the  same  effect  when 
in  excess,  and  appear  to  lessen  the  oxidation  of  the  two  other  classes. 

It  is  now  generally  admitted  that  the  success  of  Mr.  Banting's  treat- 
ment of  obesity  is  owing  to  two  actions  :  the  increased  oxidizing  effect  on 
fat,  consequent  on  the  increase  of  meat  (especially  if  exercise  be  combined), 
and  the  lessened  interference  with  the  oxidation  of  fat  consequent  on  the 
dejDrivation  of  the  starches. 

Health  cannot  be  maintained  on  albuminates,  salts,  and  water  alone  ; 
but,  on  the  other  hand,  it  cannot  be  maintained  without  them. 

The  salts  and  water  are  as  essential  as  the  nitrogenous  substances. 
Lime,  chiefly  in  the  form  of  phosphate,  is  absent  from  no  tissue  ;  and 
there  is  reason  to  think  no  cell  growth  can  go  on  without  it ;  certainly,  in 
enlarging  morbid  growths  and  in  rapidly  growing  cells,  it  is  in  large 
amount. 

When  phosphate  of  calcium  was  excluded  from  the  diet,  the  bones  of 
an  adult  goat  were  not  found  by  H.  Weiske  to  be  poorer  in  lime,*  because 
probably  lime  was  drawn  from  other  parts  ;  but  the  goat  became  weak  and 
dull,  so  that  nutrition  was  interfered  with.  Experiment  has  shown  that 
the  growth  of  wheat  is  more  quickly  and  effectually  checked  by  the  ab- 
sence of  phosphoric  acid  than  of  any  other  constituent  fi'om  the  soil.  The 
lowest  forms  of  life  {Bactey^ia  and  Fungi)  will  not  grow  without  earthy 
phosphates. 

Magnesia  is  probably  also  an  essential  constituent  of  growth  in  some 
tissues.     Potash  and  soda,  in  the  forms  of  phosphates  and  chlorides,  are 

'  In  addition  to  physiological  evidence  from  experiments  on  animals,  there  are  cer- 
tain forms  of  diabetes  which  seem  to  prove  that  sugar  must  be  formed  either  from 
albuminates  or  fat,  most  probably  the  former. 

■^  Archiv.  fur  ges.  Phys.,  Band  v.,  p.  40. 

^  In  some  experiments,  both  with  Liebig's  essence  of  meat  and  Hassall's  dried  food 
with  bread,  Dr.  Parkes  was  very  much  struck  with  the  bad  effect  produced  on  the 
health  of  the  experimentators,  and  with  Ihe  immediate  relief  given  by  the  addition  of 
butter  and  a  larger  supply  of  starch,  without  augmentation  in  the  amount  of  nitrogen. 

*  Zeits.  fur  Biol.,  Band  vii.,  p.  179 


208 


PRACTICAL    HYGIENE. 


equally  important,  and  wovild  seem  to  be  especially  concerned  in  the  mo- 
lecvdar  currents  ;  forming  parts  of  almost  all  tissues,  they  are  less  fixed,  so 
to  sjDeak,  than  the  magnesian  and  lime  salts.  It  is  also  now  certain,  that 
the  two  alkalies  do  not  rejilace  each  other,  and  have  a  different  distribu- 
tion ;  and  it  is  so  fai'  observable,  that  the  jDotash  seems  to  be  the  alkali  for 
the  formed  tissues,  such  as  the  blood-cells  or  muscular  fibre  ;  Avhile  the 
soda  salts  are  more  largely  contained  in  the  intercellular  fluids  which  bathe 
or  encircle  the  tissues. 

The  chloi-ine  and  phosphoric  acid  have  also  very  pecuHar  propertie.s — 
the  former  apparently  being  easily  set  free,  and  then  giving  a  very  strong 
acid,  which  has  a  special  action  on  albuminates,  and  the  latter  having  re- 
markable combining  proporiions  with  alkahes.  Both  are  fiu-nished  in 
almost  all  food  ;  the  sodium  chloride  also  sepai'ately.  Carbonic  acid  is 
both  introduced  and  made  in  the  system,  and  probably  serves  many  uses. 
Iron  is,  of  course,  also  essential  for  certain  tissues  or  parts,  esjDecially  for 
the  red-blood  corjxiscles,  and  for  the  coloring  matter  in  muscle,  and  in 
small  quantity  is  found  almost  in  eveiy  tissue,  and  in  eveiy  food.  The  sul- 
phur and  phosphoms  of  the  tissues  apj)ear  to  enter  especially  as  such 
with  the  albuminates. 

Some  salts,  especially  those  which  form  carbonates  in  the  system,  such 
as  the  lactates,  tartrates,  citrates,  and  acetates,  give  the  alkalinity  to  the 
system  which  seems  so  necessary  to  the  integrity  of  the  molecular  cur- 
rents. The  state  of  malnuti-ition,  which  in  its  highest  degree  we  call 
scurvy,  appears  to  follow  ineritably  on  their  absence  ;  and  as  they  exist 
chiefly  in  fresh  vegetables,  it  is  a  well-known  inile  of  dietetics  to  supj^ly 
these  with  great  care,  though  their  nutritive  power  othei-wise  is  small.  So 
important  are  those  substances,  that  they  might  well  be  placed  in  a  sepa- 
rate class,  although  Dr.  Faxj  remarks  that  "  these  principles  are  hardly  of 
sufficient  imjDortance,  in  an  ahmentary  point  of  riew,  so  called,  for  their 
consideration  under  a  distinct  head."  Surely,  this  is  an  under-estimate  of 
their  importance,  considering  the  inevitable  malnutrition  that  follows  on 
their  absence. 

In  addition  to  the  substances  composing  these  four  classes,  there  are 
others  which  enter  into  many  diets,  and  which  have  been  termed  "  acces- 
soiT  foods,"  or  by  some  writers  "force  regulators"  (like  the  salts).  The 
various  condiments  which  give  taste  to  food,  or  excite  salivary  or  alimentary 
secretions,  and  tea,  coffee,  cocoa,  alcohol,  etc.,  furnish  the  chief  substances 
of  this  class.  Much  discussion  has  taken  place  as  to  the  exact  actioii  in 
nutrition  of  these  substances,  but  little  is  definitely  known. 

A  classification,  on  a  simplified  plan,  may  be  made  as  follows : 


to    ) 


1.  Albtimi'nafes. 

All  substances  containing 
nitrogen,  of  a  composition  iden- 
tical with,  or  nearly  that  of 
albumin ;  proportion  of  nitro- 
gen to  carbon  being  nearly  as  2 
to  7,  or  4  to  14. 


Examples, 
f  Albumin, 
I  Fibrin, 
Syntonin, 


Myosin, 


*^*  Substances  containing  a 
larger  proportion  of  nitrogen  are 
apparently  less  nutritious. 

Proportion  of  nitrogen  to  car- 
[bon  about  2  to  U,  4  to  11. 


<   I  Globulin, 
(Casein, 

i  r 

^   !  Glutin, 
§3 1  Legumin, 

>    [ 

Gelatin, 
Ossein, 
Chondrin, 
Keratin, 


Functions. 
Formation    and    repair 
of  tissues  and  fluids  of  the 
body. 

Regulation  of  the  ab- 
sorption and  utilization  of 
oxygen. 

May  also  form  fat  and 
yield  energy  under  special 
conditions. 


Tliese  perform  the  above 
functions  less  perfectly,  or 
only  under  particular  cir- 
cumstances. 


FOOD. 


209 


f  3.  Fats  (or  Hydro-Carbons).         ^ 

Substances  containing  no  ni- 
trogen, but  made  up  ot:  carbon, 
bjdrogen,  and  osj-gen ;  the  pro- 
portion of  oxjgen  being  less  than 
sufficient  to  convert  all  the  hy- 
j  drogen  into  water. 

Proportion  of  unoxidized  hy- 
drogen to  carbon  about  1  to  7.     j 

3.    Carbo-hydrates.  ^ 

Substances  containing  no  ni- 
trogen, but  made  up  of  carbon, 
hydrogen,  and  oxjigen  ;  the  oxy- 
\  gen  being  exactly  sufficient  to  j> 
convert  all  the  hydrogen  into 
water. 

Proportion  of  water  to  carbon 
being  about  3  to  2.  J 


Examples 


Olein, 

Stearin, 

Margarin, 


Starch, 
Dextrin, 
Cane  sugar, 
Grape  sugar, 
Lactin    (or 
milk  sugar), 


Functions. 


Supply  of  fatty  tissues  ; 
nutrition  of  nervous  sys- 
tem ■?  Supply  of  energy 
and  animal  heat  by  oxida- 
tion. 


Production  of  energy 
and  animal  heat  by  oxida- 
tion. Conversion  into  fat 
by  de-oxidation. 


3  («)•  Vegetable  acids  (and  pectcus 
substances  P) 
Substances  containing  no  ni- 
trogen, but  made  up  of  carbon, 
hydrogen,  and  oxygen ;  the  oxy- 
gen being  generally  in  greater 
amount  than  is  sufficient  to  con- 
vert    all     the     hydrogen     into 
l_^  water. 

r 


S   -{  4  Salts  (mineral). 


Oxalic  acid, 
Tartaric  " 
Citric       " 
i- Malic       " 


fin    these    the^       Preserving   the 


oxygen  is  mare 
j  than  sufficient 
1  to  convert  all 


I 


alkalinity  of  the 
blood  by  conver- 
sion into  carbon- 
I  the    hydrogen  [>  ates  ;     furnish    a 
1^  into  water.         1  small   amount   of 
Acetic      "     ^  In  these  there     energy  or  animal 
Lactic      "     •<  is  no  excess  of  j  heat     by     oxida- 
J  (  oxygen.  J  tion. 

f  Sodium  chloride,      ^       Various :      support     of 
I  Potassium    "  |  bony   skeleton,  supply   of 

■{  Calciiim  phosphate,  }■  HCl    for     digestion,     etc. 
I  Magnesium    "  |  Regulators  of  energy  and 

l^Iron,  etc.  J  nutrition. 


Si's- Section'  L — QrA^'Tirr  of  each  Class  of  PEOxniATE  Altmext  en-  a  Good 
Diet  foe  Healthy  Men. 
"We  cannot  deduce  these  quantities  fi'om  milk,  for  this,  though  it  is  a 
perfect  food  for  the  young,  does  not  contain  the  various  constituents  in  the 
best  proportions  for  adults.  The  relative  amounts  have,  therefore,  been 
determined  partly  by  observation  on  a  great  number  of  dietaries,  and 
partly  by  physiological  experiments.  The  general  results  of  the  v,-hole  are 
given  in  the  following  tables  : — 

Average  Daily  Diet  of  Men  in  Quietude. 


Sabsistence  Diet  (Playfair). 

East. 

Oanc8s  Avoir.'     Grammes. 

1 

Ounces  Avoir. 

Granunes. 

Albuminates 

2.0 

0.5 

12.0 

0.5 

57 

14 

310 

14 

2.5 

1.0 

12.0 

71 

Fats 

28 

Carbo-hydrates 

340 

Salts 

0.5 

14 

Total  water-free  food . . 

15.0 

425        i 

1 

16.0 

453 

The  subsidence  diet  is  calculated  as  sufficient  for  the  internal  mechani- 
cal work  of  the  body,  but  it  is  doubtful  if  an  average  man  could  exist  on 
it  without  losing  weight,  as  it  supposes  absolute  repose. 
Vol  I.-14 


210 


PRACTICAL    HYGIENE. 


The  diet  foi'  rest  supposes  very  gentle  exertion,  and  is  probably  the 
minimum  for  a  male  adult  of  average  size  and  vreight,  say  150  ib  or  67 
kilogi'ammes. 

Each  constituent  above  named  is,  theoretically,  absolutely  water-fi'ee, 
but  practically  the  amount  of  "n"ater  present  in  the  so-called  sohd  food 
would  be  from  100  to  150  per  cent,  more,  so  that  the  weights  respectively 
would  be  about  32  to  40  ounces  gi-oss  (907  to  1,134:  grammes). 

For  mere  subsistence,  without  doing  visible  work,  a  man  therefore  re- 
quii'es  about  y'„  of  an  ounce  of  water-fi'ee  food  for  each  ft  weight  of  his 
body,  or  about  ji-^  of  his  total  weight  every  twenty-four  hours. 

Of  the  standard  diets  given  in  the  next  table,  Moleschott's  scale  has 
been  pretty  generally  accepted,  but  the  fat  is  iDerhajDS  rather  low. 

Assuming  the  water-fi'ee  food  to  be  23  ounces,  and  a  man's  weight  to  be 
150  lb,  each  ib  weight  of  the  body  receives  in  twenty-four  hours  0.15 
ounces,  or  the  whole  body  receives  nearly  yJpg-  part  of  its  own  weight. 

This  is  the  dry  food,  but  a  certain  amount  of  water  (between  50  and  60 
per  cent,  usually)  is  contained  in  ordinaiy  food,  and  adding  this  to  the 
water-fi'ee  sohds,  the  total  daily  amount  of  so-called  dry  food  (exclusive  of 
liquids)  is  about  48  to  60  ovmces.     In  addition  to  this,  from  50  to  80 

Standard  Daily  Diets  for  a  Man  in  Ordinary  Work. 


Albuminates 

Fats 

Carbo-hydrates 

Salts 

Total  water-free  food. 


Moleschott. 

I 

Pettenkofer  and 
Voit-i 

1 

1                        1 

Eanke." 

1 

Oz.  Av. 

Gram. 

Oz.  Av. 

Gram. 

Oz.  Av. 

Gram. 

4.59 

2.96 

14.26 

1.06 

130 

84 
4041 

30  1 

4.83 

4.12 

12.40 

1.06 

137 

117 

352 

30 

3.52 
3.52 

8.46 
0.89 

100 
100  'l 
240    ' 
25 

22.87 

648 

22.41 

636 

1  16.39 

«'ii 

Means. 


Oz.  Av.    Gram. 


4.31 

3.53 

11.71 

1.70 


123 
100 
332 

28 


20.65       582 


ounces  of  water  are  taken  in  some  liquid  form,  making  a  total  supply  of 
water  of  70  to  90  ounces,  or  on  an  average  0.5  ounce  for  each  ft  weight  of 
body. 

This  average  amount  of  food  and  water  varies  considerably  from  the 
following  causes  : — 

1.  Individual  conditions  of  size,  vigor,  activity  of  circulation,  and  of 
the  eliminating  organs,  etc.  No  men  eat  exactly  the  same,  and  no  single 
standard  will  meet  all  cases.'     The  usual  average  range  in  different  male 

'  Zeitschrift  fiir  Biologie,  Band  ii.,  p.  523.  Somewhat  different  quantities  are  given 
by  Voit  in  his  later  researches  made  with  Forster,  Renk,  and  Schuster  (Munich,  1877), 
the  fat  during  work  being  much  increased.  See  Fliigge,  Lehrbuch  der  hygienischen 
Untersuchungsmethoden,  Leipzig,  1881.  -  Physiologie  des  Menschen,  18(j8,  p.  1^8. 

^  This  has  been  well  exemplified  in  our  convict  prisons,  in  which,  as  a  matter  of 
convenience,  soldiers  are  sometimes  confined.  The  ordinary  diet,  which  is  suflicient  for 
the  convict,  is  insuflficient  for  the  soldier,  and  that  for  several  reasons:  1.  The  convict 
is  a  smaller  man  on  the  average.  2.  The  previous  life  of  the  convict  is  an  irregular 
one,  in  which  his  food  is  generally  insuflicient ;  whereas  the  soldier's  life  is  usually 
the  opposite,  his  food  is  fairly  good  and  his  meals  regular.  3.  The  crimes  for  which 
the  convict  is  imprisoned  are  crimes  against  society,  and  his  removal  to  a  prison  cannot  be 
considered  much  of  a  degradation  morally,  whereas  his  physical  condition  is  really  im- 
proved. On  the  other  hand,  the  soldier's  crime  is  often  one  of  a  military  character  only, 
hence  his  removal  to  a  prison  is  a  moral  degradation,  especially  if  it  be  a  convict  prison. 
The  result  is,  that,  whilst  the  majority  of  the  civil  prisoners  retain  their  weight  or  even 


:FOOD. 


211 


adults  is  from  40  to  60  ounces  of  so-called  solid  food,  and  from  50  to  80 
ounces  of  water. 

2.  Differences  of  exertion.  If  men  are  tmdergoing  great  exertion  they 
take  more  food,  and,  if  they  can  obtain  it,  the  increase  is  especially  in  the 
classes  of  albuminates  and  fat,  as  shown  in  the  next  table. 

This  would  represent  of  so-called  sohd  food  from  66  to  77  oz.  (1,970  to 
2,180  gxammes). 

The  amount  of  water  is  also  increased,  but  is  veiy  various  according  to 
circumstances,  and  is  apj^arently  not  so  much  augmented  as  the  sohd  food. 

3.  Diff'erences  of  climate.  It  is  a  matter  of  general  behef  that  more 
food  is  taken  in  cold  seasons  and  in  cold  countries  than  in  hot.  It  is  sup- 
posed that  more  energy  in  some  fonn  (finally  in  that  of  heat)  is  necessary, 
and  more  food  is  requned  ;  but  there  may  be  other  causes,  such  as  varying 
exertion. 

Average  Daily  Water-free  Diet  required  for  an  adult  Man  in  very  laborious 
Work,^  or  of  a  Soldier  on  Service  and  in  the  Field. 


Ounces  Avoir. 


Albuminates 

Fats    

Carbo-hjdrates 

Salts 

Total  water-free  food. 


6.0   to 

7.0 

170 

to 

198 

3.5   to 

4.5 

99 

to 

128 

16. 0'  to 

18.0 

454 

to 

510 

1.2   to 

1.5 

34 

to 

43 

26.7   to 

31.0 

757 

to 

879 

The  following  may  be  taken  as  an  approximative  basis  for  the  calcula- 
tion of  diets  according  to  size  and  work  :  — 


For  subsistence  during 

rest.                      j 

For  work  of  about  300 
foot-tons  per  diem. 

For  work  of  about  100,000 
kilog.-metres  per  diem. 

Proximate 
Aliment. 

OuncesAvoir. 

per  lb.  of  body 

weight. 

Grammes  per 

kUogTamme 

of  body 

weight. 

OuncesAvoir. 

per  lb. of  body 

weight. 

Amount  to  be 

added  to  sub- 
sistence   diet 
per  Ib.of  body 
for  every  foot- 
ton  of  work. 

OuncesAvoir. 

G-rammes  per 

kilogramme 

of  body 

weight. 

Amount  to  be 
added  to  sub- 
sistence   diet 
per  kilogr.  of 
body    weight 
foreveryl.OOO 
kilog.-metres 
of  work. 

Grammes. 

Albuminates  . . 

Fats 

Carbo-liydrates, 
Salts 

.017 
.007 
.080 
.003 

1.1 

0.4 
4.9 
0.2 

.031 
.019 
.095 
.007 

.00005 
.00004 
.00005 
.00001 

1.9 
0.9 
7.3 
0.4 

.008 
.005 
.023 
.003 

Total. . . . 

.107 

6.6 

.152 

.00015 

10.4 

.038 

gain,  tbe  majority  of  soldier  prisoners  lose.  It  is  also  found  that  age  has  an  effect,  the 
older  men  losing,  tbe  younger  generally  gaining.  Length  of  sentence  has  also  an  in- 
fluence, partly  on  account  of  some  difference  of  diet  and  work,  but  probably  chiefly 
on  account  of  the  svstem  ultimatelv  accommodating  itself  to  the  altered  conditions. 
Thus  the  men  who  lose  weight  are,  the  heaviest  originally,  the  oldest,  those  with  short- 
est sentences  ;  those  who  are  stationary  or  gain  weight  are,  the  lightest  originally,  the 
youngest,  those  with  longest  sentences.  For  the  data,  from  which  the  above  conclu- 
sions'are  drawn,  I  am  indebted  to  Brigade-Surgeon  J.  G.  Marston,  M.D. — (F.  de  C.) 

'  Plavfair  gives  the  diet  of  a  prize-fighter  in  training  as  9.8  ozs.  albiiminates,  3.1  fats, 
and  3.27  starch  and  su^ar.  There  w'ere  690  grains  of  nitrogen,  and  4,366  grains  of 
carbon. 


212 


PKACTICAL    HYGIENE. 


Beyond  300  foot-tons  (or  100,000  kilogramme-metres)  the  addition 
would  require  to  be  greater. 


For  work  of  450  to  500  foot-tons 
per  diem. 

For  work  of  about  150,000  kilogramme- 
metres  per  diem. 

Proximate  Aliment. 

Ounces  Avoir,  per 
lb.  of  body  weight. 

Amount  to  be 
added  to  ordinary 
work  diet  per  Ib.of 
body  weight  for 
every  foot-ton  of 
work  beyond  300. 

Grammes  per 

kilogramme 

of  body  weight. 

Amount  to  be 
added  to  ordinary 
work  diet  per  Icilo- 
gramme  of  body 
weight  foi'  every 
l,OOUkilog. -metres 
beyond  100,000. 

Albuminates 

Fats 

Carbo-hydrates 

Salts 

.047 
.030 
.120 
.010 

.000107 
.000068 
.000166 
.000020 

2.9 
1.9 
7.6 
0.6 

.020 
.020 
.008 
.004 

Total 

.207 

.000361 

13.0 

.042 

In  the  case  of  any  diet,  the  articles  of  which  are  known,  the  amounts 
of  the  four  classes  of  alimentary  principles  may  be  calculated  fi"om  a  table 
of  mean  composition.      The  following  table  is  compiled  from,  in  most 

Table  for  Calculating  Diets. 


Articles. 


Meat  of  best  quality,  with  little  fat,  [ 
like  beefsteaks ) 

Uncooked  meat  of  the  kind  supplied  ^ 
to  soldiers,  —  beef  and  mutton.  ! 
Bone  constitutes  -J-th  of  the  sol-  j 
dier's  allowance  ' J 

Uncooked  meat  of  fattened  cattle.  ^ 
Calculated  from  Lawes'  and  Gil- 
bert's experiments.     These  num- 
bers are  to  be  used  if  the  meat  is  | 
very  fat J 

Cooked  meat,''  roast,  no  dripping  be-  i 
ing  lost.  Boiled  assumed  to  be  > 
the  same ) 

Corned  beef  (Chicago)  ^ 

Salt  beef  (Girardin) 

"    pork  (Girardin) 

Fat  pork  (Letheby) 


Ik  lOU  Parts. 


Water. 


74.4 

75 

63 

54 

40 
49.1 
44.1 
39.0 


Albumi- 
nates. 


20.5 
15 

14 

27.6 

40 
29.6 
26.1 
9.8 


Fats. 


3.5 

8.4 

19 

15.45 

15 
0.2 
7.0 

48.9 


Carbo- 
hydrates. 


Salts. 


1.6 
1.6 

3.7 

2.95 

5 
21.1 
22.8 

2.3 


'  The  gelatine  of  the  meat  is  reckoned  with  the  albuminates  ;  it  is  not  certain  what 
deduction  should  be  made  on  account  of  its  lower  nutritive  value,  which  is  about  one- 
fourth  that  of  albumen  (Bischof). 

'■'  These  numbers  are  taken  from  John  Eanke's  analysis. 

^  This  is  excellent  meat,  palatable  and  nutritrious  :  half  a  pound  would  form  an  am- 
ple ration  for  the  field,  with  the  due  proportion  of  biscuit,  etc.  As  it  is  merely  corned 
and  not  suited  like  ordinary  salt  meat,  it  is  probable  that  its  constituents  may  be  allowed 
nearly  their  full  nutritive  value. 


FOOD. 


213 


Table  for  Calculating  Diets. — Continued. 


Dried  bacon  (Letheby) 

Smoked  liam  (J.  Konig) 

Horse  flesh.  (J.  Konig) 

"VVbite  fish  (Lethebyj 

Poultry  (Letheby) • 

Bread,  'white   wheaten,  of   average  \ 

quality f 

Wheat  flour,  average  quality 

Biscuit 

Rice 

Oatmeal  (Letbeby) 

Maize  (Poggiale)  (cellulose  excluded) 

Macaroni  (Konig) ...    

Millet  (Konig)  (cellulose  excluded) . . 

Arrow-root 

Peas  (dry) 

Potatoes 

Carrots  (cellulose  excluded) 

Cabbage 

Butter 

Egg(10  percent,  mustbe  deducted  for  ) 
shell  from  the  weight  of  the  egg) ) 

Cheese 

Milk  (sp.  gr.  1,029  and  over) 

Cream  (Letheby) 

Skimmed  milk  (Letheby) 

Sugar 

Pemmican  (de  Cbaumont)  ^ 


In  100  Parts. 


15.0 

27.8 
74.3 
78.0 
74.0 

40 

15 
8 
10 
15 
13.5 
13.1 
12.3 
15.4 
15 
74 
85 
91 

6 

73.5 

36.8 
86.8 
66 

88 
3 

7.2 


Albnmi- 

Fats. 

Carbo- 

nates 

hydrates. 

8.8 

73.3 

24.0 

36.5 

21.7 

2.6 

18.1 

2.9 

21.0 

3.8 

8 

1.5 

49.2 

11 

2 

70.3 

15.6 

1.3 

73.4 

5 

0.8 

83.2 

12.6 

5.6 

63.0 

10 

6.7 

64.5 

9.0 

0.3 

76.8 

11.3 

8.6 

67.3 

0.8 

83.3 

22 

2 

53 

2.0 

0.16 

21.0 

1.6 

0.25 

8.4 

1.8 

0.5 

5.8 

0.3 

91 

1.3.5 

11.6 

...'. 

33.5 

24.3 

4 

3.7 

4.8 

2.7 

26.7 

2.8 

4.0 

1.8 

5.4 
96.5 

35.4 

55.2 

Salts. 


2.9 

10.1 

1.0 

1.0 

1.2 

1.3 

1.7 
1.7 
0.5 
3 

1.4 
0.8 
2.3 
0.27 
2.4 
1 

1.0 

0.7 

variable 

taken  as  2. 7 


5.4 
0.7 
1.8 
0.8 
0.5 
1.8 


cases,  several  analyses  by  different  authors,  those  analyses  being  selected 
which  seem  best  to  represent  the  food  of  the  soldier." 

The  mode  of  using  the  table  is  very  simple  :  the  quantity  of  uncooked 
meat  or  bread  being  kao'O'n,  and  it  being  assumed  or  proved  that  there  is 
no  loss  in  cooking,  a  rule-of-three  brings  out  at  once  the  proportions. 
Thus,  the  ration  allowance  of  meat  for  soldiers  being  12  ounces,  2.4 
ounces,  or  20  per  cent.,  is  deducted  for  bone,  as  the  soldier  does  not  get 
the  best  parts.     The  quantity  of  water  in  the  remaining  9.6  ounces  will  be 

75  X  9  6 

—       '    =  7.2,  and  the  water-free  solids  will  be  2.4  ounces.     The  albu- 
minates will  be  1.44  ounce  ;  the  fats,  .8064  ;  and  the  salts,  ,1536  ounce. 


^  The  sweet  pemmican  used  in  the  Arctic  Expedition  of  1875-76  was  similar  to  the 
above  (the  ordinary  pemmican  used  in  the  same  expedition),  witb  tbe  addition  of  about 
5  per  cent,  of  cane  sugar.  In  other  cases,  particularly  in  the  American  pemmican, 
raisins  and  currants  are  added.  (See  Report  of  Committee  on  Scurvy  for  analyses 
by  Professor  Frankland  and  Dr.  de  Cbaumont.)  A  little  pepper  is  added,  not  reckoned 
quantitatively  in  the  above  analysis,  but  probably  included  in  the  "loss,"  i.e.,  the  dif- 
ference between  the  sum  of  tbe  above  constituents  and  100. 

■^  Of  course,  sucb  tables  are  merely  approximative  ;  but  tbey  are  very  useful  as  giv- 
ing a  general  idea  of  a  diet,  althougb  they  are  not  accurate  enough  to  be  used  in  phys- 
iological inquiries. 


214 


PRACTICAL    HYGIENE. 


Whenever  practicable,  the  nutritive  value  should  be  calculated  on  the 
raw  substance,  as  the  analyses  of  cooked  food  are  more  variable.  It  must 
then  be  seen  that  no  loss  occui's  in  cooking. 

In  the  case  of  salt  beef  or  pork,  it  is  not  certain  how  the  value  should 
be  ctilculated.  The  analysis  by  Girardin '  for  uncooked  salt  beef  (American) 
is  given  in  the  table,  but  the  analysis  of  the  brine  shows  that  much  of  the 
nutritious  matters,  organic  and  mineral  (phosj^horic  acid,  lactic  acid,  mag- 
nesia), have  j)assed  out  of  the  meat."  Liebig  has  reckoned  the  nutritive  loss 
at  one-third,  or  even  one-half.  It  appears  from  Kiihne's  observations,  that 
myosin  is  soluble  in  a  10  per  cent,  solution  of  chloride  of  sodium,  and 
hence  a  large  quantity  of  this  substance  necessarily  j^asses  into  the  brine. 
Analyses  show,  it  is  true,  a  large  percentage  of  tibrin  and  cellular  tissue  in 
salt  meat,  but  this  is  made  up  of  indigestible  nitrogenous  substances,•^^•hich 
affox'd,  probably,  little  real  nutritive  material.  Perhaps  salt  beef  may  be 
reckoned  as  equal  to  two-thii'ds  the  quantity  of  fresh  beef ;  this  estimate  is 
certainly  quite  high  enough. 

The  proportion  of  the  nitrogenous  substances  to  the  fats,  carbo-hydrates, 
and  salts  in  the  standard  diet  is  as  foUows : — 


Moleschott. 

Pettenkofer 
and  Voit. 

Ranke. 

Mean. 

Albuminates 

100 
65 

315 
23 

100 

87 

258 

22 

100 

100 

240 

25 

100 

Fats 

82 

Cai-bo-hvdrates 

272 

Salts 

23 

Amount  of  Nitrogen  and  Carbon. — As  the  phenomena  of  nutiition  are 
chiefly  owing  to  the  various  chemical  interchanges  of  nitrogen  and  carbon, 
and  in  some  cases  of  hydrogen,  with  oxygen,  it  may  be  desired  to  calculate 
the  amount  of  these  constituents  in  any  diet.  This  may  be  done  in  two 
ways. 

1.  Calculate  out  the  diw  albuminates,  fat,  and  carbo-hydi-ates  in  ounces, 
and  then  use  the  following  table  : — 


Water-free  constituents. 

Nitrogen, 
grains. 

Carbon, 
grains. 

Hydrogen, 
grains. 

Sulphur, 
grains. 

Albuminate  :  1  ounce  contains 

1  at :  1  ounce  contains 

69 

212 
336 

194 
184 

175 

13 

48 

8 

Carbo-hydrates  : 

(a)  Starch  :  1  ounce  contains 

(6)  Cane-sugar  :  1  ounce  contains . . 

(^)   1  Glucose :  }  ^  °^^^  contains. . 

The  total  amount  of  carbon  in  one  ounce  of  albuminate  is  233  grains,  but 
of  this  about  29  grains  are  converted  into  urea,  and  are  therefore  oxidized 


'  Comptes  Rendus,  xli.,  756. 

^  Liebig  found  that  the  brine  is  saturated  with  the  juice  of  meat,  and  Mr.  Whitelaw 
(Chemical  News,  March,  1864)  has  shown  that  extract  of  meat  may  be  obtained  by 
dialysis  from  the  brine. 


FOOD. 


215 


only  as  far  as  carbon  monoxide  ;  making  allowance  for  this,  we  have  a  net 
total  equal  to  212  grains  of  carbon  fully  oxidized. 

2.  in  the  following  table,  the  calculation  of  these  ingredients  per  ounce 
has  been  made  ;  the  substance  being  supposed  to  be  in  its  natural  state,  and 
to  have  the  composition  already  assigned  to  it  in  the  former  table. 


One  ounce 

(=437.5  grains)  contains  in  its  natural  state 

in  grains. 

Substance. 

Carbon, 

Hydrogen, 

Sulphur, 

Water. 

Nitrogen. 

capable 
of  being 

capable 
of  being 

capable 
of  being 

Salts. 

oxidized. 

oxidized. 

oxidized. 

Uncooked  meat   (beef)   of  the 

best  quality 

336 

14.14 

55 

4.4 

1.6 

7 

Uncooked  meat  as  supplied  to 

soldiers 

328 

10.35 

60 

6.0 

1.2 

7 

Uncooked  fat  meat  (beef) 

276 

9.6 

94 

10.9 

1.1 

16 

Cooked  meat 

236 

175 

19.0 
27.6 

110 
135 

11.0 

12.4 

2.2 
3.2 

13 

Corned  beef  (Chicago) 

31 

Salt  beef 

215 
193 

20.4 
18.0 

63 

79 

3.9 

6.8 

2.4 
2.1 

93 

Salt  pork 

100 

Fat  pork 

170 

6.8 

185 

24.8 

0.8 

10 

Dried  bacon 

66 
122 
325 
341 
324 

6.1 
16.6 
15.0 
12.5 
14.5 

265 

174 

55 

48 
57 

36.8 

20.6 

4.0 

3.7 

4.5 

0.7 
2.0 
1.7 
1.5 
1.7 

13 

Smoked  ham 

44 

Horse  flesh 

4 

White  lish 

4 

Poultry 

5 

Bread 

175 
66 
35 

5.5 

7.6 

10.8 

116 
166 

180 

1.7 
2.4 
2.6 

0.6 
0.9 
1.3 

5 

Wheat  fl[our 

7 

Biscuit 

7 

Rice 

44 

3.5 

175 

3.3 

0.4 

2 

Oatmeal 

66 

8.7 

168 

4.8 

1.1 

13 

Maize 

59 

7.0 

169 

1.4 

0.8 

6 

Macaroni 

57 
54 

6.3 

7.8 

169 
166 

3.9 
3.5 

0.7 
0.9 

3 

MUlet 

10 

Arrow-root 

57 
66 

0.5 
15.2 

162 
156 

"3.9 

i'.7 

Peas  (dried) 

10 

Potatoes 

324 

1.4 

45 

0.4 

0.2 

4 

Carrots 

372 

1.1 

20 

0.4 

0.1 

4 

Cabbage 

398 

1.3 

17 

0.5 

0.1 

3 

Butter 

26 

0.2 

312 

43.7 

13 

Eggs 

322 

9.3 

68 

7.4 

i.i 

4 

Cheese 

161 
380 

23.2 

2.75 

153 

30 

16.0 
3.3 

3.7 
0.3 

24 

Milk  (sp.  gr.  1,029  and  over). . . 

3 

Cream  ....    

289 

1.9 

100 

13.1 

0.3 

8 

Skimmed  milk 

385 
13 
31 

2.8 
MA 

34 
178 
250 

1.3 

31".  i 

0.3 

3^7 

3 

Sugar 

3 

Pemmican 

8 

The  standard  daily  diet  for  an  adult  man  in  ordinary  work  (Moleschott), 
calculated  in  this  way,  gives — 

Nitrogen 317  grains. 

Carbon 4,750      " 

Hydrogen 202      "  > 

Sulphur 24      " 

Salts 461      " 

Not  infrequently  the  standard  is  stated  as  20  grammes  of  nitrogen,  and  300 
grammes  of  carbon  ;  this  is  equal  to  308.6  and  4,629  grains. 

The  usual  range  is  from  250  to  350  grains  of  nitrogen  for  adult  men. 


216  PKACTICAL    HYGIENE. 

and  the  extreme  range  is  from  2  to  7  ounces  of  dry  albuminate,  or  fi-om  138 
grains  of  nitrogen  (-whicli  is  the  smallest  amount  necessary  for  the  inner 
movements  of  the  body,  and  the  bare  maintenance  of  Hfe,  as  calculated  by 
Plavfaii*),  to  483  or  500  gi-aias,  which  is  the  amount  taken  under  \ev\  gi-eat 
exertion.  Edwai-d  Smith's  careful  observations  on  ill  fed  and  fauly  fed 
operatives,  give  a  range  of  from  135  grains  of  nitrogen  and  3,271  gi-aius  of 
carbon  (in  London  needlewomen)  to  319  grains  of  nitrogen  and  6,195  grains 
of  carbon  (in  Iiish  fann  laborers).  Usually,  however,  in  what  are  almost 
starvation  diets,  the  nitrogen  is  180  to  200  gi-ains,  and  the  carbon  from 
3,900  to  4,300  gi-ains  (Edward  Smith's  investigations  into  the  food  in 
Lancashire  during  the  cotton  famine).  In  convict  prisons,  Dr.  Wilson  teUs 
us  that  the  men  on  hght  labor  receive  224  gTains  of  nitrogen  and  4,651 
gi'ains  of  cai-bon,  and  this  is  sufficient.  Those  on  hard  labor  receive  255 
gi-ains  of  nitrogen  and  5,289  grains  of  cai-bon,  and  on  this  diet  they  lose 
weight,  and  have  to  be  continuously  shifted  from  heavy  to  hghter  work. 
In  tiie  case  of  militai-y  j)risoners  at  hard  labor  even  281  gi-ains  of  nitrogen 
and  5,373  gi-ains  of  carbon  were  insufficient  to  prevent  men  losing  weight. 
In  India  an  improved  diet  was  introduced  by  the  late  Surgeon-General 
Beatson,  C.B.,  in  which  the  nitrogen  was  about  300  grains  and  the  carbon 
about  5,300.  This  appears  to  have  been  sufficient  to  jDrevent  loss  of  weight, 
although  there  was  a  deficiency  of  fat.  The  carbon  ranges  in  various  diets, 
fi'om  3,600  to  5,800  or  6,000  grains.  The  amount  of  the  salts  (461)  apjDeai'S 
rather  large  ;  it  is  difficult  to  test  it  by  determining  the  salts  in  the  excreta, 
as  so  much  sodium  chloride  and  hme  salts  are  lost  through  the  skin,  and 
some  of  the  excreted  salts  may  also  he  mere  sui^Dlusage.  The  salts  seem 
to  be  made  up  of  chloiine,  120  gi'ains  ;  jihosiDhoric  acid,  50  grains  ;  i^otash, 
40  ;  soda,  40  ;  lime,  about  4  grains  by  the  urine  (Byasson),  and  some  by 
the  bowels ;  magnesia,  4.7  gi-ains  by  the  imne,  and  a  considerable  amount 
by  the  bowels  ;  and  iron,  the  amount  of  which  is  imcertain. 

Actual  expeiiipent  has,  to  a  gi-eat  extent,  confinned  the  conclusicns 
di'a^^Ti  fi'om  a  study  of  these  dietaries.  Pettenkofer  and  Yoit,  in  two 
healthy  men,  determined  many  times  the  amount  of  nitrogen  during 
common  exercise,  and  found  it  to  be  19.82  gi-ammes,  or  305.8  grains.  Dr. 
Pai'kes  experimented  on  four  healthy  average  men  in  common  work,  and 
found  the  amount  which  kept  them  in  perfect  health  and  unifoiTQ  weight 
was  293  to  305  grains  of  nitrogen  in  twenty-four  hours.  AU  these  deter- 
minations are  near  Moleschott's  numbers.  The  amount  of  carbon  is,  how- 
ever, perhaps  too  large.  A  certain  proportion  between  the  carbon  and 
nitrogen  ought  to  be  maintained ;  in  the  best  diets  this  is :  Nitrogen  1  to 
carbon  15.' 

Sub-Section  TL — Ox  the  E>*eegt  Obtainable  fkom  the  Various  Articles 

OF  Food. 

The  possible  amount  of  energy  which  can  be  manifested  in  the  body 
■will  be  the  result  of  two  conditions  :  first,  the  amount  of  potential  energy 
stored  up  in  the  food,  which  is,  c>f  course,  easily  deteiTnined  and  expressed 
in  teims  of  units  of  heat  or  of  motion  ;  and  second,  the  extent  to  which  the 
processes  in  the  body  can  hberate  and  apply  this  energy.  For  examj)le, 
an  ounce  of  albumen  can  give  rise  to  a  certain  heating  eftect,  if  it  be  burnt 
in  oxygen  ;  but  in  the  body  thorough  oxidation  can  never  occiu-.  for  some 
(about  one-thu'd)  of  the  constituents  of  the  albumen  pass  out  incompletely 

>  The  Soldier's  Ration,  by  F.  de  Chaumont,  Sanitary  Record,  February  5,  1876. 


FOOD.  217 

oxidized  in  the  form  of  ui^ea.  An  ounce  of  sugar,  on  the  other  hand,  is  as 
a  general  rule  destroyed  to  the  fullest  extent,  and  ends  in  carbon  dioxide 
and  water,  and  its  actual  energy  in  the  body,  under  whatever  form  it 
appears,  is  equal  to  its  theoretical  energy. 

One  ounce  of  dry  albuminate  yields 173          foot-tons  of  potential  energy. 

"    fat 378  " 

"                 "     starclL 138  " 

"                "     cane-sugar 131  " 

"                 "    lactin  or  glucose 124  '• 

One  grain  of  carbon  (converted  into  CO2)  0.710  " 

hydrogen  (water) 3.000  " 

"               sulphur  (SOo) 0.205  " 

"                phosphorus  (P2O5) 0.510  " 

''               carbon  (forming  urea) 0.198  " 

In  the  following  table  (page  218)  Dr.  Franldand's  experimental  results 
have  been  selected  as  the  most  exact,  but  they  agree  veiy  closely  with  the 
theoretical  results,  particularly  with  those  given  by  Playfair '  and  others. 
Some  of  the  numbers  are  calculated  from  the  ascertained  composition  of 
the  substance. 

A  table  of  this  kind  is  useful  in  showing  what  can  be  obtained  from  our 
food,  but  it  must  not  be  supposed  that  the  value  of  food  is  in  exact  relation 
to  the  possible  energy  which  it  can  fui-nish.  In  order  that  the  energy  shaU. 
be  obtained,  the  food  must  not  only  be  digested  and  taken  into  the  body 
properly  prepared,  but  its  energy  must  be  develoj)ed  at  the  place  and  in 
the  manner  proper  for  nutrition.  The  mere  expression  of  potential  energy 
cannot  fix  dietetic  value,  which  may  be  dependent  on  conditions  in  the 
body  unknown  to  us.  For  example,  it  is  quite  certain,  from  observation, 
that  gelatine  cannot  fully  take  the  place  of  albumen,  though  its  potential 
energy  is  little  inferior,^  and  it  is  easily  oxidized  in  the  body.  But  owing 
to  some  circumstances,  yei  unknown,  gelatine  is  chiefly  destroyed  in  the 
blood  (?)  and  gland-cells,  and  its  energy,  therefore,  has  a  different  direction 
from  that  of  albumen.  The  tables  of  energy  give  broad  indications,  and 
can  be  used  in  a  general  statement  of  the  value  of  a  diet ;  but  at  present  they 
do  not  throw  light  on  the  intricacies  of  nutrition. 


Sub-Section  HL — On  the  Relative  Value  op  Food  of  the  same  Class. 

The  chemical  composition  of  animal  and  vegetable  albuminates  is  very 
similar,  and  they  manifestly  serve  equal  pui'poses  in  the  body.  The  meat- 
eater,  and  the  man  who  Hves  on  corn,  or  peas  and  rice,  are  equally  well 
nourished.  But  it  has  been  supjDosed  that  either  the  kind  or  the  rapidity 
of  nutrition  is  different,  and  that  the  man  who  feeds  on  meat,  or  the  cai"- 
nivorous  animal,  will  be  more  active,  and  more  able  to  exert  a  sudden  vio- 
lent effort,  than  the  vegetarian,  or  the  herbivorous  animal,  whose  food  has 
an  equal  potential  energy,  but  which  is  supposed  to  be  less  easily  evolved. 
The  evidence  in  favor  of  this  view  seems  very  imperfect.     The  rapid  move- 

1  On  the  Food  of  Man  in  Relation  to  his  Useful  Work,  1865. 
•  -  One  gramme  of  dry  isinglass  will  develop  4,520  heat-units  when  burnt  in  oxygen  ; 
one  gramme  of  dry  boiled  ham,  4,343  ;  one  gramme  of  dry  beef,   5,313  heat-units. 
(Frankland,  Philos.  Mag.,  September,  18G6,  p.  169.)     The  potential  energy  of  isinglass 
is  more  than  that  of  ham,  but  its  nutritive  power  is  far  inferior. 


218 


PRACTICAL    HYGIENE. 


Energy  Developed  by  One  Ounce  of  the  following  Substances  ichen  Oxidized 

in  the  Body. 


Name  of  Substance. 


In  usual   state,  | 
with    the    same  ^ 
percentage      of ,  ^^e  ounce,  water- 
water  as  in  the  I 
table  on  p.  212. 


free. 


Beef,  uncooked,  best  quality  (beefsteaks)  . . . 

Meat,         "          as  sui^pliecl  to  soldiers 

Beef,           "          fattened 

Meat,  cooked 

Coraed  beef  (Chicago) 

Salt  beef 

Foot-tons. 

48.5 

57.8 

96.0 
106.2 
124.0 

52.0 

71.6 
202.0 
292.3 
179.6 

46.4 

44.3 

50.7 

87.5 
123.6 
173.3 
126.5 
130.0 
132.0 
122.7. 
125.9 
116.4 
118.9 

33.0 

14.3 

13.0 
344.5 

67.3 
149.9 

26.9 
109.2 

20.4 
126.4 
270.1 

30.0 

41.5 

Fcot-tons. 
199 

243 
280 
240 
217 
138 

Salt  pork 

166 

Fat  pork 

336 

Dried  bacon 

346 

Smoked  ham 

267 

Horse  flesh 

189 

White  fish 

209 

Poultry    

204 

Bread  

147 

TNTieat  floiu- 

146 

Biscuit 

189 

Rice 

141 

Oatmeal    

154 

Maize 

160 

Macaroni 

146 

MiUet 

149 

AiTow-root 

138 

Peas  (dried) 

151 

Potatoes 

141 

137 

Cabbage 

158 

Butter 

367 

EfTcfs        . .    . 

265 

245 

Milk  (cow's),  new 

225 

365 

Skimmed  milk 

181 

128 

Pemmican 

Stout  (Guinness") 

293 
260 
360 

ments  of  the  caraivora  have  been  contrasted  -with  the  slow,  dull  action  of 
domestic  cattle  ;  but,  not  to  speak  of  the  horse,  whoever  has  seen  the 
lightning  movements  of  the  wild  antelope  or  cow,  or  even  of  the  wild  pig, 
which  if:  herbivorous  in  many  cases,  can  doubt  that  vegetable  feeders  can 
exert  a  movement  even  more  rapid  and  more  endui'ing  than  the  tiger  or 
the  wolf?    And  the  evidence  in  men  is  the  same.     In  India,  the  iU-fed 


EOOD.  219 

people,  on  rice  and  a  little  millet  or  pea,  may  indeed  show  less  power  ;  but 
take  the  well-fed  corn-eater,  or  even  the  well-fed  rice  and  pea-eater,  and  he 
will  show,  when  in  training,  no  inferiority  to  the  meat-eaters.  An  argu- 
ment has  been  drawn  from  the  compUcated  ahmentary  canal  of  the  herbi- 
vora,  but  probably  this  is  chiefly  intended  to  digest  the  cellulose,  and  the 
digestion  and  absorption  of  albuminates  may  be  as  rapid  as  in  other  ani- 
mals. 

It  appears  from  Dr.  Beaumont's  experiments  that  animal  food  is  di- 
gested sooner  than  farinaceous,  and  possibly  meat  might  therefore  replace 
more  quickly  the  wasted  nitrogenous  tissue  than  bread  or  peas  ;  and  it  may 
be  true,  as  asserted,  that  the  change  of  tissue  is  more  quick  in  meat-eaters, 
who  require,  therefore,  more  frequent  supplies  of  food.  Even  this,  how- 
ever, seems  not  yet  thoroughly  proved. 

It  has  been  also  supposed  that  there  is  a  difference  in  the  nutrition 
of  even  such  nearly  allied  substances  as  wheat  and  barley,  but  the  evi- 
dence is  imperfect,  and  is  perhaps  dependent  on  differences  in  ease  of  di- 
gestion. 

With  respect  to  the  fats,  their  differences  of  nutrition  are  probably  de- 
pendent entu-ely  on  facility  of  digestion  and  absoi-ption.  The  animal  fats 
aj)pear  easier  of  absorption  than  the  vegetable.  Berthe '  found  that,  in 
addition  to  the  fat  in  his  ordinary  diet,  he  could  absorb  30  grammes,  or 
1.059  ounce  of  cod-liver  oil,  butter,  or  other  animal  oil  ;  in  some  instances 
If  ounce  were  absorbed.  Of  vegetable  oils  only  20  grammes,  or  0.7 
ounce,  were  absorbed.  When,  in  experiments  with  cod-liver  oil,  40 
grammes  were  taken,  31.5  were  absorbed,  8.5  passed  by  the  bowels  ;  when 
60  grammes  were  taken,  48  were  absorbed  and  12  passed.  But  when  he 
took  60  grammes  daily,  the  amount  of  fat  in  the  faeces  graduaUy  increased, 
until  50  grammes  daily  passed  off  in  that  way.  In  the  dog,  however,  Bisch- 
off  and  Voit  found  that  250  and  300  grammes  (8.8  and  10.5  ounces)  of  but- 
ter were  easily  absorbed.  During  the  digestion  of  the  fats  they  are,  prob- 
ably, in  part  decomposed  ;  and  the  fatty  acids,  like  the  acids  derived  from 
the  starch,  must,  to  a  certain  extent,  antagonize  the  introduction  of  alkah 
in  the  food. 

The  various  carbo-hydrates  are  generally  supposed  to  be  of  equal  value. 
Starch  requires  a  little  more  preparation  by  the  digestive  fluids  than  grape 
sugar,  into  which  it  appears  first  to  pass  ;  but  the  change  is  so  rapid 
that  it  can  hardly  be  made  a  point  of  difference  between  them.  It  is 
observable,  however,  that  even  when  sugar  is  very  cheap  and  accessible, 
it  is  not  used  to  replace  starch  entirely ;  but  this,  perhaps,  may  be  a  mat- 
ter of  taste. 

Sub-Section  IV. — The  Digestibility  of  Food. 

In  order  that  food  shall  be  digested  and  absorbed,  two  conditions  are 
necessary :  the  food  must  be  in  a  fit  state  to  be  digested,  and  it  must  meet 
in  the  ahmentary  canal  with  the  chemical  and  physical  conditions  which 
can  digest  and  absorb  it. 

Fitness  for  digestibility  depends  partly  on  the  original  natiu-e  of  the 
substance,  as  to  hardness  and  cohesion,  or  chemical  nature,  and  partly  on 
the  manner  in  which  it  can  be  altered  by  cooking.  Tables  of  degi'ee  of 
digestibility  have  been  formed  by  several  writers,  and  especially  by  Dr. 
Beaumont,  by  direct  experiment  on  Alexis  St.  Martin  ;  but  it  must  be  re- 

'  Lud wig's  Phys.,  Band  ii.,  p.  668. 


220  PRACTICAL    HYGIENE. 

membered  that  these  are  merely  approximative,  as  it  is  so  difficult  to  keep 
the  conditions  of  cooking  equal. ' 

Rice,  tripe,  Avhipped  eggs,  sago,  tapioca,  barley,  boiled  milk,  raw  eggs, 
lamb,  i^arsnijDS,  roasted  and  baked  potatoes,  and  fx'icasseed  chicken,  are  the 
most  easily  digested  substances  in  the  order  here  given, — the  rice  disap- 
pearing from  the  stomach  in  one  hour,  and  the  fricasseed  chicken  in  2f 
hours.  Beef,  pork,  mutton,  oysters,  butter,  bread,  veal,  boiled  and  roasted 
fowls,  are  rather  less  digestible, — roast  beef  disappearing  from  the  stom- 
ach in  three  hours,  and  roast  fowl  in  four  hours.  Salt  beef  and  pork  disap- 
peared in  4:^  hours.  ^ 

As  a  rule,  Beaumont  found  animal  food  digested  sooner  than  farina- 
ceous, and  in  proportion  to  its  minuteness  of  division  and  tenderness  of 
fibre. 

The  admixtiu-e  of  the  different  classes  of  food  aids  digestibility  ;  thus 
fat  taken  with  meat  aids  the  digestion  of  the  meat ;  some  of  the  accessory 
foods  probably  increase  the  outpour  of  saliva,  gastric  or  enteric  juice,  etc. 

The  degree  of  fineness  and  division  of  food  ;  the  amount  of  solidity  and 
of  trituration  which  should  be  left  to  the  teeth,  in  order  that  the  fluids  of 
the  mouth  and  salivary  glands  may  flow  out  in  due  proportion  ;  the  bulk 
of  the  food  which  should  be  taken  at  once,  are  points  seemingly  slight,  but 
of  real  importance.  There  is  another  matter  which  appears  to  aff'ect  di- 
gestibility, viz.,  variety  of  food. 

According  to  the  best  writers  on  diet,  it  is  not  enough  to  give  the 
proximate  dietetic  substances  in  j^roper  amount.  Variety  must  be  intro- 
duced into  the  food,  and  dift'erent  substances  of  the  same  class  must  be 
alternately  employed.  It  may  appear  singidar  that  this  should  be  neces- 
sary ;  and  certainly  many  men,  and  most  animals,  have  perfect  health  on  a 
very  uniform  diet.  Yet,  there  appears  no  doubt  of  the  good  eftect  of  vari- 
ety, and  its  action  is  probably  on  primary  digestion.  Sameness  cloys  ; 
and  wdth  variety,  more  food  is  taken,  and  a  larger  amount  of  nutriment  is 
introduced.  It  is  impossible,  with  rations,  to  introduce  any  great  variety 
of  food  ;  but  the  same  object  appears  to  be  secured  by  having  a  variety  of 
cooking.  In  the  case  of  children,  especially,  a  great  imj)rovement  in 
health  takes  place  when  variety  of  cooking  is  introduced  ;  and  by  this 
plan  (among  others).  Dr.  Balfour  succeeded  in  marvellously  impi'oving  the 
health  of  the  boys  in  the  Duke  of  York's  School. 

The  internal  conditions  of  abundance  and  proper  composition  of  the 
alimentary  fluids,  and  the  action  of  the  muscular  fibres  in  moving  the  food, 
so  that  it  shall  be  submitted  to  them,  depend  on  the  perfection  of  the 
nervous  currents,  the  vigor  of  circulation,  and  the  composition  of  the 
blood.  Many  of  the  digestive  diseases  the  jjhysican  has  to  treat  depend 
on  alterations  in  these  conditions,  so  that  the  food  is  only  imperfectly 
digested.  Experiments,  by  Plusz,  Maly,  and  Gyergyai,  seem  to  show  the 
value  of  converting  the  albuminates  into  peptones  by  artificial  digestion,  so 
as  to  aid  the  digestion  of  the  sick.^ 

In  framing  diets,  it  is  well  to  remember  that  almost  every  article  has 
some  portion  which  is  more  or  less  indigestible,  but  which  is  generally  iu- 

'  The  prepartion  of  food  by  cooking  is  so  important  a  matter,  that  the  art  of  cookery 
ought  not  to  be  considered  as  merely  the  domain  of  the  gourmand.  Health  is  greatly 
influenced  by  it,  and  it  is  really  a  sixbject  to  be  practically  studied  by  chemists  and 
physiologists. 

■^  An  extended  table  is  given  in  Cox's  excellent  edition  of  Combe's  Physiology  of 
Digestion,  p.  123. 

•*  Ueber  Peptone,  Arcliiv.  f iir  die  Ges.  Phys. ,  Band  ix. ,  p.  333. 


rooD.  221 

eluded  in  the  calculation  of  its  proximate  or  ultimate  constituents.  The 
proportion  thus  unutUized  varies,  but  it  ranges  on  an  average  from  5  to  10 
per  cent.     Elaborate  tables  are  given  by  Fliigge  '  and  Meinert.^ 


SECTION  n. 

DISEASES  CONNECTED   WITH  FOOD. 

So  great  is  the  influence  of  food  on  health,  that  some  writers  have  re- 
duced hygiene  almost  to  a  branch  of  dietetics.  Happiness,  as  well  as 
health,  is  considered  to  be  insured  or  imperilled  by  a  good  or  improper 
diet,  and  high  moral  considerations  are  suppose(J  to  be  involved  in  the  due 
performance  of  digestion.  If  there  is  some  exaggeration  in  this,  there  is 
much  truth  ;  and  doubtless,  of  all  the  agencies  which  affect  nutrition,  this 
is  the  most  important. 

The  diseases  connected  with  food  form,  probably,  the  most  numerous 
order  which  proceeds  from  a  single  class  of  causes  ;  and  so  important  are 
they  that  a  review  of  them  is  equivalent  to  a  discussion  on  diseases  of 
nutrition  generally. 

It  is  of  course  impossible  to  do  more  here  than  outUne  so  large  a 
topic. 

Diseases  may  be  produced  by  alterations  (excess  or  deficiency)  in 
quantity  ;  by  imperfect  conditions  of  digestibility,  and  by  special  characters 
of  quaUty. 

Sub-Section  I. — Alterations  in  Quantity. 

1.  Excess  of  Food. — In  some  cases,  food  is  taken  in  such  excess,  that  it 
is  not  absorbed  ;  it  then  undergoes  chemical  changes  in  the  alimentary 
canal,  and  at  last  putrefies  ;  quantities  of  gas  (carbon  dioxide,  carburetted 
hydrogen,  and  hydrogen  sulphide)  are  formed.  As  much  as  30ib  of  a 
half-putrid  mass  have  been  got  rid  of  by  purgatives.^  Dyspepsia,  constipa- 
tion, and  irritation,  causing  diarrhoea,  which  does  not  always  empty  the 
bowels,  are  produced.  Sometimes  some  of  the  putrid  substances  are  ab- 
sorbed, as  there  are  signs  of  evident  poisoning  of  the  blood,  a  febrile  con- 
dition, torjaor  and  heaviness,  ffetor  of  the  breath,  and  sometimes  possibly 
even  jaundice.  It  was  no  doubt,  cases  of  this  kind  w^hich  led  to  the  rou- 
tine practice  of  giving  purgatives  ;  and  as  this  condition,  in  a  moderate  de- 
gree, is  not  uncommon,  the  use  of  purgatives  will  probably  never  be  dis- 
continued. 

The  excess  of  food  may  be  absorbed.  The  amount  of  absorption  of  the 
different  alimentary  principles  is  not  precisely  known.  Dogs  can  digest 
an  immense  quantity  of  meat,  and  especially  if  they  are  fed  often  ;  and  not 
simply  largely,  once  or  twice  a  day.  In  men,  also,  much  meat  and  albu- 
minous matter  can  be  digested,^  though  it  is  by  no  means  uncommon, 

^  Untersuchungen,  etc.,  p.  424. 

''  Armee-  und  Volks-Ernahrung,  Berlin,  1880,  vol.  i.,  pp.  129-131,  in  -which  he 
quotes  from  Riibner  (Zeitschr.  f.  Biologie,  xv.  u.  xvi.)  and  Voit. 

^  A  good  case  of  this  kind  is  recorded  by  Eouth(Ffecal  Fermentation,  p.  19).  Some 
convicts  in  Australia  received  from  7}  to  7^  lbs  of  food  daily.  Obstinate  constipation, 
dyspepsia,  diarrhoea,  skin  diseases,  and  ophthalmia  were  produced.  Purgatives  brought 
away  large  quantities  of  half-putrid  masses. 

"  Jones's  and  especially  Hammond's  experiments,  Experimental  Researches,  1857, 
p.  20. 


222  PRACTICAL    HYGIENE. 

in  large  meat-eaters,  to  find  much  muscular  fibre  in  the  feces.  Still, 
enough  can  be  taken,  not  merely  to  give  a  large  excess  of  nitrogen,  but 
even  to  supply  carbon  in  sufficient  quantity  for  the  Avants  of  the  system. 

There  is  certainly  a  limit  to  the  digestion  of  starch  (though  sugar,  how- 
ever, is  absorbed  in  large  amount),  as  after  a  very  large  meal  much  starch 
passes  unaltered.  This  is  also  the  case  with  fat.  But  in  all  cases,  habit 
probably  much  affects  the  degree  of  digestive  power  ;  and  the  continued 
use  of  certain  articles  of  diet  leads  to  an  increased  formation  of  the  fluids 
which  digest  them. 

"When  excess  of  albuminates  continually  passes  into  the  system,  conges- 
tions and  enlargements  of  the  Kver,  and  probably  other  organs,  and  a  gen- 
eral state  of  plethora,  are  produced.  If  exercise  is  not  taken  at  the  same 
time,  there  is  a  dispropc*-tion  between  the  absorbed  oxygen  and  the  ab- 
sorbed albuminates,  which  must  lead  to  imperfect  oxidation,  and  therefore 
to  retention  in  the  body  of  some  substances,  or  to  iiTitation  of  the  ehmin- 
ating  organs  by  the  passage  through  them  of  products  less  liighly  elabor- 
ated than  those  they  are  adapted  to  remove. 

Although  not  completely  proved,  it  is  highly  probable  that  gouty  affec- 
tions arise  partly  in  this  way,  partly  probably  from  the  use  of  hquids  which 
delay  metamorphosis,  and  therefore  lead  to  the  same  result  as  increased  in- 
gestion, and  in  some  degree  also  from  the  use  of  indigestible  articles  of  food. 

Vei*y  often  large  meat-eaters  are  not  gouty,  and  do  not  appear  in  any 
way  over-fed.  In  this  case  either  a  great  amount  of  exercise  is  taken,  or,  as 
is  often  the  case  in  these  persons,  the  meat  is  not  absorbed,  owing  frequent- 
ly to  imperfect  mastication. 

A  great  excess  of  albuminates,  -u-ithout  other  food,  produces,  in  a  short 
time  (five  days — Hammond)  marked  febrile  symptoms,  malaise,  and  diar- 
rhoea ;  and  if  persevered  iu,  albumen  appears  in  the  ui-ine.  Eanke  has 
attributed  the  depression  especially  to  the  effect  of  the  salts  of  the  meat. 

Excess  of  starches  and  of  fats  delays  the  metamorphosis  of  the  nitrogen- 
ous tissues  and  produces  excess  of  fat.  Sometimes  acidity  and  flatidence 
are  caused  by  the  use  of  much  starch.  It  is  not  understood  if  profounder 
diseases  follow  the  excessive  use  of  starches,  unless  decided  corpulence  is 
produced,  when  the  muscular  fibres  of  the  heart  and  of  many  voluntary 
muscles  lessen  in  size,  and  the  consequences  of  enfeebled  heart's  action 
occirr.  "WTien  an  excessive  quantity  of  starch  is  used  to  replace  albumi- 
nates, in  physiological  experiments,  the  condition  becomes  of  course  a  com- 
plex one. 

If  an  excess  of  starch  be  taken  under  an}'^  cii'cumstances,  much  passes 
into  the  faeces,  and  the  urine  often  becomes  saccharine. 

There  may  be  also  excess  of  food  in  a  given  time  ;  that  is,  meals  too  fre- 
quently repeated,  though  the  absolute  quantity  in  twenty-foiu-  houi's  may 
not  be  too  great. 

2.  Deficiency  of  Food. — The  long  catalogue  of  effects  produced  by  fam- 
ine is  but  too  well  known,  and  it  is  unnecessary  to  repeat  it  here.  But  the 
effects  produced  by  deficiency  in  any  one  of  the  four  great  classes  of  ali- 
ments, the  other  classes  being  in  normal  amount,  have  not  yet  been  per- 
fectly studied. 

The  complete  deprivation  of  albuminates,  without  lessening  of  the  other 
classes,  produces  marked  effects  only  after  some  days.  In  a  strong  man 
kept  only  on  fat  and  starch,  Dr.  Parkes  found  full  rigor  presented  for  five 
days  ;  in  a  man  in  whom  the  amount  of  nitrogen  was  reduced  one  half,  full 
vigor  was  retained  for  seven  days.  If  the  abstention  be  prolonged,  how- 
ever, there  is  eventually  great  loss  of  muscular  strength,  often  mental  debil- 


FOOD.  223 

ity,  some  feverish  and  dyspeptic  symptoms.  Then  follow  anaemia  and  gi-eat 
prostration.  The  elimination  of  nitrogen  in  the  form  of  ru-ea  greatly  lessens, 
though  it  never  ceases,  while  the  luic  acid  diminishes  in  a  less  degree.  If 
starch  be  largely  supphed,  the  weight  of  the  body  does  not  lessen  for  seven 
or  eight  days  (Hammond). 

If  the  deprivation  of  albuminates  be  less  complete  (70  to  100  grains  of 
nitrogen  being  given  daily),  the  body  gradually  lessens  in  activity,  and 
passes  into  more  or  less  of  an  adynamic  condition,  which  predisposes  to  the 
attacks  of  all  the  specific  diseases  (especially  of  malarious  affections  and 
typhus),  and  of  jpneumonia,  and  modifies  the  course  of  some  of  these  diseases 
as,  for  instance,  of  typhoid,  which  runs  its  course  with  less  elevation  of  tem- 
perature than  usual,  and  with  less  or  with  no  excess  of  lu-eal  excretion. 

The  dej^rivation  of  starches  can  be  borne  for  a  long  time  if  fat  be  given, 
but  if  both  fat  and  starch  are  excluded,  though  albuminates  be  supplied, 
illness  is  joroduced  in  a  few  days.  Nor  is  it  difficult  to  explain  this  :  as  al- 
bumen contains  53.3  per  cent,  of  total  carbon  (of  which  about  49  per  cent, 
is  available  for  nutrition)  and  15.5  per  cent,  of  nitrogen,  to  supply  3,500 
grains  of  carbon,  no  less  than  1,139  grains  of  nitrogen  must  be  introduced, 
a  quantity  three  times  as  great  as  the  system  can  easily  assimilate,  unless 
enormous  exertion  be  taken,  and  then  the  quantity  of  carbon  becomes  in- 
sufficient. 

Men  can  be  fed  on  meat  for  a  long  time,  as  a  good  deal  of  fat  is  then 
introduced,  and  if  the  meat  be  fresh  (and  raw  ?),  scurvy  is  not  readily  in- 
duced. 

The  deprivation  of  fat  does  not  appear  to  be  well  borne,  even  if  starches 
be  given  ;  but  the  exact  effects  are  not  known.  The  great  remedial  effects 
produced  by  giving  fat  in  many  of  the  diseases  of  obscure  malnutrition, 
prove  that  the  partial  deprivation  of  fat  is  both  more  common  and  more 
serious  than  is  supposed.  In  all  the  diets  ordered  for  soldiers,  prisoners, 
etc.,  the  fat  is  greatly  deficient  in  every  country.  The  depiivation  of  the 
salts  is  also  evidently  attended  with  marked  results,  which  are  worthy  of 
more  attention  than  they  have  yet  received. 

Bad  effects  are  also  produced  if  the  intervals  between  meals  are  too  long  ; 
this  is  a  matter  in  which  there  is  great  individual  difference,  and  need  not 
be  further  referred  to. 

Sub-Section  II. — Conditions  of  Digestibility  and  Assimilation. 

A  great  number  of  diseases  are  produced,  not  by  alterations  in  quantity 
or  by  imperfections  in  the  quality  of  the  raw  food,  but  by  conditions  of  in- 
digestibility,  either  dependent  on  physical  or  chemical  conditions  of  the 
food  itself,  or  of  the  digestive  fluids.  To  some  persons  certain  foods  are 
indigestible  at  all  times,  or  at  particular  times.  Indigestibility  leads  to  re- 
tention, and  then  to  the  results  of  retention,  viz.,  chemical  changes  and 
putrefaction  going  on  in  the  stomach  and  bowels  under  the  influence  of 
warmth,  moistui-e,  and  air.  Then  irritation  is  produced,  and  dyspepsia, 
diarrhoea,  or  dysentery  is  caused. 

Indigestibility  extends,  however,  farther  than  this.  There  is  some  rea- 
son for  thinking  that  the  albuminates  sometimes  pass  into  the  circulation 
less  properly  prepared  than  usual  to  undergo  the  action  of  the  hver,  and 
that  they  therefore  produce  irritation  of  that  organ,  and  passing  into  the 
blood  in  some  unassimilable  state,  produce  irritation  of  the  skin  or  kidneys. 
Sometimes,  indeed,  albumen  appears  in  the  urine,  as  if  it  had  circulated 
like  a  foreign  body  in  the  blood.     Such  conditions  are  usually  aihed  to  some 


224  PE ACTIO AL    HYGIENE. 

evident  error  in  primary  digestion,  but  occasionally  are  not  obviously  ac- 
companied by  any  gastric  disorder.  "Whether  there  is  any  similar  imper- 
fection in  the  digestion  of  starch  or  fat  is  not  at  present  known. 

SuB-SeCTIOX    HL CONMTIOXS    OF    QuALITY. 

Altered  quality  of  what  is  otherwise  good  food  produces  a  great  num- 
ber of  diseases.  Most  of  these  ai-e  referred  to  under  the  headings  of  the 
different  articles  of  food,  and  the  subject  is  merely  introduced  here  to  com- 
plete the  general  sketch  of  the  production  of  disease  from  food. 

In  inquiring,  then,  into  the  effect  of  food,  the  following  ajDpears  to  be 
the  best  order  of  procedure  : — 

1.  Is  the  food  excessive  or  deficient  in  quantity  as  a  whole  or  in  any 

of  the  piimary  classes  of  ahments  ? 

2.  Are  the  different  articles  digestible  and  assimilable,  or,  fi'om  some 

cause  inherent  in  the  food  or  proper  to  the  individual,  is  there 
difficulty  in  j^rimary  digestion  or  want  of  pi-oper  assimilation  ? 

3.  Is  the  cjuahty  of  the  food  altered  either  before  or  after  cooking  ? 

# 


CHAPTER  VI. 

QUALITY,   CHOICE,   AND   COOKING-  OF   FOOD,   AND    DIS- 
EASES ATTRIBUTABLE  TO  IMPROPER  QUALITY. 


SECTION  I. 

MEAT. 

The  advantages  of  meat  as  a  diet  are — its  large  amount  of  nitrogenous 
substance,  the  union  of  this  with  much  fat,  the  presence  of  important  salts 
(viz.,  chloride  of  potassium,  phosjDhate,  and  cai'bonate  of  potassium,  or  a 
salt  forming  carbonate  in  incineration),  and  ii'on.  It  is  also  easily  cooked, 
and  is  very  digestible ;  it  is  probably  more  easily  assimilated  than  any 
vegetable,  and  there  is  a  much  more  rapid  metamorphosis  of  tissue  in  car- 
nivorous animals  than  in  vegetable  feeders.  Whether  the  use  of  large 
quantities  of  meat  increases  the  bodily  strength  or  the  mental  faculties 
more  than  other  kinds  of  nitrogenous  food  is  uncertain.  The  great  dis- 
advantage of  meat  is  the  vrant  of  starch. 

The  composition  of  fi-esh  and  salt  meat  has  been  already  given  ;  but 
the  annexed  table  will  supply  further  details  : — ■ 

Composition  of  Fresh  Beef.     (Jloleschott — Jlean  of  all  the  Continental 

Analyses.) 

Water 73.4 

Soluble  albumen  and  hsematin 2.25 

Insoluble  albuminous  substances ,  15.2 

Gelatinous  substances , 3.3 

Fat ' 2.87 

Extractive  matters 1.38 

Kreatin 0.068 

Ash 1.6 

It  is  worthy  of  remark  that  StolzeP  found  89  per  cent,  of  carbonic  acid 
in  100  of  ash,  which  indicates  probably  lactic  acid.  Are  the  anti- scorbutic 
properties  of  fresh  and  raw  (?)  meat  connected  with  this  acid,  and  is  it 
destroyed  by  cooking?  More  than  one-third  of  the  ash  is  composed  of 
phosphoric  acid.     It  is  alkahne. 

Beef,  mutton   and  pork  form  the  chief  meats  eaten  by  the  soldier. 

In  time  of  peace  he  only  receives  as  fresh  meat  beef  and  mutton,  and 

^  The  amount  of  fat  in  this  analj-sis  is  certainly  too  low. 
'^  Liebig's  Annalen,  Band  Ixxvii.,  p.  256, 
Vol.  I.— 15 


-'2{j  PBACTICAL    HYGIENE. 

more  seldom  pork  ;  in  time  of  war  he  lias  salt  beef  and  salt  pork. '  The 
meat  is  supplied  by  contractors,  or  is,  at  some  stations,  furnished  by  the 
commissariat,  who  have  theu'  own  slaughter-houses. 

The  medical  officer  may  be  called  on  to  see  the  animals  during  life,  or 
to  examine  the  meat. 

Sub-Section  I. — Inspection  of  Animals. 

Animals  should  be  inspected  twenty-four  hours  before  being  killed.* — 
In  this  country  killing  is  done  twenty-four  or  forty-eight  hours  before  the 
meat  is  issued ;  in  the  tropics  only  ten  or  twelve  hours  previously. 

Animals  should  be  well  gTown,  well  nourished,  and  neither  too  young 
uor  too  old.  The  flesh  of  young  animals  is  less  rich  in  salts,  fat,  and 
syntonin,  and  also  loses  much  weight  (40  to  70  per  cent.)  in  cooking. 

Weight. — -An  ox  should  weigh  not  less  than  600  lb,  and  will  range  from 
this  to  1,200  lb.  The  French  rules  fix  the  minimum  at  250  kilogrammes 
(—550  lb  av.).  The  mean  weight  in  France  is  350  kilogrammes  (=770  lb 
av.).  A  cow  may  weigh  a  few  pounds  less;  a  good  fat  cow  will  weigh 
from  700  to  740  ft.  A  heifer  should  weigh  350  to  400  ft.  The  French 
rules  fix  the  minimum  of  the  cow's  weight  at  IGO  kilogrammes  (  =  352  ft). 
The  mean  weight  of  cows  in  France  is  230  kilogrammes  (  =  506  ft). 

There  are  several  methods  of  determining  the  weight  ;  the  one  most 
commonly  used  in  this  country  is  to  measure  the  length  of  the  trunk  from 
just  in  front  of  the  scapulpe  to  the  root  of  the  tail,  and  the  girth  or  circum- 
ference just  behind  the  scapulte  ;  then  multiply  the  square  of  girth  by  0.08, 
and  the  product  by  the  length,  the  dimensions  in  cubic  feet  are  obtained ; 
each  cubic  foot  is  supposed  to  weigh  42  ft  avoirdupois.  The  formula  is 
(C  X  .08)  X  L  X  42.  An  ox  or  cow  gives  about  60  per  cent,  of  meat,  exclu- 
sive of  the  head,  feet,  liver,  lungs,  and  spleen,  etc.^ 

A  fuU-grown  sheep  will  weigh  from  60  to  90  ft,  but  the  difference  in 
different  breeds  is  very  great.  It  also  yields  about  60  per  cent,  of  avail- 
able food. 

A  fuU-growai  pig  weighs  from  100  to  180  ft,  or  more,  and  yields  about 
75  to  80  per  cent,  of  available  food. 

Age. — The  age  of  the  ox  and  cow  should  be  from  three  to  eight  years  ;* 
the  age  is  told  chiefly  by  the  teeth,  and  less  perfectly  by  the  horns.  The 
temporary  teeth  are  in  part  thi'ough  at  birth,  and  all  the  incisors  are 

'  Professor  Morgan  of  Dublin  proposed  tlie  following  plan  of  salting,  wliicli  in  cer- 
tain cases  might  be  nsefuUy  employed  :  Immediately  after  death  the  thorax  is  opened 
and  a  pipe  inserted  into  the  left  ventricle  ;  the  pipe  is  connected,  by  an  india-rubber 
tube,  with  a  tank  of  brine  placed  at  a  few  feet  elevation,  and  through  this  the  vessel  is 
injected.  After  the  blood  has  been  driven  out  through  the  right  auricle,  the  exit  is 
closed,  and  the  pressure  forces  the  brine  into  the  smallest  ramifications  of  the  vessels. 
The  process  is  finished  in  ten  to  twenty  minutes ;  the  meat  is  then  cut  up,  dried,  if 
necessary,  in  a  hot-air  chamber,  and  packed  in  charcoal.  The  injected  fluid  is  com- 
posed of  1  gallon  of  brine  to  the  cwt.,  i  to  ^  ft  of  nitre,  2  lbs  of  sugar,  a  little  spice,  salt, 
and  i  oz.  of  phosphoric  acid,  which  serves  more  completely  to  retain  the  albumen,  and 
also  adds  a  little  phosphoric  acid.  The  brine  can  be  used  hot.  This  is  an  excellent 
plan,  but  the  meat  is  too  salt. 

'^  Every  contract  should  have  a  clause  giving  officers  the  power  of  inspection. 

'  The  animal  is  divided  into  carcass  and  offal;  the  former  includes  the  whole  of  the 
skeleton  (except  the  head  and  feet),  with  the  muscles,  membranes,  vessels,  and  fat,  and 
the  kidneys  and  fat  surrounding  them.  The  offal  includes  the  head,  feet,  skin,  and 
all  internal  organs,  except  the  kidneys. 

*  Dr.  Pav}'  gives  four  years  for  the  highest  perfection  of  ox  beef,  on  the  authority  oi; 
an  "intelligent  and  experienced  grazier." 


QUALITY,    CHOICE,    AISTD    COOKING    OF    FOOD.  227 

througli  in  twenty  days  ;  the  first,  second,  and  third  pau's  of  temporary 
molars  are  through  in  thirty  days  ;  the  teeth  are  grown  large  enough  to 
touch  each  other  by  the  sixth  month ;  they  gradually  wear  and  fall  in 
eighteen  months  ;  the  foiu'th  permanent  molars  are  through  at  the  fourth 
month ;  the  fifth  at  the  fifteenth  ;  the  sixth  at  two  years.  The  temporary  teeth 
begin  to  fall  at  twenty-one  months,  and  are  entii'ely  replaced  by  the  thirty- 
ninth  to  the  forty -fifth  month ;  the  order  being — central  pair  of  incisors 
gone  at  twenty-one  months ;  second  pau'  of  incisors  at  twenty-seven  months  ; 
first  and  second  temporary  molars  at  thirty  months ;  third  temporary 
molars  at  thii'ty  months  to  three  years  ;  third  and  fourth  temporary  in- 
cisors at  thirty-three  months  to  three  years.  The  development  is  quite 
complete  at  fi'om  five  to  six  years.  At  that  time  the  border  of  the  incisors 
has  been  worn  away  a  little  below  the  level  of  the  grinders.  At  six  years 
the  fii'st  grinders  are  beginning  to  wear,  and  are  on  a  level  with  the  in- 
cisors. At  eight  years  the  wear  of  the  first  grinders  is  very  apparent.  At 
ten  or  eleven  years  the  used  surfaces  of  the  teeth  begin  to  bear  a  square 
mark  surrounded  with  a  white  line  ;  and  this  is  pronounced  on  all  the 
teeth  by  the  twelfth  year ;  between  the  twelfth  and  fourteenth  year  this 
mark  takes  a  round  form. 

The  rings  on  the  horns  are  less  useful  as  guides.  At  ten  or  twelve 
months  the  first  rmg  appears ;  at  twenty  months  to  two  years,  the  second  ; 
at  thirty  to  thirty-six  months,  the  thuxl  ring  ;  at  forty  to  forty-six  months, 
the  fourth  ling  ;  at  fifty-four  to  sixty  months,  the  fifth  ring,  and  so  on. 
But  at  the  fifth  year  the  three  first  rings  are  indistinguishable,  and  at  the 
eighth  year  all  the  rings.     Besides,  the  dealers  file  the  horns. 

In  the  sheep,  the  temporary  teeth  begin  to  appear  in  the  first  week,  and 
fill  the  mouth  at  three  months  ;  they  are  gTadually  worn  and  fall  about  fif- 
teen or  eighteen  months.  The  fourth  permanent  grinders  appear  at  three 
months,  and  the  fifth  pair  at  twenty  to  twenty-seven  months.  A  common 
rule  is  "  two  broad  teeth  every  year."  The  wear  of  the  teeth  begins  to  be 
marked  about  six  years. 

The  age  of  the  pig  is  known  up  to  three  years  by  the  teeth  ;  after  that 
there  is  no  certainty.  The  temporary  teeth  are  complete  in  three  or  four 
months  ;  about  the  sixth  month,  the  premolars,  between  the  tusks  and  the 
first  pau'  of  molars,  appear ;  in  six  or  ten  months,  the  tusks  and  posterior 
incisors  are  replaced  ;  in  twelve  months  to  two  years,  the  other  incisors  ; 
the  foiir  permanent  molars  appear  at  six  months  ;  the  fifth  pair  at  ten 
months  ;  and  the  sixth  and  last  molars  at  eighteen  months. 

Condition  and  Health. — There  ought  to  be  a  proper  amount  of  fat, 
which  is  best  felt  on  the  false  ribs  and  the  tuberosities  of  the  ischia,  and 
the  line  of  the  belly  from  the  sternum  to  the  pelvis  ;  the  flesh  should  be 
tolerably  firm  and  elastic  ;  the  skin  should  be  sujDple. 

As  showing  health,  we  should  look  to  the  general  ease  of  movements, 
the  quick,  blight  eye ;  the  nasal  mucous  membrane  red,  moist,  and 
healthy-looking  ;  the  tongue  not  hanging  ;  the  respiration  regular,  easy  ; 
the  expired  air  without  odor  ;  the  circulation  tranquil ;  the  excreta  natu- 
ral  in  ajDiDearance. 

When  sick,  the  coat  is  rough  or  standing  ;  the  nostrils  dry  or  covered 
with  foam  ;  the  eyes  heavy;  the  tongue  protruded;  the  i-espu-ation  diffi- 
cult ;  movements  slow  and  difficult ;  there  may  be  diarrhoea ;  or  scanty  or 
bloody  urine,  etc.     In  the  cow  the  teats  are  hot. 

The  diseases  of  cattle  which  the  medical  officer  should  watch  for  are — 
1.  Epidemic  Pleura-pneumonia  (or  hmg  disease). — Not  easily  recog- 
nized at  first,  but  with  marked  lung  symptoms  after  a  few  days. 


228  PRACTICAL    HYGIENE. 

2.  Foot  and  Mouth  Disease  (muiTain,  aphtha,  or  eczema  ei^izootica). — 

At  once  recognized  by  the  examination  of  the  mouth,  feet,  and 
teats. 

3.  Cattle  Plague  (typhus  contagiosus,  Steppe  disease,  Eindei-pest). — 

Recognized  by  the  eai-ly  prostration  (hanging  of  head,  di-ooping 
of  ears),  shivering,  running  from  eyes,  nose,  and  mouth,  pecu- 
har  condition  of  tongue  and  Hj)s,  cessation  of  rumination,  and 
then  by  abdominal  pain,  scouring,  etc. 

4.  Anthrax  (mahgnant  pustule,  carbuncular  fever). — If  boils  and  car- 

bimcles  form,  they  are  at  once  recognized  ;  if  there  is  erysij^e- 
las,  it  is  called  black  quarter,  quarter  ill,  or  blackleg  (Eiysipelas 
cai'bunculosum),  and  is  easily  seen.  The  peculiar  organism. 
Bacillus  anthracis,  may  be  detected. 

5.  Simple  viftammatory  affections  of  the  lungs,  bronchitis,  and  simple 

pneumonia.     All  have  obvious  symptoms. 

6.  Dro2:>sical  affections  from  kidney  or  heart  disease. 

7.  Indigestion,  often  combined  with  apoplectic  sj-mptoms. 

A  great  number  of  other  diseases  attack  cattle,  which  it  is  not  necessai-y 
to  enumerate.  All  the  above  are  tolerably  easily  recognized.  The  pres- 
ence of  Tcenia  mediocanellata  cannot,  it  would  seem,  be  detected  before 
death. 

The  diseases  of  sheep  are  similar  to  those  of  cattle  ;  they  suffer  also  in 
certain  cases  from  splenic  apoplexy  or  "braxy,"  which  is  considered  by 
Professor  Gamgee  to  be  a  kind  of  anthrax,  and  is  said  to  kill  50  per  cent, 
of  all  young  sheep  that  die  in  Scotland  ;  the  animals  have  a  ''  jieculiar  look, 
staggering  gait,  blood-shot  eyes,  rapid  breathing,  full  and  fi'equent  pulse, 
scanty  secretions,  and  great  heat  of  the  body. " ' 

The  small-pox  in  sheep  (variola,  ovina,  c'lavelee  of  the  French)  is  easily 
known  by  the  flea-bitten  apj)earance  of  the  skin  in  the  early  stage,  and  by 
the  rapid  appearance  of  nodules  or  papulae  and  vesicles. 

The  sheep  is  also  subject  to  black  cjuarter  (Eiysipelas  carbunculosum)  ; 
one  Umb  is  affected  ;  and  the  limp  of  the  animal,  the  fever,  and  the  raj^id 
swelling  of  the  limb,  are  sufficient  diagnostic  marks. 

The  sheep,  of  course,  may  suffer  from  acute  lung  affection,  scom-ing, 
red  water  (haematuria),  and  many  other  diseases.  Of  the  chronic  lung 
affections,  one  of  the  most  important  is  the  so-called  "  phthisis,"  which  is 
produced  by  the  ova  of  Strongylus  filaria.  This  entozoon  has  not  yet  been 
found  in  the  muscles,  and  the  meat  is  said  to  be  good.  The  rot  in  sheep 
(fluke  disease)  is  caused  by  the  presence  of  Distoma  hepaticum  in  large 
numbers  in  the  liver,  and  sometimes  by  other  joarasites.  The  princij^al 
symptoms  are  dulness,  sluggislmess,  followed  by  rapid  wasting  and  pallor 
of  the  mucous  membrane,  diarrhoea,  yellowness  of  the  eyes,  falling  of  the 
hair,  and  dropsical  swellings.  The  animal  is  supposed  to  take  in  Gercaria 
(the  embryotic  stage  of  distoma)  from  the  herbage.  The  so-called  "  gid," 
"sturdy,"  or  "  tumsick,"  is  caused  by  the  development  of  Ccenurus  cere- 
fj7-alis  in  the  brain. 

The  pig  is  also  attacked  bj'  anthrax  in  different  forms,  b}'  tj'phoid,  and 
by  hog  cholera.*     The  swelling  in  the  first  case,  and  the  scom-ing,  fever, 

'  Fifth  Report  of  the  ]\redical  Officer  to  the  Privy  Council,  p.  222. 

-  Dr.  Cobbold  (Monthly  Microscopical  Journal,  November,  1871)  has  pointed  out 
that  the  pig  is  affected,  both  in  America  and  Australia,  -with  a  large  parasite  (Stephanu- 
rus  dentatus).  This  worm  is  found  cliiefly  though  not  solely  in  the  fat,  and  is  at  first 
free  and  then  encysted ;  the  cyst  is  large,  and  may  be  If  inch  in  length  and  ^  inch  in 
diameter.     The  full-grown  worm  may  be  as  much  as  IJ  inch  in  length.     Three  to  si.K 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  229 

and  prostration  in  the  second,  are  sufficient  diagnostic  marks.  In  1864,  a 
severe  fever  of  this  kind,  with  or  without  scoui-ing,  prevailed  among  the 
pigs  in  London. 

The  so-called  measle  of  the  pig  is  caused  by  the  presence  in  the  muscle 
of  Gysticercus  cellulosce.  It  is  detected  in  the  following  way : — The 
"  measle  trier "  throws  the  pig  on  its  back,  draws  out  and  wipes  the 
tongue,  and  looks  and  feels  for  the  subHngual  vesicles  containing  the  Cys- 
ticerci.  Sometimes  a  bit  is  cut  out  of  the  muscle  under  the  tongue,  and 
the  Gysticerci  are  microscopically  examined.  A  small  harpoon  can  be  used 
for  this  purpose,  and  gives  httle  pain.  Sometimes  the  Gysticercus  can  be 
seen  on  the  conjunctiva,  or  on  the  folds  of  the  anus.  When  the  disease  is 
far  advanced,  the  animal  is  dull,  the  eyes  heav;v',  appetite  bad.  These  symp- 
toms are,  however,  not  peculiar ;  there  is  said  to  be  sometimes  tenderness 
in  the  groin  (Greve),  but,  according  to  Delpech,  this  is  very  uncertain  ;  a 
better  sign  is  a  certain  amount  of  swelling  of  the  shoulder,  which  causes  a 
sort  of  constriction  of  the  neck,  and  somewhat  impedes  the  movements  of 
the  animals  (Delpech).  The  presence  of  Trichina  spiralis  is  indetectable 
before  death,  unless  found  in  the  muscles  under  the  tongue. 


Sub- Section  IE. — Inspection  of  Dead  Meat.* 

1.  FEESH    jVCEAT. 

Meat  should  be  inspected,  in  temperate  climates,  twenty-four  hours 
after  being  killed  ;  in  the  tropics,  earher. 

The  following  points  must  be  attended  to  : — 

(a)  Quantity  of  Bone. — In  lean  animals,  the  bone  is  relatively  in  too 
great  proportion  ;  taking  the  whole  meat,  20  per  cent,  should  be  allowed. 

(6)  Quantity  and  Gharacter  of  the  Fat. — It  should  be  sufficient,  yet  not 
excessive,  else  the  relative  proportion  of  albuminous  food  is  too  low  ;  it 
should  be  firm,  heal  thy -looking,  not  like  jelly,  or  too  yellow ;  without 
hemorrhage  at  any  point.  The  kind  of  feeding  has  an  effect  on  the 
color  of  the  fat  ;  some  oil-cakes  give  a  marked  yellow  color. 

Professor  Gamgee  states  that  pigs  fed  on  flesh  have  a  peculiarly  soft 
diffluent  fat,  and  emit  a  strong  odor  from  their  bodies.  The  same  au- 
thority tells  us  that  the  butchers  will  rub  melted  fat  over  the  carcass  of 
thin  and  diseased  animals,  to  give  the  glossy  look  of  health. 

(c)  Gondition  of  the  Flesh. — The  muscles  should  be  firm,  and  yet 
elastic  ;  not  tough  ;  the  pale  moist  muscle  marks  the  young  animal,  the 
dark-colored  the  old  one  ;  the  muscular  fasciculi  are  larger  and  coarser 

eggs  are  found  in  the  cyst,  and  the  young  worms  migrate.     During  their  migration,  it 
has  been  surmised  that  they  cause  the  "  hog  cholera." 

'  In  the  city  of  London,  about  1  ton  in  750  tons  is  condemned,  but  much  escapes  detec- 
tion. Letheby  (Lectures  on  Food,  2d  edition,  page  309)  states  that  700  tons  of  meat 
were  destroyed  in  seven  years;  of  this,  850,653  Tb  were  diseased,  568,375  lb  were  pu- 
trid, and  193,782  Tb  were  from  animals  which  had  died  of  accident  or  disease.  "In 
the  city  of  London,  the  practice  is  to  condemn  the  flesh  of  animals  infected  with  cer- 
tain parasites,  such  as  measles  and  flukes,  etc.,  and  of  animals  suffering  from  fever  or 
acute  inflammatory  affections,  or  rinderpest,  pleuro-pneumonia,  and  the  fever  of  par- 
turition, and  of  animals  emaciated  by  lingering  disease,  and  those  which  have  died 
from  accident  or  from  natural  causes,  as  well  as  all  meat  tainted  with  physic,  or  in  a 
high  state  of  putrefaction."  (Ibid.,  p.  210.)  It  may  be  a  question  if  meat  should  be 
condemned  in  some  of  these  cases,  as,  for  instance,  pleuro-pnerrmonia.  In  India,  meat 
with  Cysficerci  is  now  ordered  to  be  received,  but  to  be  carefully  cooked  ;  but  it  would 
be  very  difiicult  to  insure  that  proper  cooking  shall  be  always  had  recourse  to. 


230  PRACTICAL    HYGIEjSTE. 

in  bulls  than  oxen.  A  deep  puiple  tint  is  said  to  indicate  that  the  animal 
has  not  been  slaughtered,  but  has  died  with  the  blood  in  it  (Letheby). 
When  good  meat  is  placed  on  a  white  plate,  a  httle  reddish  juice  fre- 
quently flows  out  after  some  houi'S.  Good  meat  has  a  marbled  appear- 
ance from  the  ramifications  of  little  veins  of  fat  among  the  muscles 
(Letheby).  There  should  be  no  li^idity  on  cutting  across  some  of  the 
muscles  ;  the  interior  of  the  muscle  should  be  of  the  same  character,  or 
a  httle  paler ;  there  should  be  no  softening,  mucilaginous  fluid,  or  pus, 
in  the  intennuscular  celluLar  tissue.  This  is  an  imporiant  point,  which 
should  be  closely  looked  to.  The  intermuscular  tissue  becomes  soft,  and 
tears  easily  when  stretched  in  commencing  putrefaction. 

The  degTce  of  freshness  of  meat  in  commencing  putrefaction  is  judged 
of  by  the  color,  which  becomes  paler ;  by  the  odor,  which  becomes  at 
an  early  stage  different  from  the  not  unpleasant  odor  of  fresh  meat,  and 
by  the  consistence.  Afterward,  the  signs  are  mai'ked  ;  the  odor  is  disa- 
greeable, and  the  color  begins  to  turn  greenish.'  It  is  a  good  jjlan  to 
push  a  clean  knife  into  the  flesh  up  to  its  hilt.  In  good  meat  the  resist- 
ance is  uniform  ;  in  putrefying  meat,  some  parts  are  softer  than  others. 
The  smell  of  the  knife  is  also  a  good  test.  Cysticerci  and  Trichince  should 
be  looked  for. 

[d)  Condition  of  the  Mo.rroir. — In  temperate  chmates  the  maiTow  of  the 
hind  legs  is  solid  twenty-four  houi's  after  killing ;  it  is  of  a  hght  rosy  red. 
If  it  is  soft,  brownish,  or  with  black  points,  the  animal  has  been  sick,  or 
putrefaction  is  commencing.  The  maiTOw  of  the  fore  legs  is  more  difflu- 
ent ;  something  like  honey — of  a  light  rosy  red. 

[e)  Condition  of  Lungs  and  Liver. — Both  should  be  looked  at  to  detect 
Sirongyhis  filaria  in  the  lungs  ;  Distoma  in  the  liver ;  also  fnr  the  presence 
of  multiple  abscesses. 

(/;  To  detect  cattle  jjlague,  the  mouth,  stomach,  or  intestines  must  be 
seen  ;  no  alterations  have  as  yet  been  pointed  out  in  the  naked -eye  aj^pear- 
ance  of  the  muscles,  though  under  the  microscope  they  are  found  to  be 
degenerating  like  the  muscles  in  human  typhoid  (Buchanan). 

But  meat  cannot  be  fuUy  judged  of  till  it  has  been  cooked,  so  as  to  see 
how  much  it  loses  in  roasting  or  boiling  ;  whether  the  fibres  cook  hard,  etc. 

In  countries  where  there  are  goats,  the  attached  foot  of  the  sheep 
should  be  sent  in  for  identification. 

Decomposing  sausages  are  difficult  of  detection  until  the  smell  alters. 
Artmann  recommends  mixing  the  sausage  with  a  good  deal  of  water,  boil- 
ing  and  adding  freshly  prepared  hme-water.  Good  sausages  give  only  a 
faint  not  unpleasant,  ammoniacal  smell ;  bad  sausages  give  a  verj'  offensive, 
pecuhar  ammoniacal  odor. 

Microscopic  Examination  of  Meat. 

In  the  flesh  of  cattle,  or  of  the  pig,  Cysticerci  may  be  found.  They  are 
generally  risible  to  the  naked  eye  as  small  round  bodies  ;  when  placed 
under  a  microscope  with  low  power,  their  real  nature  is  seen  ;  they  are 
sometimes  so  nxunerous  as  to  cause  the  flesh  to  crackle  on  section.  The 
smallest  Cysticerciis  noticed  by  Leuckai't  in  the  pig  was  about  T^Tyths  of  an 
inch  long  and  y^-oths  broad  ;  but  they  are  generally  much  larger,  and  will 
reach  to  y^oths  or  j^y ths  or  |ths  of  an  inch.     In  some  countries  they  are 

'  In  diseased  meat  there  is  a  disagreeable  odor,  sometimes  a  smell  of  physic  ;  very 
discoverable  when  the  meat  is  chopped  up  and  drenched  with  warm  water. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  231 

extremely  common  in  cattle,  and  have  been  a  source  of  considerable  trouble 
in  Northwest  India.  Cyslicercus  of  the  ox  produces  in  man  Tcenia  medio- 
canellata.  In  sheep  Cobbold  has  described  a  small  Cysticercus  with  a  double 
crown  of  hooks,  26  in  number.  He  thinks  that  possibly  a  special  Tcenia 
may  arise  from  this.^  In  diagnosing  Cysticerci  of  j)orkthe  booklets  should 
always  be  seen. 

Trichinoi  may  be  present  in  the  flesh  of  the  pig  ;  if  encapsuled  they  will 
be  seen  with  the  naked  eye  as  small  round  specks  ;  but  very  often  a  micro- 
s3ope  is  necessary.  A  power  of  50  to  100  diameters  is  sufficient.  The  best 
plan  is  to  take  a  thin  slice  of  flesh  ;  put  it  into  liquor  potassa^  (1  part  to  8 
of  water),  and  let  it  stand  for  a  few  minutes  till  the  muscle  becomes  clear ; 
it  must  not  be  left  .too  long,  otherwise  the  TridiincE  will  be  destroyed. 
The  white  specks  come  out  clearly,  and  the  worm  will  be  seen  coiled  up. 
If  the  capsule  is  too  dense  to  allow  the  worm  to  be  seen,  a  drop  or  two  of 
weak  hydrochloric  acid  should  be  added.  If  the  meat  is  very  fat,  a  little 
ether  or  benzine  may  be  put  on  it  in  the  first  place.  The  parts  most  likely 
to  be  infected  are  said  to  be  the  muscular  part  of  the  diaphragm,  the  inter- 
costal muscles,  and  the  muscles  of  the  eye  and  jaw.^  In  diagnosing  TiHchince, 
the  coiled  worm  should  be  distinctly  seen.  Stephanurus  dentatus  in  the  pig 
ho.s  been  already  referred  to. 

The  so-called  Fsorospermia,  or  Eainey's  capsules,  must  not  be  mistaken 
for  Trichince,  nor  indeed  with  care  is  error  possible.  These  are  Uttle,  al- 
most transparent,  bodies,  found  in  the  flesh  of  oxen,  sheep,  and  pigs.  They 
are  in  shape  oval,  spindle-shaped,  or  sometimes  one  end  is  pointed  and  the 
other  rounded,  or  they  are  kidney-shaped.  The  investing  membrane  ex- 
hibits delicate  markings,  caused  by  a  hnear  arrangement  of  minute,  hair- 
hke  fibres,  which  Mr.  Rainey  ^  states  increase  in  size  as  the  animal  gets 
older.  Tney  sometimes  are  pointed,  and  the  appearance  under  a  high 
power  (1,000  diameters)  is  as  if  the  investment  consisted  of  very  dehcate, 
transparent,  conical  hairs,  terminating  in  pointed  process."  The  contents 
of  the  cysts  consist  of  granular  matter,  the  gTanules  or  particles  of  which, 
when  mature,  are  oval,  and  which  adhere  together,  so  as  to  form  indistinct 
divisions  of  the  entu-e  mass.  The  length  varies  from  3^th  to  ith  of  an 
inch.  They  are  usually  narrow  ;  they  lie  within  the  sarcolemma,  and  appear 
often  not  to  irritate  the  muscle. 

Up  to  the  present  time  no  injurious  effect  has  been  known  to  be  pro- 
duced on  men  by  these  bodies,  notwithstanding  their  enormous  quantities 
in  the  flesh  of  domestic  animals,  nor  have  they  been  discovered  in  the 
muscles  of  men.  But  in  pigs  these  bodies  sometimes  produce  decided 
illness  ;  besides  general  signs  of  illness,  there  are  two  invariable  symptoms, 
viz.,  paralysis  of  the  hind  legs,  and  a  spotty  or  nodular  eruption.'  In 
sheep,  they  have  been  known  to  affect  the  muscle  of  the  gullet,  and  produce 
abscesses,  or  what  may  be  called  so,  viz.,  swellings  sometimes  as  large  as  a 
nut,  and  containing  a  milky,  purulent-looking  fluid,  with  myiiads  of  these 
capsules  in  it.     Sheep  affected  in  this  way  often  die  suddenly." 

It  is  by  uo  means  improbable  that  some  effect  on  man  may  be  hereafter 
discovered  to  be  produced. 


'  Surgeon-Major  Oldham  describes  Cysticercus  tenuicoUis  (from  T(^nia  marginata  of 
dog)  as  common  in  the  sheep  of  the  Punjab ;  it  has  four -suckers  and  a  double  coronet 
of  82  hooks.  — Indian  Medical  Gazette,  August,  1873. 

2  Lion,  Comp.  des  Sanit.-Pol.,  p.  171.  ^  Ph-il.  Trans.,  1857. 

'  Beale,  in  Third  Report  of  the  Cattle  Plague  Commission,  Appendix. 

^  Virchow's  Archiv,  Band  xxxviii.,  p  355. 

*  Leisering,  in  Virchow's  Archiv,  Band  xxxvii.,  p.  431. 


232  PRACTICAL    HYGIENE. 

Some  bodies,  which  have  been  also  termed  Psoro^ermia,  found  in  the 
hver  of  the  rabbit,  aud  other  parts,  and  in  the  Hver  of  man,  and  which 
have  been  described  by  many  observers  in  difterent  terms,'  may  possibly 
be  found  in  other  animals,  as  they  have  been  seen  in  the  dog  by  \  irchow. 
They  are  quite  different  from  Eainey's  coi'puscles  ;  they  are  oval  or  rounded 
bodies,  at  first  with  gi'anular  contents,  and  then  with  aggregations  of 
gi'anules  into  thi'ee  or  four  rounded  bodies,  on  which  something  like  a 
nucleolus  is  seen.     They  have  often  been  mistaken  for  pus-cells. 

Some  other  bodies  occur  in  the  flesh  of  pigs,  the  nature  of  which  is  not 
yet  known.  Wiederhold  ^  describes  a  case  in  which  little  white  specks, 
with  all  the  appearance  at  first  of  encapsuled  Trichina',  could  not  be  proved 
to  be  so,  and  their  real  nature  was  quite  obscure. 

Vii'chow  has  described  httle  concretions  in  the  flesh  of  the  pig,  which 
seemed  to  be  composed  of  guanin  ;  ^  these  were  also  at  first  taken  for  en- 
capsuled  Irichincp. 

Koloff*  has  noted  little  hard  round  nodules  in  the  flesh  of  the  jiig, 
some  seem  very  small,  others  as  large  as  the  head  of  a  pin,  with  Httle  pro- 
longations running  to  the  suiTounding  muscular  fibres  to  which  they  are 
attached.  On  the  outside  of  these  bodies  are  bundles  of  fine  haii's  or 
needles,  sometimes  aiTanged  in  quite  a  feather- hke  form.  The  bodies  have 
a  great  resemblance  to  the  guanin  bodies  of  Virchow,  but  the  needles  are 
not  crj'stalline.  Eoloff  puts  the  question  if  these  bodies  are  of  post-mortem 
origin. 

It  is  hardly  necessary  to  state  that  in  cutting  across  meat,  small  bits  of 
tendons  or  fascia,  sometimes  veiy  like  a  little  cyst,  ■vsill  be  found  ;  but  com- 
mon care  will  prevent  a  mistake. 

2.    SALT    MEAT. 

It  is  not  at  all  easy  to  judge  of  salt  meat,  and  the  test  of  cooking  must 
often  be  employed.     The  following  points  should  be  attended  to  : — 

(a)  The  salting  has  been  tvell  done,  but  the  parts  inferior. — This  is  at  once 
detected  by  taking  out  a  good  number  of  pieces  ;  those  at  the  bottom  of 
the  cask  should  be  looked  at,  as  well  as  those  at  the  top. 

[b)  Ihe  salting  icell  done,  and  the  parts  good,  but  the  meat  old. — Here  the 
extreme  hardness  and  toughness,  and  shriveUing  of  the  meat,  must  guide 
us.  It  would  be  desirable  to  have  the  year  of  salting  placed  on  the  cask 
of  salt  beef  or  pork. 

(e)  ITie  salting  well  done,  but  the  meat  bad. — If  the  meat  has  partially 
putrefied,  no  salting  will  entirely  remove  its  softness ;  and  even  there  may 
be  putrefactive  odor,  or  gi'eenish  color.  A  shght  amount  of  decomjiosition 
is  arrested  by  the  salt,  and  is  probably  indetectable.  Cysticerci  are  not 
killed  by  salting,  and  can  be  detected.  Measly  pigs  are  said  to  salt  badly, 
but  according  to  Gamgee  this  is  not  the  case. 

{d)  The  salting  badly  done,  either  from  haste  or  bad  brine. — In  both  cases 
signs  of  putrefaction  can  be  detected  ;  the  meat  is  paler  than  it  should  be ; 
often  slightly  greenish  in  color,  and  with  a  peculiar  odor. 

It  should  be  remembered  that  biine  is  sometimes  poisonous ;  this  occtu'S 
in  cases  where  the  brine  has  been  used  several  times  ;  a  lai'ge  quantity  of 

'  Leuckart,  Die  Menschl.  Paras,  Band   i.,  p.  740;  Stieda,  Virchow's  Archiv,  Band 
xxxii.,  p.  182  ;  Roloff,  Virchow's  Archiv,  Band  xliii.,  p.  512. 
■'  Virchow's  Archiv,  Band  xxxiii.,  p.  549. 
2  Ibid.,  Band  xxxv.,  358.  *  Ibid.,  Band  xliii.,  p.  524. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  233 

animal  substance  passes  into  it,  and  appears  to  decompose.     The  special 
poisonous  agent  has  not  been  isolated. 

Stjb-Sectiok  he. — Diseases  aeising  from  altered  Quality  of  ISIeat. 

A  Tery  considerable  quantity  of  meat  from  diseased  animals  is  brought 
into  the  market,  but  the  amount  is  uncertain. 

Instances  are  not  at  all  uncommon  in  which  persons,  after  partaking  of 
butcher's  meat,  have  been  attacked  vv-ith  serious  gasti-o-intestinal  sym2Dtoms 
(vomiting,  cUaiThcea,  and  even  cramp),  followed  in  some  cases  by  severe 
febrile  symptoms  ;  the  whole  complex  of  symptoms  somewhat  resembles 
cholera  at  first,  and  afterwai'd  typhoid  fever.  The  meat  has  been  often 
analyzed,  for  the  purpose  of  detecting  poison,  but  none  has  been  foimd.^ 
In  the  records  of  these  cases,  the  kind  of  meat,  the  -part  used,  and  the  origin 
from  a  diseased  animal,  are  not  stated,  and,  in  some  cases,  it  may  be  con- 
jectured that  the  cooking,  and  not  the  meat,  was  in  fault.  StiU,  the  in- 
stances are  becoming  numerous,  and  are  increasing  every  day,  as  attention 
is  directed  to  the  subject.  We  should  conclude  from  general  principles, 
that  as  ah  diseases  must  affect  the  composition  of  flesh,  and  as  the  com- 
position of  our  own  bodies  is  inextiicably  blended  with  the  composition  of 
the  substances  we  eat,  it  must  be  of  the  greatest  importance  for  health  to 
have  these  substances  as  pure  as  possible.  Animal  poisons  may  indeed  be 
neutralized  or  destroyed  by  the  processes  of  cooking  and  digestion,  but  the 
composition  of  muscle  must  exert  an  influence  on  the  com]30sition  of  our 
own  nitrogenousus  tises  which  no  preparation  or  digestion  can  remove. 

On  looking  through  the  hterature  of  the  subject,  however,  we  find  less 
evidence  than  might  be  expected.  This  is  probably  partly  owing  to  im- 
perfect obseiwation,  especially  when  we  think  for  how  long  a  time 
Trichina  disease  was  overlooked. 

1  Thefiesh  of  healthy  animals  may  produce  Poisonous  Symptoms. — This 
is  the  case  with  certain  kinds  of  fish,  esi3ecially  in  the  tropical  seas. 
There  is  no  evidence  that  the  animal  is  diseased,  and  the  flesh  is  not 
decomposed  ;  it  produces,  however,  violent  symptoms  of  two  kinds — gastro- 
intestinal irritation,  and  severe  ataxic  nervous  symptoms,  with  great  de- 
pression and  algidity  The  Httle  herring  [Clupjea  harengo  minor),  the 
silver-fish  [Zeus  gallas),  the  pilchard,  the  white  flat-fish,  and  several  others, 
have  been  known  to  have  these  effects.^  In  some  cases,  though  not  in  all, 
the  poison  is  developed  during  the  breeding  time.  Oysters  (even  when  in 
season;  and  mussels  have  been  known  to  produce  similar  symptoms,  with- 
out any  decomposition.  The  production  of  dysj)epsia  and  nettle-rash  in 
some  persons  from  eating  shell-fish  need  scarcely  be  mentioned. 

Among  the  Mammalia  the  flesh  of  the  pig  sometimes  causes  diarrhoea 
— a  fact  noticed  by  Dr.  Parkes  in  India,  and  often  mentioned  by  others. 
The  flesh  is  probably  affected  by  the  unwholesome  garbage  on  which  the 
pig  feeds.  Sometimes  pork,  not  obviously  diseased,  has  produced  choleraic 
symptoms.^     In  none  of  these  cases  has  the  poison  been  isolated. 

2.  The  Jlesh  of  healthy  animals  ivhen  decompoising  is  eaten  sometimes 

'  See  Professor  Gamgee's  paper  in  the  Fifth  Eeport  of  the  iredical  Officer  to  the 
Privy  Council,  1863,  p.  287.  He  refers  to  cases  noted  by  Maclagan,  Taylor,  Letheby, 
Dundas,  Thomson,  and  Keith. 

-  A  list  of  more  than  forty  fishes,  which  are  occasionally  poisonous,  is  given  by 
Pappenheim. — Hand,  der  Sanitats-Pol. ,  Band  i.,  p.  395. 

■'  Kesteren  cites  a  good  case  in  which  twelve  persons  were  affected. — Med.  Times  and 
Gazette,  March  5,  1864. 


234  PRACTICAL   HYGIENE. 

■without  danger  ;  but  it  occasionally  gives  rise  to  gastro-intestinal  disorder 
— vomiting,  diarrhoea,  and  gi-eat  depression  ;  in  some  cases  severe  febiile 
symptoms  occur,  which  are  hke  typhus,  on  account  of  the  great  cerebral  com- 
plication.    Cooking  does  not  appear  entii-ely  to  check  the  decomposition. 

It  ajopears  to  be,  in  some  cases,  the  acid  fluids  of  cooked  meat  which 
promote  this  alteration. 

Saiisages  and  pork -pies,  and  even  beefsteak-pies,'  sometimes  become 
poisonous  from  the  formation  of  an  as  yet  unknown  substance,  which  is 
perhaps  of  a  fatty  nature.  It  is  not  trimethylamine,  amylamine,  or  pheny- 
lamine — these  are  "not  poisonous  (Schlossberger).  The  symptoms  are 
severe  intestinal  uiitation,  followed  rapidly  by  nervous  oppression  and 
collapse.^  Neither  salts  nor  spices  hinder  the  production  of  this  poison. 
M.  Yandem  Corput  attributes  the  poisonous  effects  of  sausages  to  a  fungus, 
of  the  nature  of  sarcina,  or  what  he  terms  Sarcina  botvlina." 

Dr.  Ballard  has  reported  two  remarkable  cases  of  poisoning  by  ham 
and  hot  baked  pork.  The  first  occun-ed  at  Welbeck  in  1880,  and  the 
second  at  Nottingham  in  1881.  In  both  instances  a  number  of  persons 
who  partook  of  the  meat  were  taken  ill,  and  some  died.  Dr.  Klein 
examined  the  meat,  and  found  it  loaded  with  Bacilli,  which  were  also 
found  in  the  organs  of  the  fatal  cases.  Gmnea-jDigs  and  mice,  inoculated 
with  the  fluids  of  the  body,  died  with  pneumonia  and  peritonitic  symjD- 
toms  ;  Bacilli  were  found  in  the  organs.^ 

Oysters  and  shell-fish,  when  decomposing,  produce  also  marked  symp- 
toms of  the  same  kind.  Eotten  fish  are  used,  however,  by  the  Biu-mese, 
Siamese,  and  Chinese  as  a  sort  of  condiment,  without  bad  effects. 

3.  The  /re>'h  and  not  decovipo^ing  flesh  of  diseased  animals  causes  in 
many  cases  injurious  effects.  A  good  deal  of  difference  of  opinion,  how- 
ever, exists  on  this  point,  and  it  would  seem  that  a  more  careful  incjuiiy  is 
necessai-^'.  The  probability  is,  that  when  attention  is  directed  to  the  sub- 
ject, the  effect  of  diseased  meat  will  be  found  to  be  more  considerable 
than  at  present  believed.^  At  the  same  time,  we  must  not  go  beyond  the 
facts  as  they  are  at  present  known  to  us,  and  at  present  certainly  bad 
effects  have  been  traced  in  only  a  few  instances  ;  perhajDS  the  heat  of  cook- 
ing is  the  safeguard. 

(a)  Accidents. — The  flesh  of  animals  killed  on  account  of  accidents  mtij 
he  eaten  without  injuiy. 

{b)  The  flesh  of  orer-dHven  animals  is  said  by  Professor  Gamgee  to  con- 
tain a  poison  which  often  produces  eczema  on  the  skin  of  those  who 
handle  it ;  and  eating  the  flesh  is  said  to  "  have  been  attended  with  bad 
effects." 

(c)  Early  Stage  of  Acute  Inflammatory  Disease. — The  meat  is  not  ap- 

'  I  have  seen  very  severe  symptoms  produced,  diarrhcBa  and  partial  collapse,  from 
eating  beefsteak  pie,  which  presented  nothing  unpleasant  to  the  taste. — (F.  de  C.) 

^  A  severe  case  of  poisoning  by  liver  sausages  took  place  at  Middeiburg,  iu  Holland, 
in  March,  1874.  Nearh'  40U  were  attacked,  and  out  of  343  reported  cases,  6  died. 
The  symptoms  commenced  a  few  hours  after  the  sausages  were  eaten,  consisting  of 
naa'sea  and  vomiting,  diarrhoea  with  offensive  stools  and  abdominal  pain  and  high  fever. 
The  symptoms,  after  apparent  convalescence,  recurred  for  several  days,  and  at  last  be- 
came quite  of  an  intermittent  character.  Chemical  and  microscopical  examination 
failed  to  detect  anj'thing,  except  that  there  were  quantities  of  the  minutest  organisms 
in  the  sausages.     (Centralblatt  fiir  die  Med.  Wiss.,  1875,  No.  14,  p.  219.) 

^  Quoted  by  Letheby,  Chemical  News,  February,  1869. 

••  Eeport  of  tlie  Medical  Officer  of  the  Local  Government  Board 

'  Professor  Gamgee  says  that  one-fifth  of  the  meat  in  London  is  more  or  less 
diseased. 


QUALITY,    CHOICE,    AND    COOKING-    OF   FOOD.  235 

parently  altered,  and  it  is  said  that  some  of  the  primest  meat  in  the  Lon- 
don market  is  taken  from  beasts  in  this  condition  ;  it  is  not  known  to  be 
iujui'ious,  bnt  it  has  been  recommended  that  the  blood  should  be  allowed 
entirely  to  flow  out  of  the  body,  and  should  not  be  used  in  any  wav. 

{d)  Chronic  ivasting  Diseases — Phthisis,  Dropsy,  etc. — The  flesh  is  pale, 
cooks  badly,  and  gives  rise  to  sickness  and  diarrhcea.  It  also  soon  begins 
to  decomjDose,  and  then  causes  very  severe  gastro-intestinal  derangement. 
Grave  doubts  have  recently  arisen  as  to  whether  tuberculosis  may  not  be 
communicable  to  man  tkrough  the  flesh  of  cattle  suffering  from  that 
disease. ' 

(e)  Chronic  Nervous  Fevers. —  Same  as  above. 
.  (/)  Epidemic  Plenro-pneumonia  of  Cattle. — Much  doubt  exists  as  to  the 
effect  of  this  disease  on  the  meat.  It  is  hardly  possible  that  the  flesh 
should  not  be  seriously  altered  in  composition,  but  it  seems  certain  that 
a  large  quautit}'  is  daily  consumed  without  apj^arent  injury.  It  is  said,  on 
the  authority  of  Staff-Surgeon  Nicolson  and  Assistant-Surgeon  Frank,  who 
made  very  careful  inqim-ies  on  this  point,  that  the  Kaffirs  ate  their  cattle, 
when  destroyed  by  the  epidemic  lung  disease  which  prevailed  at  the  Cape 
a  number  of  years  ago,  without  injury.  Dr.  Livingstone,  however,  states 
that  the  use  of  such  flesh  produces  carbuncle. 

{g)  Anthrax  and  Malignant  Pustule. — Many  of  the  older  authors  (Eam- 
azzini,  Lancisi,  quoted  by  Levy)  mention  facts  tending '  to  prove  the  dan- 
ger of  using  the  flesh  of  animals  affected  with  malignant  pustule.  Chaus- 
sier  also  affirmed  the  same  thing,  but  subsecjuently  modified  his  opinion 
considerably.  The  apparent  increase  in  the  number  of  cases  of  malignant 
pustule  in  men  has  been  ascribed  to  eating  the  flesh  of  animals  with  this 
disease,  but  it  is  quite  as  likely  that  inoculation  may  have  taken  place  in 
other  ways. 

The  evidence  laid  before  the  Belgian  Academy  of  Medicine  led  them 
to  beheve  the  flesh  of  cattle  affected  with  carbuncular  fevers  to  be  inju- 
rious, and  it  is  not  allowed  to  be  sold. 

It  has  been  supposed  that  the  outbreaks  of  boils,  which  have  certainly 
become  more  prevalent  of  late  years,  are  produced  by  meat  of  this  kind, 
but  the  evidence  is  very  imj)erfect. 

Menschel'  has  recorded  a  case  in  which  twenty-four  persons  were  seized 
wdth  malignant  pustule,  the  majority  after  eating  the  flesh  of  beasts  suf- 
fering from  the  disease,  the  others  from  direct  inoculation.  Those  who 
ate  the  flesh  were  attacked  in  three  to  ten  days  ;  those  who  were  inocu- 
lated in  three  to  six  days.  It  is  also  stated  that  jDigs  fed  on  the  flesh  got 
the  disease,  and  that  a  woman  who  ate  some  of  the  diseased  pork  was  also 
attacked. 

On  the  other  hand,  several  old  authors,  and  more  lately  Neffel,^  assert 
that  the  Kii^ghises  constantly  eat  horses  and  cattle  (either  killed  or  dying 
spontaneously)  affected  with  malignant  pustule,  without  injury. 

Parent-Duchatelet'  quotes  a  case  fi'om  Hamel  (1737),  in  which  a  buU 
infected  three  persons  who  aided  in  kilhng  it,  and  a  sui'geon  who  opened 
one  of  the  tumors  of  a  person  affected  ;  yet,  of  more  than  100  persons  W'ho 
ate  the  flesh  roasted  and  boiled,  no  one  experienced  the  slightest  incon- 
venience, and  Parent  states  that  many  other  cases  are  known  in  hterature. 

'  Creighton,  on  Bovine  Tuberculosis  in  Man ;  also,  Transactions  of  the  International 
Medical  Congress,  1881,  vol.  iv.,  p.  481. 

^  Preuss.  Med.  Zeit.,  4tli  June,  1862;  and  Canstatt's  Jaliresb.,  1862,  Band  iv.,  p. 
257. 

3  Canstatt's  Jaliresb.  for  1860,  Band  ii.,  p.  137.  ♦  *  Tom.  ii.,  p.  196. 


236  PRACTICAL    HYGIENE. 

Parent-Ducliatelet  and  hC'vy'  quote  from  Morand  (1766)  an  instance  in 
which  two  bulls  commuuicated  malignant  pustule  to  two  butchei-s  by 
inoculation,  yet  the  flesh  of  the  animals  was  eaten  at  the  "Invalides" 
without  injury.  But  both  these  instances  are  of  old  date.  Pappenheim'' 
states  (without  giving  special  instances)  that  there  are  many  cases  in 
which  no  bad  ellect  resulted  from  the  cooked  flesh  of  charbon — that  the 
peasants  of  Posen  eat  such  meat  with  perfect  indifference,  and  believe  it  is 
harmless  when  boiled. 

With  regard  especially  to  eiysipelas  carbuncvdosum,  or  black-quarter, 
as  distinguished  from  malignant  pustiile  (if  it  is  to  be  so  distinguished). 
Professor  Gamgee'  refers  to  cases  of  jDoisoning,  and  two  deaths  mentioned 
to  him  by  Dr.  Keith  of  Aberdeen,  caused  by  eating  an  animal  aftected 
with  black-quarter.  He  also  notices  an  instance  which  occurred  ''  a  num- 
ber of  years  ago  in  Dumfriesshu'e,"  when  seventeen  persons  were  more  or 
less  affected,  and  at  least  one  died,  and  states  that  a  number  of  cases  have 
been  related  to  him  by  different  obsei-vers. 

The  discrepancy  of  e\idence  is  so  gi-eat  as  to  lead  to  the  conclusion, 
that  the  stage  of  the  disease,  or  the  part  eaten,  or  the  mode  of  cooking, 
must  have  great  influence,  and  that  a  much  more  careful  study  than  has 
yet  been  given  to  this  subject  is  necessary  to  clear  up  these  great  varia- 
tions of  statement. 

{h)  Splenic  Apojilexy  or  Braxy  of  Sheep. — Professor  Simonds*  states 
that  pigs  and  dogs  died  in  a  few  hom-s  after  eating  the  flesh  of  shee^D  dead 
of  braxy.  Professor  Gamgee^  affirms  the  same  thing  ;  but,  on  the  other 
hand.  Dr.  M'Gregor  states  that  dogs  eat  the  meat  with  perfect  impunity. 
The  experiments  at  Alfort"  have  also  shown  that  pigs,  dogs,  and  fowls  ai-e 
not  incommoded  hj  this  poison,  which  yet  acts  riolently  when  swallowed 
by  sheep,  goats,  or  horses.  So  also  Dr.  Smith'  states,  that  the  shejjherds 
in  the  Highlands  of  Scotland  eat  by  preference  braxy  sheep,  and  are  quite 
healthy.  Dr.  M'Gregor  says  that  the  flesh  of  braxy  sheep  is  never  cooked 
until  it  has  been  steeped  for  two  months  in  brine,  and  then  suspended  for 
a  time  from  the  kitchen  roof.  It  is  preferred  to  ordinary  salt  mutton, 
because  it  has  rather  a  flavor  of  game. 

(i)  Small-pox  of  Sheep. — The  flesh  has  a  peculiar  nauseous  smell,  and  is 
pale  and  moist.  It  produces  sickness  and  diarrhoea,  and  sometimes  febrile 
sjTuptoms. 

(j)  Foot-and-mouth  Disease  {Aphtha  (or  Eczema)  epizoofica). — Levy' states 
that  at  different  times  (1834,  1835,  1839)  the  aphthous  disease  has  prevailed 
among  cattle  both  at  Paris  and  Lyons,  Avithout  the  sale  of  the  meat  being 
inteiiaipted  or  giving  rise  to  bad  results.  The  milk  of  cows  affected  with 
foot-and-mouth  disease  has  been  supposed  to  cause  vesicular  aflection  of 
the  mouth  in  men.^  The  evidence  seems,  however,  veiy  uncertain.  The 
discharges  from  the  mouth  are  constantly  on  the  hands  of  the  fann 
laborers,  who  are  not  very  cleanly,  and  who  must  constantly  convey  them 
to  their  own  mouths,  and  yet  these  discharges,  so  infectious  to  other  cattle, 
produce  no  effect  on  them. 

(k)  Cattle  Plague  (Einderpest,  Typhus  contagiosus  of  the  French). — A 
priori,  such  flesh  would  be  considered  highly  dangerous,  and  the  Belgian 

'  Traite  d'Hygil-ne,  1879,  torn,  ii.,  p.  680. 

-  Handb.  der"Sanitats-Pol.,  Band  i.,  p.  587. 

'  Fifth  Eeport  of  Medical  Officer  to  the  Privy  Council,  p.  290. 

*  Agricultural  Journal,  No.  50,  p.  232.         ^'Privv  Council  Repiort,  1863,  p.  280. 

«  Levy,  t.  ii.,  p.  631.  '  Social  Science  Trans,  for  1863,  p.  559. 

«  Traite  d'Hygiene,  1879,  t.  ii.,  p.  631.         «  Jour,  of  the  Epid.  Soc,  vol.  i.,  p.  423. 


QUALITY,    CHOICE,    AND    COOKING    OF   FOOD.  237 

Academy  of  Medicine  so  consider  it  ;  but  there  is  some  strong  evidence  on 
the  other  side.  In  Strasbourg  and  in  Paris,  in  1814,  many  of  the  beasts 
eaten  in  those  cities  for  several  months  had  rinderpest,  and  yet  no  iU  con- 
sequences were  traced.  But  it  may  be  questioned  whether  they  were 
looked  for  in  that  careful  way  they  would  be  at  the  present  day. '  Some 
other  evidence  is  stronger  :  Renault,  the  director  of  the  Veterinary  School 
at  Alfort,  made  for  several  years  after  1828  many  experiments,  and  asserts 
that  there  is  no  danger  from  the  cooked  flesh  of  cattle,  pigs,  or  sheep  dead 
of  any  contagious  disease  ("quelle  que  soit  la  repugnance  bien  naturelle 
que  puissent  inspirer  ces  produits").'  So  also  during  the  occurrence  of  the 
rinderpest  in  England  (1865),  large  quantities  of  the  meat  of  animals  liiUed 
in  all  stages  of  the  disease  were  eaten  without  ill  effects.  In  Bohemia 
also,  in  1 863,  the  peasants  dug  up  the  animals  dead  with  rinderpest,  and 
ate  them  without  bad  results.^ 

(l)  Rabies  in  the  dog  and  cow  produces  no  bad  effects.* 

[m)  Diseases  in  the  pig,  like  scarlet  fever  and  pit/  tyjjhus,  have  prevailed 
recent!}'  in  London,  and  the  flesh  has  been  eaten.  No  injury  has  been 
proved.  ^ 

(n)  Cysticercus  ceUulosce  of  the  pig  produces  Tcenia  solium,  and  that  of 
the  ox  and  cow  Tcenia  inediocaneliata.  These  entozoa  often  arise  from 
"eating  the  raw  meat,  but  neither  cooking  nor  salting  are  quite  preservative, 
though  they  may  lessen  the  danger.  Smokmg  appears  to  kill  Gysticerci, 
and  so,  according  to  DeljDech,  does  a  temperature  of  212°  Fahr.  T.  Lewis'^ 
found  that  a  much  lower  temperature  sufficed.  When  Gysticerci  had  been 
exposed  for  five  minutes  to  a  heat  of  130°  Fahr.,  he  could  detect  no  move- 
ments, and  he  considers  that  a  temperature  of  from  135°  to  140°  F.  for 
five  minutes  would  certainly  kill  them.  Lewis  considers  there  is  no  danger 
if  the  cooking  is  well  done,  as  the  temperature  of  well-done  meat  is  never 
below  150°  F. 

(o)  Trichina  spiralis  in  the  pig  gives  rise  to  the  curious  Trichina  disease 
caused  by  the  wanderings  of  the  young  Trichina; .  The  affection  is  highly 
febrile,  resembling  typhoid  or  even  typhus,  or  acute  tuberculosis,  but  at- 
tended with  excessive  paias  in  the  limbs,  and  oedema.'  Boils  are  also 
sometimes  caused.  The  eating  of  raw  trichiniferous  pork  is  the  chief 
cause,  and  the  entozoon  is  not  easily  killed  by  cooking  or  salting.  A  tem- 
perature of  144°  to  155°  Fahr.  kills  free  Trichince,  but  encapsuled  Trichince 
may  demand  a  greater  heat  (Fiedler).  During  cooking,  a  temperature 
which  will  coagulate  albumen  (150°  to  155°  Fahr.)  renders  Trie/mice  in- 
capable of  propagation,  or  destroys  them.  As  a  jDractical  rule,  it  may  be 
said  that  if  the  interior  of  a  piece  of  boiled  or  roasted  pork  retains  much 

'  The  words  of  Coze  (Parent-Duchatelet,  t.  xi.,  p.  201)  are,  however,  very  strong. 
At  Strasbourg  he  says :  ' '  Un  millier  de  boeuf s  de  grande  taille,  malades  pour  la  plupart 
au  plus  haut  degre,  pnisqu'un  assez  grand  nombre  ont  ete  egorges  au  moment  ou  ils 
allaient  expirer,  a  ete  consomme,  pendant  et  apres  le  blocus,  et  eet  aliment  n'a  produit 
aucune  maladie." 

-  Payen,  Des  Substances  Alimentaires,  pp.  30,  31. 

^  Evidence  of  Cattle  Plague  Commission,  question  997,  and  other  places. 

■*  Parent-Duchatelet,  t  ii.,  p.  197,  cites  a  case  of  seven  mad  cows  being  sold  without 
injury  to  those  who  ate  the  flesh. 

^  Letheby,  Chem.  News,  January  15,  1869. 

«The  Bladder  Worms  found  in  Beef  and  Pork,  by  T.  R.  Lewis,  M.D.,  Calcutta, 
1872. 

'  Aitken's  Practice  of  Medicine,  7th  edit.,  vol.  i.,  p.  162.  See  also  reports  on  Hy- 
giene by  the  late  Dr.  Parkes,  in  the  Army  Medical  Reports  for  1860,  1861,  1862,  and 
1868,  where  references  to  most  of  the  early  cases  will  be  found.  See  also  Dr.  Thudi- 
chum's  treatise  in  Mr.  Simon's  Report  to  the  Privy  Council,  1864. 


238  PRACTICAL    HYGIENE. 

of  the  blood-red  color  of  uncooked  meat,  the  temperature  has  not  been 
higher  than  131°  Fahr.,  and  there  is  still  danger.  Intense  cold  and  com- 
I^lete  decomposition  of  the  meat  do  not  destroy  Trichince.^  Hot  smoking, 
when  tlioroughly  done,  does  destroy  them  (Leuckart) ;  but  the  common 
kinds  of  smoking,  when  the  heat  is  often  low,  do  not  touch  Trichince 
(K  ii  chenmeister ). 

(p)  Echinococcus  Disease. — It  is  well  known  that  many  persons  w^iU  eat 
freely  of,  and  even  prefer,  the  hver  of  the  sheeji  full  of  Hukes.  No  direct 
evidence  has  been  given  of  the  production  of  disease  from  this  cause,  at 
least  in  this  countiy.  In  Iceland,  Echinococcus  disease,  which  affects  a 
large  number  of  persons,  is  derived  from  sheep  and  cattle,  who,  in  their 
turn,  get  the  disease  from  Tcenia  of  the  dog  (Leared  and  Krabbe). 

{q)  Glanders  and  farcy  in  horses  do  not  appear  to  produce  any  injurious 
effects  on  theu-  flesh  w^hen  eaten  as  food.  Parent-Duchatelet"  quotes  two 
instances,  in  one  of  which  300  glandered  horses  were  eaten  without  injury. 
In  1870,  during  the  siege  of  Paris,  large  quantities  of  flesh  from  horses 
with  farcy  and  glanders  were  eaten  without  injury. 

(?•)  Medicines,  especially  antimony,''  given  to  the  animals  in  large  quan- 
tities, have  sometimes  produced  vomiting  and  diarrhcea.  Arsenic,  also,  is 
occasionally  given,  and  the  flesh  may  contain  emough  arsenic  to  be  dan- 
gerous.'' 

In  time  of  peace,  the  dut}'  of  the  army  surgeon  is  simple.  Under  the 
terms  of  the  contract,  all  sick  beasts  are  necessarily  excluded.  Without 
reference,  then,  to  any  uncertain  questions  of  hurtfulness,  or  the  reverse, 
he  must  object  to  the  use  of  the  flesh  of  such  animals.  This  is  the  safe 
and  projDer  course. 

But,  in  time  of  war,  he  may  be  placed  in  the  dilemma  of  allowing  such 
meat  to  be  used,  or  of  getting  none  at  all.  He  should  then  allow  the  issue 
of  the  meat  of  all  animals  ill  with  inflammatory  and  contagious  diseases, 
with  the  exception  of  small-pox,  and  perhaps  splenic  apoplex}-  in  sheep. 
But  it  will  be  well  to  take  the  precautions — 1st,  Of  bleeding  the  animals 
as  thoroughly  as  possible  ;  2d,  Of  using  only  the  muscles,  and  not  the 
organs,  as  it  is  quite  possible  these  may  be  more  injiuious  than  the  mus- 
cles, though  there  are  no  decided  facts  on  this  point ;  and,  3d,  Of  seeing 
that  the  cooking  is  thoroughly  done.  But  animals  with  small-pox,  Gysti- 
cerci,  and  Trichince,  should  not  be  used.  If  dire  necessity  compels  their 
use,  then  the  employment  of  a  gi-eat  heat  in  a  baker's  oven  and  smoking", 
if  it  can  be  used,  may  lessen  the  danger.  If  such  things  can  be  got,  it 
would  be  well  to  try  the  effect  on  the  meat  of  antiseptics,  especially  of 
carboHc  acid,  which  destroys  low  animal  life  of  that  kind  with  great  cer- 
tainty. 

Sub-Section  TV. — Cooking  of  Meat. 

Boiling. — The  loss  of  weight  is  about  20  to  80  per  cent.,  sometimes  as 
much  as  40.     If  it  is  wished  to  retain  as  much  as  possible  of  the  salts  and 

'  Carre  (Comptes  Rendus,  xcv.,  p.  147)  saj'S  that  tliey  are  destroyed  at  40"  to  50° 
below  zero  of  Centicrade  (=  40    to  58"  below  zero  of  Fahrenheit). 

''  Hyg.  Publ.,  t.  Ii.,  194 ;  see  also  Levy,  t.  ii.,  p.  630. 

^  See  a  well-marked  case  cited  by  Pavy  (A  Treatise  on  Food  and  Dietetics,  2d  ed. , 
1875,  p.  160),  as  quoted  by  Gamgee,  from  the  Central  Zeitung  fiir  die  gesaminte  Yeter- 
inrirmedizin  fiir  1854,  where  107  persons  were  attacked  after  eating  the  flesh  of  an  ox 
which  had  been  treated  with  tartar-emetic  previous  to  being  slaughtered. 

■■  Levy,  Traite  d'Hygieue,  1879,  t.  ii.,  pp.  663-4;  reference  to  experiments  of  Dan- 
ger, Flandin,  and  Chatin. 


QUALITY,    CHOICE,    AN^D    COOKING    OF    FOOD.  239 

soluble  substances  in  the  meat,  the  piece  should  be  left  large,  and  should 
be  plunged  into  boihng  water  for  five  minutes  to  coagulate  the  albumen. 
After  this  the  heat  can  scarcely  be  too  low.  The  temperature  of  coagula- 
tion of  the  albuminoid  substances  differs  in  the  different  constituents ;  one 
kind  of  albumen  coagulates  at  as  low  a  heat  as  86°,  if  the  muscle  seiiim  be 
very  acid  ;  another  albumen  coagulates  at  113°  Fahr. ;  a  large  quantity  of 
albumen  coagulates  at  167°.  The  hsematogiobulin  coagulates  at  158°  to 
162°,  below  which  temperature  the  meat  will  be  underdone.  If  the  tem- 
perature is  kept  above  170°,  the  muscular  tissue  shrinks,  and  becomes  hard 
and  indigestible.  Liebig  recommends  a  temperature  of  158°  to  160°.  Most 
military  cooks  employ  too  great  a  heat :  the  meat  is  shrunken  and  hard.  In 
boiling,  ammonium  sulphide  is  evolved,  with  odoriferous  compounds,  and 
an  acid  hke  acetic  acid. 

If  it  is  desired  to  make  good  broth,  the  meat  is  cut  small  and  put  into 
cold  water,  and  then  warmed  to  150°  Y.;  beef  gives  the  weakest  broth.  In 
a  pint  there  are  about  150  grains  of  organic  matter,  and  90  grains  of  salts. 
Mutton  broth  is  a  little  stronger,  and  chicken  broth  strongest  of  all. 
About  82  per  cent,  of  the  salts  of  beef  pass  into  the  broth,  viz.,  all  the 
chlorides,  and  most  of  the  phosphates. 

Broth  made  without  heat,  by  the  addition  of  four  drops  of  hydrochloric 
acid  to  a  pint  of  water  and  a  half  pound  of  beef,  is  richer  in  soluble  albu- 
men. Lactic  acid  and  chloride  of  potassium  added  together  have  the  same 
effect.  If  rather  more  hydrochloric  acid  be  used,  but  no  salt,  heat  can  be 
apphed,  and,  if  not  higher  than  130°  Fahr.,  nearly  50  jDer  cent,  of  the  meat 
can  be  obtained  in  the  broth. 

Boasting. — The  loss  varies  from  20  to  35  per  cent.;  in  beef  it  is  rather 
less  than  in  mutton  (Oesterlen).  This  loss  is  chiefly  water  ;  the  j)roportion 
of  carbon,  hydrogen,  nitrogen,  and  oxygen  remaining  the  same  (Playfair). 
Boasting  should  be  slowly  done  ;  to  retain  the  juices,  the  meat  must  be 
first  subjected  to  an  intense  heat,  and  afterward  cooked  very  slowly ;  the 
dry  distillation  forms  aromatic  products,  which  are  in  part  volatihzed  ;  the 
fat  is  in  part  melted,  and  flows  out  with  gelatin  and  altered  extractive 
matters.  The  fat  often,  improperly,  becomes  the  perquisite  of  the  cook, 
and  may  be  lost  to  the  soldier.  The  loss  in  baking  is  nearly  the  same,  or 
a  Httle  less. 

Stewing. — This  is  virtually  the  same  as  roasting,  only  the  meat  is  cut 
up,  is  continually  moistened  with  its  own  juices,  and  is  often  mixed  with 
vegetables.  Like  boiling  and  roasting,  it  should  be  done  slowly,  at  a  low 
heat ;  the  loss  then  is  about  20  per  cent.,  and  chiefly  water. 

In  all  cases  there  is  one  grand  rule,  viz.,  to  cook  the  meat  slowly,  and 
with  little  heat,  and,  as  far  as  possible,  to  let  the  loss  be  water  only.  The 
fault  in  military  kitchens  has  been,  that  excessive  heat  is  used.  The  meat 
is  then  often  a  sodden,  tasteless  mass,  with  hard,  shrunken,  and  indigest- 
ible fibres.  The  thermometer  will  be  found  very  useful,  especiaUy  in 
showing  cooks  that  the  temperature  is  often  much  higher  than  they  think. 
In  the  cooking  of  salt  meat,  the  heat  should  be  very  slowly  aj)phed,  and 
long  continued  ;  it  is  said  that  the  addition  of  a  little  vinegar  softens  the 
hard  sarcolemma,  and  it  is  certain  that  vinegar  is  an  agreeable  condiment 
to  take  with  salt  meat,  and  is  probably  very  useful.  It  may  be  of  impor- 
tance to  remember  this  in  time  of  war. 

In  cutting  up  meat,  there  is  a  loss  of  about  5  per  cent.,  and  there  is 
also  a  loss  from  bone,  so  that,  all  deductions  being  made,  the  soldier  does 
not  get  more  than  5  or  6  ounces  of  cooked  meat  out  of  12  ounces. 

The  large  quantity  of  flesh  extract  contained  in  the  bx'ine  can  be  ob- 


240  PRACTICAL    HYGIENE. 

tained  hj  dialysis ;  from  two  gallons  of  brine  a  fluid  has  been  obtained, 
which,  on  evaporation,  yielded  1  lb  of  extract.' 

Sub-Section  V. — Preservation  of  Meat. 

Meat  may  be  kept  for  some  time  by  simjDly  heating  the  outside  very 
strongly,  so  as  to  coagulate  the  albumen  ;  or  by  placing  it  in  a  close  vessel, 
in  which  sulphur  is  burnt,  or  by  covering  the  surface  with  charcoal,  or 
strong  acetic  acid,  or  calcium  disulphite,  or  weak  carbolic  acid.  Injections 
of  alum  and  aluminium  chloride  through  the  vessels  will  preserve  it  for  a 
long  time  ;  water  should  be  injected  first,  and  then  the  solution.  Even 
common  salt  injected  in  the  same  way  will  keep  it  for  some  time.  So  also 
will  free  exposure  to  pure  air  ;  charcoal  thrown  over  it,  and  suspended  also 
in  the  air  ;  or  the  meat  being  cut  into  smaller  portions,  and  placed  in  a 
large  vessel,  heat  should  be  applied,  and,  while  hot,  the  mouth  of  the  vessel 
should  be  closed  tightly  with  well  washed  and  dried  cotton-wool ;  the  air 
is  filtered,  and  partially  freed  from  germs.  The  application  of  sugar  to  the 
sui'face  is  also  a  good  plan.  Cold  is  a  great  preservative  of  meat ;  in  ice  it 
can  be  jireserved  for  an  unlimited  period,  and  the  suj)posed  rapid  decom- 
position after  thawing  seems  to  have  been  exaggerated.'  Fresh  meat  is 
now  largely  imported  from  America  and  Austraha,  by  being  kept  in  refrig- 
erated chambers. 

Plans  of  this  kind  may  be  useful  to  medical  officers  under  two  circum- 
stances, \iz.,  on  board  ship,  and  in  sieges,  when  it  is  of  imj)ortance  to  pre- 
sei-ve  eveiy  portion  of  food  as  long  as  possible.  The  covering  the  whole 
surface  with  powdered  charcoal  is  perhaps  as  convenient  as  any  plan.  A 
coating  of  paraffin,  and  many  other  plans  of  excluding  au',  are  also  used. 

Meat  is  also  jDreserved  in  tin  cases,  either  simply  by  the  complete  ex- 
elusion  of  air  (Appert's  process),  or  by  partly  excluding  air,  and  destroying 
the  oxygen  of  the  remaining  part  by  sodium  sulphite  (M'Call's  process). 
It  is  not  necessary^  to  raise  the  heat  so  high  in  this  case,  and  the  meat  is 
less  sapid.  Meat  prepared  in  either  way  has,  it  is  said,  given  rise  to  diar- 
rhoea, but  this  is  simply  from  bad  preparation  ;  when  well  manufactured 
it  has  not  this  eifect. 

Meat  is  also  preserved  by  drawing  off  the  air  from  the  case,  and  sub- 
stituting niti'ogen  and  a  little  sulphur  dioxide  (Jones  and  Trevithick's 
patent),  or  the  air  can  be  heated  to  400°  or  500°  so  as  to  kill  all  germs 
(Pasteur),  and  then  allowed  to  flow  into  an  exhausted  flask. ^ 

Various  other  plans  have  been  proposed,  such  as  the  use  of  antiseptics, 
carbohc  acid  (?),  borax,  boracic  acid,  salicylic  acid,  etc.  ;  but  it  is  doubtful 
if  any  of  them  should  be  adopted  ^\^.thout  further  inquiry,  as  it  is  by  no 
means  certain  that  such  agents  might  not  exercise  a  harinful  influence  on 
the  human  economy.^ 

'  Whitelaw,  Chemical  News,  March,  1864. 

•  Bonley,  Comptes  Rendus.  xcv.,  p.  147. 

'  Dr.  Letheby's  Cantor  Lectures  on  Food,  delivered  before  the  Society  of  Arts  in 
I860,  2d  edition,  1872,  give  a  good  account  of  some  of  the  patents  for  the  preserva- 
tion of  meat.  See  also  Meinert,  Armee- und  Volks-Erniihrung,  Berlin,  1880,  vol.  ii., 
p.  205 ;  also  Renk,  Conservirung  von  Nahrungsmitteln,  Deutsche  Vierteljahrschr.  f. 
off.  Gesundheitspfl. ,  Band  xiii.,  Heft  1. 

*  A  substance  called  Glacialin  has  been  recommended  :  this  consists  of  borax,  bor- 
acic acid,  sugar,  and  glycerin.  The  two  latter  are  preservative  of  themselves,  so  that 
the  addition  of  the  former  seems  superfluous.  The  mixture  of  borates  with  glycerin 
has  also  been  recommended  by  Le  Bon  in  France  and  Barff  in  England. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  241 

SECTION  n. 

WHEAT. 

Advantages  as  an  Article  of  Diet. — ^It  is  poor  in  water  and  rich  in  solids, 
therefore  very  nutritious  in  small  bulk  ;  when  the  two  outer  coats  are 
separated,  the  whole  grain  is  digestible.  The  nitrogenous  substances  are 
large  and  varied,'  consisting  of  soluble  albumen  (1  to  2  per  cent.)  and 
gluten  (8  to  12  per  cent.),  which  itself  consists  of  four  substances,  which 
are  named  by  Eitthausen,^  glutin-casein,  ghadin  (or  vegetable  gelatin), 
giutin-fibrin,  and  mucedin.  The  starchy  substances  (starch,  dextrin,  sugai*) 
ai'e  large,  60  to  70  per  cent.,  and  are  easily  digested ;  and,  according  to 
Mege-Mouries,  a  nitrogenous  substance  (cereahn)  is  contained  in  the  in- 
ternal envelope,  which,  like  diastase,  acts  energetically  in  transforming 
starch  into  dextrin,  sugar,  and  lactic  acid.  Some  consider  this  cerealin  to 
be  merely  a  form  of  diastase.  Cholestrin  is  found  in  wheat,  but  in  very 
small  quantity  (Ritthausen).  The  salts  are  chiefly  phosphates  of  potash 
and  magnesia. 

Disadvantages. — It  is  deficient  in  fat,  and  in  vegetable  salts  which  may 
form  carbonates  in  the  system. 

As  usually  prepared,  the  grain  is  separated  into  flour  and  bran  ;  the 
mean  being  80  parts  of  flour,  16  of  bran,  and  4  of  loss.  The  flour  is  itself 
divided  into  best  or  supei-fine,  seconds  or  middlings,  pollards  or  thirds  or 
bran  flour.  In  different  districts  different  names  are  used.  The  wheats  of 
commerce  are  named  fi-om  color  or  consistence  (hard  or  soft ;  white  or 
red) ;  the  hard  wheat  contains  less  water,  less  starch,  and  more  gluten  than 
the  soft  wheat. 

Sub-Section  I. — "Wheat  Grains. 

The  medical  officer  will  seldom  be  called  on  to  examine  wheat  grains, 
but  if  so,  the  following  points  should  be  attended  to.  The  grains  should 
be  well  filled  out,  of  not  too  dark  a  color ;  the  furrow  should  not  be  too 
deep  ;  there  should  be  no  smell,  no  discoloration,  and  no  evidence  of  insects 
or  fungi.  The  heavier  the  weight  the  better.  In  the  Belgian  army  the 
minimum  weight  is  77  kilogrammes  the  hectolitre.^  In  England,  good 
wheat  weighs  60  lb  to  the  bushel ;  light  wheat  58  lb  or  even  50  lb.  Fungi, 
if  present,  will  be  found  at  the  roots  of  the  hairs,  and  if  in  small  amount, 
are  only  microscopic.  If  in  large  amoimt  they  cause  the  diseases  known  by 
the  name  of  rust,  bunt  or  smut,  or  dust  brand  ;  they  are  owing  to  species 
of  Uredo  and  Puccinia.  If  any  grains  are  seen  pierced  with  a  hole,  and  on 
examination  are  found  to  be  a  mere  shell,  with  all  the  starch  gone,  this  is 
owing  to  the  weevil,  and  the  little  insect  can  itself  be  found  readily  enough 
if  a  handful  of  wheat  be  taken  and  spread  over  a  large  plate.  The  weevil 
can  hardly  escape  being  seen.  Acarusfarlnce  may  also  prey  on  the  wheat 
grain,  but  cannot  be  seen  without  a  microscope. 

'  These  reach.  14  to  15  per  cent.,  especially  in  the  hard  wheats  of  Italy  and  Sicily, 
which  are  used  for  macaroni  (Letheby). 

•^  Die  Eiweisskorper  der  Getreidearten,  von  Dr.  H.  Ritthausen,  1872. 
3  Squillier,  Des  Subsist.  Mil.,  p.  37. 
Vol.  I.— 16 


242  PRACTICAL    HYGIENE. 


Sub-Section  II. — Flour.' 

Almost  all  the  bran  is  separated  from  the  finest  flour ;  it  has  been  a 
question  whether  this  is  desu-able,  as  the  bran  contains  nitrogenous  mat- 
ter— as  much  sometimes  as  15  per  cent,  "with  3.5  per  cent,  of  fat,  and  5.7 
per  cent,  of  salts.  But  if  the  bran  is  used,  it  seems  probable  that  much  is 
left  undigested,  and  all  the  nuti-iment  which  is  contained  in  it  is  not  ex- 
tracted. A  plan  has  been  employed  by  Mege-Mouries,  which  seems  to 
save  all  the  most  valuable  parts  of  the  bran  ;  the  two  or  three  outer  and 
highly  sihceous  envelopes  of  the  wheat  are  detached,  and  the  fourth  or  in- 
ternal envelope  is  left.  Several  plans  of  decorticating  wheat  have  been 
proposed,  but  none  of  them  at  present  have  superseded  the  old  system  of 
grinding. 

If  the  whole  wheat  is  used,  it  should  be  ground  very  fine,  as  the  harder 
envelopes  are  very  irritating,  and  it  is  well  to  remember  that  for  sick  per- 
sons with  any  bowel  complaints  bread  must  be  used  entirely  without  bran. 
Dysenteries  have  been  found  most  intractable,  merely  from  attention  not 
being  directed  to  this  simple  point.  It  is  all  the  more  necessary  to  insist 
upon  this,  as  whole  meal  bread  has  been  much  recommended  and  used  of 
late. 

Examination  of  Flour  for  Quality  and  Adulteration. 

Flour  should  be  examined  physically,  microscopically,  chemically,  and 
practically  by  making  bread. 

The  quality  is  best  determined  by  chemical  examination  ;  adulterations 
by  the  microscope. 

Physical  Examination. 

Sight. — The  starch  shoidd  be  quite  white,  or  with  the  very  slightest 
tinge  of  yellow  ;  any  decided  yellow  indicates  commencing  changes ;  the 
amount  of  bran  should  not  be  great. 

Touch. — There  should  be  no  lumps,  or  if  there  are,  they  shoidd  at  once 
break  down  on  slight  pressure  ;  there  must  be  no  grittiness,  which  shows 
that  the  starch  grains  are  changing,  and  adhering  too  strongly  to  each 
other,  and  will  give  an  acid  bread.  There  should,  however,  be  a  certain 
amount  of  adhesion  when  a  handful  of  floui-  is  compressed,  and  if  thrown 


'  The  follQwing  is  given  by  Peligot  (mean  of  14  analyses),  as  the  relative  composi- 
tion of  flour  and  bran.  The  analyses  of  Von  Bibra  (Die  Getreidearten  und  das  Brod, 
1860)  agree  very  closely  with  it. 

Wheat  Flour  and  Bran.  i"  i?0  parts. 

Flour.  Bran. 

Water 14.0  10.3 

Fatty  matters 1-2  2.82 

Nitrogenous  substances  insoluble  in  water  (gluten). ,   12.8  10.84 

Nitrogenous  substances  soluble  in  water  (albumen). .     1.8  1.64 

Non-nitrogenous  soluble  substances  (dextrin,  sugar).      7.2  5.8 

Starch.... 59.7  22.02 

Cellulose 1-7  43.98-' 

Salts 1-6  2.52 


2  ThiH  is,  however,  the  cellulose  of  the  entire  prain,  both  of  the  husk  and  the  interior  of  the  grain.  Pot- 
ash, pliosphoric  acid,  and  magnepia  are  the  principal  ingredients  of  tlio  salts ;  the  earthy  phosphates  are 
especially  combined,  and  in  definite  proportions,  with  the  albuminates  (Mayer),  and  also  the  gummy  matter 
(Bibra).  The  alkaline  phosphates  are  free.  The  bran  contains  much  silica.  Oudemans  places  the  cellulose 
lower  (25  to  30  per  cent.),  and  the  salts  higher  (4  to  6  per  cent.). 


QUALITY,    CHOICE,    AND    COOKHiTG    OF    FOOD.  243 

against  a  wall  or  board  some  of  the  floux  should  adhere.  When  made  into 
a  paste  with  water,  the  dough  must  be  coherent,  and  draw  out  easily  into 
strings. 

Taste. — The  taste  must  not  be  acid,  though  the  best  flour  is  slightly 
acid  to  test-paper.  An  acid  taste,  showing  lactic  or  acetic  acid,  is  sure  to 
give  an  acid  bread. 

Smell. — There  must  be  no  smell  of  feiTnentation  or  mouldiness. 

Age  of  flour  is  shown  by  color,  grittiaess,  and  acidity. 

Chemical  Examination. 

It  is  seldom  that  a  medical  officer  will  be  able  to  go  through  a  com- 
plete examination,  but  he  should  always  determine  the  foUov^ing  points  : — 

1.  Amount  of  Water. — Weigh  1  gTamme,  spread  it  out  on  a  dish,  and 
dry  either  by  a  water  bath  or  in  a  hot-au*  bath  or  oven,  the  temperature 
not  being  allowed  to  go  above  212°.  The  flour  must  not  be  at  all  burnt 
or  much  darkened  in  coloi\  Weigh  directly  the  flour  is  cold  ;  the  loss  is 
the  percentage  of  water. 

The  range  of  water  is  from  10  (in  the  best  dried  flours)  to  18  in  the 
worst.  The  more  water  the  greater  hability  of  change  in  the  flour,  and, 
of  course,  the  less  is  the  amount  of  nutriment  purchased  in  a  given 
weight.  If,  then,  the  water  be  over  18  per  cent.,  the  flour  should  be  re- 
jected ;  if  over  16,  it  should  be  unfavorably  spoken  of. 

2.  Amount  of  Gluten. — Weigh  10  grammes,  and  mix,  by  means  of  a 
glass  rod,  with  a  little  water,  so  as  to  make  a  well-mixed  dough  ;  let  it 
stand  for  quarter  of  an  hour  in  an  evaporating  dish  ;  then  pour  a  little 
water  on  it ;  work  it  about  with  the  rod,  and  carefully  wash  off  the 
starch  ;  pour  off  from  time  to  time  the  starch  water  into  another  vessel. 
After  a  tune,  the  gluten  becomes  so  coherent,  that  it  may  be  taken  in  the 
fingers  and  worked  about  in  water,  the  water  being  from  time  to  time 
poured  off  till  it  comes  off  quite  clear.  If  there  is  not  time  to  diy  the 
gluten,  then  weigh  ;  the  dry  gluten  is  rather  more  than  one-third  the 
weight  of  the  moist ;  1  to  2. 9  is  the  usual  proportion  ;  therefore  divide 
the  weight  of  the  moist  gluten  by  2.9.  If  there  be  time,  dry  the  gluten 
thoroughly,  and  weigh  it.  This  is  best  done  by  spreading  it  out  on  a 
crucible  lid  and  drying  it  in  the  bath.  The  dry  gluten  ranges  fi'om  8  to 
12  per  cent.  ;  flour  should  be  rejected  in  which  it  falls  below  8.  If  there 
is  much  bran,  it  often  apparently  increases  the  amount  of  gluten  by  adher- 
ing to  it,  and  should  be  separated  if  possible  ;  in  fact,  the  gluten,  as  thus 
obtained,  is  never  pure,  but  always  contains  some  bran,  starch,  and  fat. 
The  gluten  should  be  able  to  be  drawn  out  into  long  threads  ;  the  more 
extensible  it  is  the  better.  It  is  always  well  to  make  two  determinations 
of  gluten,  especially  if  there  is  any  disputed  question  of  quality.' 

3.  Amount  of  Ash. — Take  10  grammes,"  put  into  a  porcelain  or  plati- 
num crucible,  and  incinerate  to  white  ash.  Weigh.  The  ash  should  not 
be  more  than  2  per  cent.,  or  probably  some  mineral  substances  have  been 
added ;  it  should  not  be  less  than  .8,  or  the  flour  is  too  poor  in  salts. 

The  incineration  of  the  flour  requires  a  crucible  and  gas.  It  is  diffi- 
cult to  do  it  over  a  spirit  lamp,  as  it  takes  a  long  time.  A  small  charcoal 
fire  is  probably  the  best  plan  when  gas  appliances  are  wanting. 

'  Mr.  Wanklyn  lias  proposed  to  utilize  the  albumiuoid  ammonia  process  for  deter- 
mining gluten,  reckoning  that  100  parts  of  flour  yield  1.2  of  ammonia. 

■  If  only  a  small  crucible  be  employed  a  smaller  quantity  should  be  taken,  as  it  is 
difficult  to  incinerate  ;  with  a  moderately  good  balance,  2  or  3  grammes  may  be  used. 


244  PRACTICAL    HYGIENE. 

If  the  ash  be  more  than  2  per  cent.,  add  hydrochloric  acid,  and  see  if 
there  be  effervescence  (magnesium  or  calcium  carbonate).  Dissolve,  and 
test  with  oxalate  of  ammonium,  and  then  for  magnesia,  in  the  same  way  as 
in  water.  As  floui-  contains  both  Ume  and  magnesia,  to  prove  adultera- 
tion, the  precise  amount  of  lime  and  magnesia  must  be  determined  by 
weighing  the  incinerated  calcium  oxalate,  or  the  magnesium  pyrophos- 
phate. 

If  there  is  no  effervescence,  add  water,  and  test  for  sulphuric  acid  and 
lime,  to  see  if  calcium  sulphate  (plaster  of  Paris)  has  been  added.  In  nor- 
mal flour  the  amount  of  sulphuric  acid  is  veiy  smaD. 

Notice,  also,  if  the  ash  be  red  (from  iron).  If  clay  has  been  added,  it 
will  be  left  undissolved  by  acids  and  water. 

If  magnesium  carbonate  has  been  added,  the  ash  is  light,  and  porous 
and  bulky  (Hassall). 

An  easy  mode  of  detecting  large  quantities  of  added  mineral  substances 
is  given  by  Redtenbacher  ;  the  flour  is  strongly  shaken  with  chloroform  ; 
the  flour  floats,  while  all  foreign  mineral  substances  fall.  This  is  a  very 
useftd  test.' 

If  the  water  be  small,  the  gluten  large,  and  the  salts  in  good  quantity, 
the  flour  is  good,  supposing  nothing  is  detected  on  microscopical  exam- 
ination. But  in  all  cases  it  is  well,  if  time  can  be  spared,  to  have  a  loaf 
made. 

Practical  Test  hy  Baking. — Make  a  loaf,  and  see  if  it  is  acid  when  fresh, 
and  how  soon  it  becomes  so  ;  if  the  color  is  good,  and  the  rising  satisfac- 
tory. Old  and  changing  flour  does  not  rise  well,  gives  a  yello-ndsh  color  to 
the  bread,  and  speedily  becomes  acid.  Excess  of  acidity  can  be  detected 
by  Jiolding  a  piece  of  bread  in  the  mouth  for  some  time,  as  well  as  by  test- 
paper. 

Ted  for  Ergot. — There  is  no  very  good  test  for  ergot  when  it  is  ground 
up  with  the  floiu'.  Laneau's  plan  is  to  make  a  paste  with  a  weak  alkaline 
solution  ;  to  add  dilute  nitric  acid  to  slight  excess,  and  then  alkali  to 
neutralization  ;  a  violet-red  color  is  said  to  be  given  if  ergot  is  present, 
which  becomes  rosy-red  when  more  nitric  acid  is  added,  and  violet  when 
alkali  is  added. 

Wittstein  considers  this  method  imperfect,  and  prefers  trusting  to  the 
peculiar  odor  of  propylamine  (herring-Hke  smell),  developed  by  liquor 
potassse  in  ergoted  flour. 

Microscopical  Examination. 

This  is  especially  directed  to  determine  the  relative  amount  of  flour 
and  bran,  the  presence  of  fungi  or  acari,  or  the  fact  of  adulteration  by 
other  grains. 

In  examining  wheat,  or  any  other  cereal  grains,  it  is  necessary  to  pre- 
pare them  beforehand  by  soaking  for  some  time  in  water.  It  will  then  be 
found  easy  to  demonstrate  the  different  stmctm-es.  By  means  of  a  needle 
and  a  pair  of  fine  forceps  the  different  coats  can  be  removed  seriatim,  some- 
times quite  separately,  but  generally  more  or  less  in  combination.  The 
only  one  that  presents  any  diflSculty  is  the  thu'd  coat  of  wheat  or  barley, 

'  The  remaining  ingredients  can  be  determined,  if  necessary,  from  the  starch 
water,  but  it  is  seldom  necessary  to  do  so.  Allow  the  starch  to  subside,  pour  off  the 
fluid,  and  wash  the  starch  by  decantation,  then  dry  and  weigh ;  take  all  the  water  and 
washings,  evaporate  to  a  small  bulk,  add  a  little  nitric  acid,  and  boil ;  albumen  is 
thrown  down ;  collect,  wash,  and  weigh.  Evaporate  the  whole  of  the  remainder  to 
dryness,  and  weigh  (mixed  dextrin  and  sugar). 


QUALITY,    CHOICE,    AND    COOKIXG    OF    FOOD. 


245 


but  generally  it  can  be  found  accompanring  the  second  or  fourtli  coats.  In 
In  the  case  of  barley,  the  proper  external  envelope  of  the  grain  sometimes 
adheres  to  the  interior  of  the  husk,  where  it  ought  to  be  looked  for  in  the 
event  of  its  not  being  on  the  siu'face  of  the  grain  itself.  After  examining 
the  separate  coats,  sections  may  be  made  of  the  whole  grain,   so  as  to  see 


Fig.  23.  — Transverse  Section  of  Envelopes  of  Wheat.     Scale  1.000:h  of  an  Inch. 

the  structures  in  situ.  The  hairs  are  generally  found  in  a  bunch  at  the 
end  of  the  gi'ain.  The  starch  grains  are  best  demonstrated  bv  picking  out 
a  little  from  the  centre  of  the  grain  ;  mixed  glycerin  and  water  form  the 
best  medium  for  demonstration. 

Strv.rdure  of  the  Wheat  Grain. — There  are  four  envelopes  (some  authors 
make  three,  others  five  or  six — the  outer  coat  being  divided  into  two  or 


fffffff^^rx^ 


^  Pig.  24.— Envelopes  of  Wheat  (longitudinal  section).     Scale  1,000th  of  an  inch. 

three)  surrounding  a  fine  and  very  loose  areolar  tissue  of  cellulose  filled 
with  starch  grains. 

Envelope;^  of  Wheat. — The  drawings  show  the  coats  f/r  .situ,  cut  transversely 
and  longitudinally,  also  the  separate  coats.     The  outer  coat  is  made  up  of 


Fig.  25.  —Outer  Coat  and  Hairs  of  Wheat.     Scale  100th  of  an  inch. 


two  or  three  layers  of  long  cells,  with  sHghtly  beaded  walls,  i-unning  in  the 
direction  of  the  axis  of  the  grain.  The  septa  are  straight  or  oblique,  and, 
as  will  be  seen,  the  cells  differ  in  length  and  breadth.     The  size  can  be 


246 


PRACTICAL    HYGIETiTE. 


taken  by  the  scale.  The  hairs  are  attached  to  this  coat,  and  are  prolonga- 
tions, in  fact,  of  the  cells.  In  the  finest  flour  the  hairs  and  bits  of  this  coat 
(as  well  of  the  other  coats)  can  be  found. 

The  second  coat,  counting  from  without,  is  composed  of  a  layer  of 
shorter  cells,  more  regular  in  size,  with  sHghtly  rounded  ends  and  beaded 


Fia.  26. — Outer  Coat  and  Halts  of  Wheat.     Scale  l.CWOth  of  an  inch. 

walls,  and  lying  at  right  angles  to  the  first  coat,  or  across  the  axis  of  the 
gi-ain.  It  is  impossible  to  mistake  it.  The  third  coat  is  a  delicate  diapha- 
nous, almost  hyaline  membrane,  so  fine  that  its  existence  was  formerly 
doubted.     Dr.  Maddox,  however,  has  distinctly  shown  it  to  have  faint  Hnes 


Fig.  27.— Second  and  Third  Envelopes  of  Wheat,     Scale  l,C0Oth  of  an  inch. 


crossing  each  other  diagonally  as  seen  in  the  drawing,  which  may  be  cells. 
"With  a  Httle  care,  it  is  veiy  easily  demonstrated.  In  the  transverse  section 
of  the  envelope  it  appears  as  a  thin  white  line.     Internal,  again,  to  this 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD. 


247 


coat  what  appears  to  be  another  coat  can  sometimes  be  made  out ;  it  is  a 
very  fine  membrane,  marked  with  widely  separated  curved  Unes,  which 
look  like  the  outlines  of  large  round  or  oval  cells.  The  internal  or  fourth 
coat,  as  it  is  usually  called,  is  composed  of  one  or  two  layers  (in  places)  of 
rounded  or  squarish  cells  filled  with  a  dark  substance  which  can  be  emp- 
tied from  the  cells.     When  the  cells  are  empty,  they  have  a  remote  re- 


FlG.  28.— Fourth  Envelope  of  Wheat. 
Scale  1,000th  of  an  inch. 


Fig.  99. — Fresh  Starch  Grains  of  Wheat  (moistened). 
x360. 


semblance  to  the  areolar  tissue  of  the  leguminosse,  and  there  is  little  doubt 
that  from  this  cause  adulteration  with  pea  or  bean  has  been  sometimes  im- 
properly asserted. 

The  starch  grains  of  wheat  are  very  variable  in  size,  the  smallest  being 
almost  mere  points,  the  largest  ^oWth  of  an  inch  in  diameter  or  larger. 
In  shape  the  smallest  are  round  ;  the  largest  round,  oval,  or  lenttcular.  It 
has  been  well  noticed  bv  HassaU  that  there  is  often  a  singular  want  of 


Fig.  so.— Dried  and  then  moistened  Starch  Grains  of  Wheat.     Scale  1,000th  of  an  inch. 

intermediate -sized  grains.  The  hilum,  when  it  can  be  seen,  is  central,  the 
concentric  lines  are  perceived  with  difficulty,  and  only  in  a  small  number  ; 
the  edge  of  the  grain  is  sometimes  turned  over  so  as  to  cause  the  appeai"- 
ance  of  a  slight  furrow  or  line  along  the  grain.  Very  weak  liquor  potassae 
causes  little  sweUings  ;  strong  liquor  potassse  bulges  them  out,  and  eventu- 
ally destroys  them.  There  is  no  difficulty  in  seeing  if  the  pieces  of  envelope 
are  too  numerous,  but  it  should  be  remembered  the  best  flour  contains 
some. 


248 


PRACTICAL   HYGIENE. 


Diseases  of  Flour. 

Fungi. — Several  fungi  are  found  in  wbeat-flour.  The  most  common 
fungus  is  a  species  of  Puccinia.  It  is  easily  recognized  by  its  round  dark 
sporangia,  which  are  either  contoured  with  a  double  line,  or  are  covered 


Fig.  31. — Diseased  Flonr  (Puccinia). 

with  little  projections.  It  is  said  not  to  be  injurious  by  some,  but  this  is 
veiy  doubtful.     The  symptoms  have  not  been  well  described. 

The  smut,  or  caries,  is  also  a  species  of  Puccinia  ;  has  large  sporules, 
and  gives  a  disagi-eeable  smell  to  the  flour,  and  a  bluish  color  to  the  bread. 
It  is  said  to  produce  diaiThoea. 

Acarus. — Acarus  farince  is  by  no  means  uncommon  in  inferior  flour, 


Fig.  Z^.—Acarvs  farina.  (  x  85  diameters).— Mites  found  in  flour  alive.  In  the  largest  figures,  the  insects 
are  coneiderably  compressed,  to  show  the  powerful  mandibles,  and  have  each  a  ventral  aspect.  In  the  small- 
est and  middle-sized  insect,  we  have  drawn  the  dorsal  aspect;  the  former  only  possesses  six  less,  as  before 
the  first  moult ;  several  ova  lie  scattered  in  the  field  of  view.  It  is  unknown  what  offlce  the  capsular  organs 
fulfil.     They  are  well  seen  on  each  side  of  the  largest  figure. 

especially  if  it  is  damp.  It  does  not  necessarily  indicate  that  leguminous 
seeds  are  present,  as  stated.  It  is  no  doubt  introduced  from  the  grain  in 
the  mill,  as  it  has  been  found  adhering  to  the  grain  itself.  It  is  at  once 
recognized.     Portions  of  the  skin  aa-e  also  sometimes  found. 


QUALITY,    CHOICE,    AXD    COOKIT^-G    OF    FOOD. 


249 


Vibriones, — These  form  for  the  most  part  in  flour  -which  has  gone 
to  extreme  decomposition,  and  which  is  moist  and  becoming  discolored. 
They  cannot  be  mistaken. 

The  presence  of  Acari  always  shows  that  the  flour  is  beginning  to 
change.  A  single  acarus  may  occasionally  be  found  in  good  floiu',  but  even 
one  should  be  looked  on  with  suspicion,  and  the  floui-  should  be  afterward 
frequently  examined  to  see  if  they  are  increasing. 

Weevil  {Calandra  granaria). — The  weevil  is  of  course  at  once  detected. 
It  is  by  no  means  so  common  in  flour  as  in  com. 


M 


Fig.  33. 
Weevil.   Xataral  size. 


Fig.  34.  —Weevil.    Magnified  12  diameters. 

Ephestia. — The  larva  of  the  moth,  which  feeds  on  cocoa  (Ephestia  elu- 
tella),  has  sometimes  caused  great  ravages  in  flour  and  in  biscuits.  At  Cork 
and  Gibraltar  many  tons  of  biscuit  have  been  rendered  useless  by  this  larva, 
which  appears  to  have  been  inti-oduced  from  the  cocoa  stored  for  the  fleet.' 

Adulterations  of  Wheat-Flour. 

At  present  there  is  very  little  adulteration  of  wheat-flour  in  this  country, 
but  with  rising  prices  the  case  might  be  different.  Abroad,  adulteration 
is  probably  more  common,  and  the  medical  officer  must  be  prepared  to  in- 
vestigate the  point. 

The  chief  adulterations  are  by  the  flour  of  other  grains,  viz.  : — 


Barley, 

Eice, 
Buckwheat, 

Potato, 

Beans  and  peas, 

IMillet, 

in  some 

]VIaize, 

Linseed, 

countries, 

Oat, 

Melampvmni, 

Eye, 

Lohum,                 J 

and  other  grains  noticed  farther  on.     All  these  are  easily  recognized  by  the 
microscope. 

Other  adulterations  are  by  mineral  substances,  viz.  : — 


Alum, 

Gypsum, 

Clay, 


Powdered  flint. 
Calcium  and  magnesium 
carbonate. 


These  are  best  detected  by  chemical  examination. 

'  Professor  Huxley  has  kindly  given  these  interesting  details.  The  larva  of  the 
Ephestia  elutella  (or  '''  chocolate  molh"'  is  small,  and  is  never  more  than  half  an  inch 
long.     The  female  moths  fly  at  night  in  swarms,  and  lay  their  eggs  on  the  hiscuits  or 


250 


PRACTICAL    HYGIENE. 


Detection  of  Barley.  — This  is  not  easy,  but  can,  with  care,  be  often 
done. 

The  envelopes  of  barley  are  the  same  in  number  as  those  of  wheat,  but 
they  are  more  delicate.  The  outer  coat  has  three  layers  of  cells  ;  the  walls 
of  the  external  layer  are  beautifully  waved,  but  not  beaded  ;  the  cells  are 
smaller  than  those  of  the  outer  coat  of  wheat.  The  second  coat  disposed  at 
right  angles  to  the  fu-st,  as  in  wheat,  is  like  the  second  coat  of  wheat,  ex- 
cept in  being  more  delicate  and  not 


beaded.  The  third  is  hyaline  and 
transparent,  as  in  wheat.  The  foiu-th 
has  the  cells  similar  in  shape  to  the  cor- 
responding wheat  coat,  but  they  are 
very  much  smaller,  as  may  be  seen 
on  reference  to  the  scale,  and  there 
are  two,  or  often  three,  layers. 
-/^'^^^^N^'^^^^^S^^^^w  The  starch-qrain.^  of  bai'lev  are  verv 

^^/   aV    W^><^^"-'H;.-e,-Nvi.??^^se==a.^     ]^Q  the  wheat,  with  a  central  hilum 

and  obscure  marking,  but  are  on 
the  whole  smaller  ;  some  have  thick- 
ened edges,  instead  of  the  thin  edges 
of  the  wheat-starch  gi'ain,  but  it  is 
very  diflScult  and  sometimes  impos- 
sible to  distinguish  them.  It  is 
therefore  speciaDy  to  the  envelopes 
that  we  must  attend. 

Defection  of  Potato  Starch. — This 
is  a  matter  of  no  difficulty  ;  the  starch-grains,  instead  of  being  round 
or  oval,  and  with  a  central  hilum  and  obscure  rings,  are  pyriform,  with  an 
eccentric  hilum  placed  at  the  smaller  end,  and  with  well-marked  con- 
centric rings.  Weak  liquor  potassai  (1  drop  of  liq.  pot.  B.P.  to  10  of 
water)  swells  them  out  greatly  after  a  time,  while  wheat-starch  is  litlle 
affected  by  this  strength  ;  if  the  strength  is  1  to  3  (as  in  the  figure),  the 
swelling  is  very  rapid. 

Detection  of  Maize  {Indian  Corn). — There  are  two  envelopes  ;  the  outer 
being  made  up  of  seven  or  eight  strata  of  cells ;  there  is  no  transverse 
second  coat,  as  in  wheat  ;  the  internal  coat  consists  of  a  single  stratum  of 
cells  like  the  fourth  of  wheat,  but  less  regular  in  shape  and  size.  The  cellu- 
lose, through  the  seed  holding  the  starch  in  its  meshes,  forms  a  very  char- 
acteristic structure,  which  on  section  looks  like  a  pavement  made  of 
triangular,  square  or  polygonal  pieces  ;  the  cells  are  filled  with  the  starch - 


Fig.  35. — Barley  (loneitndinal  section).     Scale  is 
the  same  as  that  of  the  Starch-grains. 


the  puncheons  which  hold  them.  The  larvas  are  soon  hatched,  and  by  means  of  strong 
jaws  and  active  legs  scrape  and  bore  their  way  through  crevices  ;  they  eat  the  biscuit, 
and  spoil  more  than  they  eat  by  spinning  their  webs  over  the  biscuit.  Cocoa  stores 
swarm  with  the  moths  and  larvae,  and  they  even  penetrated  into  many  parts  of  H.M.S. 
Hercules. 

After  examining  into  the  ravages  caused  by  these  larvae  in  the  biscuit  at  Gibraltar, 
Mr.  Huxley  made  the  following  suggestions : 

1.  To  have  no  cocoa  stored  in  any  place  in  which  biscuits  are  manufactured. 

2.  To  head  up  all  biscuit  puncheons  as  soon  as  they  are  full  of  the  freshly  baked 
biscuit. 

3.  Coat  puncheons  with  tar  after  they  are  headed  up,  or  at  least  work  lime-wash 
well  into  all  the  joints  and  crevices. 

4.  Line  the  bread-rooms  of  ships  with  tin,  so  that  if  the  Epheitia  has  got  into  a  pun- 
cheon it  maj'  not  get  into  the  rest  of  the  ship. 

5.  If  other  means  fail,  expose  woodwork  of  puncheons  to  a  heat  of  200'  Fahr.  for 
two  hours. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD. 


251 


grains,  whicli  are  very  small,  and  compressed,  so  as  to  have  facets.     They 
are  very  different  from  tlie  smooth,  uncompressed  round  cells  of  wheat. 


Fig.  36.— Outer  Coat  and  Hairs  of  Barley  (low  power).     FiG.  37.— Outer  Coat  of  Barley  (higher  power). 

Bits  of  cellulose,  with  its  peculiar  angular  markings,  are  always  found 
if  the  wheat  is  adulterated  with  maize. 

Detection  of  Bean  and  Pea. — These  adulterations  are  also  at  once  dis- 


FiG  38.— Barley  (second  and  third  coats). 


covered  ;  the  meshes  of  cellulose  are  very  much  larger  than  those  of  the 
fourth  coat  of  wheat,  with  which  it  has  sometimes  been  confounded,  and 


252 


PifACTICAL   HYGIENE. 


tlae  starch-grains  are  also  quite  different ;  they  are  oval  or  reniform,  or 
with  one  eud  slightly  larger  ;  they  have  no  clear  hilum  or  rings,  but  many 
have  a  deep  central  longitudinal  cleft  ninning  in  the  longer  axis,  and  oc- 
cupying two-thirds  or  three-fourths  of  the  length,   but  never  reaching 


00 


TDTn; 

Fig.  39.— Barley  (fourth  coat) 


c 


«>  .^©m^^- 


Fio.  40.— Barley  (Starch-grains). 


completely  to  the  end ;  this  cleft  is  sometimes  a  line,  sometimes  almost  a 
chasm,  and  occasionally  secondary  clefts  abut  upon  it  at  parts  of  its  com-se  ; 
sometimes,  instead  of  a  cleft,  there  is  an  irregular-shaped  depression.  If 
a  little  Uquor  potassie  be  added,  the  cellulose  is  seen  more  clearly.     Pea- 


FlG.  41.— Potato  Starch  x  285.     See  also  Plate  of 
Starches. 


Fig.  42. — Medium  and  small-sized  Potato 
Starch-grains,  treated  with  Liq.  Pot.  B.P. 
(strength  1  to  3),  and  x  285. 


flour  is  never  added  to  a  gi-eater  extent  than  4  per  cent.,  as  it  makes  the 
bread  heavy  and  dark.  If  the  flour  be  mixed  with  a  little  boihng  water, 
the  smell  of  the  pea  or  bean  is  perceptible. 

Detection  of  Oa^.— There  are  two  or  three  envelopes  ;  the  outer  longi- 
tudinal cells  ;  the  second  obliquely  transverse,  and  not  veiy  clearl}'  seen  ;  the 
cells  are  wanting  in  parts,  or  pass  into  the  cells  of  the  third  coat ;  the  third 
a  layer,  usualh'  single,  of  cells  like  wheat.  The  husk  must  be  detached 
before  the   envelopes  are  looked  for.     The  stai'ch-cells   ai'e  small,  many- 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD, 


253 


sided,  and  cohere  into  composite  round  bodies,  which  are  very  character- 
istic, and  which  can  be  broken  down  into  the  separate  grains  by  pressiu-e. 
A  high  power  is  the  best  for  this.  The  oat  starch  does  not  polarize  light. 
There  is  no  difficulty  in  the  detection  of  the  starch-grains. 

Detection  of  Pace. — The  husk  of  rice  is  very  peculiar  ;  on  the  outer  coat 
are  numerous  siliceous  gTanules,  arranged  in  longitudinal  and  transverse 


/^r^^--- 


v\ 


XSrJO 
Pig.  43. — Indian-Corn  Flour.     See  also  Plate 
of  Starches. 


Cellulose  of   Indian  Corn,  x  500,  with  marking's  from 
the  Starch-grains  on  the  intercellular  membrane. 


ridges  (Figs.  49  and  50)  (a).  There  are  numerous  hairs,  some  of  which 
are  seated  over  stomata.  Below  this  is  a  membrane  of  transverse  and 
longitudinal  rough-edged  fibres  {b  c),  while  below  these  again  is  a  fine 


Fig.  44. — Longitudinal  Section  of  Coats  of  Indian  Corn  and  Cellulose,  x  190. 


membrane  of  transverse  angular  cells  (d),  coveiing  a  very  delicate  mem- 
brane of  large  cells.  The  starch  corpuscles  are  veiy  small  (Fig.  48)  ;  an- 
gular under  low  powers  ;  under  high  powers  they  are  seen  to  be  facetted 


254 


PRACTICAL    HYGIENE. 


and  compressed.  They  cannot  be  mistaken  for  the  round  cells  of  wheat, 
but  may  be  confounded  with  oat  starch,  fi-om  which,  however,  they  are  dis- 
tinguished by  the  absence  of  the  compound  cells  or  glomeruli.  Their 
shape  is  also  a  little  Hke  maize,  but  they  are  very  much  smaller. 

Detection  of  Bye. — The  envelopes  are  very  like  those  of  wheat,  and  can 


Fig.  4.5. — Bean  Starch. 


perhaps  hardly  be  distinguished  from  them.  The  recent  starch-grains  are 
also  like  those  of  wheat,  but  they  are  much  more  distinctly  spherical.  They 
have  also  sometimes  a  peculiar  rayed  hilum,  which  used  to  be  thought 


-1 — I — I — ^ — ! — ) — \ — \ 


Fig.  46.— Pea  Flour, 


peculiar  to  the  older  and  drier  grains.  It  is,  however,  to  be  seen  even  in 
the  starch  of  fresh  soft  grains,  whilst  the  plant  is  still  gi-een.  In  the  starch 
of  wheat  it  is  only  met  with  occasionally,  w^hen  the  grain  is  very  old  or  dry. 
Rye,  if  in  any  quantity,  is  discovered  by  baking  ;  it  makes  a  dark,  acid 
bread. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD. 


255 


Linseed  is  not  a  common  adulterant.     The  envelopes  are  peculiar  :  the 
external  is  made  up  of  hexagonal  cells,  containing  oil ;  the  second  of  round 


Fig.  47. — White  Oat  (long,  sect.,  2d  and  3d  coats  not  separable),     a  Compound  grains,  x  100.     &  One  do., 

X  500. 

cells ;  the  third  of  fibres  ;  and  the  fourth  of  angular  cells,  containing  a 
dark  reddish  coloring  matter. 


<0  'C^'^^f^P  *°^-'"-  '^-s-,  . 


">r  y«Jb>>i'-/7^;V>- 


Fig.  48.— Ground  Rice  Flour,  x  350. 


Buckwheat  (Polygonum  Fagopyrum,  or  Fagopyrum  esculentum). — Like 
rye,  this  is  only  likely  to  be  found  in  wheat  coming  from  the  Baltic.     The 


256 


PRACTICAL    HYGIENE. 


di'awing  siifficiently  shows  tlie  texture  of  the  envelopes,  -which  is  very  com- 
plicated. The  starch-gi-ains  are  small  and  rovmd,  and  adhere  together  in 
masses.  Under  a  high  power  there  are  indications  of  concentric  lings. 
Bread  made  with  this  grain  has  a  dai-kish,  somewhat  violet,  color. 


^^*'4'wy^ 


d     ^ 


Fig.  49.— Rice,  x  170. 


Fig.  50.— Rice,  x  178. 


X  170. 


Fig.  49.  Transverse  Section  of  the  Husk  of  Rice I 

Fig.  50.  Appearance  of  Husk  of  Rice  as  seen  in  a  transparent  medium  of  glycerine  and  gum.  C 
a.  Siliceous  granules,  arranged  in  longitudinal  and  transverse  ridges,  perforated  by  openings — stomata.  some 
having  hairs  seated  over  them,  b  c.  Transverse  and  longitudinal,  brittle,  rough-edged  fibres,  d,  A  fine 
membrane  of  transverse  angular  cells ;  these  overlie  a  very  delicate  membrane  of  large  cells,  e. 

31illet. — In  India,  Egypt,  China,  and  West  Coast  of  Africa,  millet  of 
some  kind  is  likely  to  be  an  adulteration.  Dr. 
Maddox's  drawing  (page  259)  shows  the  beautiful 
structure  of  the  envelopes,  which  could  not  be 
confounded  M-ith  those  of  wheat.  The  starch- 
grains  are  very  small,  round,  and  tolerably  uni- 
form in  size. 

3Ielainpijrum  arvense  and  other  species  (Pur- 
ple cow-wlieat — Scrophidariaceoe). — This  has  oc- 
casionally been  mixed  with  flour ;  it  is  not 
injurious,  but  gives  the  bread  (not  the  flour")  a 
peculiar  smok}^  violet  or  bluish-\iolet  tint.  This 
depends  on  a  coloring  matter  in  the  seed,  which, 
when  warmed  with  acid,  gives  the  violet  color.' 

Trifolium  arvense  (Trefoil — Leguminosce). — 
This  also  gives  the  bread  a  red-violet  color.    It  is  not  known  to  be  injurious. 

Rhinanthus  major  and  crista  galli  {YeWow-raitle—Scrophulariaceis)  gives 
bread  a  bluish-black  color,  a  moist,  sticky  feel,  and  a  disagreeable  sweet 


Fig.  51. — Rye  starch,  with  rayed 
hilum  (after  Hassall),  x  420. 


>  Pellischek,  Schmidt's  Jahrb.,  1863,  No.  3,  p.  287. 


QUALITY,    CHOICE,    AXD    COOKING    OF   FOOD. 


257 


taste.     It  is  not  injurious.      Onohrychis  saliva  (Sainfoin — Leguminosce)  has 
also  been  used. 


Pig.  52.— Eye— 1.  Transverse  Section  of  Testa,  etc.,  xl08;    2.  Coats  in  mtu  from  -without,  xlTO.    a,  Ex- 
ternal ;  6,  iliddle ;  c,  Internal  coat ;  li,  Starch-grains  x  108. 


Fig.  53.— Outer  coat  of  Buckwheat,  ap-  Internal  coats.     The  most  internal  is  composed 

parently   of   irregular    and    interlacing  of  cells  with  an  irregnlar  waved  ontUne,  and 

fibrospirai  cells,  separable  by  boiling  the  longiradinal  cells  over  the  starch-cells,  x  ITO. 

testa  and  macerating  it.  Outside  these 
cells  is  a  very  thin  and  delicate  mem- 
brane, retaining  the  marks  of  attach- 
ment of  the  spiral  cells,  x  170. 

Lolium  temulentum  (Darnel — Gramineoe ;  otlier  species  maybe  used). 
Vol.  I.-17 


258 


PRACTICAL    HYGIENE. 


— This  gives  the  bread  no  color,  but  produces  narcotic  symptoms,  vertigo, 
hallucinations,  delirium,  convulsions,  and  paralysis.'  Pellischek  states 
that  these  symptoms  do  not  occur  if  the  grain  be  dried  in  an  oven  before 


Fig.  54. — Buckwheat — transverse  section  of  outer,  middle,  and   internal  coats,  with  I  x  170. 

cellulose  containing  starch-grains f  Starch-grains  x  500. 

baking,  or  if  the  bread  is  left  for  some  days  before  being  used.  The 
detection  of  the  lolium  is  best  effected  by  means  of  alcohol,  vv^hich  gives  a 
greenish  solution  with  a  disagreeable,  repulsive  taste,  and  on  evaporation 

'  The  peculiar  symptoms  produced  by  Lolium  temulentum,  or  bearded  Darnel,  were 
well  known  to  the  ancients.  Pereira  states  that  the  first  symptoms  are  gastro-intestinal, 
snch  as  vomiting  and  colic,  and  then  cerebro-spinal  symptoms  come  on,  viz.,  headache, 
giddiness,  tinnitus,  confusion  of  sight,  dilated  pupils,  delirium,  trembling  and  paralysis 
(Elements  of  Materia  Medica,  1850,  vol.  ii.,  p.  977).  The  same  effects  are  produced 
on  animals.  Pereira  states  that  he  did  not  succed  in  obtaining  the  chemical  test  noted 
in  the  text,  viz.,  the  green  alcoholic  solution  and  the  yellow  resin  on  evaporation. 
Hassall  figures  the  starch-grains  of  the  lolium  as  small  and  something  like  rice  ;  fifty 
or  sixty  may  adhere  together  and  form  a  compound  grain  not  very  unlike  the  oat. 
The  envelopes  are  tolerably  distinctive ;  the  cells  of  the  outer  coat  are  made  up  of  a 
single  layer,  and  are  disposed  transversely  instead  of  longitudinally.  The  second  coat 
is  in  two  layers,  and  the  cells  have  a  vertical  arrangement.  The  third  coat  is  like  the 
inner  coat  of  wheat.     This  account  is  taken  from  Hassall. 

It  is  not  very  likely  that  any  other  grains  except  those  mentioned  in  the  text  will 
be  mixed  with  wheat  flour.  The  seeds  of  the  Peruvian  food,  the  Chenopodium  Quinoa 
have  not  apparently  been  used  as  a  falsification.  The  starcli-grain  of  the  Quinoa  are 
said  to  be  the  smallest  known.  It  may  be  worth  remarking  that  this  seed  is  very  rich 
in  salts  (2.4  per  cent.),  and  particularly  so  in  iron  (.75  per  cent.) ;  indeed,  it  is  the  rich- 
est in  iron  of  any  vegetable.  It  is  possible  that  it  might  be  a  useful  food  in  some  cases 
of  illness.     It  is  fairly  nutritious  and  digestible. 

The  starch-grains  of  the  acorn,  which  might  perhaps  be  added  in  times  of  great 
scarcity,  would  be  immediately  detected,  as  they  have  a  very  characteristic  central 
depression,  and  are  also  quite  different  in  shape  from  the  flat,  round,  smooth  starch- 
cells  of  the  wheat  and  barley. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD, 


259 


a  resinous  yellow-green  disagreeable  extract  is  left.  Pure  flour  gives 
with  alcohol  only  a  clean  straw-colored  solution,  with  an  agreeable  taste 
(PeUischek). 

Bromus  or  Sei^rafalcus  (Brome-grass — Graminece  ;  different  species— 
Arvensiii  or  Secalinus). — PeUischek  states  that  the  seeds  of  this  plant  give 
the  bread  a  dark  color,  and  make  it  indigestible.  It  is  probably  a  most 
uncommon  adulteration. 


Fig.  55. — Millet  Seed — a,  Transverse  Section  of  Testa  Coats,  seen  from  inside,     a,  Outer;  6,  Middle;  c, 
Inner  coat  x  170  ;  S,  Starch-grains  x  5UU.     Scale  l-lOOOth  inch. 


It  will  be  found  that,  when  mixed  with  floirr,  the  microscope  wiU  de- 
tect readily  many  of  these  substances.  Detection  is  often  very  difficult 
when  the  flour  is  made  into  bread,  and  therefore,  whenever  from  the  bread 
there  is  any  cause  of  suspicion,  means  should  be  taken  to  obtain  some  of 
the  flour. 

Co7ies  Flour. — A  flour  obtained  from  Eevel  wheat  is  used  by  bakers  for 
dusting  their  troughs.  Hassall  has  found  this  Cone's  flour  to  be  greatly 
adulterated  with  rice,'  maize,  beans,  rye,  and  barley.  Sometimes  Cones 
flour  is  mixed  with  good  flour. 

Cooking  of  Flour. 

The  effect  of  heat  is  to  coagulate  the  albumen,  and  to  transform  some 
of  the  starch  into  dextrin.  Substances  are  also  added  to  the  bread  to 
cause  a  further  transformation  of  the  starch. 

Cakes. — The  unfermented  cakes  '^  are  simjjly  made  with  water  and  salt. 
As  they  are  very  readily  made,  are  agreeable  to  taste,  and  nutritious,  it  is 
very  desirable  to  teach  every  soldier  to  make  them  ;  so  that  in  war,  when 
bread  is  not  procurable,  he  may  not  be  confined  altogether  to  biscuit.  The 
Australian  "  damper"  is  simply  made  by  digging  a  hole  in  the  ground,  fill- 
ing it  with  a  wood  fire,  and,  when  the  fire  has  thoroughly  burnt  up,  re- 


^  Several  samples  I  have  examined  contained  nothing  but  rice, 
sold  as  "  Rice  Cones." — (P    de  C. ) 
'  The  Chupatty  of  India. 


This  is  sometimes 


260  PEACTICAL    HYGIENE. 

moA-ing  it,  placing  the  dough  on  a  large  stone,  covering  it  with  a  tin  j^late, 
and  heaping  the  hot  ashes  round  and  over  it.  In  a  campaign,  even*  sol- 
dier, if  he  could  get  Hour  and  wood,  would  soon  learn  to  bake  a  cake 
for  himself.  The  only  point  of  manipulation  which  requires  practice  is 
not  to  have  the  heat  too  great  ;  if  it  be  above  212°  too  much  of  the  starch 
is  changed  into  dextrin,  and  the  cake  is  tough.  Exposed  to  greater  heat, 
and  well  dried,  the  unfermented  cakes  become  biscuit. 

Macaroni  is  flour  from  a  hard  Italian  grain,  moistened  with  water,  and 
pressed  through  a  number  of  small  openings,  while  at  the  same  time  heat 
is  applied.  As  it  is  very  nutritious  in  small  bulk,  and  keeps  well,  it 
would  be  a  good  food  for  soldiers  in  war  if  its  cost  could  be  lessened. 

Sub-Section  III. — Biscuit. 

To  make  biscuit,  flour  is  often  taken  with  little  or  no  bran  (on  account 
of  the  hygroscopic  jDroperties  of  bran)  ;  but  bran  is  also  sometimes  used  : 
no  salt  is  added.  The  simplest  biscuits  are  merely  flour  and  water.  Some 
biscuits  are  made  with  milk,  eggs,  etc. 

Choice  of  Biiicuit. — Biscuit  should  be  well  baked,  but  not  burnt ;  of  a 
light  yellow  color,  and  should  float  and  partially  dissolve  in  water  ;  when 
struck,'  it  should  give  a  ringing  sound  ;  and  a  piece  put  into  the  mouth 
should  thoroughly  soften  down.  It  should  be  free  from  weevils,  which 
are  easily  seen. 

Advantages  as  a  Diet. — As  it  contains  little  water,  and,  bulk  for  bulk,  is 
more  nutritious  than  bread,  three-fourths  of  a  pound  are  usually  taken  to 
equal  1  lb  of  bread.     Its  bulk  is  small,  and  it  is  easily  transported. 

Disadvantages. — Like  flour,  it  is  deficient  in  fat.  After  a  time,  it  seems 
difficult  of  digestion.  Perhaps  the  want  of  variety  is  objectionable  ;  but 
certain  it  is,  that  men  do  not  thrive  well  upon  it  for  long  periods.  In  war, 
it  has  always  been  a  rule  with  the  best  English  army  surgeons,  for  more 
than  a  century,  to  issue  bread  as  much  as  possible,  and  to  use  biscuit 
only  in  cases  where  it  cannot  be  avoided. 

Sub-Section  IV. — Bread. 

If  carbon  dioxide  gas  is  any  way  formed  in  or  forced  into  the  interior 
of  dough,  so  as  to  divide  the  dough  into  a  number  of  little  cavities,  bread 
is  made. 

There  are  three  kinds  of  bread  : 

1.  Carbon  dioxide  is  disengaged  by  a  fermentative  process,  caused  by 
yeast  or  leaven.  Dui-ing  the  baking  a  certain  amount  of  performed  sugar 
yields  CO^ ;  a  portion  of  starch  is  converted  into  dextrin  and  sugar,  and 
also  yields  C0„  ;  a  little  lactic  and  butp-ic  acids,  and  extractive  matters 
are  formed.  It  is  of  importance  to  prevent  this  change  from  going  too 
far ;  and  herein  is  one  of  the  arts  of  the  baker  ;  and  it  is  partly  to  prevent 
this  that  alum  is  added,  which  has  the  property  of  arresting  the  change. 

In  making  bread,  the  proportions  are  20  ft  of  flour  ;  8  to  12  ft  of  tepid 
water  ;  4  oz.  of  yeast,  to  which  a  little  potato  is  added,  and  1^  to  2  oz.  of  salt ; 
280  ft  of  flour  (1  sack)  will  give  from  90  to  105  4-ft  loaves  ;  or  100  ft  of 
flour  will  make  from  129  to  150  ft  of  bread.  If  there  is  14  per  cent,  of 
water  in  the  flour,  the  bread  will  contain  in  the  former  case  33.1  per  cent., 
and  in  the  latter,  42.7  per  cent.  If  100  ft  of  flour  contain  14  j)er  cent,  of 
water,  and  make  141^  ft  of  bread,  the  bread  will  contain  40  per  cent,  of 
water ;  the  baker  always  endeavors  to  combine  as  much  water  as  he  can 


QUALITY,    CHOICE,    AND    COOKING    OF   FOOD.  261 

SO  as  to  get  more  loaves.     6^  ft  of  dougli  yield  6  ft  of  bread.     Machines 
are  now  generally  used  for  mixing  the  dough  (Stevens'  Machine). 

2.  CO^  is  disengaged  by  mixing  sodium  or  ammonium  caa-bonate  with 
the  dough,  and  adding  hydi-ochloric,  tartaric,  phosphoric,  or  citric  acids. 
Baking  powders  ai-e  compounds  of  these  substances. 

3.  CO^  is  forced  thi-ough  the  dough  by  pressure  (Daughsh's  patent 
aerated  bread).  This  process  has  the  great  advantage  of  rendering  it  im- 
possible that  the  conversion  of  starch  into  dextrin,  sugar,  and  lactic  acid 
shall  go  too  far.  About  20  cubic  feet  of  C0„  (derived  from  chalk  and  sul- 
phuric acid)  are  used,  for  280  ft  of  flour  ;  and  about  11  cubic  feet  ai'e 
actually  incoi-porated  with  the  flour  (OdHng). 

Advantages  of  Bread  as  an  Article  of  Diet. 

.  It  is  hardly  necessary  to  mention  these.  The  great  amount  of  nitro- 
genous matters  and  starch  it  shares  with  flour ;  the  nitrogen  is  to  the  car- 
bon as  1  to  21.  It  thei'efore  requires  more  nitrogen  for  a  perfect  food. 
The  process  of  baking  renders  it  more  digestible  than  flour.  Xo  satiety 
attends  its  use,  although  it  may  be  always  made  in  the  same  way  ;  this  is 
probably  owing  to  the  great  variety  of  its  components. 

Disadvantages. — It  is  poor  in  fat  and  some  salts,  especially  in  the  case 
of  the  finest  floui'  freed  from  the  internal  envelope.  Therefore  we  see  that 
the  practice  of  using  fat  with  it  (butter  for  the  rich,  fat  bacon  for  the  poor 
man)  is  extremely  common.  As  to  the  relative  advantages  of  the  three 
methods  of  making  bread,  the  last  (aeration  by  C0„)  is  said  to  have  the 
advantage  of  making  white  bread,  though  the  inner  envelopes  are  left ;  of 
not  causing  any  loss  of  starch,  or  permitting  the  change  to  go  too  far  ;  of 
not  containing  any  unwholesome  yeast.  The  systen  of  making  bread  with 
yeast  has  been  objected  to  on  the  ground  that  bad  yeast  is  often  used  ;  the 
fermentative  changes  go  on  in  the  stomach,  much  C0„  is  disengaged,  and 
dyspepsia,  flatulence,  and  unpleasant  sensations,  such  as  heart-bum,  are 
produced.  There  is  no  doubt  that  badly  prepared  bread  gives  rise  to 
these  symptoms,  though  that  this  is  owing  to  bad  yeast  is  at  least  uncer- 
tain. The  second  method  yields  a  wholesome  bread,  but  is  too  expensive 
for  common  use,  and  it  has  also  been  pointed  out  that  the  hydrochloric 
acid  of  commerce  always  contains  arsenic.  The  amount  would  be  too 
small  to  be  hurtful,  but  might  be  of  medico-legal  consequence. 

Special  Points  aboid  Making  of  Bread. 

Bread  may  be  of  bad  color — rather  yellowish,  from  old  flour ;  from 
grown  flotu'  (in  which  case  the  changes  in  the  starch  have  generally  gone 
on  to  a  considerable  extent,  and  the  bread  contains  more  sugar  than  usual, 
and  does  not  rise  well),  and  perhaps  fi'om  bad  yeast.  The  color  given  by 
admixture  of  bran  must  not  be  confounded  with  yellowness  of  this  kind. 

Bread  is  also  dark  colored  from  admixture  of  other  grains,  as  already 
noticed  under  flour  (rye,  buckwheat,  melampjr-um,  sainfoin,  etc.).  Bread 
may  be  acid,  from  bad  flour  giving  rise  to  an  excess  of  lactic  and  perhaps 
acetic  acids,  or,  it  is  said,  from  bad  yeast.  In  finding  the  cause  of  acidity 
in  bread,  look  first  to  the  floui',  which  may  be  old,  and  a  little  discolored, 
a  id  too  acid  ;  if  nothing  can  be  made  out,  examine  the  yeast,  and  change_ 
the  source  of  supply  ;  then  look  to  the  vessels  in  which  the  dough  is 
kneaded,  and  to  the  water.  Enforce  great  cleanhness  on  the  part  of  the 
men  who  make  up  the  dough.     In  India  bread  becomes  sour  fi'om  bad 


262  PRACTICAL    HYGIENE. 

cleaning  of  the  flour.  Dr.  Godwin,  A.M.D.,'  states  that  at  Bareilly  the 
wheat  was  imj^erfectly  gi-ound  in  small  hand-mills  ;  it  was  then  separated 
by  shifting  into  four  portions,  viz.,  bran  ;  "  attar,"  which  corresponds  to 
pollards;  "  soojie,"  which  consists  of  gluten  and  starch;  and  "maida," 
which  is  nearly  all  starch.  The  soojie,  from  imperfect  gi-inding,  is  granu- 
lated, and  chiefly  used  for  bread,  a  small  portion  only  of  maida  being 
mixed  with  it.  To  cleanse  the  wheat  before  grinding  it,  it  was  washed 
and  then  dried  in  heaps  in  the  sun  ;  this  caused  fermentation  and  a  rajoid 
development  of  acidity.  The  heaps  of  corn  were  quite  hot  to  the  feel.  A 
very  acid  bread  was  given,  but  when  the  wheat  was  not  thus  washed  it 
yielded  a  good  bread. 

Bread  is  heavy  and  sodden  fi-om  bad  yeast  fermenting  too  rapidlj^,  or 
when  the  fermentation  has  not  taken  place  (cold  weather,  bad  water,  or 
some  other  cause,  will  sometimes  hinder  it),  or  when  the  wheat  is  grown  ; 
when  too  little  or  too  much  heat  has  been  employed.  It  is  said  also,  that 
if  the  flour  has  been  dried  at  too  great  a  heat  (above  200°  Fahr.),  the 
gluten  is  altered,  and  the  bread  does  not  rise  well.  It  is  bitter  from  bitter 
yeast. 

It  becomes  mouldy  rapidly  when  it  contains  an  excess  of  water. 

Eice  is  used  as  an  addition  because  it  is  cheaper  ;  it  retains  water,  and 
therefore  the  bread  is  heavier.  Kice  bread  (if  25  per  cent,  of  rice  be  added) 
is  heavier,  of  closer  texture,  and  less  filled  with  cavities.  Potatoes  are 
sometimes  added,  but  are  generally  used  only  in  small  quantity  with  the 
yeast. 

Alum  is  added  to  stop  an  excess  of  fermentation,  when  the  altering 
gluten  or  cerealin  acts  too  much  on  the  starch,  and  it  also  whitens  the 
bread  ;  it  does  not  increase  the  amount  of  water  ;  it  enables  bread  to  be 
made  from  flour  which  otherwise  could  not  be  used.  Sulphates  of  copj^er 
and  of  zinc,  in  very  small  amoimt,  are  sometimes  employed  for  the  same 
purpose. 

For  acid  flour,  hme-water  is  used  instead  of  pure  water  ;  lime-water  has 
this  advantage  that,  while  it  does  not  check  the  fermentation  of  yeast,  it 
hinders  the  action  of  diastase  on  starch.  It  must  be  caustic  lime-water, 
and  not  chalk  and  water,  as  sometimes  is  the  case. 

Loaves  are  generally  weighed  when  hot,  and  that  is  considered  to  be 
their  weight.  In  the  Austrian  army,  a  loss  of  2.9  per  cent,  in  four  days  is 
permitted. 

After  being  taken  from  the  oven  bread  begins  to  lose  weight.^ 

The  loss  of  weight  depends  upon  size,  amount  of  crust,  temperatm-e, 
and  movement  of  air. 

In  a  sheltered  place,  at  ordinary  temperature,  a  2-ft)  loaf,  baked  with 
crust  all  over,  loses  about  f  per  cent,  in  coohng,  and  from  1  to  1:^  in  five 
hours. 

A  similar  loaf,  with  only  top  and  bottom  crust,  loses  3  per  cent,  in 
coohng,  and  about  4  per  cent,  in  five  or  six  hours.  A  loaf  with  four  sides 
cmst  loses  2  per  cent,  in  cooling,  and  retains  its  weight  without  much 
further  loss  for  five  hours.  For  each  of  six  sides  that  is  not  crust  there  is 
a  loss  of  weight  of  about  1  per  cent,  in  the  first  five  hours. 

At  the  end  of  twenty-four  hours  the  proportion  is  about  one-half  more, 
and  the  total  loss  is  doubled  at  the  end  of  seventy-two  hours  (three  days). 
If  the  bread  is  baked  in  larger  loaves  (4  ft),  for  instance)  the  loss  will  be 

'  Army  Medical  Report,  vol.  vii.,  p.  451. 

*  See  Report  on  Hygiene,  Army  Medical  Reports,  vol.  xviii.,  p.  219. 


QUALITY,    CHOICE,    AISTD    COOKING    OF    FOOD.  263 

proportionately  less,  the  ratio  of  tlie  evaporating  surface  to  the  bulk  of  the 
loaf  being  diminished. 

When  loaves  become  stale  they  can  be  dipped  in  water  and  rebaked, 
and  then  taste  quite  fresh  for  twenty-four  hours  ;  after  that  they  rapidly 
change. 

Old  biscuit  also,  soaked  in  water,  can  be  rebaked,  and  becomes  palat- 
able. 

In  the  French  army  different  kinds  of  bread  are  used  :'  ordinary  bread  ; 
biscuited  bread  ;  bread  half  biscuited  ;  bread  one  quarter  biscuited  ;  hos- 
pital bread.  The  "  Paia  biscuite  "  is  used  only  on  service  ;  it  is  baked 
more  firmly  than  ordinary  bread. 

Pain  de  munition  ordinaire  keeps  5  days  in  summer  and  8  in  winter. 
'*     au  quart  biscuite  "     10  to  15  days. 

"    demi  "  "     20  to  30     " 

"     biscuite  "     40  to  50     " 

The  French  munition  loaf  weighs  1.5  kilogrammes  (3.3  lb  avoir.),  and 
contains  two  rations  of  760  grammes  (each  1.65  lb).  The  ration  of  biscuit 
is  550  grammes  (1.2  lb). 

It  would  be  useful  to  adopt  the  practice  of  strongly  baked  bread  in  our 
army  ;  it  is  a  good  substitute  for  biscuit. 

Examination  of  Bread. 

There  is,  perhaps,  no  article  on  which  the  medical  officer  is  more  often 
called  to  give  an  opinion. 

General  Characters. — There  should  be  a  due  proportion,  not  less  than 
80  per  cent,  of  crust ;  the  external  surface  should  be  well  baked,  not  burnt ; 
the  crumb  should  be  permeated  with  small  regular  cavities  ;  no  parts  should 
be  heavy,  and  without  these  little  cells  ;  the  partitions  between  the  cavities 
should  not  be  tough  ;  the  color  should  be  white  or  brownish  from  admix- 
ture of  bran  ;  the  taste  not  acid,  even  when  held  in  the  mouth.  If  the 
bread  is  acid  the  flour  is  bad,  or  leaven  has  been  used  ;  if  the  color  changes 
soon,  a.n(\.  fungi  form,  the  bread  is  too  moist ;  if  sodden  and  heavy,  the  flour 
is  bad,  or  the  baking  is  in  fault ;  the  heat  may  have  been  too  gxeat,  or  the 
sponge  badly  set. 

Chemical  Examination. — This  is  conducted  chiefly  to  ascertain  the 
amount  of  water  and  acidity,  and  the  presence  of  alum  or  sulphate  of 
copper. 

Water.  —Take  a  weighed  quantity  (say  10  grammes)  of  criuub,  and  dry 
in  a  water  bath  ;  powder,  and  then  dry  again  in  a  hot-air  bath  or  oven,  and 
weigh  ;  the  water  should  not  be  more  than  45  per  cent. ;  if  more,  the  bread 
is  pro  tanto  less  nutritious,  and  is  liable  to  become  sooner  mouldy. 

Acidity. — This  can  be  determined  by  a  standard  alkaline  solution.^ 

In  two  samples  of  fresh  good  bread  examined  at  Netley,  the  percentages 
of  acidity  (reckoned  as  glacial  acetic)  were  respectively  0.054  and  0.055 
(3.78  and  3.85  grains  per  lb)  ;  in  a  sample  rather  underbaked,  but  fairly 
good,  0.072  per  cent.  (5.04  grains  per  ft)  ;  and  in  three  samples,  condemned 
as  inferior,  0.085,  0.088,  and  0.104  per  cent,  respectively  (5.95,  6.16,  and 
7.28  grains  per  ft).'  On  another  occasion,  two  samples  of  fairly  good  bread 
yielded  0.102  and  0.12  per  cent.  (7.14  and  8.4  per  ft   respectively)  ;  and 

^  Code  des  Officiers  de  Sante,  1863.  ]  See  Appendix  A,  Vol.  II. 

'  Report  on  Hygiene,  Armj  Medical  Reports,  vol.  xviii.,  p.  222. 


264  PRACTICAL    HYGIENE. 

two  others,  from  bakers  in  the  neighborhood,  0,084  and  0.000  (5.88  and 
6.30  i^er  ib  respectively).  A  sample  condemned  as  som-  yielded  0.18  (12  G 
per  til)  ;  8  grains  per  lib  (0.114  per  cent.)  ought  certainly  to  be  the  limit. 

Alum. — The  determination  of  the  presence  of  alum  is  not  difficult,  but 
the  quantitative  analysis  is  necessary,  since  it  has  been  shoAvn  by  Wanklyu 
that  unalumed  bread  may  contain  an  appreciable  amount.  Many  processes 
have  been  proposed,"  some  of  which  are  merely  modifications  of  each  other. 
The  process  described  in  the  foot  note  seems  the  most  simple.' 

Wanklyn  considers  that  unalumed  bi*ead  may  contain  5  or  6  milli- 
grammes of  phosphate  of  aluminium  in  every  100  grammes  of  bread 
(=  0.005  per  cent.).  This  is  equal  to  about  li  grain  of  crystallized  alum 
per  lb  of  bread.  It  will  be  Avell  to  deduct  this  amount  from  the  total  amount 
of  phosphate  of  aluminium  found  ;  the  remainder  will  represent  the  amount 


'  By  Kuhlmann,  Letheby,  Odling,  Wentwortli  Scott,  Crookes,  Ilassall,  Hadow, 
Horsley,  Diipru,  Wanklyn. 

•  1st  part. — Take  at  least  |  fb  of  crumb,  put  it  in  a  mortar,  and  soak  it  well  in  cold 
distilled  water ;  filter,  and  get  as  clear  a  fluid  as  possible  ;  add  a  few  drops  of  hydro- 
chloric acid,  and  then  chloride  of  barium  If  there  is  no  precipitate  no  alum  can  have 
been  added,  and  the  process  need  not  be  proceeded  with.  If  there  is  a  slight  precipi- 
tate, it  may  be  accounted  lor  by  sulphate  of  lime  or  magnesia  in  the  water  used  in 
baking,  or  of  sulphate  of  magnesia  in  the  salt,  or  by  the  slight  amount  of  sulphuric 
acid  naturally  existing  in  the  grain,  or  added  during  the  grinding.  Perhaps  the  medi- 
cal officer  will  know  whether  the  water  or  the  salt  contains  sulphates,  and  if  so,  the 
absence  of  alum  may  be  inferred.  If  there  be  a  large  precipitate,  the  presence  of  alum 
is  probable,  but  is  not  certain,  .and  the  process  must  be  continued. 

2d  part. — Dupre's  process,  as  modified  by  Wanklyn,  seems  on  the  whole  the  sim- 
plest and  least  liable  to  error,  as  it  gets  rid  of  one  great  source  of  fallacy,  namely,  the 
presence  of  alumina  in  the  liquor  potassae,  which  reagent  is  not  required.  The  pro- 
cess is  as  follows:  Take  100  grammes  (=  3i  ounces)  of  bread  ;  incinerate  for  four  or 
five  hours  in  a  platinum  dish  to  a  gray  ash  ;  weigh  (tlie  ash  should  not  sensibly  exceed 
2  grammes);  moisten  with  ;3  C.C.  of  pure  hydrochloric  acid  to  separate  silica;  add  20 
to  30  C.C.  of  distilled  water,  boil,  filter,  wash  the  filter  well  with  boiling  water  ;  add  to 
the  filtrate,  which  contains  the  phospliates  of  calcium,  magnesium,  aluminium,  and 
iron,  5  C.C.  of  liquor  ammonire  (sp.  gr.  880),  which  causes  a  precipitate  of  these  phos- 
phates ;  then  add  gradually  20  C.C.  of  strong  acetic  acid,  which  partially  clears  the 
fluid  by  dissolving  the  phosphates  of  calcium  and  magnesium  ;  boil  and  filter.  The 
undissolved  part  is  a  mixture  of  phosphate  of  aluminium  and  phosphate  of  iron  ;  wash, 
precipitate  well  with  boiling  water,  dry,  ignite,  and  weigh. 

The  iron  must  now  be  determined  in  this  precipitate.  This  may  be  done  by  the 
permanganate,  but  Wanklyn's  colorimetric  test  is  probably  better :  it  is  as  follows  : 
Dissolve  1  gramme  of  pure  iron  wire  in  nitro-hydrochloric  acid,  precipitate  the  ferric 
oxide  with  ammonia ;  wash  the  precipitate,  dissolve  it  in  a  little  hydrochloric  acid, 
and  dilute  to  1  litre:  one  C.C.  therefore  equals  1  milligramme  of  metallic  iron  ;  when 
used  it  is  diluted  1  in  100  so  as  to  make  a  solution,  of  which  each  C.C.  contains  jliith 
milligramme  (=  0.01  of  a  milligramme)  of  metallic  iron.  To  use  this,  dissolve  the 
phosphates  of  aluminium  and  iron  (obtained  by  the  above  described  process;  in  pure 
hydrochloric  acid,  and  dilute  to  100  C.C.  Test  the  .solution  to  see  if  it  give  a  deep 
color  with  ferrocyanide  of  potassium  ;  if  the  color  is  not  too  deep  take  50  C.C.  of  the 
solution,  but  if  it  be  deep  take  a  smaller  quantity,  and  make  it  up  to  50  C.C.  with  dis- 
tilled water,  taking  care  that  it  is  well  acidulated.  Put  it  into  a  cylindrical  glass,  and  add 
1  or2  C.C.  of  solution  of  ferrocyande  of  potassium:  a  blue  color  is  given.  Into  another 
glass  1  C.C.  of  strong  hydrochloric  acid  is  put,  and  50  C.C.  of  distilled  water;  1  or  3 
C.C.  of  ferrocyanide  are  added;  the  standard  solution  of  iron  is  then  dropped  in  till 
an  equal  color  is  produced.  The  amount  of  iron  is  then  read  off  and  calculated  as 
phosphate  (1  of  iron  =  2.696  FePOi).  Deduct  the  weight  from  the  total  weight  of 
phosphate  of  aluminium  and  iron ;  the  remainder  is  phosphate  of  aluminium  {=  Al 
POj),  of  which  1  part  equals  0.42  alumina,  or  2.1  dry  or  8.9  crystallized  potas.sium 
alum  ;  or  1.9  dry  or  3.7  of  crystallized  ammonium  alum,  which  last  is  almost  the  only 
kind  now  in  the  market. 

Winter-Elyth  (Analyst,  vol.  vii.,  1882,  p.  19)  proposes  to  dissolve  out  the  added 
alumina  by  long  digesting  in  a  large  bulk  of  5  per  cent,  hydrochloric  acid.  Should 
this  succeed  it  will  simplify  the  operation. 


QUALITY,    CHOICE,    A:N"D    COOKIXG    OF    FOOD.  265 

eorrespondmg  to  alum  added.  Carter  Bell '  deducts  10  grains  per  4-ib 
loaf,  or  2-k  grains  per  ft),  before  reckoning  adulteration. 

Dr.  Lethebj  also  used  a  decoction  of  logwood  as  a  test ;  a  piece  of  pure 
bread  and  a  piece  of  suspected  bread  are  put  into  a  glass  containing  fi-eshly 
prepared  decoction,  and  left  for  twenty-four  hoiu'S  ;  the  pui'e  bread  is 
simply  stained,  the  alumed  bread  is  dark  pm-pHsh,  as  the  alum  acts  hke  a 
mordant.  Mr.  Hadow  and  I\Ir.  Horsley "  have  also  used  this  test  with  advan- 
tage, but  'Mr.  Crooks,  after  many  experiments,  came  to  the  conclusion  that 
it  was  valueless.^  Winter-Blyth  proposes  the  use  of  slips  of  gelatine  soaked 
in  the  aqueous  solution  of  the  suspected  bread.  If  the  bread  is  pure  the 
gelatine  is  stained  only  a  reddish-brown  by  logwood,  and  can  be  decolor- 
ized by  glycerine  ;  alumed  bread  gives  a  more  or  less  deejD  blue  color,  which 
is  permanent  in  glycerine. 

Alum  is  not  much  used  except  with  inferior  breach^  The  amount  of 
alum  in  bread  is  said  to  be,  on  an  average,  3  ounces  to  a  sack  or  280  lb  of 
flour ;  if  the  sack  gives  105  -i-ft  loaves,  there  T\ill  be  3  gi-ains  in  a  lb  of 
bread  ;  but  if  crystallized  alum  is  meant  by  this,  there  will  only  be  about 
1^  grain  of  diy  alum.  HassaU  states  the  C|uantity  to  be  ^  ft)  (8  ounces)  to 
240  ft)  of  flour,  but  that  the  c|uantity  diflers  for  old  and  new  flour.  A  very 
good  witness,^  in  the  inquiry  into  the  gTievances  of  the  journeymen  bakers, 
gave  the  c[uantity  at  10  ounces  per  sack  ;  this  would  give  41.6  grains  per 
4-ft)  loaf,  or  10.4  grains  per  ft).  T\Tien  mixed  with  flour  and  baked,  the 
alum  is  decomposed,  part  of  the  alumina  combines  most  strongly  with 
phosphoric  acid ;  and  either  this  or  the  alum  itself  is  presumed  to  be  in 
combination  with  the  gluten  ;  potassium  disulphate  is  probably  formed. 

Gupric  Sulphate. — Cut  a  smooth  shce  of  bread,  and  draw  over  it  a  glass 
rod  dipj)ed  in  potassium  ferrocyanide.  If  copper  be  present,  a  brick-red 
color  is  given  by  the  formation  of  fen'ocyanide  of  copj^er.  The  test  is  very 
dehcate.  It  is  beheved  to  be  a  very  rare  adulteration  in  England.  It  has 
been  said  that  cobalt  is  used  instead  of  cojiper,  but  it  is  also  probably  very 
rare  ;  it  can  be  detected  by  the  blueness  of  the  ash.^ 

Potatoes. — If  potatoes  in  any  c[uantity  have  been  added,  the  ash  of  the 
bread,  instead  of  being  neutral,  is  alkahne  ;  this  can  only  occur  from  sodium 
carbonate  having  been  added,  or  fi'om  the  presence  of  some  salts  of  organic 
acids,  citrates,  lactates,  tartrates,  which  form  carbonates  on  incineration. 
But  if  it  be  from  sodium  carbonate,  the  solution  of  bread  will  be  alkaline, 
so  that  it  can  be  known  if  the  alkalinity  is  produced  during  incineration. 
If  so,  it  is  almost  certain  to  be  fi'om  potato. 

Examination  of  YeaM. — Common  brewers'  yeast  is  not  likely  to  be 
adulterated.  If  any  solid  mineral  substances  are  mixed  with  German  yeast, 
they  are  detected  either  by  washing  or  by  incineration.  Dr.  Letheby  found 
German  yeast,  imported  in  1863,  to  be  adulterated  with  30  per  cent,  of 
pipe-clay. 

'  Analyst,  Xo.  40,  1879,  p.  126. 

^  Chemical  Xews,  May,  lbT2. 

''Ibid. ,  September,  1862. 

*  Eeport  on  Journeymen  Bakers,  1862,  p.  164;  see  also  Odling's  Papers.  Hassall, 
however,  found  alum  in  half  the  loaves  examined.  A  writer  in  the  Lancet  (January, 
1872)  states  that  at  that  date  alum  was  found  in  10  out  of  20  loaves,  and  the  amount 
was  from  12  to  96  grains  in  the  4-lb  loaf. 

°  Report  on  Journeymen  Bakers,  1862.  p.  163.  Some  of  the  statements  are  beyond 
even  this  amount — 1  lb  to  4  lb  per  1,000  (4-lb  ?)  loaves  (p.  xxxvi.) ;  but  this  is  probably 
an  exaggeration. 

^  Dr.  Campbell  Brown. 


2G6  PRACTICAL    nTGIET^. 

Microscopical  Examination  of  Bread. 

This  is  of  Ten'  little  use  as  far  as  adtilteration  is  concerned,  but  the 
presence  oi fungi  can  be  detected. 

The  most  common  fungus  is  a  kind  of  Penicillium  (sitophilum  and 
roseum),  which  gives  a  greenish,  bi'owTiish,  or  reddish-yellow  color  ;  sporules, 
sporangia,  and  mycelium  can  all  be  seen.  The  Oidium  aurantiacum  has 
been  several  times  detected  in  France  and  Algeria  ;  it  is  distinguished  by 
its  orange-red  color.  A  greenish  mucor  is  often  found  in  bread.  Fuccinia, 
so  common  in  flour,  has  not  been  detected. 

Diseases  connected  with  the  Qualify  of  Flour  and  Bread. 

1.  The  Flour  originally  bad. — It  may  be  ergoted,  or  grown  and  ferment- 
ing, or  with/;<H^i  forming.  An  anomalous  disease  approaching  to  ergot- 
ism should  lead  at  once  to  an  examination  of  the  flour.  The  fermenting 
flour  produces  dyspejDsia  and  diarrhoea  ;  the  heat  and  moisture  of  the 
stomach,  no  doubt,  excite  at  once  very  rapid  fermentation  ;  the  gluten, 
already  metamorphosing,  acts  very  energetically  on  the  starch,  and  C0„  is 
rapidly  developed ;  hence  uncomfortable  feelings,  flatulence,  imperfect 
digestion,  and  diarrhoea.  It  is  to  remedy  this  condition  of  floui-  that  alum 
is  added,  and  some  of  the  effects  ascribed  to  alum  may  be  really  owing  to 
the  flour. 

The  most  important  disease  connected  with  flour  is,  however,  ergot- 
ism ;  this  is  less  common  in  wheat  than  in  rj^e  flour,  but  yet  is  occasion- 
ally seen.  Sometimes  ergoted  meal  produces  at  once  violent  stomach  and 
intestinal  symptoms,  at  other  times  primary  digestion  is  well  performed, 
and  the  early  symptoms  are  great  general  depression  and  feverishness, 
ushering  in  the  local  symptoms  of  acrodynia. 

2.  Flour  originally  good,  hut  altering  either  from,  age  or  from  not  having 
been  icell  dried. — The  bread  is  often  acid,  and  sometimes  highly  so  ;  this 
may  produce  diarrhoea,  though  such  bread  has  sometimes  been  used  for  a 
long  time  without  this  effect ;  usually  persons  will  not  eat  much  of  it,  and 
thus  the  supply  of  nutriment  is  lessened.  If  the  bread  be  too  moist,  fungi 
form,  and  Oidium,  aurantiacum,  in  particular,  has  been  known  in  Algiers 
to  give  rise  to  little  endemics  of  diarrha;a  (Boudin  and  Foster).'  Mucor 
mucedo  either  does  not  produce  this,  or  rarely.  It  should  be  remem- 
bered, however,  that  mouldy  oats  (the fungus  being  Aspergillus)  have 
given  rise  to  paralytic  symptoms  in  horses,  so  that  these  fungi  are  to  be 
looked  on  with  suspicion  f  and  a  case  of  the  kind  has  been  reported  by 
H.  Hoffman  in  Giessen.^  Professor  Yarn  ell  also  states*  that  six  horses 
died  in  three  days  from  eating  mouldy  oats  ;  there  was  a  large  amount  of 
matted  mycelium,  and  this,  when  given  to  other  horses  for  experiment, 
killed  them  in  thirty-six  houi's  ;  there  was  a  "  pecviliar  growth  "  on  the 
mucous  membrane  of  the  small  intestine.  It  is  net  known  that  Acarv,s, 
so  common  in  flour,  has  any  bad  effects  when  eaten. 

3.  Substances  added. — Alum,  of  course,  is  the  chief  substance  ;  there 
has  been  much  difference  of  opinion  as  to  its  eftects.  It  has  been  asserted 
to  produce  dyspepsia  ;  to  lessen  the  nutritive  value  of  bread  by  rendering 
the  phosphoric  acid  insoluble,  and  to  be  also  a  falsification,  inasmuch  as  it 

'  Archives  Gen.  de  Med.,  1848,  p.  244. 

'  Sanderson's  Report  in  Syd.  Soc.  Year-Book  for  1862.  p.  462. 

^  Virfhow's  Arcliiv,  Band  xliii.,  p.  178. 

*  Journal  of  the  Society  of  Arts,  April,  1865. 


QUALITY,    CHOICE,    AND    COOKING    OF   FOOD.  267 

permits  an  inferior  flour  to  be  sold  for  a  good  one.  The  last  allegation  is 
no  doubt  correct ;  the  second  probably  so,  as  there  is  little  doubt  of  the 
formation,  and  none  of  the  insolubility,  of  phosphate  of  alumina.  The  first 
point  is  more  doubtful,  though  several  physicians  of  great  authority  (Car- 
penter, Dundas,  Thomson,  Gibbon,  Normandy)  have  considered  its  action 
very  deleterious,  and  that  it  causes  dysj)epsia  and  constipation.  Pereira 
considered  that  whatever  may  have  been  the  effect  in  the  case  of  healthy 
persons,  sick  persons  did  really  suffer  in  that  way.  A  question  like  this 
is  obviously  difficult  of  that  strict  proof  we  now  demand  in  medicine. 
Seeing,  indeed,  that  the  usual  effect  of  bad  flour  is  flatulence  and  diar- 
rhoea, if  constipation  were  decidedly  produced  by  bread,  it  would  be  more 
likely  to  proceed  fc-om  alum  than  from  any  other  ingredient  of  the  bread. 
Looking  again  to  the  fact  that  sometimes  bread  has  contained  large  quan- 
tities of  alum, — sometimes  as  much  as  40  grains  in  a  4-ft)  loaf,  and  proba- 
bly more, — we  get  an  amount  in  an  ordinary  meal  which  (if  the  aluminium 
phosphate  is  an  astringent)  might  very  well  cause  constipation.  Looking, 
then,  to  the  positive  evidence,  and  the  reasonableness  of  that  evidence,  it 
seems  extremely  likely  that  strongly  alumed  bread  does  produce  the  in- 
jurious effects  ascribed  to  it. 

The  addition  of  alum  is  forbidden  by  law. 

Sulphuric  acid  is  said  to  be  added'  before  grinding  instead  of  alum  ;  it 
has  the  same  power  of  preventing  decay. 

Sulphate  of  Copper. — The  amount  is  so  small  that  it  seldom  produces 
any  symptoms  ;  still  it  is  jDOSsible  that  some  anomalous  cases  of  stomach 
irritation  might  be  owing  to  this. 

Lead. — Dr.  Alford,'^  medical  officer  for  Taunton,  reports  a  case  of  poi- 
soning from  lead  getting  into  flour.  Six  or  seven  families,  including  fifteen 
to  twenty  persons,  suffered,  some  very  severely.  The  water  was  analyzed, 
but  no  lead  found,  and  then  it  was  noted  that  the  persons  attacked  all  got 
their  flour  from  the  same  mill.  On  making  inquiries,  it  was  found  that 
the  millstones  used  had  (from  the  nature  of  the  stone)  large  spaces  in 
them,  which  had  been  filled  up  with  lead  !  It  was  mentioned  at  the  meet- 
ing of  the  sanitary  authority,  by  one  of  the  members,  that  lead  was  not 
usually  employed  in  that  way,  that  what  was  generally  used  was  red-lead 
and  borax,  or  alum  and  borax,  both  highly  objectionable.  If  such  be  the 
case,  this  is  another  possible  source  of  alum,  which  ought  to  be  recollected. 

Lolium  temulentum  gives  rise  to  narcotic  symptoms. 

Hour  from  other  Grains. — It  is  not  known  whether  the  addition  of 
potatoes,  rice,  barley,  peas,  etc.,  in  any  way  injures  health,  except  as  it  may 
affect  nutrition  or  digestion.  Occasionally,  in  times  of  famine,  other  sub- 
stances are  mixed — chestnuts,  acorns,  etc.  In  1835,  during  famine,  fatal 
dysentery  ap]3eared  in  Konigsberg,  owing  to  the  people  mixing  their  flour 
with  the  pollen  of  the  male  catkin  of  the  hazel  bush.  In  India  the  use  of 
a  vetch,  Lathyrus  sativus  (kassaree-dholl),  with  barley  or  wheat,  gives  rise 
to  a  special  paralysis  of  the  legs,  when  it  exceeds  one-twelfth  part  of  the 
flour;  L.  cicera  has  the  same  effect.^  During  the  siege  of  Paris,  straw,  to 
the  extent  of  one-eighth,  was  introduced  into  the  bread  ;  this  had  a  very 
irritating  effect. 

'  Dr.  Angus  Smith,  Annual  Report  of  tte  Manchester  and  Salford  Sanitary  Associa- 
tion for  186:5. — Report  of  Sub-Committee. 

2  Sanitary  Record,  May  25,  1877. 

^  Dr.  Irvine  (Indian  Annals,  January,  1868)  described  the  symptoms  produced  by 
the  kassaree-dholl  or  Lnthyi'us.  The  first  symptoms  are  gastro-lntestinal  irritation,  and 
the  paraplegia  follows  on  this. 


268  PRACTICAL    HYGIENE. 

SECTION  m. 

BARLEY. 

As  an  article  of  diet,  barley  has  the  same  advantages  and  disadvantages 
as  wheat.  It  is  said  to  be  rather  laxative  (Pereira),  and  it  was  noticed  by 
the  late  Dr.  Parkes,  that  either  from  this  cause,  or  from  the  imperfect 
sepai-atiou  of  the  shaii^  husks,  barley  bread  was  pai'ticularly  unsuited  for 
dvsenteric  cases.  It  contains  rather  more  protein  bodies  than  wheat,  and 
these  consist  of  glutin-casein,  glutiu-fibrin,  mucedin,  and  albumen.'  It  is 
certainly  very  nutritious,  and  the  Greeks  ti'ained  their  athletes  on  it.  Its 
richness  in  phosphoric  acid  and  ii-on  render  it  particularly  adapted  for  this. 

Choice  of  Barky  (Scotch  or  pot  barley,  \\z.,  the  gi-ain  -s^ithout  the  husks). 
— For  the  i3ai-ley  grains  the  same  points  are  to  be  attended  to  as  in  wheat. 

For  the  pearl  bai-ley  (which  is  mei-ely  the  grain  rounded  off),  the  best 
tests  are  the  physical  chai-acters,  color,  freedom  from  dust,  giit,  and  in- 
sects, and  the  test  of  cooking. 

The  patent  prepared  or  powdered  barley  should  be  examined  with  the 
microscope  ;  au}^  kind  of  cheaper  grain  may  be  mixed  with  it. 

Diseases  arising  from  Altered  Quality. — These  are  the  same  as  those  of 
wheat,  viz.,  intligestion,  flatulence,  and  diaiThcea.  There  appears  to  be 
nothing  peculiai*  in  the  action  of  diseased  barley  as  distinguished  from 
diseased  wheat. 

SECTION  IV. 

OATS. 

Oats  have  been  considered  even  more  nutritious  than  wheat  or  barley, 
and  certainly  not  only  is  the  amount  of  nitrogenous  substance  great,  but 
the  proportion  of  fat  is  large.  Unfortunately,  the  nitrogenous  siibstance 
has  no  adhesive  property,  and  bread  cannot  be  made  ;  the  amount  of  in- 
digestible cellulose  is  large.  But,  on  the  other  hand,  oatmeal  has  the 
great  advantage  of  being  veiy  readily  cooked,  much  more  so  than  wheat 
or  barley.  The  researches  of  Ki'eusler"  show  that  the  nitrogenous  sub- 
stances of  oats  contain  ghadin,  and  especially  glutin-casein.  This  last 
substance  is  that  called  "avenin"  by  Norton  and  Johnstone  ;  it  approaches 
very  closely  to  the  legumin  of  peas  and  beans,  and  is  so  called  by  Ritthausen. 
In  nutritive  properties,  it  causes  oatmeal  to  stand  nearer  to  the  Leguminosce 
than  the  cereals  do.  It  contains  double  as  much  sulj)hur  as  the  legumin 
of  peas. 

For  this  reason,  and  because  it  contains  much  nutriment  in  small 
bulk,  because  it  can  be  eaten  for  long  periods  with  rehsh,  and  keeps  un- 
changed for  a  long  time,  it  would  seem  to  be  an  excellent  food  for  soldiers 
during  war — an  opinion  which  does  not  lose  in  force,  when  we  remember 
that  it  formed  the  staple  food  of  one  of  the  most  martial  races  on  record, 
the  Scotch  Highlanders,  whom  Jackson  considered  also  one  of  the  most 
enduring.  Fonnerly,  when  oats  were  badly  cleaned,  intestinal  concretions 
of  the  husk  and  hairs  were  common  among  those  who  Hved  on  oatmeal, 
but  these  are  now  uncommon.  It  has  been  thought  to  be  "  heating"  when 
taken  continually,  but  this  is  probably  a  prejudice.  The  supporting  qualities 
of  oatmeal,  used  as  a  drink,  made  into  a  thin  gruel,  are  testified  to,  in  hard 
work,  by  the  chief  and  divisional  engineers  of  the  Great  Western  Railway.^ 

'  Ritthausen,  op.  cit.,  p.  103.  -Ibid.,  p.  125. 

'  On  the  Issue  of  a  Spirit  Ration  during  the  Ashantee  Campaign  of  1874,  Appendix 
ii.,  by  E.  A.  Parkes,  M.D.,  F.R.S.,  etc.,  1874. 


QUALITY,    CHOICE,    AND    COOKIZs^G    OF    FOOD.  269 

Adulterations. — Baiiev-meal  and  the  husks  of  barley,  of  -svlieat,  and  of 
oat  itself,  are  added  veiy  frequently.  A  single  look  through  the  microscope 
detects  the  round  and  smooth  bailey  starch  ;  the  envelopes  are  recognized 
with  very  httle  more  trouble.  Rice  and  maize  are  also  sometimes  used. 
The  drawings  ah-eady  given  will  also  enable  these  substances  to  be  detected. 
Hassall  found  about  haH  the  samples  of  oatmeal  adulterated. 

Choice  of  Oatmeal. — There  should  be  a  good  proportion  of  envelope, 
but  no  branny  chai'acter,  which  usually  arises  from  barley  husks  ;  the 
stai'ch  should  not  be  discolored.  A  microscopic  examination  should  always 
be  made,  both  for  adulterations  and  Acari. 

« 

SECTION  Y. 

MAIZE  AXD  EYE. 

Both  these  grains  are  very  nutritious.  Maize  contains  a  large  quantity 
of  yellowish  fat  (6  or  7  per  cent.).  The  gluten  cannot  be  washed  out,  as 
in  wheat,  though  this  was  stated  by  Gorham,  who  found  a  special  sub- 
stance which  he  termed  "  Zein."  This  is  called  "maize-fibrin"  by  Eitt- 
hiiusen.  It  requii-es  veiy  careful  cooking,  as  otheiTNise  much  passes  out 
undigested.  Dr.  Johnstone  noticed  an  outbreak  of  diarrhoea  in  a  mihtary 
prison  clearly  due  to  badly  cooked  maize.  It  should  be  soaked  in  water, 
l3ut  not  too  long  (two  to  four  hom's),  and  then  thoroughly  boiled  for  sev- 
eral hours  (four  to  sixj,  at  a  rather  low  heat,  llaize  cakes  are  both  palat- 
able and  nutritious. 

Eye  makes  a  very  acid,  dai'k  bread,  which  causes  dian'hoea  in  those 
unaccustomed  to  it.  Custom,  however,  soon  remedies  this,  and,  as  far  as 
nutritive  value  goes,  it  appears  equal  to  wheat.  It  contains  less  vegetable 
fibrin,  and  more  casein  and  albumen,  and  a  peculiar  odorous  substance. 

Diseases  connected  icith  2Iaize  and  Eye. 
It  is  presumed  that  alterations  in  the  flour  will  produce  the  same  dis- 
eases as  in  the  analogous  case  of  wheat.  Ei'gotism  is,  however,  more  com- 
mon in  lye  than  any  other  grain.  The  PeUagi-a  of  Lombai'dy  has  been 
ascribed  to  d. fungus  { Yerderame,  or  Yerdet)  forming  in  the  maize.  Many 
volumes,  with  ditferent  statements,  have  been  written  on  this  point,  and  it 
is  stiU  doubtful  whether  or  not  the  Yerdet  has  this  effect.  The  evidence 
is  not  sufficient,  but,  on  the  whole,  seems  most  in  favor  of  the  view  which 
connects  Pellagra  with  diseased  maize. 

SECTIOX  YL 

EICE. 

The  whole  gi'ain  (paddy)  deprived  of  the  husk  is  sold  as  rice.  There 
are  many  varieties,  of  difi'erent  colors  (white,  red,  brown  ?)  and  composi- 
tion. The  amount  of  nitrogenous  matter  varies  greatly,  fi'om  3  to  7.5  per 
cent.  As  an  article  of  diet,  it  nas  the  advantage  of  an  extremely  digestible 
stai-ch-grain,  and,  like  the  other  Cerealia,  there  is  a  great  admixture  of 
substances  :  it  is,  however,  poorer  in  nitrogenous  substances  than  wheat, 
and  is  much  poorer  in  fat.  Consequently,  among  rice-feeding  nations, 
feguminous  seeds  are  taken  to  supply  the  first,  and  animal  or  vegetable 
lats  to  remedy  the  latter  defect.     Eice  is  also  poor  in  salts. 

Coobing  of  Eice. — It  should  properly  be  steamed,  not  boiled,  and  the 
steaming  should  be  thoroughly  done,  else  the  starch-grains  are  not  swoUen 
and  digestible.     If  boiled," it  should  not  be  for  too  long  a  time,  otherwise 


270 


PRACTICAL    HYGIENE. 


the  rice  for  conjee)  water  contains  some  albuminous  matter,  and  the  grain 
loses  in  nutritive  jDower. 

Choice  of  Rice. — The  grains  should  be  clean,  without  grit ;  the  indi- 
vidual grains  without  spots  or  evidence  of  insects.  The  size  varies  much, 
according  to  the  kind  ;  the  lai'ge  kinds  usually  command  the  highest 
market  price.' 

CompaTlson  of  the  foregoing  Grains — Order  of  Bichness. 


Nitrogenous 
Substances. 

Fat 

» 

Starch,  etc. 

Salts. 

Wheat. 

j  Maize. 

Rice. 

Barley. 

Barley. 

(  Oats. 

Maize. 

Oats. 

Eve. 

Barle}'. 

Wheat. 

Wheat. 

Oats. 

Eve. 

Eve. 

Rve. 

Maize. 

Wheat 

Oats. 

Maize. 

Rice. 

Rice. 

Barley. 

Rice. 

SECTION  vn. 

MILLET,  RAGGY,  BUCKWHEAT. 

Various  other  grains  belonging  to  the  Cerealia,  or  to  other  natural 
orders,  but  having  similar  properties,  are  used  as  food  in  different  coun- 
tries. Of  these,  the  above-named  are  chiefly  those  the  medical  oflScer  may 
have  to  report  on. 

^Millet  is  used  largely  in  Africa  (west  coast)  and  Algeria,  in  Italy,  Spain, 
Portugal,  some  pai'ts  of  India,  China,  etc. 


English  Xames. 


Common  millet. 


Small  millet, 
Spiked  millet, 


Botanical  Names. 


Indian  Names. 

Sawee  Cheunawaree 

(Hindustani). 

Varagoo  (Tamul). 

,  c<      r.  T>     •         ( Dhurra  (Arabic). 

(  oorqhum  or  Fanicum  \  ^,,    ,       )m        ^\ 
]        f  J     .  i  Cholam  (Tamul). 

^  -^     ''  (Joaror  Jowree  (Hind.). 


Fanicum  miliaceum, 


Pencillaria  spicata. 


Golden-colored  millet,  Sorghum  saccharatum. 


J  Biijra  or  Bajree  (Hind.). 
I  Cum^ 


Jumboo  (Tamul;. 


Italian  millet, 
German  millet, 


Setaria  Italica, 
Setaria  Germanica. 

Eleusine  corocana, 


\  Kala  kangnT  (Hind.). 
(  Tenay  (Tamul). 

<  Eaggee  or  Eaggy  (Hind., 
\  Cauarese,  and  Tamul). 
y  Murha  and  !Maud  in  the 
'      X.  Px'o v.  of  Hindustan.'' 

The  millets  are  xery  similar  in  composition  (as  given  in  the  table,  p. 
212).     The  ash  is  rich  in  sihca  and  j^hosphates. 

'  The  larger  grains — especially  the  American  kinds— have  often  much  less  flavor 
than  the  smaller  and  less  attractive  Indian  kinds. 

■'  The  native  names  of  the  Indian  grains  and  pulses  used,  especially  in  Southern 
India,  are  given  very  fully  in  a  paper  by  Mr.  Elliot  (Edinburgh  Philosophical  Journal, 
July,  1S62);  and  also  in  Mr.  Cornish's  excellent  paper  (Madras  Medical  Journal,  Feb- 
ruary, 1864). 


QUALITY,    CHOICE,    AIS^D    COOKING    OF   FOOD.  271 

j\Iillet  bread  is  very  good,  and  some  was  issued  to  the  troops  in  the  last 
•China  Expedition.  This  should  always  be  done  in  a  millet  country,  if 
■wheat  or  barley  cannot  be  got.  In  Northern  China  millet  is  almost  exclu- 
sively used. 

Eaggy  or  Eagee,  Murha  and  Maud  of  the  ujDper  provinces  [Eleusine 
corocana),  is  largely  used  in  Southern  India  (Mysore),  and  in  some  parts  of 
Northern  Hindustan,  and  is  considered  even  more  nutritive  than  wheat.  It 
is  veiy  indestructible,  and  can  be  presei'ved  for  many  years  (even  sixty)  in 
dry  gTain  pits. 

Buckwheat  is  not  so  likely  to  be  used.  It  is  poor  in  nitrogenous  sub- 
stances and  fat,  but  makes  a  fair  tasting  bread. 


SECTION  ATH. 
LEGUMIXOS.E. 

The  Leguminosce,  in  respect  of  dietetic  properties,  are  broadly  distin- 
guished from  other  vegetables  by  their  very  large  amoimt  of  nitrogenous 
substance,  caUed  legumin  or  vegetable  casein ;  there  are,  in  addition,  a  httle 
albumen  and  other  protein  bodies.  The  advantages  of  peas  and  beans  as 
articles  of  diet  are  the  gTeat  amount  of  legumin,  and  the  existence  of  much 
sulphur  and  phosphorus  in  combination  with  the  legumin ;  in  salts  also 
they  are  a  httle  richer  than  the  (Jerealia,  especiaUy  in  potash  and  lime,  but 
ai'e  rather  poorer  in  phosphoric  acid  and  magnesia ;  1  tb  of  j^eas  contains 
about  168  grains  of  salts.  The  disadvantage  of  peas  and  beans  is  a  certain 
amount  of  indigestibihty  ;  about  6.5  per  cent,  of  the  ingested  pea  passes 
out  unchanged,  and  starch-cells,  giving  a  blue  reaction  with  iodine,  are 
found  in  the  fseces  ;  much  flatus  is  also  produced  by  the  hydrogen  suljDhide 
formed  from  the  legumin.  Still,  they  are  a  most  valuable  article  of  food, 
and  always  ought  to  be  used  when  much  exercise  is  taken,  as  they  are  an 
excellent  addition  to  meat  and  Cerealia.  Both  men  and  beasts  can  be 
nourished  on  them  alone  for  some  time.  Added  to  rice,  they  form  the 
staple  food  of  lai'ge  populations  in  India.  !Mi\  Cornish  mentions  that,  in 
the  Sepoy  Corps,  the  men  ai'e  much  subject  to  diarrhoea  from  the  too 
great  use  of  the  "dhoU"  (Caja/ius  indicuf).  Gram  [Cicer  aHetinum),  al- 
though chiefly  used  for  horses  and  cattle,  is  sometimes  employed  as  food 
for  men  in  India  ;  it  makes  palatable  and  nutritious  cakes. 

Choice  of  Pea. — By  keeping,  peas  lose  their  color,  become  veiy  pale  and 
much  shrivelled,  and  extremely  hard.  Anything  like  decomposition,  or 
existence  of  insects,  is  at  once  detected.  The  powder  does  not  keep  very 
long  ;  the  whole  peas  should  be  split.  The  microscope  should  be  used  to 
detect  Acarus. 

Cooking  of  Peas  and  Beans. — They  must  be  boiled  slowly,  and  for  a  long 
time,  otherwise  they  are  very  indigestible.  If  old,  no  amount  of  boiling 
softens  them  ;  in  fact,  the  longer  they  are  boiled  the  harder  they  become  ; 
they  shoiild  then  be  soaked  in  cold  water  for  twenty-four  houi-s,  cnished, 
and  stewed  ;  in  this  way  even  veiy  old  peas  may  be  made  digestible  and 
palatable.  Chalk-water  must  be  avoided  in  the  case  of  peas  as  of  other 
vegetables,  as  the  lime-salts  form  insoluble  compounds  with  the  legiomin. 

Lathy rus  sa^iuus  (Kassaree-dhoU  of  India). — Occasionally  in  Europe,  and 
constantly  in  some  parts  of  India,  this  vetch  has  been  used  when  mixed 
with  wheat  or  barley  flour  for  bread.  "V^Tien  used  in  too  great  quantities, 
it  produces  (without  there  being  necessarily  any  alteration  of  the  gTain  ?) 
constipation,  cohc,  and  some  form  of  indigestion,  and  if  eaten  in  large 
quantity,  paraplegia.     It  is  also  injurious  to  horses,  but  less  so  to  oxen. 


272  PRACTICAL    HYGIENE. 

In  Bengal,  Dr.  Irvine  '  found  in  some  villages  no  less  than  from  10  to  15 
per  cent,  of  the  people  paralji^ic  from  this  cause.  From  its  composition, 
it  would  not  ajjpear  to  be  innutritions. 

SECTION  IX. 

STARCHES*  AND  SUGAR. 

Sub-Section  L — Aerowkoots. 

3Iaranta  Arroioroot  (West  Indian). — The  chief  kind  is  obtained  from 
Maranta  arundinacea.  The  quality  of  Maranta  arrowroot  is  judged  of  by 
its  wLiteness  ;  by  the  grains  being  aggregated  into  little  lumps,  and  by  the 
jelly  being  readily  made,  and  being  firm,  colorless,  transj^arent,  and  good 
tasted.  The  jelly  remains  firm  for  three  or  four  days  witJiout  turaing  thin 
or  sour,  Avhereas  potato  lloiu'  jelly  in  twelve  hours  becomes  thin  and  ace- 
scent. Under  tlie  microscope,  the  starch-gi-ains  are  easily  identified.  They 
are  slightly  ovoid,  like  potato  starch,  but  have  a  mark  or  hne  at  the 
larger  end  (the  hilum  of  the  potato  starch  is  at  the  smaller  end),  the  con- 
centric Hnes  are  well  marked.  The  most  common  adulterations  are  sago, 
tapioca,  and  potato  starch.  All  these  starch-grains  are  readily  detected  by 
the  microscope. 

Curcuma  Arrowroot. — AiTowroot  obtained  ft'om  Curcuma  has  the  same 
physical  characters  as  Maranta,  but  under  the  microscope  the  starch-grains 
are  large  and  oblong,  marked  with  very  distinct  concentric  lines,  which, 
however,  are  not  entire  cu'cles,  having  an  indistinct  hilum  at  the  smaller  end. 

Manihot  Arrowroot. — This  comes  from  Rio,  and  is  obtained  from 
Jatropha  manihot.     The  starch-grains  are  very  marked." 

Tacca  or  Otaheiti  Arrowroot. — Hassall  gives  a  figure  which  shows  that 
the  starch-grains  resemble  those  of  Manihot. 

Arum  Arroicroot. — The  Ai-um  or  Portland  aiTOwroot  has  small,  angu- 
lar, and  facetted  starch-grains,  which  cannot  be  confounded  with  any  of 
the  former.  They  are  a  little  hke  maize.  This  is  sometimes  called  Port- 
land Sago. 

British  or  Potato  Arrowroot. — Under  the  term  "Farina,"  potato  starch 
is  sold  in  the  market ;  so  white  and  crackling,  and  making  so  good  a 
jelly,  that  it  is  not  always  easy  to  distinguish  it  from  3Ianihot.  The  micro- 
scope at  once  detects  it.  The  peax'-shaped  gi-ains,  marked  hilum  toward 
tlie  smaller  end,  and  the  swelling  with  weak  liquor  potass?e,  render  a  mis- 
take impossible.  In  making  the  jelly  a  much  larger  cpiantity  is  required 
than  of  Mai'anta  arro-oToot.  Maranta  arundinacea,  mixed  with  twice  its 
weight  of  hydrochloric  acid,  produces  a  white  oj^aque  paste,  whereas  po- 
tato starch  treated  similarly  produces  a  transparent  acid  jelly-like  paste. 

Canna  or  Tous-les-Mois  Arrowroot,  obtained  from  Canna  edulii<,  N.O. 
Marantacece. — The  starch-grains  are  like  those  of  the  potato,  but  much 
larger,  and  the  concentric  Unes  are  beautifully  marked  and  distinct.' 

Sub-Section  II. — Tapioca. 

This  is  obtained  from  the  finest  part  of  the  pith  of  Jatropha  manihot  or 
Ca.Hsava. 

Under  the  microscope  the  starch-gi-ains  are  small,  with  a  central  hilum  ; 
and  sometimes  three  or  four  adhere  together  and  form  compound  grains. 

'  Indian  Annals,  18.57.  Ibid.,  January,  1808,  p.  89,  Dr.  Irvine  notices  the  resem- 
blance of  the  symptoms  to  the  Barbiers  of  Bontius. 

^  See  table,  p.  273,  and  plate  of  drawings  by  Dr.  Maddox  farther  on. 


QUALITY,    CHOICE,    AND    COOKHSTG    OF    FOOD. 


273 


It  is  adulterated  with  sago  and  potato  starch,  both  of  which  are  easily 
detected  by  the  microscope. 

Sub-Section  HE. — Sago. 

The  best  kinds  are  derived  fx'om  the  sago  palm  {Sagus  fariyxifera),  but 
the  sago  of  the  Gycas  circinalis  is  also  sold  ;  it  is,  however,  inferior. 

Granulated  sago  is  either  "common"  or  "pearl;"  the  latter  is  chiefly 
used  in  hospitals.  The  starch  is  soluble  in  cold  as  well  as  in  hot  water. 
The  starch-grains  are  elongated,  rounded  at  the  larger  end,  and  com- 
pressed at  the  other  ;  and  hence  their  shape  is  quite  different  from  the 
potato  starch.  The  hilum  is  a  point,  or  more  often  a  cross,  slit,  or  star, 
and  is  seated  at  the  smaller  end  ;  whereas,  as  in  Maranta  arrowroot,  the 
hilum  is  at  the  larger  end.     Rings  are  more  or  less  clearly  seen. 

In  the  market  is  a  iictitious  sago  made  of  potato  flour.  This  is  some- 
times colored  red  or  brownish,  either  from  cochineal  or  sugar.  In  thirty 
specimens  HassaU  found  five  to  be  fictitious.  The  microscojoe  easily  de- 
tects potato  starch. 

It  is  sometimes  difficult  to  remember  the  characters  of  the  different 
forms  of  starch,  but  it  may  be  to  a  certain  extent  facilitated  by  a  tabulated 
arrangement.  The  following  table  has  been  compiled  by  Dr.  J.  D.  Mac- 
donald,  R.N.,  F.R.S. 

Microscopical  DiscHmination  of  the  Principal  Arrowroots  and  Starches. 
I.  Starches  with  isolated  smooth  or  unfacetted  grains,  being  originally 
free  in  the  cell  cavity. 

General  Characters.  Particular  Characters.  Name. 


r       Form. 


Hilum. 


'  Grains  large. 

Hilum  at 

the  small 

end. 


A. — Contour 

ovoid. 

Hilum 

eccentric. 


B. — Contour 
oval. 


Grains  me- 
dium sized. 
Hilum  at 
the  larger 
end. 


Hilum 

longitudinal. 

linear 

lateral. 


f  Form. 

Outline  even.  Con- 
tinuous rings,  ob- 
lique, including 
more  than  half 
the  grain. 

Outline  even.  Con- 
tinuous rings, 
nearly  transverse, 
including  less  than 
^     half  the  grain. 

'  Outline  uneven, 
often  with  beak- 
like projections. 


Hilum. 
Hilum  distinct. 


f  Hilum  distinct. 

I 

I 

I  Hilum  indistinct. 


Hilum.  slit-like,  tri- 
radial  or  crucial 


Outline  more  even, 
beak  less  fre- 
quently seen. 


[  Whole     grain    still 
[      smoother  and 

t_     more  regular. 

f  Grains  often  broad 
I      and  reniform. 

Grains  narrower  and 
[     more  uniform. 


Hilum  similar,  but 
less  apparent. 


Hilum  similar,  but 
still  less  marked. 


Potato  ;    British 
arrowroot. 


Tons  -  les  -  mois 
{Canna)  ar- 
rowroot. 

Curcuma  arrow- 
root. 

Bermuda  {Mar- 
anta) arrow- 
root. 

St.  Vincent  ar- 
rovTTOot. 


C. — Contour  ( 
round.       "( 


Hilum. 
central. 


Vol.  I.— 18 


Form  lenticular. 


[  Form  spherical.         j 


Hilum  cleft-like, 
puckered,  irregu- 
lar. 

Hilum  less  puckered 
and  more  regular. 

f  Surface    convex  at 
I      the  hilum.  Grains 
I      large  and  minute 
1      only. 
Surface  depressed  at 
the  hilum.  Grains 
large,       medium- 
sized,  and  minute. 
Hilum  often  deeply 
fissured,  star-like. 


Natal  arrowroot. 


Bean  starch. 


Pea  starch. 


Wheat  starch. 


Barley  starch. 


Rye  starch. 


274 


PRACTICAL    HYGIENE. 


n.  Starches  with  the  grains  facetted  by  original  juxtaposition  in  the 
cell  cavity.     Hilum  central. 


f  Grains   very   large,   with  a 
central  sinus  or  cavernous 
antrum. 
(Rings  sinuous,  irregular. ) 


(Hilum.    often 
cavernous. 

in  the  cluster.  r  n     •  ^^ 

I  Hilum      stel-    ^^^'^'^^  ^'^^^\ 
j      1   .  -l      (Like  Tapioca  without 


I  Grains  small. 

I,         (Sago  in  miniature. ) 


B. — Altogether  facetted. 


f  Hilum 
late. 


Btel- 


Hilum  incon- 
spicuous. 


preparation.) 

Grains  small. 

(Discoidal  with  facetted 
margin. 


Grains 
minute. 


fin  rounded  glo- 
meruli or  com- 
pound  grains, 

J    and  free  in  the 
cells. 
Closely  packed    Rice, 
in     the     cells, 
and  fixed. 


Tapioca. 


Rio  arrowroot. 


Maize. 


Oats. 


Sub-Section  IV. — Sugar. 

Choice  and  Examination. — The  sugar  should  be  more  or  less  white, 
crystalline,  not  evidently  moist  to  the  touch,  and  should  dissolve  entirely 
in  water,  or  leave  merel}^  small  fragments,  which  on  examination  with  the 
microscope  will  be  found  to  be  bits  of  cane.  The  whiter  the  qualit;ji  the 
less  is  the  percentage  of  water,  which  varies  in  different  kinds  of  sugar, 
from  about  .25  per  cent,  (in  the  finest  sugar)  to  9  or  even  10  per  cent,  (in 
the  coarser  brown  sugars).  Most  of  the  sugar  now  sold  is  very  good  and 
pure. 

The  unpurified  sugars  contain  albuminous  matters  which  decompose, 
and  a  sort  of  fermentation  occvu's.  Acarus,  or  the  sugar-mite,  is  usually 
found  in  such  sugar,  which  is  not  known  to  be  hurtful.  Fungi  also  are 
very  frequently  present. 


Method  of  Examination. 

1.  Determine  physical  characters  of  color,  amount  of  crystallization, 
etc. 

2.  Dissolve  in  cold  water  ;  fragments  of  cane,  starch,  sand,  gypsum,  cal- 
cium phosphate  are  left  behind  ;  test  with  iodine  for  starch.  The  best  way 
is  to  dis.solve  under  the  microscope,  as  all  adulterations  are  then  at  once 
detected. 

3.  Determine  percentage  of  water  by  drying  thoroughly  10  grammes, 
and  again  weighing. 

4.  Excess  of  glucose  (a  little  is  always  present)  is  detected  by  the  large 
immediate  action  on  the  copper  solution. 


QUALITY,    CHOICE,    AND    COOKINa    OF    FOOD.  275 

SECTION  X. 

SUCCULENT  VEGETABLES. 

Almost  all  other  vegetables  (except  potatoes)  are  used,  not  so  much  on 
account  of  nutritive  qualities,  as  for  the  supply  of  salts  ;  some  of  them,  how- 
ever, contain  very  digestible  starch  and  sugar,  or  other  substances,  such  as 
pectin  or  asparagin,  or  pecuhar  oils  which  act  as  condiments,  as  in  onions. 

Sub-Section  I. — Potatoes  (Solanuvi  tuberosum). 

The  potato  contains  only  a  small  amount  of  nitrogenous  matter,  and 
hardly  any  fat.  Its  ash  is  also  poor  in  potash  and  phosphoric  acid.  But 
its  starch  is  very  digestible,  and  it  contains  a  large  quantity  of  vegetable  acids 
and  their  salts  (malates?  tartrates?  citrates),  which  form  carbonates  on 
incineration.  The  juice  is  acid,  and  there  is  no  better  anti-scorbutic.  The 
acids  are  combined  with  potash,  soda,  and  lime. 

As  the  amount  of  salts  is  small,  and  that  of  water  large,  at  least  8  to  12 
ounces  of  potatoes  should  be  taken  daily  if  no  other  vegetables  are  eaten 
(=8  ounces  at  1  per  cent,  of  salts  contain  35  grains  ;  at  1.5  per  cent.  =52.5 
grains). 

Choice. — Potatoes  should  be  of  good  size,  firm,  cut  with  some  resistance, 
and  present  no  evidence  of  disease  or  fungi. 

A  still  better  judgment  may  be  formed  by  taking  the  specific  gravity, 
and  using  the  following  tables  :  Multiply  the  specific  gravity  by  the  factor 
opposite  it,  and  divide  by  1,000  ;  the  result  is  the  percentage  of  solids  : — 


Specific  gravity, 
between 

Factor. 

Specific  gravity, 
between 

Facte 

1061-1068 

16 

1105-1109 

24 

1069-1074 

18 

1110-1114 

26 

1075-1082 

20 

1115-1119 

27 

1083-1104 

22 

1120-1129 

28 

If  the  starch  alone  is  to  be  determined,  deduct  7  from  the  factor,  and 
proceed  as  before,  the  result  is  the  percentage  of  starch. 
If  the  specific  gravity  of  the  potato  is — 

Below  1068,  the  quality  is  very  bad. 

Between  1068-1082,  "  inferior. 

Between  1082-1105,  "  rather  poor. 

Above  1105,  "  good. 

Above  1110,  "  best. 

As,  however,  the  medical  officer  will  seldom  have  an  hydrometer  '  which 
will  give  so  high  a  specific  gravity',  and  must  work,  therefore,  with  a 
common  urinometer,  the  following  plan  must  be  adopted  : — Take  a  sufficient 
quantity  of  water,  and  dissolve  in  it  ^  an  ounce  or  an  ounce  of  salt,  and 
take  the  specific  gravity  ;  then  add  another  ^  ounce  or  ounce,  and  take 
again  the  specific  gravity  ;  do  this  two  or  three  times,  so  as  to  get  the  in- 
crease of  specific  gravity  for  each  addition  of  a  known  quantity  of  salt ;  then 
add  salt  enough  to  bring  the  specific  gravity  to  the  desired  amount.  This 
is,  of  course,  not  quite  accurate,  but  in  the  absence  of  proper  instruments 
it  is  the  only  plan  that  seems  feasible. 

Cooking  of  Potatoes. — The  skins  should  not  be  taken  off,  or  a  large 
amount  of  salts  passes  into  the  water ;  using  salt  water  is  a  good  plan,  as 

'  Baum  i's  or  Twaddell's  hydrometers  are  the  best  for  the  purpose. 


276  PRACTICAL    HYGIENE. 

fewer  of  the  salts  then  pass  out.  The  boihng  must  be  complete,  as  the 
starch-grams  are  otherwise  undigested,  and  it  must  be  slow,  else  the  cellu- 
lose and  albuminates  are  hard.  Steaming  potatoes  is  by  far  the  best  plan  ; 
the  heat  must  be  moderate  ;  the  steam  penetrates  everywhere,  and  there  is 
no  loss  of  salts. 

Preservation  of  Potatoes. — Sugar,  in  the  form  of  molasses,  is  the  best 
plan  on  a  large  scale  ;  a  cask  is  filled  with  altei-nate  strata  of  molasses  and 
peeled  and  sliced  jootatoes.  On  a  small  scale,  boiling  the  potatoes  for  a  few 
minutes  wiU  keep  them  for  some  time.  Free  exposure  to  air,  turning  the 
potatoes  over  and  at  once  removing  those  that  are  bad,  are  useful  plans. ' 

The  preserved  jjotatoes  are  sliced,  dried,  and  granulated,  and  when  well 
prepared,  are  extremely  usefid. 

The  Sweet  Potato  and  the  Yam  are  somewhat  similar  to  the  ordinary 
potato,  and  form  good  substitutes  Avhen  potatoes  cannot  be  obtained. 

Sue-Section  II. — Other  Vegetables. 

The  composition  of  CaiTots  and  Cabbage  has  been  already  given.  The 
composition  of  the  other  kinds  of  vegetables  is  similar. 

Some  vegetables  contain  special  ingredients,  such  as  asj^aragin  in 
asparagus  (a  small  amount  is  also  contained  in  potatoes),  wax,  pectin,  which 
is  a  little  more  oxidized  than  starch  or  sugar ;  or  pecuUar  oils  and  savory 
or  odoriferous  matters. 

On  account  of  its  volatile  oils,  the  onion  tribe  is  lax'gely  used,  and  is  a 
capital  condiment,  and  has  an  effect  as  an  anti-scorbutic.  It  contains  some 
citrate  of  calcium. 

There  are  many  vegetables  which  can  be  employed  as  anti-scorbutics 
besides  potatoes,  onions,  and  green  vegetables.  The  wild  artichoke  and 
Agave  americana  (cactus)  are  both  excellent  anti-scorbutics,  and  the  latter 
is  said  to  be  better  than  Hme-juice.  Sorrel,  and  in  a  less  degree  scurvy- 
grass  and  mustard  and  cress,  are  useful.  In  New  Mexico,  a  salad  made  of 
the  "  lamb's  quarter"  {Chenojjodiuin  album)  has  been  found  very  useful.'^ 

In  war  almost  any  kind  of  vegetables  may  be  used  rather  than  that  the 
troops  should  be  left  without  such  food.  In  one  of  the  Caftre  wars,  an 
African  corps  kept  free  from  scurvy  by  using  a  sort  of  grass  (?)  in  their  soup. 

The  dried  vegetables,  and  especially  the  dried  potato,  have  consider- 
able anti-scorbutic  powers  (Armstrong).^  The  dandelion  was  largely  used 
in  the  French  army  in  the  Crimean  war.  The  American  Indians  jDut  up 
for  winter  quantities  of  dried  plums,  buffalo  berries,  and  choke  berries, 
and  thus  escape  scurvy.^ 

If  vegetables  cannot  be  procured,  citric  acid,  or  citrate,  tai'trate,  and 
lactate  of  potassium  should  be  given.     These  can  be  carried  as  lozenges. 


'  In  the  Crimean  war  there  was  a  considerable  loss  of  potatoes  sent  up  to  Balaklava, 
and  at  a  time  wlien  the  men  were  most  in  need  of  them.  The  addition  of  sugar  to  the 
raw  potatoes  might  have  been  made. 

2  Mil.  Med.  and  Surg.  Essays  prepared  for  the  U.  S.  Sanitary  Com.,  1864,  p.  202. 

^  Naval  Hygiene,  p.  112.  In  the  American  war,  however,  the  anti  scorbutic  efi'ects 
of  the  dried  vegetables  were  not  foiand  to  be  very  great.  I  found  that,  in  a  sound  raw 
potato,  the  amount  of  free  and  combined  acid  (reckoned  as  citric)  was  0.4503  per  cent.  ; 
and  that  in  the  preserved  potato  used  in  the  Arctic  Expedition  (187.5-76)  it  was  1.085  ; 
or  in  the  ratio  of  1  to  2.4.  From  this  we  find  that  7  ounces  of  the  preserved  potato 
contained  the  equivalent  of  3H  grains  of  citric  acid,  or  one  ounce  of  navy  lime-juice. 
The  ration  usually  issued  (2  to  4  ounces)  is,  therefore,  too  small,  unless  other  anti- 
scorbutics be  given.  (See  Report  of  Committee  on  Scurvy,  Appendix,  xiii.,  365.)— 
[F.  deC] 

*  Hamilton's  Mil.  Surg.,  p.  212. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  277 


SECTION  XI. 

COW'S  MILK. 

A  cow  gives  very  variable  quantities  of  milk,  according  to  food  and 
race,  and  age  of  the  calf  ;  perhaps  20  to  25  pints  in  twenty-four  hours  is 
the  average  for  the  j'ear,  but  with  poor  feeding  it  will  fall  much  below 
this  ;  occasionally  a  cow,  soon  after  calving,  will  give  50  pints,  but  this  is 
not  common.     A  goat  will  give  6  to  8  pints. 

Sub-Section  I. — Milk  as  an  Akticle  or  Diet. 

Milk  contains  all  the  four  classes  of  aliment  essential  to  health.  Being 
intended  especially  for  feeding  during  growth,  the  proportions  of  nitro- 
genous substances  and  fat,  as  compared  to  sugar,  are  large. 

For  the  average  composition  of  good  milk,  see  table,  p.  212. 

In  addition  to  casein,  a  small  quantity  of  time  albumen  remains  in  so- 
lution after  the  casein  has  been  thrown  down  ;  and  there  is  also,  according 
to  Millon,'  another  albuminoid  substance,  which  he  calls  lactoprotein.  In 
cow's  milk  the  amount  of  albumen  is  said  to  be  5.25  grammes  iper  litre  ; 
the  amount  of  lactoprotein  is  much  smaller,  but  has  not  been  precisely 
determined.'^ 

The  amount  of  salts  varies  from  .5  to  .8  per  cent.,  but  seldom,  if  ever, 
exceeds  1  per  cent.  The  usual  average  is  about  0.7  to  0.75.  This  is  of 
importance  in  the  detection  of  adulteration  by  salts.  In  poor  milk  the 
salts  may  be  as  low  as  .3  -per  cent. 

Milk  is  very  largely'  used  in  some  countries,  especially  in  India  and 
Tartary,  where  the  use  of  the  koumiss,  prepared  from  mare's  milk,  has 
been  supposed  to  prevent  phthisis.  This  fermented  drink  is  now  also  pre- 
pared from  cow's  milk,  and  largely  used  in  this  country. 

Milk  varies  in  quantity  and  composition  according  to — 1st,  the  age  of 
cow  ;  2d,  the  number  of  pregnancies,  less  milk  being  given  with  the  first 
calf  (Hassall)  ;  3d,  to  the  age  of  the  calf,  being  at  first  largely  mixed  with 
colostrum  ;  4th,  to  the  kind  of  feeding,  beet  and  carrot  augmenting  the 
sugar  ; '  5th,  and  remarkably  according  to  the  race,  some  coavs  giving  more 
fat  (as  Alderneys),  others  more  casein  (as  the  long-horns).  The  last 
portion  of  the  milk  given  in  milking  is  richest  in  cream  (Hassall). 

Wanklyn  states  that  the  proportion  of  solids  is  more  stable,  and  never 
falls  below  11.5  per  cent.  In  Sweden,  the  milk  of  a  herd  of  cows  being 
analyzed  daily  for  a  year,  the  solids  never  fell  to  11.5,  and  only  4  times  to 
12  per  cent.  (Wanklyn). 

The  goat's  milk  is  rather  richer  in  solids  (14.4  per  cent. — Payen),  and 
contains  also  a  peculiar  smelling  acid  (hircin  or  hircic  acid).  Specific 
gravity,  1032-1036. 

Ass's  milk  is  rather  poorer  in  solids  (9.5  per  cent. — Payen).  This  is 
owing  to  a  small  amount  of  casein  and  fat ;  it  is  rich  in  lactin.  The  speci- 
fic gravity  varies  from  1023  to  1035. 

'  Comptes  Rendus,  t.  lix  ,  p.  396. 

^  Commaille  (Comptes  Rendus,  November  9,  1868)  found  creatinin  in  some  putrid 
milk,  derived,  he  tliinks,  from  creatin.  He  admits  also,  after  Lefort,  that  there  is  a 
little  urea.     He  found  also  some  organic  acids,  the  natxire  of  which  is  doubtful. 

^  Some  observations  of  Dr.  Subbotin  (Virchow's  Archiv,  Band  xxxvi.,  p.  561)  on  the 
milk  of  bitches,  show  a  marked  effect  by  food  ;  the  fat  was  much  increased  by  meat ; 
the  casein  was  less  affected ;  a  large  quantity  of  fat  greatly  lessened  the  secretion. 


278  PEACTICAL    HYGIENE. 

The  buffalo  milk  is  richer  in  all  the  ingredients. 

Taking  the  total  solids  of  cow's  milk  at  13.2  per  cent,  (specific  gravity 
1030),  one  pint  (20  ounces)  will  contain,  in  round  numbers — 

Casein 350  grains. 

Fat  324       " 

Lactin 420       " 

Salts 66       " 

Total 1,160 

or  more  than  2^  ounces  avoir,  of  water-free  food. 

To  give  23  ounces  of  water-free  food  (or  one  day's  allowance  for  an 
adult),  about  9  pints  of  milk,  of  specific  gravity  1030,  are  necessary.  For 
an  adult  this  would  be  far  too  much  water,  and  the  albuminates  and  fat 
would  be  in  great  excess.  But  for  the  rapid  fonnation  and  elimination  of 
the  young,  the  water  and  fat  are  essential.  It  is  a  question  whether,  in  old 
age,  large  quantities  of  milk  might  not  be  a  remedy  for  failures  in  tissue 
formation  and  elimination.' 

Sub-Section  II. — Axteeations  of  IVIilk. 

The  cream  rises  in  from  four  to  eight  hours  ;  it  is  hastened  by  adding 
warm  water,  but  its  quantity  is  not  increased  (Hassall).  A  new  apparatus 
has  been  recently  introduced  by  which  the  cream  is  obtained  by  agitation 
in  a  few  minutes. 

Milk  alters  on  standing  ;  it  absorbs  oxygen,  and  gives  off  C0„  ;  placed 
in  contact  with  a  volume  of  air  greater  than  its  own  bulk,  it  absorbs  all  the 
oxygen  in  three  or  four  days  (Hoppe-Seyler).  The  C0„  is  formed  at  the 
expense  of  the  organic  matter  (probalDly  casein — HojDpe-Seyler),  and  bodies 
richer  in  carbon  and  hydrogen  are  formed  ;  fat  increases  in  amount,  and 
oxalic  acid  is  said  to  be  formed. 

Subsequently  lactic  acid  is  formed  in  large  quantities  from  the  lactin  ; 
the  milk  becomes  turbid,  and  finally  casein  is  deposited.  The  cream  which 
had  preAdously  risen  to  the  surface  disappeai'S. 

Milk  given  by  Diseased  Cows. 

Milk  from  diseased  animals  soon  decomposes  ;  it  may  contain  colos- 
trum, or  heaps  of  gi'anules  collected  in  roundish  masses,  pus-cells,  or  epi- 
thelium, and  occasionally  blood.  It  then  soon  becomes  acid,  and  the 
microscope  usuaDy  detects  abnormal  cell-forms,  and  casts  of  the  lacteal 
tubes. 

In  cattle  plague,  it  is  said  by  Hvisson  that  the  lactin  lessens,  while  the 
nitrogenous  matters  are  increased,  and  blood  and  aggregated  granules  are 
seen  under  the  microscoi^e.  In  foot-and-mouth  disease  the  specific  gra\*ity 
rapidly  falls  (from  1030  to  1024),  though  this  is  not  invariable  ;  there  are 
gi-anular  heaps  under  the  microscope,  and  often  blood  or  pus-cells  ;  Mr. 
M'Bride  says  pus  can  be  found  for  a  month  after  recovery.  Bacteria  and 
small  ovid  and  round  cells  are  common.'^  The  milk  sometimes  coagulates 
on  boiling. 

'  This  was  a  point  debated  by  Galen,  so  old  is  this  suggestion.  It  is  still  undecided. 
Some  old  persons  cannot  digest  milk. 

"  Figures  of  the  microscopical  appearances  are  given  in  some  very  good  papers  on  the 
subject  in  the  British  Medical  Journal,  October,  1869. 


QUALITY,    CHOICE,    AND    COOKING    OF   FOOD. 


279 


Sub-Section  m. — Examination  of  Milk. 

This  is  intended  first  to  determine  the  quaUty.  Put  some  of  the  milk 
in  a  long  glass,  which  is  graduated  to  100  parts  ;  a  100  centimetre  or  Htre 
measure  will  do,  or  a  glass  may  be  specially  prepared  by  simply  marking 
with  compasses  100  equal  lines  on  a  piece  of  papei',  and  gumming  it  on 
the  glass.  Allow  it  to  stand  for  twenty-four  houi's  in  a  cupboard  secured 
from  currents  of  air.  By  this  means  the  percentage  of  cream  can  be  seen, 
and  the  presence  of  deposit,  if  any,  observed.  There  should  be  no 
deposit  till  the  milk  decomposes  ;  if  there  be,  it  is  probably  chalk  or 
starch. 

The  cream  should  be  from  y^-Q-ths  to  ^y^^ths  ;  it  is  generally  about 
jfoths;  in  the  milk  of  Alderney  cows  it  will  reach  y^^'^ths  or  -^^/yths. 
The  time  of  year  (as  influencing  pasture),  and  the  breed,  should  be  con- 
sidered. 

While  this  is  going  on,  determine — 

1.  The  Physical  Characters. — Placed  in  a  narrow  glass,  the  milk 
should  be  quite  opaque,  of  full  white  color,  without  deposit,  without 
peculiar  smell  or  taste.  When  boiled  it  should  not  change  in  appear- 
ance. 

2.  Reaction. — Reaction  should  be  slightly  acid  or  neutral,  or  very  feebly 
alkaline  ;  if  strongly  alkaline,  either  the  cow  is  diseased  (?)  or  there  is 
much  colostrum,  or  sodium  carbonate  has  been  added. 

3.  Specific  Gravity. — The  specific  gravity  varies  from  1026  to  1035, 
A  very  large  quantity  of  cream  lowers  it,  and  after  the  cream  is  removed, 
the  specific  gravity  may  rise,  under  ordinary  circumstances,  about  2°.' 
The  average  specific  gravity  of  unskimmed  milk  may  be  taken  as  1030  at 
60°  Fahr.,  and  the  range  is  nearly  4°  above  and  below  the  mean.  It  varies 
with  temperature,  so  that  in  the  tropics  the  medical  officer  will  have  to 
allow  for  this  difi'erence.  The  following  are  the  relative  degrees  of  a  milk 
that  show^s  1030  at  60°  Fahr.,  and  1031  at  39°  Fahr.  (maximum  density- 
point  of  water) : — 


Temperature  of  Milk,  39°  F.  =  1031 
"  60°  F.  =1030 
"       70°F.  =  1029 


Temperature  of  Milk,  80°  F.  =1027.5 
"  90°  F.  =1025.8 
"     100°  P.  =  1024.0 


The  addition  of  water  may  be  detected  by  the  specific  gravity.  At  60° 
Fahr.  there  is  a  loss  of  3°  for  every  10  per  cent,  of  water  added.  No 
doubt  the  method  is  not  perfect,  but  its  ease  of  application  strongly  rec- 
ommends it. 

4.  Examine  Chemically  for  the  Amount  of  the  Different  Constituents. 

(a)  Total  solids. — Evaporate  a  known  quantity  to  dryness  in  a  flat  and 
shallow  dish,  and  weigh.     Calculate  the  percentage.     The  heat  must  not 


'  Dr.  Davies  records  a  case  where  the  specific  gravity  was  1024.6  ;  there  was  17  per 
cent,  of  cream,  and  the  solids  were  16.25.  A  case  of  this  kind  cannot  mislead  if  the 
amount  of  cream  is  determined.  Davies  recommends  that  the  specific  gravity  of  the 
whey  sliould  be  taken  ;  he  says  it  is  very  constant  between  1026  and  1028. 

In  one  sample  I  examined  the  specific  gravity  was  1020,  and  the  cream  -.^^rj  the 
specific  gravity  of  the  skimmed  milk  was  1028.9.  Another  sample  gave — specific  grav- 
ity 1017.6,  cream  -,'^oHi  ;  specific  gravity  of  skimmed  milk,  1082.75.  Another  sample 
(which  piirported  to  be  the  same  as  the  last)  gave  a  specific  gravity  of  1018.84,  but  the 
cream  was  only  jinr ;  in  this  case  the  greater  part  of  the  cream  had  been  removed,  and 
about  50  per  cent,  of  water  added.  —  (F.  de  C.) 


280 


PRACTICAL    HYGIENE. 


exceed  212°  Fahr.  (100°  C),  and  should  be  continued  for  at  least  three 
hours.     There  should  be  no  charring. 

(b)  A.-<h. — Incinerate  the  dried  solids,  and  weigh. 

(c)  Determine  the  amount  of  fai.  This  is  best  done  by  means  of  the 
fat  apparatus  of  Gei'ber  or  of  Soxhlets,  in  which  ether  is  made  to  pass  re- 
peatedly^ through  the  di'ied  sohds  and  caxiies  with  it  the  fat.  The  ether  is 
then  evaporated  and  the  fat  weighed.  An  approximate  result  can  be 
given  by  the  emplo^nnent  of  an  insti-ument  called  a  lactoscope,  which 
measvu'es  the  degree  of  transparency.  The  lactoscope  of  Donne  has  been 
improved  by  Yogel,  as  a  simple  plan  for  ascertaining  the  amount  of  fat  in 
milk.' 


'  Vogel's  instrument  consists  of  a  little  cup,  formed  by  two  parallel  pieces  of  glass, 
distant  ^  a  centimetre  (=  .1908  inch,  say  -liths  of  an  inch)  from  each  other,  and 
closed  everywhere  except  at  the  top,  so  as  to  form  a  little  vessel  ;  a  glat^s  graduated  to 
100  CO.,  and  a  little  pipette,  which  is  divided  to  Jt  C.C.,  are  also  required.  Water  (ICO 
C.C.)  is  placed  in  the  measure,  and  2  or  8  C.C.  of  milk  (which  shoiild  be  at  first  agita- 
ted, so  as  to  mix  any  separate  cream)  are  added  to  it.  The  parallel  glass  cup  is  then 
filled  with  this  diluted  milk,  and  a  candle  placed  about  one  metre  from  the  eye 
(=  89.37  inches)  is  looked  at  in  a  rather  darkened  room  ;  if  the  tlame  of  the  candle  is 
seen,  the  milk  is  poured  back  into  the  large  measure  ;  more  milk  is  added  to  it,  and  it 
is  poured  again  into  the  parallel  glass,  and  the  light  is  again  looked  at ;  the  experi- 
ment ends  when  the  contour  of  the  light  is  completely  obscured.  The  candle  should 
be  a  good  one,  but  the  difference  in  the  amount  of  light  is  not  material.  Tlie  percent- 
age amount  of  fat  in  the  milk  is  then  calculated  by  the  following  formula  (which  has 
been  determined  by  a  comparison  of  the  results  of  the  instrument,  and  of  chemical 
analysis) :  x  being  the  quantity  of  fat  sought,  and  m  the  number  of  C.C.  of  milk  which 
added  to  the  100  C.C.  of  water  suffice  to  obscure  the  light. 

X  = h  0.23, 

m 

If,  for  example,  8  C.C.  of  milk,  added  to  the  100  of  water,  were  sufficient  to  obscure 
the  light,  the  percentage  of  fat  is  : 

'28  2 
X  =^~-  +  .23  =  7.96  per  cent, 
o 

From  this  formula  the  following  table  has  been  calculated,  which  enables  us  to 
read  off  at  once  the  percentage  of  fat : — 


C.C. 

Milk. 


Per  cent, 
of  Fat  in 
the  Milk. 


1  to  100  of  water  obscures  the  light=23.48 
1.5  "  "  15.69 

2  "  "  11.83 
2.5  "  "  9.51 

3  "  "  7.96 
3.5  "  "  6.86 

4  "  "  6.08 
4.5  "  "  5.38 

5  "  "  4.87 
5.5  "  "  4.45 

6  "  "  4.09 
6.5  "  "  8.80 

7  "  "  3.54 
7.5  "  "  3.32 

8  '«  "  3.13 
8.5  "  "  2.96 

9  "  "  2.80 
9.5  "  •«  2.67 

10  "  "  2.55 

11  "  "  2.43 

12  "  "  2.16 

13  "  "  2.01 


C.C. 

Milk. 


Per  cent, 
of  Flit  in 
the  Milk. 


14  to  100  of  water  obscures  the  light =1.^ 


15 
16 
17 
18 
19 
20 
22 
24 
26 
28 
30 
35 
40 
45 
50 
55 
60 
70 
80 
90 
100 


1.78 
1.68 
1.60 
1.52 
1.45 
1.39 
1.28 
1.19 
1.12 
1.06 
1.00 
0.89 
0.81 
0.74 
0.69 
0.04 
0.61 
0.56 
0..52 
0.49 
0.46 


If,  for  example,  1  cubic  centimetre  of  milk  to  100  of  water  obscures  the  light,  the 


QUALITY,    CHOICE,    AND    COOKITfG    OF    FOOD.  281 

(d)  Cafiein. — Take  a  weiglied  or  measured  quantity  ;  add  two  or  thi-ee 
drops  of  acetic  acid,  aud  boil.  Add  a  good  deal  of  water  ;  allow  to  stand 
for  twenty -four  hours  ;  pour  off  the  supernatant  fluid  ;  wash  the  precipitate 
well  with  ether  at  80^  ;  dry,  and  weigh.  Calculate  the  percentage.  It  is 
difficult  to  free  it  entirely  from  fat.  Wanklyn  recommends  the  albumi- 
noid ammonia  process,  as  in  the  case  of  nitrogenous  matter  in  water :  1 
part  of  casein  yielding  0.065  of  ammonia.  The  determination  is  not  often 
required. 

(e)  Determine  the  amount  of  lactin  by  the  saccharometer,  or  by  the 
standard  copper  solution.'  '  To  do  this,  take  10  C.C.  of  milk,  add  a  few 
drops  of  acetic  acid,  and  warm — this  coagulates  the  casein  with  the  fat ; 
then  make  uj)  to  100  C.C.  with  distilled  water,  filter,  and  put  the  filtered 
whey  (which  ought  to  be  as  clear  as  possible)  into  a  burette.  Take  10 
C.C.  of  standard  copper  solution,  put  it  in  a  porcelain  dish,  and  add  20  or 
30  C.C.  of  distilled  water  ;  boil ;  as  soon  as  it  is  in  brisk  ebullition  drop 
in  the  whey  from  the  biu-ette  ;  take  care  that  the  liquid  is  boiling  all  the 
time  ;  continue  the  process  until  the  copper  is  all  reduced  to  red  suboxide 
and  no  blue  color  remains  in  the  supernatant  liquid  ;  but  stop  before  any 
yellow  color  appears.  Read  off  the  amount  of  whey  used,  and  divide  by 
10  ;  the  result  is  the  amount  of  milk  which  exactly  decomposes  10  C.C.  of 
the  copper  solution.  The  10  C.C.  of  the  copper  solution  are  equal  to 
.0667  gramme  of  lactin.  The  amount  of  lactin  in  the  10  C.C.  of  milk  is 
then  known  by  a  simple  rule  of  three  ;  and  the  amount  in  100  C.C.  of  milk 
is  at  once  obtained  by  shifting  the  decimal  point  one  figure  to  the  right. 

Example  : — 15  C.C.  of  diluted  whey  were  required  to  reduce  the  10  C.C. 

15 

of  copper  solution ;  vTv  =  1.5   the  amount  of  original  milk;    0.0667    -^ 

1.5  =  0.0445  gramme  of  lactin  in  1  C.C. ;  therefore  0.0445  x  100  =  4.45 
per  cent. 

5.  Examine  the  Milk  microscopically. — The  only  constituents  of  milk 
are  the  round  oil  globules  of  various  sizes  in  an  envelope  and  a  little  epi- 
thelium. The  abnormal  constituents  are  epithelium  in  large  amount,  pus, 
conglomerate  masses,  and  casts  of  the  lacteal  tubules.  The  added  ingre- 
dients may  be  starch-grains,  portions  of  seeds,  and  chalk  (round  and  often 
highly  refracting  bodies,  with  often  a  marked  double  outline,  and  at  once 
disappearing  in  acid).  Colostrum,  occurring  for  three  to  eight  days  after 
the  birth  of  the  calf,  is  composed  of  agglomerations  of  fat  vesicles  united 
by  a  granular  matter.  Infuaoria  are  sometimes  found  in  milk,  and  fungi 
(Oidium  lactis  and  Penicillium)  are  so  almost  invariably,  if  the  milk  has 
been  kept.^ 

percentage  of  fat  is  23.48  ;  if  8  cubic  centimetres,  added  to  100  of  water,  are  needed  to 
obscure  the  light,  the  percentage  is  8. 13,  etc.  ;  so  that  in  four  or  five  minutes  an  ap- 
proximate analysis  of  the  milk  is  made,  as  far  as  the  fat  is  concerned. 
Wanklyn  states  that  0.2  gramme  of  fat  equal  1  gramme  of  cream, 
'  See  Appendix  A.,  Vol.  II.  Wanklyn  recommends  dissolving  out  the  lactin  from 
the  solids  (after  the  fat  is  removed)  by  means  of  alcohol,  evaporating  and  weighing  ; 
then  incinerating  •,  the  difference  gives  the  amount  of  lactin.  This  seems  on  the  whole 
less  convenient  for  the  medical  ofiicer  than  the  copper  test.  Macnamara  (Indian 
Medical  Gazette,  1873)  uses  alcohol  for  extracting  the  lactin,  but  determines  it  by 
Fehling's  copper  test. 

■^  Dr.  Willard  of  Cornell  University  notes  the  experience  of  Professor  Law,  who  ob- 
served a  peculiar  ropy  material  in  milk,  and  traced  it  to  cows  drinking  stagnant  water 
containing  organisms  similar  to  those  found  in  the  milk  ;  a  drop  of  this  water,  put  into 
good  milk,  soon  developed  these  organisms.  The  cows  were  feverish. — (Dr.  John  Ogle, 
Journal  of  the  Agricultural  Society,  November  15,  1872  ;  Lancet,  October  11,  1873.) 


282  PRACTICAL    HYGIENE. 


Scheme  for  a  Short  Examination. 

As  a  medical  of&cer  is  constantly  called  upon  to  examine  milk,  and  will 
seldom  have  time  to  go  thoroughly  into  all  the  points  just  noted,  the  fol- 
lowing short  scheme  will  be  useful : — 

1.  Put  some  milk  into  the  long  gi-aduated  glass  for  deposit,  and  for 
determining  percentage  of  cream.' 

2.  Take  ])hysical  characters,  reaction,  and  specific  gravity.  Take  spe- 
cific gra\ity  of  the  whey,  if  there  be  time  to  do  this. 

3.  Determine  fat  by  Yogel's  milk-test.' 

4.  Examine  the  milk  with  the  microscope.  The  comparison  of  the  spe- 
cific gi-avity,  and  the  amount  of  cream  which  rises,  or  of  fat,  will  be  found 
to  give,  in  conjunction  with  the  physical  characters,  a  very  good  idea  of 
the  quality  of  the  milk. 

Sub-Section  IV. — Preservation  of  Milk. 

1.  Boiled,  the  bottle  quite  filled,  and  at  once  corked  up  and  well 
sealed,  the  milk  lessens  in  bulk,  and  a  vacuum  is  formed  above.  It  will 
keep  for  some  time.  A  little  sugar  aids  the  presei-^-ation.  If  the  heat  is 
can'ied  in  a  close  vessel  to  250°  Fahr.,  the  milk  is  preserved  for  a  long- 
time, even  for  years ;  the  butter  may  separate,  but  this  is  of  no  con- 
sequence. 

2.  Sulphur  dioxide  passed  through  it,  or  sodium  sulphite  added. 
This  may  be  done  after  boUing. 

3.  A  little  sodium  carbonate  and  sugar  added,  with  or  without  boiling. 
This  will  keep  for  ten  days  or  a  fortnight. 

4.  The  addition  of  salicylic  acid,  borax,  boracic  acid,  or  boroglyceride 
(Barif 's  patent). 

In  the  market  are- — milk  in  tins,  preserved  in  the  usual  way  by  exclu- 
sion of  air,  concentrated  milk  mixed  Avith  sugar,  and  desiccated  or  dried 
milk.  This  last  is  milk  carefully  dried  at  a  low  temperature,  with  a  little 
sugar.     Dissolved  in  Avater,  it  forms  an  excellent  milk. 

The  preserved  liquid  milk  often  has  the  butter  separated  ;  if  so,  it  may 
be  spread  on  bread.  It  is  not  easy  to  remix  it  with  milk,  but  it  is  said 
that  the  separation  may  be  prevented  by  adding  a  little  yolk  of  egg. 

Sub-Section  V. — Adulterations. 

1.  Water. — This  is  extremely  common,  and  is,  in  fact,  generally  the 
only  adulteration  ;  it  is  best  detected  by  specific  gravity  or  by  the  amount 
of  solids  by  evaporation.  Wanklyn  suggests  the  amount  of  ash  as  a  good 
test  of  watering  ;  the  normal  ash  being,  according  to  him,  about  0.73  per 

^  Macnamara  (Indian  Medical  Gazette,  1873)  finds  that  the  cream  is  not  very  useful 
in  India  as  a  test,  the  rapid  coagulation  of  the  milk  preventing  it  rising ;  similarly 
Vogel's  test  does  not  give  satisfactory  results.  It  would,  therefore,  be  necessary  to  de- 
termine the  constituents  by  the  chemical  methods  if  possible.  The  following  plan  may 
be  adopted :  Measure  out  carefully  two  portions  of  milk,  and  evaporate  both  to  dry- 
ness :  weigh  :  from  this  the  total  solids  may  be  obtained.  Then  incinerate  one  portion  : 
weigh  :  this  gives  the  ash.  Exhaust  the  other  M'ith  ether  in  Gerber's  or  Soxhlet's  ap- 
paratus: from  this  the  fat  vaay  be  obtained.  Exhaust  the  residue  with  alcohol ;  this 
gives  the  lactin,  which  may  be  determined  either  by  weighing  or  incineration,  or  by 
Fehling's  process  ;  weigh  the  residue,  then  incinerate  it,  and  weigh  again  :  the  differ- 
ence will  be  the  casein.  The  last  weighing  also  gives  a  controlling  determination  of  the 
ash. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  283 

cent.     In  this  case  the  calculation  would  be  as  follows : — Let  (a)  be  the 

100a 
observed  percentage  of  ash  and  (A)  the  normal  amount :  then  100— — j—  = 

100x.50_ 
per  cent,  of  water  added  :  let  (a)  =  .50,  and  A  =  .73  :  then  100— ^ — ■ — 

31.5  per  cent,  of  water  added.     In  a  similar  way  the  amount  of  "  solids  not 
fats  "  may  be  used  as  a  standard. 

2.  Starch,  dextrin,  or  gum,  to  conceal  the  thinness,  and  the  bluish 
color  produced  by  water.  Not  a  common  adulteration.  Add  iodine  at 
once  for  starch  ;  boil  with  a  drop  of  acetic  acid,  and  add  iodine  for  dex- 
trin, or  add  acetate,  of  lead  and  then  ammonia,  a  white  precipitate  falls. 

3.  Annatto  or  turmeric  is  added  to  give  color.  Liquor  potassae  at  once 
detects  turmeric. 

4.  Emulsions  of  seeds  (hemp  or  almond),  added  ;  this  is  uncommon. 
BoiL  The  albumen  of  the  seeds  coagulates ;  the  milk  will  not  mix  with 
tea.     Hemp  seed  gives  an  unpleasant  odor  to  the  milk  (Normandy). 

5.  Glijcerin  has  been  sometimes  met  with.  The  milk  will  be  sweeter 
than  usual,  and  there  will  be  a  difficulty,  if  not  impossibility,  in  drying 
the  solids  by  evaporation. 

6.  Chalk,  to  neutralize  acid,  and  to  give  thickness  and  color.  Let  it 
stand  for  deposit ;  collect  and  wash  deposit,  and  add  acetic  acid  and  water ; 
after  effervescence,  filter,  and  test  with  oxalate  of  ammonium. 

7.  Sodium  Carbonate. — Very  difficult  of  detection  unless  the  milk  be 
alkaline.  Determine  the  ash,  and  see  if  it  effervesces ;  if  so,  either  some 
carbonate  has  been  added,  or  if  the  sodium  have  united  Avith  lactic  acid, 
this  will  be  converted  into  carbonate,  and  enough  lactic  acid  to  give  an 
effervescing  ash  does  not  exist  in  good  milk. 

8.  Milk  is  often  boiled  to  preserve  it ;  it  may  then  take  up  from  the 
vessel  lead,  copper,  or  zinc,  if  these  metals  are  used. 

Cream  is  adulterated  or  made  with  magnesium  carbonate,  tragacanth, 
and  arrowroot.  The  microscope  detects  the  latter,  and  particles  of  magnesi- 
um carbonate  (round)  can  also  be  seen,  and  found  to  disappear  with  a  drop 
of  acid.     It  is  also  said  that  yolk  of  egg  is  added  both  to  cream  and  milk.' 

In  most  cases  of  falsification,  milk  is  toatered  or  creamed,  or  both  creamed 
and  loatered.  Watering  alone  is  detected  by  a  lowered  specific  gravity  and 
a  diminished  quantity  of  cream.  Creaming  alone  is  detected  by  a 
heightened  specific  gravity  and  a  diminished  quantity  of  cream.  "When 
both  are  resorted  to,  the  cream  will  be  small  in  amount,  but  the  specific 
gravity  may  be  normal.  When  a  quantitative  analysis  can  be  made, 
watering  alone  is  indicated  by  a  general  lowering  of  the  constituents, 
which,  however,  preserve  their  normal  jDroportions  to  each  other.  Cream- 
ing alone  is  indicated  by  a  lessened  amount  of  fat,  but  a  normal  amount 
of  everything  else,  except  total  solids.  Creaming  and  watering  may  be 
known  by  a  general  lowering  of  all  constituents,  but  the  deficiency  in  fat  will 
be  most  marked. 

Sub-Section  VI. — Effects  of  Bad  Mjxk. 

Professor  Mosler'^  has  directed  attention  to  the  poisonous  effects  of 
"  blue  milk  " ' — that  is  to  say,  milk  covered  with  a  layer  of  blue  substance, 

'  Mr.  Bottle,  Pharmaceutical  Journal,  February,  1873. 

^  Virchow's  ArcMv,  Band  xliii.,  p.  161  (1868). 

^  Blue  milk  is  given  by  feeding  cows  with  some  vegetable  substances,  as  Myosotis 
palustris,  Polygomim  aviculare  and  Fagopyrum,  Mercurialis  perennis,  and  other  plants 
(Hosier) ;  but  this  is  different  from  the  blue  color  referred  to  above. 


2S4  PRACTICAL    HYGIENE. 

which  is  in  fact  a  fungus,  either  Oiclium  lactis  or  PeniciUium,  which  seems 
to  have  the  power,  iu  certain  conditions,  of  causing  the  a2:)pearance  in  the 
milk  of  an  anihue-hke  substance. '  The  existence  of  this  form  of  fungus 
was  noted  by  Fuchs  as  long  ago  as  1861.  Milk  of  this  kind  gives  rise  to 
gastric  u-ritation  (tirst  noted  by  Steinhof)  ;  and,  in  four  cases  mentioned 
by  Mosler,  it  j^roduced  severe  febrile  gastritis. 

IVlilk  which  is  not  blue,  but  which  contains  large  quantities  of  Oidium, 
appears,  from  Hesshng's  observations,"  to  pi'oduce  many  dyspeptic  symp- 
toms, and  even  cholera-hke  attacks,  as  well  as  possibly  to  give  rise  to  some 
aphthous  affections  of  the  mouth  in  children. 

Milk  contaminated  with  pus  from  an  inflamed  udder,  or  an  abscess  on 
the  udder,  will  give  rise  to  stomatitis  in  children,  and  to  aphthae  on  the 
mucous  membrane  of  the  lips  and  giims.^ 

There  has  been  much  discussion  whether  the  milk  from  foot-and-mouth 
disease  in  cows  (Eczema  epizootica)  can  cause  affections  of  the  mouth,  or 
give  rise  in  human  beings  to  any  disease  similar  to  that  of  cattle.  Pigs 
can  certainly  get  the  disease  from  the  milk  of  the  cow  ;  sheep  and  hares, 
which  also  have  the  disease,  perhajDS  get  it  from  the  saliva  on  herbage. 
In  men  the  evidence  is  discordant,  and  in  a  great  measure  negative  ;^  still 
there  are  some  striking  cases,  which  seem  sufficient  to  prove  that  disease 
of  the  mouth  (ajjhthous  ulceration,  general  redness,  diphtheritic-like  coat- 
ing, swollen  tongue),  and  sometimes,  though  rarely,  an  affection  of  the 
feet  may  occur."  Some  positive  evidence  has  been  adduced  by  Professor 
M 'Bride, °  Gooding,'  Hislop,"  Latham, °  and  Briscoe."  It  is,  of  course, 
possible  that  some  pus  or  blood  from  abscesses  on  the  teat  or  udder  may 
have  ^ot  into  the  milk,  but  it  is  unlikely  that  this  should  have  been  over- 
looked. 

A  remarkable  outbreak,  which  took  j^lace  in  Aberdeen,  in  Apiil,  1881, 
has  been  recorded  by  Dr.  Beveiidge.  The  symptoms  were  febrile,  but 
anomalous,  and  their  cause  is  as  yet  unexplained.  The  cases  were  Ihnited 
to  the  area  of  a  particular  milk  supply,  88  per  cent,  of  the  families  using 
the  milk  being  attacked."  There  seems  reason  to  believe  that  bovine 
tuberculosis  maybe  communicated  to  man  through  milk.'" 

A  pecuhar  disease  has  several  times  prevailed  in  the  Western  States  of 

'  Erdmann  (Journal  fur  Prakt.  Chem.,  xcix.,  p.  385,  quoted  by  Mosler)  has  dis- 
covered tliat  vibrivnes  have  the  power  of  producing  aniline  coloring  matter  from  pro- 
tein substances. 

•^  Virchow's  Archiv,  Band  xxxv.,  p.  561.  See  also  Report  on  Hygiene,  Army  Med- 
ical Reports,  vol.  vi.,  p.  ;^85. 

"  See  a  good  case  by  Dr.  Fagan  (British  Med.  Journal,  November  13,  1869). 

*  See  Dr.  Thome's  paper  in  the  Report  of  the  Medical  Officer  to  the  Privy  Council, 
p.  294,  and  Mr.  Simon's  remarks  on  it,  p.  62.  Also  Report  on  Hygiene,  Army  Med. 
Blue  Book,  vol.  x. ,  p.  223.  Dr.  Lawson  Tait's  negative  evidence  against  it  is  exceed- 
ingly strong  (Medical  Times  and  Gazette,  October,  1869) ;  the  disease  was  all  round, 
and  the  milk  was  used,  yet  not  a  case  occurred  which  could  be  referred  to  it.  See  also 
Whitmore's  evidence  in  Marylebone  (British  Medical  Journal,  October,  1869). 

*  A  case  of  the  foot  being  involved  is  recorded  by  Mr.  Amyot  (Med.  Times  and  Ga- 
zette, November  4,  1871). 

"  Brit.  Med.  Journal,  November  13,  1869.  An  anonymous  writer  in  the  same 
journal,  September,  1869,  adduces  also  a  few  doubtful  cases  (p.  327),  though  his  evi- 
dence is  otherwise  negative. 

■=  Medical  Times  and  Gazette,  January,  1872. 

*  Edin.  Med.  Journal,  November,  1869. 
=  British  Medical  Journal,  Mav,  1872. 

'0  Ibid.,  October,  1872. 

"  Sanitary  Record,  vol.  ii.,  new  series,  p.  425. 

'-  On  Bovine  Tuberculosis  in  Man,  Creighton. 


QUALITY,    CHOICE,    AND    COOEHiTG    OP    FOOD.  285 

America,  which  is  caused  by  the  unboiled  (not  by  the  boiled)  milk  of  cows 
afifected  with  the  "trembles,"  which  is  supposed  to  be  produced  by  the 
cows  feeding  on  Rhus  Toxicodendron.  In  children  who  get  this  milk- 
sickness  there  is  extreme  weakness,  vomiting,  fall  in  bodily  temperature, 
swollen  and  dry  tongue,  and  constipation.  Boiling  aj)pears  to  remove  the 
hurtful  qualities  of  the  milk/  Cases  of  severe  diarrhoea  have  oceuiTed 
from  the  use  of  milk  from  goats  that  had  fed  on  Eujihorbium ;  this  has 
been  observed  at  Malta. 

]\Iilk  may  also  be  a  means  of  conveying  the  poisons  of  enteric  fever,  of 
scarlet  fevei',  and  of  diphtheria.  In  the  first,  it  has  probably  usually  arisen 
from  the  watering  of  the  milk  with  foul  water  containing  tbe  agent,  but  it 
may  possibly  have'in  some  cases  arisen  from  the  typhoid  effluvia  being  ab- 
sorbed by  the  milk,  as  in  the  case  at  Leeds.  The  scarlet  fever  and  diphtheria 
poisons  have  probably  got  into  the  milk  from  the  cuticle  or  throat  dis- 
charges of  persons  affected  with  those  diseases,  who  were  employed  in  the 
dairy  while  ill  or  convalescent.  JVIr.  Ernest  Hart "'  has  collected  and  tabu- 
lated 50  epidemics  of  enteric  fever,  15  of  scarlet  fever,  and  7  of  diphtheria, 
which  have  been  traced  to  milk  poisoning. 


SECTION  xn. 

BUTTER. 

As  an  article  of  diet,  butter  supplies  to  most  people  the  largest  amount 
of  fat  which  they  take.  Many  persons  take  from  1^  to  2  oz.  daily,  if  the 
butter  used  in  cooking  be  included,  and  the  average  amount  for  persons 
in  easy  circumstances  is  1  oz.  daily.  Butter  appears  to  be  easily  digested 
by  most  persons,  except  when  it  is  becoming  rancid.  It  then  causes  dys- 
pepsia and  diarrhoea,  and  as  a  rule  it  may  be  said  that  decomposing  fats 
of  all  kinds  disagree. 

Composition  ajstd  Examination. 

1.  The  average  amount  of  water  varies  from  5  to  10  per  cent.,  but  may 
be  higher,  even  in  genuine  butter.  Hassall  has  found  as  much  as  15^  per 
cent,  in  fresh,  and  28|-  per  cent,  in  salt  butter  ;  Wanklyn  records  23.6  per 
cent,  in  fresh  butter  supplied  to  Paddington  Workhouse.  The  retail 
dealer,  by  beating  up  the  butter  in  watei',  endeavors  to  increase  the 
amount.  This  can  be  detected  by  evaporation  in  a  water  bath  ;  if  the 
quantity  of  water  be  very  large,  melting  the  butter  will  show  a  little  water 
below  the  oil.  An  unusually  small  amount  of  water  is  suspicious  (AngeU), 
as  suggestive  of  the  presence  of  foreign  fat. 

2.  Casein. — All  butter  contains  some  casein,  as  some  milk  is  taken  up 
with  the  cream.  The  best  butter  contains  least.  The  amount  can  be  told 
roughly  by  melting  in  a  test-tube.  The  casein  collecting  at  the  bottom 
does  not  exceed  one-third  of  the  height  of  the  contents  of  the  tube  in  the 
best  butter,  or  between  one-third  and  one-half  in  fair  butter.  In  bad 
butter  it  may  reach  to  more  than  this.     A  better  plan  is  dissolving  the 

'  Boston  Med.  and  Surg.  Journal,  January,  1868,  and  Transactions  of  the  Kentucky 
State  Medical  Society,  quoted  in  Medical  Times  and  Gazette.  There  have  been  many 
instances  in  the  last  half  century,  and  they  have  all  been  collected  by  Hirsch. 

^  Transactions  of  the  International  Medical  Congress,  1881,  vol.  iv.,  p.  391. 


286  PRACTICAL    HYGIEKE. 

fat  by  ether,  washing  and  then  weighing  the  remainder  ;  the  casein  then 
weighs  from  5  to  3  grains  in  every  100  of  veiy  good  butter.  In  bad  but- 
ter it  is  much  more  than  this. 

The  rancidity  of  butter  is  chiefly  owing  to  changes  in  the  fat,  produced 
apparently  by  alterations  in  the  casein,  and  therefore  the  greater  amount 
of  casein  the  more  the  chance  of  rancidity. 

3.  Fat. — The  fat  amounts  to  from  86  to  92  per  cent,  of  the  butter. 
Butter  oil  consists  of  volatile  fatty  acids  (butyric,  caproic,  capi-ylic,  and 
capric),  and  of  non -volatile  acids  (stearic,  palmitic,  and  oleic),  all  combined 
with  glycerin.  In  examining  it,  the  butter  should  be  melted  in  a  beaker- 
glass  placed  in  hot  water,  and  the  fat  should  be  poured  off  the  casein,  and 
allowed  to  cool.  It  then  forms  a  solid  and  usually  yellow  mass,  with  the 
characteristic  smell  of  buttei',  and  should  be  further  examined  as  follows : 

(a)  Smell,  tmte,  and  color  of  this  recongeded  fat. — The  smell  and  taste 
are  very  characteristic,  and  with  a  Httle  care  the  quality  of  butter,  and 
even  the  presence  of  some  adulterations,  such  as  mutton  fat,  can  be  deter- 
mined. The  color  is  usually  yellowish-white  ;  other  fats  are  white,  but 
annatto  may  be  used  for  coloring  them,  or  true  butter  may  be  white,  so 
that  the  coloration  is  not  a  safe  test. 

(6)  Examine  the  recongealed  fat  with  the  microscope. — Butter  shows 
nothing  but  oil-globules  ;  lard  and  other  fats  often,  but  not  always,  con- 
tain acicvdar  and  stellate  crystals  of  margaric  (reaUy  a  mixture  of  palmitic 
and  oleic)  and  stearic  acids,  as  pointed  out  by  Hassall.  Starch  and  other 
impurities  may  be  sometimes  seen,  and  tinged  by  iodine.  The  casein  left 
after  the  fat  has  been  poured  off  should  be  also  examined,  and  starch, 
membrane,  or  other  impurities  may  be  seen  in  it.  The  jDolariscope  may 
be  used  to  bring  out  more  strongly  the  stellate  stearic  acid  crystals,  if 
present.  Angell  and  Hehner  point  out  that  even  genuine  butter  some- 
times shows  crystals  after  melting  and  recongealing  ;  they  therefore  think 
the  presence  of  crystals  gi'ound  for  apprehension  only,  showing  no  more 
than  that  the  fat  has  been  melted. 

(c)  Determine  the  meltimj-point  of  the  fat  after  separation  from  the 
casein. — Some  of  the  fat  should  be  put  into  a  wide  tube,  and  placed  in  an 
evaporating  dish  -u-ith  water  ;  a  thermometer  should  be  in  the  water  and 
another  in  the  fat  Raise  the  temperature  of  the  water  verv'  gradually  ; 
remove  the  lamp  from  time  to  time,  so  that  the  temperature  of  the  fat 
may  rise  slowly.  Note  the  temj^erature  when  it  begins  to  melt  ;  when  it 
is  completely  melted  ;  and  when  (after  removal  from  the  wann  water)  it 
begins  to  recongeal,  and  becomes  Cjuite  solid.  The  melting-points  are, 
however,  not  constant,  owing  to  the  variable  amounts  of  stearin  and  olein, 
and  the  volatile  fatty  acids,  but  stiU  they  run  within  tolerably  naiTow 
limits. 

The  temperature  when  the  fat  is  completely  melted  appeared  to  be  the 
mo.st  marked  point  in  Dr.  Parkes'  experiments.  The  butter  oil  is  most 
easily  melted,  and  requii-es  the  greatest  amount  of  cooling  before  recon- 
gealing;  usually  there  is  a  difference,  often  12^  to  15",  between  the  points 
of  commencing  and  completed  fusion.  The  deteiTuination  of  the  melting- 
point  is,  however,  certainly  more  useful  in  proving  that  the  butter  has 
only  sHght  admixtui-e,  than  in  proving  complete  puritj',  i.e.,  the  presence 
of  a  Bmall  quantity  of  lard  or  beef  dripping  would  not  raise  the  melting- 
point  sufficiently  for  detection.  In  the  case  of  beef  drijDping,  aLso,  the 
ruelting-poijit  is  rather  close  to  that  of  butter. 


QUALITY,    CHOICE,    AND    COOKING    OE    FOOD. 


287 


Temperature  ^  of  Melting  and  Solidifying. 


Fusion. 

Solidification. 

Commencing. 

Completed. 

Commencing. 

Completed. 

Butter  oil 

Degrees. 

65-68 

76-80 

68-85 

86-100 

81-92 

Degrees. 

80-90 

100-115 

100-120 

140-150 

110 

Degrees. 

70-80 

90-100 

90-100 

120-130 

88 

Degrees. 

60-82 ' 

Lard 

71-75 

Beef  dripping 

72-76 

Mutton  dripping 

Palm  oil ' 

86-92 
69 

{d)  Angell  and  Hehner  *  recommend  examining  the  sinking-point,  by 
means  of  a  little  glass  bulb  weighted  with  mercury  to  3.4  grammes  ;  the 
mean  sinking-point  of  24  genuine  butters  was  35.5°  C.  (96°Fahr.),  ranging 
from  34.3°  C.  to  36.3°  C.  (93.7°  Fahr.  to  97.3°  Fahr.).  The  butter  is 
melted  and  poured  into  a  test-tube,  and  allowed  to  cool ;  as  it  cools  a  slight 
conical  depression  appears  on  the  surface  ;  this  must  be  rendered  even  by 
remelting  the  upper  part.  If  other  fats  are  present,  the  depression  is 
much  more  marked.  The  tube,  with  the  bulb  on  the  top  of  the  fat,  is 
then  plunged  into  a  larger  beaker  of  water,  which  is  gradually  heated 
until  the  bulb  sinks,  the  temperature  of  sinking  being  noted  by  means  of  a 
thermometer  placed  in  the  water. ^ 

(e)  Another  method,  recommended  by  the  same  chemists,  consists  in 
determining  the  percentage  of  fixed  fatty  acids,  which  seems  to  be  pretty 
constant  in  butter  fat,  forming  about  87.3  per  cent,  of  its  weight ;  88.5 
being  adopted  as  a  maximum,  whereas  most  other  fats  give  about  95.5  per 
cent. — the  difference  in  butter  being  made  up  by  volatile  fatty  acids.  The 
plan  employed  is  to  saponify  the  fat  by  boiling  with  caustic  potash  and 
water,  to  decompose  the  soap  with  hydrochloric  acid,  filter  and  wash  with 
boiling  water,  and  then  weigh  the  fatty  acids  remaining  undissolved  on  the 
filter.  The  saponification  is  much  facilitated  by  commencing  the  process 
with  methylated  spirit,  as  suggested  by  Mr.  G.  Tui-ner. 

(/)  The  specific  gravity  of  butter  fats  has  also  been  suggested  by  Mr. 
Bell  as  a  good  means  of  determining  purity.  He  melts  the  fat  at  100° 
Fahr.,  and  weighs  in  a  specific  gravity  bottle.  He  shows  that  the  specific 
gravity  of  ordinary  fats  varies  between  902.83  and  904.56  ;  whilst  that  of 
butter  fat  rarely  falls  below  910,  generally  ranging  between  911  and  913." 

'  Dr.  Parkes  attached  more  importance  to  the  melting-point  than  to  the  solution  in 
ether. 

^  It  i«  rare  for  butter  oil  to  be  completely  solid  at  82^,  but  Dr.  Parkes  once  found  it 
so  in  an  undoubtedly  pure  butter,  made  during  the  winter  on  a  gentleman's  private 
farm.     But  usually  butter  is  not  solid  till  68^  or  65°. 

^  Dr.  Campbell  Brown  of  Liverpool. 

■*  Butter  :   its  Analysis  and  Adulterations,  2d  ed.,  1877. 

^  Hassall  employs  a  converse  plan,  using  a  float  instead  of  a  sinker,  the  temperature 
at  which  it  rises  to  the  surface  being  noted;  this  generally  occurs  about  2'  C. ,  or 
5.6°  Fahr.  lower  than  the  sinking-point  above  mentioned.  Other  plans  have  been  pro- 
posed by  Dr.  Tripe,  Mr.  Heisch,  Dr.  Redwood,  and  Mr.  Bell.  Mr.  P.  Duffy  has  pointed 
out  the  curious  fact  that  pork,  mutton,  and  beef  fats  have  two  or  three  allotropic  con- 
ditions, with  different  melting-points. 

^  Pharmaceutical  Journal,  July  22,  1876. 


288  PRACTICAL    HYGIENE. 

4.  Salt  is  added  to  all  butter.  In  fresh  butter  it  should  not  be  more 
than  .5  to  2  per  cent.  (8  grains  per  ounce)  ;  in  salt  butter,  not  more  than  8 
per  cent.  (35  grains  per  ounce).  To  determine  the  salt,  wash  a  weighed 
portion  of  butter  thoroughly  with  cold  distilled  water,  and  determine  the 
chloride  of  sodium  by  standard  nitrate  of  silver.  Dr.  Tidy  recommends  in- 
cineration and  weighing  the  residue  ;  he  j^laces  the  limit  at  7  per  cent. 

By  this  method  the  amount  of  water,  casein,  oil,  and  salt  will  be  deter- 
mined, and  the  quahty  of  the  butter  oil  will  have  been  examined. 

Scheme  for  a  Short  Examination. 

1.  Determine  quality  by  the  taste  and  smell  of  the  whole  butter,  and  of 
the  melted,  poured  off,  and  recongealed  fat.' 

2.  When  melting  for  the  fat  in  a  tube,  notice  approximate  amount  of 
casein. 

3.  Determine  the  sinking-point  by  AngeU's  plan,  or  the  floating-point 
h\  HassaU's. 

4.  Examine  butter  and  recongealed  fat  with  microscope,  and  add  a 
weak  solution  of  iodine  to  test  for  starch. 

5.  If  time  and  means  allow,  determine  the  percentage  of  fixed  fatty 
acids  in  the  butter  fat,  by  AngeU  and  Hehner's  method,  or 

6.  Determine  the  specific  gi'avity  by  Bell's  method. 

Adulterations. 

Butter  is  supposed  to  be  frequently  adulterated  with  lard,  and  with 
beef,  mutton,  and  horse  fat,  and  with  vegetable  oils.  In  a  process  devised 
by  Mege-Moiiries,^  fresh  beef  suet  is  converted  into  a  kind  of  butter  (oleo- 
margarine). But  it  is  so  comphcated  that  it  would  not  pay  a  dishonest 
tradesman  to  do  it,  and  it  could  only  be  practised  on  a  large  scale. 

A  similar  substance  fi'om  New  York  has  lately  made  its  appearance  in 
the  market  under  the  name  of  Butterine  ;  it  appears  to  be  a  wholesome  fat, 
and  as  long  as  it  is  sold  honestly  as  a  substitute  for  butter,  but  not  as 
genuine  butter,  its  introduction  will  jDrobably  be  a  boon  to  many  on  ac- 
count of  its  chea2:)ness.  The  sinking-point  and  the  determination  of  the 
amount  of  fixed  fatty  acids  would  probably  detect  it  when  sold  for  genuine 
butter. 

Potato  or  other  starches  are  sometimes  added.  It  is  a  rare  adulteration, 
and  is  at  once  detected  b}'  iodine,  either  at  once  or  after  melting.  Gypsum 
and  sulphate  of  barium  have  been  added,  it  is  said  ;  this  must  be  very  rare, 
and  be  at  once  detected  by  melting  and  poiuing  everything  off  the  insoluble 
powder,  or  hj  incinerating,     Annatto  is  frequently  used  to  color  butter.^ 

Preservation  of  Butter.  — Poiu'ing  water  which  has  been  boiled  over  butter 
will  keep  it  for  some  time  ;  but  a  better  plan  is  one  discovered  by  M.  Brcon,^ 
viz.,  water  acidulated  slightly  (3  grammes  to  1  litre)  with  acetic  or  tartaric 
acid,  is  added,  and  the  whole  is  jilaced  in  a  close-fitting  vessel.  Sugar  also 
has  a  j)reservative  effect,  especially  when  mixed  with  a  httle  salt. 

'  Butter  becomes  rank  and  bad,  by  the  cream  being  allowed  to  become  sour  before 
churniniJ^in  consequence  of  dirty  vessels  ;  it  is  a  good  plan  to  stir  up  the  cream  from 
time  to  time. 

^  Pharmaceutical  Journal,  October,  1872. 

^  AngeU  and  Hehner  record  two  cases  of  adulteration  by  mixing  with  milk. 

•*  Payen,  Des  Subst.  Alim.,  4th  ed.,  p.  179. 


QUALITY,    CHOICE,    AND   COOKING    OF    FOOD.  289 


SECTION  XHL 

CHEESE. 

As  an  Article  of  Diet.— It  contains  a  very  large  amount  of  nitrogenous 
matter  in  small  bulk  (p.  212),  and  as  it  is  agTeeable  to  the  palate,  it  must 
be  an  excellent  food  for  soldiers  in  war.  About  ^  Sb  contains  as  mucli  nitro- 
genous substance  as  1  ft)  of  meat  and  -J  of  a  lb  as  much  fat.  It  does  not, 
however,  keep  well  in  warm  climates. 

Tlie  quality  is  known  by  the  taste.  The  only  adulteration  is  from  sub- 
stances to  give  weight.  Starch  is  chiefly  employed,  and  can  be  detected  at 
once  by  iodine.     There  is  usually  about  5  or  6  per  cent,  of  salt. 

Sulphate  of  copjDer  and  arsenious  acid  are  sometimes  used  to  destroy 
insects  ;  the  rind  is  then  the  most  poisonous  part.  Copper  is  detected  by 
ammonia  or  potassium  ferrocyanide.  Ai'senic  by  any  test  (Reinsch's  or 
Mai'sh's).  Sometimes  cheese  becomes  soui-,  particularly  if  made  from 
sheep's  milk,  and  may  cause  diarrhoea. 

Acarus  domesticus,  Aspergillus  glaucus  (blue  and  green  mould),  and 
Sporendonema  casei  (red  mould),  form  duriag  decay.  During  decay  the  fat 
augments  at  the  expense  of  the  casein  ;  leucin  is  produced,  and  valerianic 
and  butyric  acids.  Lactic  acid  is  also  often  produced,  from  the  lactin  of 
the  milk  contained  in  the  cheese.  The  aroma  of  cheese  partly  arises  from 
this  decomposition,  and  the  production  of  volatile  acids. 

SECTION  XIV. 

EGGS. 

Composition  and  Choice. — An  egg  weighs  from  600  to  950  grains,  or  even 
more  ;  the  average  weight  is  about  2  ounces  avou". ;  10  j)arts  are  shell,  60 
white,  and  30  yolk  ;  the  white  contains  86  per  cent,  of  water  ;  the  yolk  52 
per  cent.  ;  100  grains  of  egg,  therefore,  contain — 

10     grains  shell. 

22.8       "       albumen  and  fat. 

67.2      "       water. 


100.0 

H  an  egg  weighs  two  ounces,  it  contahas  nearly  200  grains  of  solids ; 
this  is  a  convenient  number  to  remember,  as  100  grains  correspond  to  1 
ounce. 

For  choice,  look  thro  ugh  the  egg;  fresh  eggs  are  more  transj)arent  in  the 
centre,  old  ones  at  the  top.  Dissolve  1  ounce  of  salt  in  10  ounces  of  water  ; 
good  eggs  sink  ;  indifferent  swim.     Bad  eggs  will  float  even  in  pure  water. 

Preservation. — Eggs  are  packed  in  sawdust  or  salt,  or  are  covered  with 
gum,  butter,  or  oil,  or  placed  in  lime-water,  with  a  httle  cream  of  tartar. ' 
Boiling  for  half  a  minute  also  keeps  them  for  some  time  ;  in  fact,  anything 
which  excludes  air. 

The  lime-water  gives  them,  it  is  said,  a  jDCculiar  taste,  and  makes  the 
albumen  more  fluid. 

'  It  is  said  that  covering  them  with,  a  solution  of  bees-wax  in  warm  olive  oil  (J-  of 
bees-wax,  fds  of  olive  oil)  will  keep  them  for  two  years. — Chemical  News,  August,  1865, 
p.  84. 

Vol.  I.— 19 


290  PRACTICAL    HYGIENE. 

SECTION  XV. 
CONCENTRATED  AND  PRESERVED  FOOD.' 

For  the  military  sui'geon  this  subject  is  so  important,  that  it  is  desirable 
to  put  the  chief  facts  under  a  separate  section. 

It  is  obvious  how  imi)ortaut  it  must  be  in  time  of  war  to  have  a  food 
which  may  be  at  once  nutritious,  portable,  easily  cooked,  and  not  hable  to 
deterioration.  Land's  sagacious  mind  long  ago  saw  this,  and  he  strongly 
urged  the  adrisabihty  of  haring  on  board  ship  prepared  food  of  this  kind. 
It  must  be  remembered,  however,  that  a  man  must  get  his  260  to  300,  or 
even  350  grains  of  nitrogen,  and  8  to  12  ounces  of  carbon,  in  each  twenty- 
four  hours,  besides  some  hydrogen  and  salts.  The  work  of  the  body  when 
in  activity  cannot  be  carried  on  with  less  ;  and  at  present  these  elements 
cannot  be  presented  to  us  in  a  digestible  fonn  in  a  smaller  bulk  than  22  or 
23  water-free  ounces.  Concentration  at  present  cannot  be  can-ied  beyond 
this,  and  practically  has  not  really  been  earned  to  this  point.  Life,  how- 
ever, and  vigor  may  for  some  days  be  preserved  with  a  much  less  amount ; 
and  the  total  amount  of  food  has  been  reduced  to  11  water-free  ounces 
dailv,  with  full  retention  of  strength  for  seven  days,  though  the  body  was 
constantly  losing  weight.  For  expeditions  of  three  or  fovu"  days,  if  trans- 
port were  a  matter  of  gi-eat  difficulty,  soldiers  might  be  kept  on  10  or  12 
ounces  of  water-free  food  daily,  prorided  they  had  been  fully  fed  before- 
hand, and  subsequently  had  time  and  food  to  make  up  the  tissues  of  their 
own  body,  which  would  be  expended  in  the  time,  and  would  not  have  been 
replaced  by  the  insufficient  food. 

When  we  inquire  into  the  concentrated  foods  now  in  the  market,  some  of 
which  profess  to  supply  all  the  substances  necessaij  for  nutrition,  we  find 
them  not  very  satisfactory.  They  ai'e  often  not  so  concentrated  as  they  might 
be,  or  are  deficient  in  important  j)rinciples,  or  are  disagreeable  to  the  taste. 

Dried  Meat. — Meat  dried  at  a  very  low  heat.  It  has  lost  the  gTeater 
part  of  its  water,  is  hard,  and  requii-es  very  careful  cooking,  but  is  believed 
to  be  nutritious  when  well  prepared. 

I\Iessrs.  M'Call  of  London  have  prepared  an  excellent  dry  meat :  it  is 
sold  in  packets,  each  of  which  weighs  4  oz.,  and  is  intended  for  one  meal. 
It  contains  salt  and  pepper,  and  12  j^er  cent,  of  water. 

Ha.<<sairs  Flour  of  Meat. — Good  fresh  meat,  freed  from  visible  fat,  is 
carefully  dried  at  a  very  low  temperature,  and  is  pulveiized  by  macliinery, 
so  that  a  very  fine  smooth  powder  is  fonned.  This  is  mixed  with  about  8 
per  cent,  of  arrowroot,  2^  per  cent,  of  sugar,  and  3  per  cent,  of  a  mixture 
of  salts,  pepper,  spices,  and  coloring  matter.  The  object  of  the  an-owroot 
is  to  assist  its  suspension  in  water.  When  to  this  suljstance  bread  and  a 
fair  amount  of  fatty  and  vegetable  foods  is  added,  it  seems  to  answer  well. 
It  keeps  very  well ;  but  if  the  open  tins  are  exposed  to  the  air,  after 
several  months,  it  shghtly  changes  color,  and  then  acquires  a  peculiar  odor. 
Subsequently  it  decomposes.  But  if  well  fastened,  it  will  keep  for  a  very 
long  time.  Dr.  C.  A.  Meinert  ^  has  also  brought  out  a  floiir  or  powder  of 
meat  (Fleischpulver),  which  is  well  spoken  of. 

'  Dr.  Letheby  stated  that  from  1800  to  1855  there  were  177  patents  taken  out  for 
drying  and  preserving  food.  Of  these  26  were  for  drying  the  food,  31  for  excluding 
atmospheric  air,  and  8  for  giving  an  impervious  coating. 

-'  Armee-  und  Yolks-Ernahrung,  von  Dr.  C.  A.  Meinert,  Berlin,  1880.  This  work 
contains  a  great  amount  of  information  on  the  subject  of  food,  as  well  as  extensive 
tables  of  analyses. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  291 

Under  the  terms  Tasajos  and  Charqui,  two  kinds  of  meat  are  prepared 
in  South  America ;  it  is  probable  that  these  terms  have  not  always  been 
used  in  the  same  sense.  According  to  Mr.  Bridges  Adams,  Tasajos  is  meat 
cut  in  thin  slices,  dipped  in  brine,  and  then  partially  dried.  Charqui  is 
thin  strips  of  muscular  fibre  from  which  the  fat  is  removed,  dried  rapidly 
by  sun  heat,  and  sprinkled  with  maize. 

The  dried  meat  of  the  Kaffirs  (beltong)  is  very  much  the  same  ;  great 
hunks  of  beef  are  sun-dried,  and  remain  undecomposed  for  a  long  time. 
So  also  m  Egypt  the  meat  is  dried  by  exposure  to  the  sun  and  north 
wind. 

The  Pemmican  of  the  Artie  voyagers  is  a  mixture  of  the  best  beef  and 
fat  dried  togethei',  and  is  an  excellent  food,  though  rather  expensive. 
Sugar  is  sometimes  added,  and  sometimes  raisins  and  currants  ;  the  latter 
would  be  a  very  desirable  addition  where  there  was  a  deficiency  of  vegetable 
food. 

Liebig's  Extractum  Carnis  is  the  juice  of  meat  extracted  on  the  follow- 
ing plan  : — Every  particle  of  meat  is  separated  from  fat  and  tendons,  and 
is  then  subjected  for  some  time  to  a  moderate  heat ;  a  viscid  dark  extract 
at  last  collects,  which  contains  the  salts,  creatin,  and  other  organic  nitro- 
genous substances.  Mixed  Avith  warm  water,  this  extract  gives  a  highly 
agreeable  and  nutritious  beef-tea  or  mutton  broth.  One  lb  of  mutton  gives 
about  two-fifths  of  an  ounce  of  extract.  It  has  the  remarkable  quality  of 
not  decomposing ;  Liebig  had  some  for  fifteen  years  in  a  bottle  loosely 
stoppered. 

There  are  now  numerous  samples  of  Extractum  Carnis  in  the  market, 
prepared  in  South  America  and  Australia.  The  majority  have  an  almost 
identical  composition. 

When  Liebig's  extract  is  taken  during  fatigue,  it  is  found  to  be  remark- 
ably restorative,  increasing  the  power  of  the  heart,  and  removing  the  sense 
of  fatigue  following  great  exertion.  Mixed  with  wine,  it  has  been  employed 
with  great  success  in  rousing  men  in  collapse  from  wounds.  As,  however, 
the  nitrogenous  compounds  in  the  Extractum  are  not  in  the  form  of  albumen 
or  fibrin,  but  of  other  compounds  (creatin,  extractives  soluble  in  water  and 
alcohol),  it  has  been  supposed  that  the  nitrogen  is  not  capable  of  being 
employed  in  the  nutrition  of  muscles  or  gland-cells,  and,  in  fact,  that  the 
Extractum  Carnis  does  not  represent  a  true  nutritive  albuminate.  Liebig 
considered  it  to  be  a  condiment  which  increases  the  power  of  the  stomach 
to  digest  vegetable  food  ;  and  Hiirschelmann, '  who  does  not  consider  it  a 
substitute  for  meat,  yet  thinks  that  it  aids  in  digesting  hard  meat,  and  that 
the  meat  ration  can  he  lessened  when  it  is  used.  By  some  its  action  has 
been  compared  to  that  of  tea  and  coffee,  but  there  does  not  apj)ear  to  be 
any  close  parallel. 

When  taken  in  very  large  doses,  the  extract  (like  large  quantities  of 
meat)  does  sometimes  cause  heaviness  and  torpor,  and  this  has  been  as- 
cribed to  the  potash  salts,  but  it  may  be  a  question  whether  it  is  not  owing 
to  the  excess  of  the  nitrogenous  extractive  matter. 

About  230  grains  of  extract  in  one  pint  of  water  are  nearly  equal  to  a 
pint  of  beef-tea  made  from  y^ths  lb  of  fresh  beef ;  fths  otmce  of  extract  in 
one  pint  are  equal  to  a  pint  made  from  1  lb  of  fresh  beef.  There  is,  how- 
ever, a  general  opinion  that  the  extract  beef-tea  is  not  so  good  as  that  made 
at  once  from  fresh  beef  ;  a  mixture  of  the  two  is  well  spoken  of. 

The  "concentrated  beef-tea  "  is  beef-tea  and  the  juices  of  the  compressed 

'  Schmidt's  Jahrb.,  January,  1872,  p.  21, 


292  PRACTICAL    HYGIENE. 

beef  mixed  and  evaporated.  This  is  a  highly  nutritious  substance,  and 
most  useful  to  the  army  surgeon.  IVIixed  with  wine,  and  given  as  soon  as 
possible  after  wounds  are  received,  in  the  time  of  shock  and  collapse,  it 
was  found  in  the  Austrian  army  (in  1859)  to  save  the  lives  of  many  wounded 
men,  and  the  experience  of  the  Federal  American  Ai-my  was  to  the  same 
effect  (Hammond).  Extractum  Carnis  is  now  made  also  by  pressure  with- 
out heat. 

Johnston's  Fluid  Beef  contains  a  large  proportion  of  the  fibiin  of  meat, 
in  addition  to  the  juices.     It  appears  to  be  a  good  preparation. 

Extract  of  3Iutton. — An  AustraUan  extract  of  mutton  is  now  sold,  which 
is  more  sohd  than  Liebig's  extract,  and  differs  from  it  in  containing  much 
fat.     It  is  a  very  good  preparation. 

Bellafs  Extract  of  Meat. ' — This  contains  the  juice  of  cooked  vegetables 
in  addition  to  that  of  meat.  A  httle  less  than  an  ounce  (25  gi'ammes)  in 
If  pint  (1  htre)  of  water  makes  a  good  beef-tea. 

Edward's  jmtent  desiccated  Soup  consists  of  a  mixture  of  beef  and  vege- 
tables ;  is  easily  prepared  by  boiling  in  water,  about  an  ounce  to  a  pint  of 
water ;  it  was  well  spoken  of  in  the  Ashantee  war. 

Meat  Biscuits. — These  biscuits  or  powders,  for  they  are  generally  pow- 
dered and  sold  in  canisters,  are  formed  by  mixing  rich  extract  of  meat  with 
wheat  flour,  and  drying.  The}'  were  very  much  used  in  the  American  war. 
In  some  cases  the  meat  is  so  much  dried  as  to  be  quite  indigestible. 

Meat  biscuits  can  be  made  in  a  verj'  simple  way,  by  mixing  together, 
cooking,  and  baking  1  lb  flour,  1  lb  meat,  ^  ft  fat  (suet),  ^  ft  potatoes,  with 
a  httle  sugar,  onion,  salt,  j^epper,  and  spices.  A  palatable  meat  biscuit, 
weighing  about  1^  ft,  containing  10  to  12  per  cent,  of  water,  is  then  ob- 
tained, which  keeps  quite  unchanged  for  foirr  months. 

Pea  Sausage. — In  the  Franco-German  war  the  Germans  made  great  use 
of  a  pea  sausage,  made  by  mixing  pea-flour  and  fat  pork,  with  a  little  salt. 
It  is  ready  cooked,  but  can  be  made  into  a  soup.  It  was  much  rehshed  for 
a  few  days,  but  the  men  got  eventually  tired  of  it,  and  in  some  it  produced 
flatulence  and  diarrhuea. 

Flour  Sausages. — A  mixtui-e  of  pork  and  wheat  flom-  has  been  used  in 
the  same  way. 

Maize  and  Beef — The  Germans  in  1870  made  also  use  of  mixture  of 
maize  and  beef,  which  appears  to  have  been  much  liked. 

Dried  Cerealia. — Many  flours,  if  well  dried,  will  keep  for  a  long  time. 
There  are  now  in  the  mai'ket  different  kinds  of  malt  biscuit  and  granulated 
malt  food.  Liebig's  food  for  infants  is  composed  of  equal  parts  of  wheaten 
flour  and  malt  flom'  mixed  with  a  httle  potassium  carbonate  and  cooked 
with  10  parts  of  milk.  The  wheat  and  malt  flom-  are  usually  cooked,  and 
sold  in  powder  ready  to  be  boiled  with  the  milk. 

Dried  Bread. — In  addition  to  biscuit  ah-eady  described,  bread  has  been 
partially  diied  by  being  pressed  in  an  hydrauhc  press  (method  of  Laignel). 
Much  water  flows  out,  but  when  taken  out  the  bread  still  feels  moist.  In 
a  day  or  two,  however,  it  becomes  as  hard  as  a  stone,  and  in  a  year's  time 
will  be  found  good  and  agreeable.  Placed  in  water,  it  slowly  swells.  The 
"  pain  biscuite  "  of  the  French  army  is  bread  dried  by  heat. 

Dried  Potatoes  are  sold  in  two  forms — slices  and  gi-anulated.  In  either 
case  the  potato  is  easily  cooked,  and  is  very  palatable.  It  should  be  soaked 
in  cold  water  first  for  some  time,  then  slowly  boiled,  or,  what  is  much  better, 
steamed.     The  du*ections  for  cooking  Edward's  preserved  potato  (which  is 

'  Poggiale,  Rec.  de  Mem.  de  Mil.  Milit.,  Avril,  1868,  p.  268. 


Plate  VII 


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1.  Potato  Starch. 

2.  Bermuda  Arrowroot, 

3.  Tous  les  Mois. 


4.  St.  Vincent  Arrowroot. 

5.  Sago  of  Commerce. 

6.  Port  Xatal  Arrowroot. 


7.  Rio  Arrowroot, 

8.  Tapioca. 

9.  Maize. 


QUALITY,    CHOICE,    AND    COOKING    OF    FOOD.  293 

granulated)  are  :  "To  three-quarters  of  a  pound  add  about  one  quart  of 
boiling  water,  stirring  it  at  the  same  time  ;  cover  it  closely  ;  the  basin  or 
vessel  used  should  be  kept  hot ;  let  it  stand  for  ten  minutes  ;  then  well  mash, 
adding  butter,  salt,  etc.,  at  discretion."  It  is  stated  to  be  equal  to  six  times 
its  bulk  of  the  fresh  vegetable,  but  this  is  hardly  borne  out  by  analysis  ; 
four  times  is  as  high  as  it  would  be  safe  to  allow.  The  analyses  made  by 
Professor  Attfield  and  Dr.  de  Chaumont'  show  that  a  lb  of  preserved  po- 
tato contains  the  sohd  matter  of  only  3^  lb  of  ordinary  fresh  potatoes. 

Dried  Vegetables  [other  than  Potatoes). — Dried  and  compressed  vege- 
tables of  aU  kinds  (peas,  caiihflowers,  carrots,  etc.)  are  now  prepared, 
especially  by  Messrs.  Masson  &  ChaUot,  so  perfectly  that,  if  properly 
cooked,  they  furnish  a  dish  almost  equal  to  fresh  vegetables.  Professor 
Attfield  found  that  dried  compressed  cabbage  contained  the  solids  of 
seven  times  its  weight  of  fresh  cabbage,  whilst  the  mixed  vegetables  con- 
tained ^ue  and  a  half  iivneB  the  sohds  of  the  fi-esh  vegetables.  They  must 
be  cooked  very  slowly.  If  there  is  any  disagreeable  taste  from  commen- 
cing putrefaction,  which  is  very  rare,  a  httle  chloride  of  lime  removes  it  at 
once.     Potassium  permanganate  can  be  also  used  for  this  purpose. 

As  anti-scorbutics  they  are  said  to  be  inferior  to  the  fresh  vegetable 
(experience  of  American  war),  but  are  still  much  better  than  nothing.^ 

Preserved  Vegetables,  that  is,  vegetables  preserved  in  their  natural  con- 
dition (cooked),  are  much  to  be  preferred,  both  as  being  more  palatable 
and  as  being  more  nutritious  and  better  anti-scorbutics.  They  occupy, 
however,  much  greater  bulk. 

Dried  Milk. — Preserved  milk  is  sold  in  a  liquid  form,  but  is  also  sold 
as  a  powder,  which  is  very  well  prepared. 

Concentrated  Milk. — Milk  is  evaporated  at  low  steam  heat  to  the  con- 
sistence of  a  thick  syrup,  and  white  sugar  is  added.  After  opening  the  tins 
the  samples  remain  good  for  over  a  month. 

Dried  Eggs. — The  yolk  is  not  easily  kept  after  drying,  but  the  white 
can  be  so  ;  it  is  cut  into  thin  scales,  and  forty-four  eggs  make  about  1  lb. 
The  yolk  and  white  are  also  mixed  with  flour,  gTound  rice,  etc.,  and  are 
then  dried. 

'  Report  of  Committee  on  Scurvy,  1877. 

'  Professor  Attfield  (loc.  cit.)  considers  that  in  the  compressed  vegetables  some,  at 
least,  of  the  juice  is  lost  in  the  preparation,  probably  by  pressure. 


CHAPTEK  VII. 

BEVERAGES  AND  CONDIMENTS. 

SECTION  I. 

ALCOHOLIC  BEVERAGES. 

Ajlthough  it  is  convenient  to  place  all  the  beverages  whicli  contain  Al' 
cohol  under  one  heading,  they  yet  differ  materially  in  composition  and 
effects. 

Sub-Section  I. — Beer. 

Composition. — The  law  formerly  allowed  only  malt  and  hops  to  be  used 
in  brewing,'  but  sugar  (under  the  name  of  saccharum)  is  now  largely  sub- 
stituted, as  AveU  as  bitter  substances  other  than  hops. 

The  specific  graA-ity  varies  from  1006  to  1030,  or  even  more,  in  the 
thick  German  beers  ;  the  average  in  English  beers  and  porters  is  from 
1010  to  1011.  The  percentage  of  extract  (dextrin,  cellulose,  sugar,  lupu- 
lite,  and  hop  resin)  is  from  4  to  15  per  cent,  in  ale,  and  from  4  to  9  per 
cent,  in  porter.  It  is  least  in  the  bitter,  and  highest  in  the  sweet  ales. 
The  alcohol  varies  from  1  to  10  per  cent,  in  volume.  The  free  acidity 
which  arises  from  lactic,  acetic,  galHc,  and  malic  acids,  ranges  (if  reck- 
oned as  glacial  acetic  acid)  from  18  to  45  grains  per  pint.  The  sugar 
has  a  great  tendency  to  form  so-called  giucinic  (or  glucic)  acid  (C,„H,jOg). 
There  is  a  small  quantity  of  albuminous  matter  in  most  beers,  but  not 
averaging  more  than  .5  per  cent.  The  salts  average  .1  to  .2  per  cent., 
and  consist  of  alkaline  chlorides  and  phosphates,  and  some  earthy  phos- 
phates. There  is  a  small  amoimt  of  ammoniacal  salt.  The  dark  beers, 
or  porters,  contain  caramel  and  assamar.  Free  carbon  dioxide  is  always 
more  or  less  present ;  the  average  is  .1  to  .2  parts  by  weight  per  cent., 
or  about  If  cubic  inch  per  ounce.  Volatile  and  essential  oils  are  also 
present. 

Adopting  mean  numbers,  1  pint  (20  ounces)  of  beer  will  contain  : — 

Alcohol 1  ounce. 

Extractives,  dextrin,  sugar 1.2  "     (524  grains). 

Free  acid 25  grains. 

Salts 13  grains. 

'  In  the  Licensing  Act  (1872),  clause  19  contains  penalties  for  using  any  deleterious 
substance  for  mixing  with  liquors  sold  by  persons  having  licenses  under  the  Act,  and 
in  the  first  schedule  to  the  Act  is  a  list  of  deleterious  ingredients,  viz.  :  "  Cocculus  in- 
dicus,  chloride  of  sodium  (otherwise  common  salt),  copperas,  opium,  Indian  hemp, 
strychnine,  tobacco,  darnel  seed,  extract  of  logwood,  salts  of  zinc  or  lead,  alum,  and  any 
other  extract  or  compound  of  any  of  the  above  ingredients."  Several  articles,  which 
are  supposed  to  be  used  as  adulterants,  are  omitted  from  this  list. 


BEVERAGES    AXD    C0NDIME:N-TS.  295 

Physiological  Action. — The  action  on  tissue  metamoi-pliosis,  so  far  as  is 
known,  is  suiDposed  to  be  one  of  lessened  excretion  ;  the  urea  and  pulmonary 
carbon  dioxide  being  both  decreased.  If  this  be  the  case,  it  is  not 
caving  to  the  alcohol,  at  least  in  moderate  dietetic  doses,  but  to  some 
of  the  other  ingredients  ;  but  the  experiments  require  repetition.  ^  On 
the  nervous  system  the  action  is  probably  the  same  as  that  of  alcohol. 
The  peculiar  exhausting  or  depressing  action  of  beer  taken  in  large 
amount  has  been  ascribed  by  Eanke  '  to  the  large  amount  of  potash  salts, 
but  probably  the  other  constituents  (especially  the  hop)  are  also  con- 
cerned. 

When  beer  is  taken  in  daily  excess,  it  produces  gradually  a  state  of 
fulness  and  jDlethora  of  the  system,  which  probably  arises  from  a  continual, 
though  slight  interference  "with  ehmination,  both  of  fat  and  nitrogenous 
tissues.  When  this  reaches  a  certain  jDoint,  appetite  lessens,  and  the  form- 
ative power  of  the  body  is  impaired.  The  imperfect  oxidation  leads  to  ex- 
cess of  partially  oxidized  products,  such  as  oxalic  and  uiic  acids.  Hence 
many  of  the  anomalous  affections,  classed  as  gouty  and  biHous  disorders, 
which  are  evidently  connected  with  defects  in  the  regressive  metamor- 
phosis. 

The  question.  What  is  excess  ?  is  not  easy  to  answer,  and  will  depend 
both  on  the  composition  of  the  beer,  and  on  the  habits  of  life  of  those  who 
take  it ;  but  judging  from  the  amount  of  alcohol  which  is  allowable,  from 
one  pint  to  two  pints,  according  to  the  strength  of  the  beer,  is  a  sufficient 
amount  for  a  healthy  man. 

Examination  of  Beee. 
This  is  directed  to  ascertain — 1.  Quality  ;  2.  Adulterations. 

1.    QUALITY. 

Physical  Characters. — The  beer  should  be  transparent,  not  turbid.  Tm> 
bidity  arises  from  imperfect  brewing  or  clarifying,  or  from  commencing 
changes.  If  the  latter,  the  acidity  \nW  probably  be  found  to  be  increased. 
The  amount  of  carbon  dioxide  disengaged  should  neither  be  excessive  nor 
deficient. 

The  taste  should  be  pleasant.  If  bitter,  the  bitterness  should  not  be 
persistent.     It  should  not  taste  too  acid. 

Smell  gives  no  indication  till  the  changes  have  gone  on  to  some  ex- 
tent. 

If  there  is  any  turbidity,  microscopic  examination  will  detect  the  pres- 
ence of  abnormal  organisms,  as  figured  by  Pasteur.^ 

2.  Determine  Specific  Gravity.  — If  this  is  done  after  the  alcohol  is  driven 
off,  an  approximate  conclusion  can  be  formed  of  the  amount  of  solids  by 
dividing  by  4  the  excess  of  the  specific  gravity  over  1000.  The  more  ex- 
tract, the  greater  is  the  body  of  the  beer. 

3.  Determine  Acidity.  — This  is  a  very  important  matter,  as  the  increase 
of  acidity  is  an  early  effect  when  beer  is  undergoing  changes. 

The  acidity  of  the  beer  consists  of  two  kinds. 
Volatile  Acids,  viz.,  acetic  and  carbonic. 

'  Binz  (Journal  of  Anatomv  and  Phvsiologv,  May,  1874)  states  that  alcoliol  dimin- 
islies  both  the  pulmonary  carbonic  acid  and  urea. 
-  Phys.  des  Menschen,  1868,  p.  139. 
2  Etudes  sur  la  Biere,  1876,  plate  i.,  p.  6. 


296  PEACTICAL    HYGIENE. 

Non- Volatile  Acids,  viz.,  lactic,  gallic  or  tannic,  malic,  and  sulphuric,  if 
it  has  been  added  as  an  adulteration. 

To  determine  the  acidity  of  beer  we  must  use  an  alkaline  solution 
of  knovrn  strength,  1  C.C,  of  which  is  equal  to  6  milligrammes  of 
glacial    acetic    acid     (C^H^OJ,    or   to    9    milligrammes    of    lactic   acid 

(C.HA).' 

Take  10  C.C  of  the  beer  to  be  examined,  and  drop  into  it  the  alkaline 
solution  from  a  burette,  till  exact  neutrality  (as  tested  by  tui-meric  and 
litmus  papers)  is  reached.  Then  read  off  the  number  of  C.C.  of  alkaline 
solution  used  ;  multiply  by  6,  and  the  result  will  be  the  amount  of  total 
acidity  in  the  quantity  of  beer  operated  on,  expressed  as  milhgrammes  of 
glacial  acetic  acid  (the  symbols  being  always  used  in  the  report).  By 
shifting  the  decimal  point  two  places  to  the  right,  the  amount  per  litre  is 
given.  To  bring  grammes  per  htre  into  gi'ains  per  pint  multiply  by  70, 
and  divide  by  20  ;  or,  what  is  the  same  thing,  multiply  at  once  the  number 
of  C.C.  of  alkaline  solution  used  by  5.25  (short  factor). 

The  total  acidity  can  be  divided  into  tixed  and  volatile  by  evaporation. 
^Iiile  the  total  acidity  is  being  determined,  evaporate  another  measiu'ed 
quantity  of  beer  to  one-third,  make  up  the  original  bulk  with  distilled 
water,  and  determine  the  acidity.  The  acetic  and  carbonic  acids  being 
volatile,  are  driven  off,  and  lactic  and  other  acids  remain.  Deduct  the 
amount  of  alkaline  solution  used  in  this  second  process  from  the  total 
amount  used,  and  this  will  give  the  amount  used  for  the  volatile  and 
fixed  acidities  respectively  ;  express  one  in  tei-ms  of  acetic,  the  other  of 
lactic  acid.  Short  factor  for  lactic  acid  =  7.875.  The  fixed  acidity  is 
greater  than  the  volatile  in  almost  all  beers,  and  sometimes  five  or  six 
times  as  much. 

Example. — 10  C.C.  of  beer  took  5  C.C.  of  alkaline  solution  :  5  x  5.25  = 
26.45  grains  of  glacial  acetic  acid  per  j)int  =  total  acidity. 

After  boiling  and  making  up  to  original  bulk  with  distilled  water,  10 
C.C.  took  4  C.C.  of  alkaline  solution  :  4  x  7.875  =  31.5  grains  of  lactic  acid 
per  pint  =  fixed  acidity.  The  difference  between  the  amounts  of  alkahne 
solution  used,  5  —  4  =  1  multipUed  by  5.25,  gives  the  volatile  acidity. 

Generally  speaking,  the  amount  of  total  acidity  of  beer  given  ia  books 
is  too  gi'eat.  It  is  seldom  found  to  be  more  than  30  grains  per  pint,  and 
even  rarely  reaches  that ;  sometimes  it  is  not  more  than  14  or  15  grains. 
In  thirty-one  kinds  of  porter  and.  stout,  the  acidity  per  pint  vai'ied  from 
25.22  grains  (the  highest)  to  14.14  grains  (the  lowest  amount).  In  twenty- 
three  kinds  of  ale,  the  highest  and  the  lowest  amounts  per  pint  were  34.89 
and  7.97  per  grain," 

4.  Determine  Amount  of  Alcohol. — There  are  various  ways  of  doing  this, 
but  one  of  the  two  follo^nng  wiU  be  sufficient. 

Measure  a  certain  quantity,  say  one  pint  of  beer,  and  take  the  specific 
grarity  at  60""  or  68^  Fahr.'  1st.  Put  into  a  retort  and  distil  at  least  two- 
thirds.  Take  the  distUlate,  dilute  to  original  volume  with  distilled  water, 
determine  the  specific  grarity  at  60°  or  68°  by  a  proper  instrument,  and 
then  refer  to  the  annexed  table  of  specific  grarities — opposite  the  found 
specific  gravity  the  percentage  of  alcohol  is  given  in  volume  (not  in 
weight). 

'  See  Appendix  A,  Vol.  II.  •  British  Medical  Journal,  June,  1870. 

'  Hassall  recommends  previous  removal  of  CO.,  by  shaking  up  in  a  corked  bottle 
fcr  ten  minutes,  opening  the  bottle  from  time  to  time,  and  sucking  air  through  it  with 
a  tube.     This  is  more  necessary  with  bottled  than  draught  beer. 


BEVERAGES  AND  CONDIMENTS. 


297 


2d.  Then,  to  check  this,  a  plan  recommended  by  Mulder  may  be  used. 
Take  the  residue  of  the  beer  in  the  retoi-t,  dilute  with  water  to  the  original 
volume,  and  take  the  specific  gTavity  at  60°  or  68°. 

Then  deduct  the  specific  gTavity  before  the  evaporation  from  the  specific 
gravity  after  it,  take  the  difference,  and  deduct  this  from  1000  (the  specific 
gravity  of  water),  and  look  in  the  table  of  siDecific  gravities  for  the  num- 
ber thus  obtained  ;  opposite  will  be  found  the  percentage  of  alcohol.  The 
results  of  these  two  methods  should  be  identical. 

If  there  is  no  retort,  this  second  plan  may  be  used  with  a  common 
evaporating  dish,  the  alcohol  being  suffered  to  escape.  A  common  uiin- 
ometer  (tested  for  correctness,  in  the  first  place,  by  immersion  in  distilled 
water  at  62°  Fahr. )  may  be  employed  for  determining  the  specific  gravity. 
The  plan  is  veiy  useful  for  medical  officers  ;  it  requires  nothing  but  a  urin- 
ometer  and  evaporating  dish,  with  reasonable  care  and  slowness  of  evapor- 
ation, so  as  not  to  char  the  residue  and  render  it  insoluble. 


Alcohol  (Volume)  according  to  Specific  Gravity. 


100  parts. 

Specific 

Gravity. 

100  parts. 

Specific 

Gravity. 

Alcohol. 

Water. 

At  68°. 

At  60°. 

Alcohol. 

Water. 

At  68°.. 

At  60°. 

50 

50 

0.914 

0.917 

24 

76 

0.966 

0.968 

49 

51 

0.917 

0.920 

23 

77 

0.968 

0.970 

48 

52 

0.919 

0.922 

22 

78 

0.970 

0.972 

47 

53 

0.921 

0.924 

21 

79 

0.971 

0.973 

46 

54 

0.923 

0.926 

20 

80 

0.973 

0.974 

45 

55 

0.925 

0.928 

19 

81 

0.974 

0.975 

44 

56 

0.927 

0.930 

18 

82 

0.976 

0.977 

43 

57 

0.930 

0.933 

17 

83 

0.977 

0.978 

42 

58 

0.932 

0.935 

16 

84 

0.978 

0.979 

41 

59 

0.934 

0.937 

15 

85 

0.980 

0.981 

40 

60 

0.936 

0.939 

14 

86 

0.981 

0.982 

39 

61 

0.938 

0.941 

13 

87 

0.983 

0.984 

38 

62 

0.940 

0.943 

12 

88 

0.985 

0.986 

37 

63 

0.942 

0.945 

11 

89 

0.986 

0.987 

36 

64 

0.944 

0.947 

10 

90 

0.987 

0.988 

35 

65 

0.946 

0.949 

9 

91 

0.988 

0.989 

34 

66 

0.948 

0.951 

8 

92 

0.989 

0.990 

38 

67 

0.950 

0.953 

7 

93 

0.990 

0.991 

32 

68 

0.952 

0.955 

6 

94 

0.992 

0.992 

31 

69 

0.954 

0.957 

5 

95 

0.994 

0.994 

30 

,70 

0.956 

0.958 

4 

96 

0.995 

0.995 

29 

71 

0.957 

0.960 

3 

97 

0.997 

0.997 

28 

72 

0.959 

0.962 

2 

98 

0.998 

0.998 

27 

73 

0.961 

0.963 

1 

99 

0.999 

0.999 

26 

74 

0.963 

0.965 

0 

100 

1.000 

1.000 

25 

75 

0.965 

0.967 

Alcohol  is  sometimes  stated  as  iveight  in  volume.  The  following  table 
shows  tolerably  accurately  the  relation  between  the  two,  and  the  relative 
amount  of  proof-spirit,  so  that  a  little  calculation  wiU  reduce  one  table 


298 


PRACTICAL    HYGIENE. 


into  another,  if  desired.  In  other  words,  if  the  percentage  of  alcohol  in 
volume  be  multipUed  by  .8,  the  iveight  of  the  alcohol  is  given  per  cent.  If 
the  percentage  of  alcohol  in  iceight  is  multiplied  by  1.25,  the  volume  is 
given.  If  the  percentage  volume  of  alcohol  be  multiplied  by  1.76,  the 
amount  of  proof-i'jnrit  is  given. ' 


Per  cent. 

Per  cent. 

in  Volume. 

in  Weight. 

1 

0.8 

2 

1.6 

3 

2.4 

4 

3.2 

5 

4.0 

Proof-Spirit. 

1.76 
3.54 
5.35 

7.00 
8.80 


Per  cent. 

Per  cent. 

in  Volume. 

in  Weight. 

6 

4.8 

7 

5.6 

8 

6.4 

9 

7.2 

10 

8.0 

Proof-Spirit. 

10.56 
12.32 
14.00 
15.76 
17.60 


5.  The  solids  can  be  determined  by  evaporation,  and  the  ash  obtained 
by  incineration  ;  but  medical  officers  will  seldom  have  occasion  to  do  this. 
The  specific  gravity  of  the  de-alcoholized  beer  gives  a  sufficient  approxi- 
mation. 

6.  Evaporate  the  beer  to  a  syrupy  consistence  ;  it  should  have  a  pleas- 
ant bitter  taste. 

The  points,  then,  to  be  determined  in  judging  of  quality  are — 1.  Taste  ; 
2.  Appearance ;  3.  Microscopic  characters ;  4.  Specific  gravity  of  de-alco- 
holized beer,  from  which  we  find  the  per  cent,  of  extract ;  5.  Acidity  ;  6. 
Amount  of  alcohol ;  7.  Taste  of  syrupy  extract. 


2.    ADULTERATIONS    OF   BEER." 

1.  Water. — ^Probably  the  most  frequent  adulteration  ;  detected  by  taste  ; 
determining  amount  of  alcohol  and  specific  gravity  of  the  beer  free  from 
alcohol. 

2.  Alcohol. — Seldom  added ;  the  quantity  of  alcohol  is  large  in  propor- 
tion to  the  amount  of  extract,  as  determined  by  the  specffic  gravity  after 
separation  of  the  alcohol. 

3.  Sodium  or  Calcium  Carbonate  in  order  to  lessen  Acidity. — Neither 
adulteration  can  be  detected  without  a  chemical  examination.  Evaporate 
beer  to  a  thick  extract,  then  put  in  a  retort,  acidulate  with  sulphuric  acid, 
and  distil ;  if  calcium  or  sodium  acetate  be  present,  acetic  acid  in  large 
quantity  will  pass  over.  The  extract  always  contains  some  acetate,  but 
only  in  small  quantity. 

Lime. — Evaporate  to  dryness  another  portion  of  beer,  incinerate,  dis- 
solve in  weak  acetic  acid,  and  precipitate  by  ammonium  oxalate.  In  un- 
adulterated beer  the  precipitate  is  moderate  only. 

Excess  of  soda,  for  some  always  exists  in  beer,  is  detected  with  much 
greater  difficulty,  and  it  will  be  w'ell  not  to  attempt  this.  Mulder  states 
that  the  presence  of  too  great  a  quantity  of  lactates  may  be  determined  by 
boiling  the  beer  with  zinc  carbonate,  when  lactate   of  zinc  deposits."     In 

'  For  method  of  testing  by  Sykes'  hydrometer,  see  Appendix,  Vol.  TI. 

*  In  his  speech  in  the  House  of  Lords  (April  17,  1872,  Times'  report),  Lord  Kimherley 
stated  that  a  common  adulteration  is  as  follows :  A  certain  amount  of  beer  is  drawn 
from  the  cask  of  84  gallons,  and  then  6  lb  of  "foots"  (a  black  coarse  sugar),  1-i  gallon 
of  *'  finings  "  (made  from  skins  of  soles  and  other  fish),  and  12  gallons  of  water  are  put 
in  per  cask.  This  beer  is  ready  for  sale  in  two  hours,  and  must  be  drunk  in  two  days 
or  it  goes  bad.  Salt  and  copperas  are  added  by  some,  but  the  use  of  copperas  is  said 
not  to  be  general.     Ale  and  stout  are  not  mixed  with  water,  but  "  finings  "  are  used. 

'  De  la  Biere  (French  edition),  1861,  p.  258. 


BE7EEAGES    AND    CONDIMENTS.  299 

these  cases  the  beer  has  begun  to  change,  and  the  microscope  and  refer- 
ence to  Pasteur's  plate  Avill  greatly  assist. 

4.  Sodium  Chloride. — Tlus  is  hardly  an  adulteration,  unless  a  veiy  large 
quantity  is  added/  Take  a  measured  quantity  of  the  beer  ;  evaporate  to 
dryness  ;  incinerate  at  as  low  a  heat  as  possible  ;  dissolve  in  water,  and 
determine  the  chlorine  by  the  standard  solution  of  nitrate  of  silver. 

5.  Ferrous  Sulphate.— il  the  beer  be  hght-colored,  a  mixture  of  potas- 
sium ferricyanide  and  ferrocyanide  (Faraday's  test)  may  be  added  at  once, 
and  will  give  a  precipitate  of  Prussian  blue  ;  if  the  beer  be  veiy  dark- 
colored,  it  must  be  decolorized  by  adding  solution  of  lead  subacetate  and 
filtering. 

Or  evaporate  a  portion  of  beer  to  dryness  and  incinerate  ;  if  any  iron 
be  present  the  ash  is  red ;  dissolve  in  weak  nitric  acid,  and  test  with  po- 
tassium ferrocyanide.  Two  grains  of  ferrous  sulj^hate  to  nine  gallons  of 
water  give  a  red  ash  (HassaUj.  The  ash  of  genuine  porter  is  always  whit-e, 
or  grayish  white  (HassaU). 

6.  Sulphuric  acid  is  added  to  clarify  beer,  and  to  give  it  the  hard  flavor 
of  age.  If  the  beer  be  pale,  add  a  few  drops  of  hydrochloric  acid,  and 
test  with  barium  chloride.  A  very  dense  precipitate  may  show  that  sul- 
phui-ic  acid  has  been  added,  but  it  must  be  remembered  that  the  water 
used  in  brewing  may  contain  lai-ge  quantities  of  sulphates.  (The  Burton 
spring  water  is  rich  in  calcium  sulphate.)  If  theie  be  a  large  precipitate, 
then  determine  the  acidity  of  the  beer  before  and  after  evaporation  ;  if  the 
amount  of  fixed  acid  be  found  to  be  very  large,  there  will  be  no  doubt 
that  sulphuric  acid  has  been  added ;  or  precipitate  with  barvia,  and 
weigh. 

Mulder  recommends  that  the  extract  of  the  beer  be  heated,  and  the 
suljDhur  dioxide  which  is  disengaged  led  into  chlorine  water  ;  sulphuric 
acid  will  be  found  in  the  chloiine  water,  and  may  be  tested  for  as  usual. 

7.  Alum. — Evaporate  to  dryness  ;  incinerate,  and  proceed  exactly  as  in 
the  analysis  of  alum  in  bread.  The  substance  added  to  give  "  head "  to 
beer  is  a  mixture  of  alum,  salt,  and  ferrous  sulphate. 

8.  Burnt  Sugar — Essentia  bina — Foots. — Evaporate  the  beer  to  an  ex- 
tract ;  dissolve  in  alcohol ;  evaporate  again  to  extract,  and  taste.  Accord- 
ing to  Pappenheim,  these  substances  prevent  the  regressive  metamorphosis 
of  the  tissues,  and  thus  injure  health.  Burnt  sugar  is  added  to  porter  to 
give  color,  and  the  addition  is  not  illegal. 

9.  Capsicum — Peppers — Grains  of  Paradise. — Evaporate  to  dryness 
carefully  ;  dissolve  in  alcohol ;  filter  ;  evaporate  very  carefully  to  dryness, 
and  taste  if  there  is  any  pungency.  In  fourteen  out  of  twenty  samples 
of  ilhcit  beer,  iMr.  Phillips  found  that  grains  of  paradise  had  been  added. 
It  is  said  that  the  oils  of  pimento,  zedoary,  and  ginger  are  sometimes  used. 

10.  Aloes.— The  taste  alone  is  not  reliable.  Dr.  Koehler'  proposes  to 
evaporate  the  beer.  Dissolve  the  residue  in  nitric  acid,  when  a  yellowish- 
red  Hquid  is  obtained,  which  takes  a  deep  blood-red  color  when  treated 
with  hq.  potassse  and  glucose,  or  with  liq.  potassae  and  either  cyanide  of 
potassium  or  sulphide  of  ammonium,  if  aloe-resin  is  present.  The  nitric 
acid  solution  is  not  decolorized  by  stannous  chloride  ;  if  hops  only  have 
been  used,  it  is  decolorized. 

11.  Colocynth. — The  residue  of  evaporated  beer,  heated  with  nitric 
acid,  yields  a  yellow  solution ;  with  concentrated  sulphuiic  acid,  an  intense 


'  The  Inland  Eevenue  Office  allows  50  grains  of  sodium  cMoride  per  gallon. 
2  Sclimidt's  Jalixb.,  1871,  No.  10,  p.  23. 


300  PRACTICAL    HYGIENE. 

red  solution ;  and  a  clierry-red  color  is  given  with  Froelide's  test  (molyb- 
date  of  sodium  dissolved  in  svdphuric  acid).' 

12.  Colchicin. — A  case  is  recorded  by  Dr.  Buttern  ^  of  Faaborg,  in  Nor- 
way, where  colchicin  was  detected  in  some  English  beer,  and  caused  symp- 
toms of  poisoning  (vomiting,  diarrhoea,  burning  pain  in  the  head,  stom- 
ach, etc.). 

13.  Santonin. — Evaporate  beer  to  extract ;  treat  with  alcohol,  filter, 
evaporate,  and  prejDare  the  santonin  as  usual  by  boiling  with  lime,  and 
precipitating  by  an  acid. 

14.  Cocculus  indicus. — It  is  not  knoANTi  whether  much  of  this  is  now 
used.  The  witnesses  examined  in  1856  by  the  Committee  of  the  House 
of  Commons  (Scholefield's)  all  doubted  it ;  a  large  quantity  of  Cocculus 
indicus  is,  however,  annually  imported,  and  no  other  use  is  known.'  In 
two  instances  out  of  twenty  specimens  of  adulterated  beer,  analyzed  in 
1863  by  Mr.  Phillips,  Cocculus  indicus  was  found  in  large  quantities. 

For  the  detection  of  Picrotoxine,  Herapath  recommends  that  the  beer 
be  first  treated  with  lead  acetate  ;  filtered ;  excess  of  lead  got  rid  of  b}' 
hydrogen  sulphide  ;  fluid  evajiorated  to  a  small  bulk,  and  mixed  with  ani- 
mal charcoal.  The  charcoal  absorbs  the  picrotoxine  ;  it  is  boiled  in  alco- 
hol, and  the  alcohol  is  evajDorated  on  slips  of  glass.  The  j^icrotoxine 
crystallizes  as  plumose  tufts  of  cii'cular  or  oat-shaped  ciystals. 

Dr.  Langley,  of  Michigan,^  recommends  acidulating  the  beer  with 
hydrochloric  acid  and  agitating  with  ether ;  the  ethereal  solution  yields  on 
evaporation  crystals  of  picrotoxine. 

A  jDlan  demised  by  Depaii-e  is  considered  by  Koehler  as  one  of  the  easiest 
and  at  the  same  time  the  best.  Mixonehtre  of  beer  with  finely  powdered 
rock  salt :  resinous  and  extractive  matters  are  thrown  down.  Shake  the 
liquid  with  ether  ;  an  impure  pici'otoxine  is  obtained,  which  can  be  purified. 

None  of  these  j^rocesses  will  give  more  than  y*oths  of  the  picrotoxine. 

"VMien  the  crystals  of  picrotoxine  are  obtained,  test  them  as  follows  : — 

(a)  Eub  the  crystals  with  3  or  4  parts  of  pure  nitrate  of  potassium  ; 
add  1  or  2  drops  of  strong  sulphuric  acid,  and  then  an  excess  of  strong 
solution  of  soda  or  potash.  A  bright  reddish-yellow  color  is  given,  if 
picrotoxine  be  pi-esent  (Langley). 

(b)  Dissolve  the  crystals  in  strong  sulphuric  acid  ;  a  yellow  fluid  is  ob- 
tained. Stir  it  with  a  glass  rod  which  has  been  dipjDed  in  a  concentrated 
solution  of  potassium  bichromate  ;  a  bluish-violet  color  is  obtained  i  like 
a  strychnine  reaction),  which  changes  soon  into  brown,  bro-oTi  green,  and 
at  last  apple  green. 

(c)  If  a  good  deal  of  picrotoxine  is  obtained,  dissolve  it  in  water,  and 
put  a  small  fish  in  the  water  ;  the  poisonous  effects  occur  in  a  short  time. 

15.  Strychnine  or  Nux  Vomica. — This  is  a  very  uncommon  adulteration, 
if  it  ever  occur.  Add  animal  charcoal  to  the  beer  ;  digest  for  twenty-foiir 
hours  ;  pour  off  the  beer  ;  boil  the  charcoal  in  alcohol  ;  filter  ;  evaporate 
one-half  ;  add  a  few  di'ops  of  liquor  potassae  and  then  ether  ;  agitate  ;  poiu: 
off  ether,  and  evaporate  to  dr^-ness ;  test  for  strj'chnine  by  the  color  test 
(sulphuric  acid  and  potassiiun  bichromate,  or  peroxide  of  lead,  or  man- 
ganese, or  potassium  peiToanganate).^ 

16.  Tobacco  is  occasionally  used ;  in  twenty  specimens  of  illicit  beer 

1  Koeliler,  op.  cit.  2  Med.  Times  and  Gazette,  May  16,  1874,  p.  29. 

'  It  is  said  to  be  obtainable  from  wholesale  druggists  under  the  name  of  inultum. 

*  Chemical  Xews,  September  6,  1862. 

*  Other  vegetable  bitters  are  used,  but  their  detection  is  difficult  and  uncertain. 
Mr.  Sorby  recommends  the  spectroscope  for  detecting  calumba  root. 


BEVERAGES    AND    CONDIMENTS.  301 

examined  in  1863  by  Mr.  Phillips,  of  the  Inland  Eevenue  Department,  to- 
bacco was  found  in  one. 

17.  Picric  {Trinitrophenic)  Acid. — Lassaigne  reeommeHds  the  addition 
of  subacetate  of  lead  and  animal  charcoal  ;  if  the  beer  has  still  a  yellow 
color,  picric  acid  is  present.  But,  as  Mulder  and  Hassall  obsei-ve,  many 
beers  destitute  of  picric  acid  remain  yellow.  Pohl  advises  to  add  white 
uncombed  wool ;  if  picric  acid  be  present,  it  stains  it.  This  is  an  uncer- 
tain test.  H.  Brunner  extracts  the  picric  acid  from  the  wool  with  hot 
aqueous  ammonia  ;  concentrates  to  a  small  bulk,  and  tests  with  a  drop  of 
solution  of  cyanide  of  potassium.  A  red  coloration  of  isopurpm-ate  of 
potassium  will  be  produced  if  there  be  1  part  of  picric  acid  in  500,000 
of  water  (Hassall).  , 

18.  Copper. — Evaporate  a  portion  of  the  beer  to  dryness;  incinerate; 
dissolve  in  weak  nitric  acid  ;  test  for  copper  by  the  insertion  of  a  clean 
knife  ;  by  addition  of  ammonia  and  of  potassium  ferrocyanide. 

19.  Lead. — Evaporate  a  considerable  quantity  of  the  beer  to  dryness  ; 
incinerate  ;  dissolve  in  weak  nitric  acid,  and  test  for  lead  as  usual 

Sub-Section  IL — Weves.' 

Composition. 

The  composition  of  wine  is  so  various  that  it  is  difficult  to  give  Cj  sum- 
mary.    The  following  are   the  chief  ingi-edients : — 

1.  Alcohol. — From  6  to  25  per  cent,  volume  in  volume,  of  anhydrous 
alcohol.  It  has  been,  however,  stated  that  the  fermentation  of  the  grape, 
when  joroj^erly  done,  cannot  yield  more  than  17  per  cent.,  and  that  any 
amount  beyond  this  is  added,"  Some  of  the  finest  wines  do  not  contain 
more  than  6  to  10  per  cent. 

Per  cent,  of  Alcohol 
(Volume  in  volume). 

Port  {analyzed  in  England) 16.62 '  to  23.2 

Sherry  [analyzed  in  Eyigland) 16  "25 

Madeu'a  {analyzed  in  England) 16. 7        "22 

Marsala  {analyzed  in  England) 15  "25 

Bordeaux  wines,  i-ed  (mean  of  90  determinations  of  dif-  ) 

ferent  sorts  :  Chateau  Lafite,   Margaux,  Larose,  St.  >  6.85      "  18 

Emilion,  St.  Estephe,  etc.)  . . .  .  , ) 

Bordeaux -wines,  white  (mean  of  27  determinations  of)  -,-.  "18  7 

sorts  :  Sauternes,  Barsac,  Bergerac,  etc.) f  *  ' 

Rhone  wines,  red  (Hermitage,  Montpelher,  Frontignan,  )  n  «        "1^7 

etc.) j 

'  For  a  fall  account  of  wines,  see  tlie  work  by  Thudicliuni  and  Dupre  (Origin, 
Nature,  and  Use  of  Wine,  1872). 

^  Mulder  (On  Wine,  p.  186)  quotes  Guijal  to  the  effect  that  pure  port  never  contains 
more  than  12.75  per  C;nt.  of  pure  alcohol;  but  Mulder  doubts  this.  Dr.  Gorman 
stated  before  the  Parliamentary  Committee  that  pure  sherry  never  contains  more  than 
12  per  cent,  of  alcohol,  and  that  6  or  8  gallons  of  brandy  are  added  to  108  gallons  of 
sherry.  Thudichum  and  Dupre  (On  Wine,  p.  682)  state  that  a  natural  wine  may  con- 
tain a  minimum  of  9,  while  the  maximum  limit  is  16  per  cent,  (of  weight  in  volume). 
They  also  state  that  a  pipe  of  115  gallons  of  port  wine  has  never  less  than  3  gallons  of 
brandy  added  to  it,  and  the  rich  port  wines  have  13  to  15  gallons  added.  It  would 
seem  that  the  natural  wines  of  Australia  contain  a  larger  quantity  of  alcohol  in  some 
instances  than  any  European  wine. 

^  Some  port  used  in  the  Queen's  establishment  contained  only  16.62,  and  the  high- 
est percentage  was  18.8  (Hofmann).  The  sherry  contained  only  16  per  cent,  and  the 
claret  6.85  to  7  per  cent.  The  highest  percentage  found  by  Thudicum  and  Dupre  in. 
port  wine  was  19.2  per  cent,  of  weight  in  volume  —  23.4  per  cent,  volume  in  volume. 


302  PRACTICAL    HYGIENE. 

Per  cent,  of  Alcohol 
(Volume  in  volume). 

Eoussillon  11  to  16 

Bui-guudy,  red  (Beavme,  Macon) 7.3  "  14.5 

white  (ChabUs,  etc.) 8.9  "  12 

Pyrenean 9  "  16 

Champagnes 5.8  "  13 

MoseUes 8  "  13 

Rhine  wines  (Johannisberger,  Hochheimer,  Rudeshei- )  r  7  "  16 

mer,  etc.) j 

Hungarian  "\\ine 9. 1  "  15 

Italian 14  "  19 

Syria,  Corfu,  Samos,  Smyrna,  Hebron,  Lebanon 13  "  18 

So  various  is  the  amount  of  alcohol  in  wines  from  the  same  district, 
that  a  very  general  notion  only  can  be  obtained  by  tables,  and  a  sample 
of  the  wine  actually  used  must  generally  be  analyzed. 

To  tell  how  much  ])m-e  alcohol  is  taken  in  any  definite  quantity  of 
wine,  measui-e  the  wine  in  ounces,  multijily  it  by  the  percentage  of  alco- 
hol, and  divide  by  100. 

9  X  13 

Example. — "Wine  drank  being  9oz.,  and  the  percentage  13,  then 

=  1.17  oz.  of  absolute  alcohol  by  measm-e. 

The  amount  of  alcohol  can  be  deteiTnined  by  distillation  or  eA"aporation, 
as  given  in  the  section  on  Beer.  Instniments,  however,  are  required,  which 
indicate  a  less  specific  gravity  than  pure  water.  If  the  medical  officer  has 
only  a  common  uiinometer,  the  only  plan  will  be  to  dilute  with  an  equal 
part  of  pure  water  at  60',  and  then  to  add  a  little  salt,  so  as  to  bring  the 
specific  gi-avity  above  that  of  the  water  ;  then  evajDOi-ate  as  usual.  Take 
the  difterence  of  the  specific  gravities  (before  and  after  evaporation)  ;  de- 
duct from  1000,  and  look  in  the  specific  gravity  table  (p.  297),  for  the 
amount  of  alcohol  in  the  diluted  vdne  ;  by  multiphdng  the  result  by  2,  the 
percentage  of  alcohol  in  the  undiluted  wine  is  found.  Sometimes,  besides 
ethyl  alcohol,  small  quantities  of  projDyl,  butyl,  and  amyl  alcohols  are  found 
in  wine.  A  little  acet-aldehyde  is  present  in  some  Greek  wines  (Thudichum 
and  Dupro),  but  is  not  considered  to  indicate  unsoundness.' 

2.  Ethers. — Qi^nanthic,  citric,  mahc,  tartaric,  racemic,  acetic,  butyi-ic, 
caprs-Hc,  caproic,  pelargonic,  and  many  others.  Dr.  Dupre  states  that 
there  ai"e  25  or  even  more  compound  ethers  in  wine,  and  some  of  them  are 
in  veiy  small  quantities.  The  "bouquet"  of  wine  is  partly  owing  to  the 
ethers  (especially  to  the  volatile) — partly,  it  is  said,  to  extractive  matters. 
(Enanthic  ether  is  that  which  gives  its  characteristic  odor  to  wine.  Dr. 
Dupre  has  given  a  veiy  good  plan  of  estimating  the  amount  of  the  volatile 
and  nonvolatile  ethers,  but  it  is  too  delicate  for  medical  oflicers.^ 

3.  Albuminous  Matters — Extractive  Coloring  Matter. — The  quantity  of 
albumen  is  not  great ;  the  extractives  and  coloring  matter  vary  in  amount. 
The  coloring  matter  is  derived  from  the  skins  ;  it  is  naturally  greenish  or 
blue,  and  is  made  violet  and  then  red  by  the  free  acids  of  wine.  The 
bluish  tint  of  some  Burgundy  wines  is  owing,  according  to  Mulder,  to  the 
very  small  amount  of  acetic  acid  which  these  wines  contain.  It  is,  accord- 
ing to  Batilliat,  composed  of  two  mattei's — rosite  and  pui'pm-ite.     "With  age 

'  If  it  is  present  in  white  wines  (such  as  Sautemes)  it  is  a  certain  sign  of  unsound- 
ness. 

*  Chem.  Journal,  November,  1867,  and  Origin,  Nature,  and  Use  of  Wine. 


BEVERAGES    AND    CONDIMENTS.  303 

clianges  occur  in  the  extractive  matters ;  some  of  it  falls  (apothema), 
especially  in  combination  with  tannic  acid,  and  the  wine  becomes  pale  and 
less  astringent. 

4.  Sugar  exists  in  varying  amounts,  and  in  the  form  for  the  most  part 
of  fruit  sugar.  Sherry  generally  contains  sugar,  but  not  always ;  it  averages 
8  grains  per  ounce  ; '  and  appears  to  be  highest  in  the  brown  sherries,  and 
least  in  Amontillado  and  Manzanilla.  In  Madeira  it  varies  from  6  to  66 
grains  per  ounce  ;  in  Marsala  a  little  less  ;  in  Port,  from  16  to  34  grains 
per  ounce,  being  apparently  greatest  in  the  finest  wines.  In  Champagne 
it  amounts  to  from  6  to  28  grains,  the  average  being  about  24  grains.  In 
the  Clarets,  Burgundy,  Rhine,  and  Moselle  wines,  it  is  absent,  or  in  small 
amount. 

In  determining  the  sugar,  if  the  copper  solution  be  used,  the  coloring 
matter  is  acted  on  by  the  alkali  of  the  copper  solution,  and  interferes  with 
the  appreciation  of  the  change  of  tint,  and  must  be  got  rid  of  by  acetate  of 
lead,  animal  charcoal,  boiling,  and  filtering.  If  any  substance  exists  which 
is  still  tiu'ned  green  by  the  alkali  of  the  copper  solution,  the  wine  must 
be  neutralized,  evaporated  to  dryness,  and  the  sugar  dissolved.  As  a  rule, 
the  copper  solution  employed  directly  with  wine  gives  \  per  cent,  too  much 
sugar  (FehUng),  and  a  correction  to  this  amount  should  be  made.^ 

5.  Fat. — A  small  amount  exists  in  some  wines. 

6.  Free  Acids. — Wine  is  acid  from  free  acids  and  from  acid  salts,  as  the 
potassium  bitartrate.  The  principal  acids  are  racemic,  tartaric,  acetic, 
malic,  tannic  (in  small  quantities),  glucic,  succinic,  lactic  {?),  carbonic,  and 
fatty  acids,  such  as  formic,  butyric,  or  propionic.  Some  acids  are  volatile 
besides  the  acetic,  but  it  does  not  seem  quite  certain  what  they  are.  The 
tannic  acid  is  derived  from  the  skins  ;  it  is  in  greatest  amount  in  new  Port 
wines  ;  it  is  trifling  in  Madeira  and  the  Rhine  wines  ;  it  is  present  in  all 
white  and  most  red-fruit  wines,  except  Champagne.  The  tannic  acid  on 
keeping  precipitates  with  some  extractive  and  coloring  matter  (apothema 
of  tannic  acid). 

7.  Salts. — The  salts  consist  of  bitartrate  of  potassium,  tartrates  of  cal- 
cium and  sodium,  sulphate  of  ]3otassium,  a  little  phosphate  of  calcimn  and 
magnesium,  chloride  of  sodium,  and  iron.  The  magnesia  is  in  larger 
amount  than  the  hme,  and  exists  sometimes  as  malate  and  acetate.  A  little 
manganese  and  copper  have  been  sometimes  found.  In  Rhine  wine  a  little 
ammonia  is  found  (Mulder).  The  total  amount  of  salts  is  .1  to  .3  per  cent. 
— i.e.,  about  9  to  26  gi'ains  per  pint,  or  ^  to  1|-  grain  per  ounce.  The  salts 
can  only  be  detected  by  evaporation  and  ignition. 

8.  The  total  soHds  in  wine  vary  from  3  to  14  per  cent.,  or  in  some  of 
the  rich  liqueur-like  wines  to  more.  The  specific  gravity  depends  uj)on  the 
amount  of  alcohol  and  of  sohds,  and  varies  from  .673  to  1.002  or  more. 
An  approximate  notion  can  be  formed  of  the  total  solids  by  taking  the 
specific  gravity,  after  driving  off  the  alcohol  by  evaporation  and  then  repla- 
cing the  water. 

Examination  of  Wine. 

The  quahty  of  wine  can  be  best  determined  by  noting  the  color,  tran- 
sparency, and  taste,  and  then  determining  the  following  points : — 

(1.)  The  amount  of  solids  as  given  by  the  specific  gravity  after  the  ehm- 

■  Bence  Jones,  in  Mulder  on  Wine,  p.  386. 

^  The  addition  of  extraneous  sugar  to  wine  may  be  detected  by  the  use  of  the  sac- 
tharometer  along  with  Fehling's  solution. 


304  PRACTICAL    HYGIENE. 

ination  of  the  alcohol.  In  the  best  clarets,  before  the  loss  of  alcohol,  the 
specific  gravity  is  very  nearly  that  of  water.  In  some  claret  used  in  the 
Queen's  establishment,  and  analyzed  by  Dr.  Hofmann,  the  specific  gravity 
was  .99952.  In  other  clarets  it  is  as  low  as  .995.  A  low  specific  gravity 
shows  that  alcohol  has  been  added,  or  that  the  solids  are  in  small  amount. 

(2.)  The  amount  of  alcohol ;  a  very  small  amount  may  show  the  addition 
of  water  ;  a  large  amount  the  addition  of  spirits. 

(3.)  The  amount  oifree  acidity.  This  is  an  important  point,  as  it  seems 
clear  that  some  persons  (especially  the  sick)  do  not  readily  digest  a  large 
amount  of  acid  and  acid  salts. 

The  amount  is  detemiined  by  the  alkaline  solution.  The  free  acidity 
is  generally  reckoned  as  crystallized  tartaric  acid  (0,11^0^),  1  C.C  of  the 
alkaline  solution  being  equal  to  7.5  milligi'ammes.  There  is  both  fixed 
and  volatile  acidity  ;  the  relative  amount  of  the  two  is  diflficult  to  determine 
satisfactorily,  as  some  acid  may  be  formed  on  distillation.  The  distillation 
should  be  conducted  at  a  low  temperature,  so  as  not  to  decompose  the 
fixed  compound  ethers.  The  volatile  acidity  is  reckoned  as  glacial  acetic, 
the  fixed  as  tartaric  acid.  All  the  acidities  of  wine  are  usually  reckoned 
as  grains  per  ounce. 

The  amount  of  free  acidity  varies  greatly  even  in  the  same  kind  of 
wines  ;  the  least  acid  wines  are  Sherry,  Port,  Champagne,  the  best  Claret,  and 
Madeii-a  ;  the  more  acid  wines  are  Burgundy,  Khine  wine,  Moselle  (Bence 
Jones).  The  amount  of  free  acid  in  good  Clarets  is  equal  to  2  to  4  grains 
of  tartaric  acid  per  ounce  ;  in  common  Clarets  and  in  Beaujolais,  it  may  be 
4  to  6  grains,  and  in  some  extremely  acid  wines  it  may  be  even  more  than 
this.  In  the  best  Champagnes  it  is  2  to  3  grains  usually  ;  but  it  has  been 
known  to  reach  in  excellent  Champagne  1.12  per  cent.,  or  4.8  grains  jDcr 
ounce.'  In  Port  it  averages  2  to  2^  grains,  but  may  reach  4  grains  ;  in 
Sherry  \^  to  2|  grains  ;  in  the  Rhine  wines,  3^  to  4  or  6  grains.  Thud- 
ichum  and  Dupre  state  that  in  good  sound  wine  the  amount  of  free  acidity 
ranges  fi"om  .3  to  .7  per  cent.,  or  from  1.3  to  3  grains  per  oimce. 

The  taste  of  wine  does  not  depend  entirely  on,  bvit  jei  is  very  greatly 
influenced  by,  the  degree  of  acidity.  Mr.  Griffin^  states  that  good-tasted 
wine  contains  from  1.87  to  2.8  grains  of  crystallized  tartaric  acid  per  ounce  ; 
that  if  it  contains  less  than  1.87  grain,  it  tastes  flat ;  that  if  more  than  3 
grains  per  ounce,  the  wine  is  too  acid  to  be  agreeable  ;  if  more  than  4.37 
gi-ains  per  ounce  (1  per  cent.),  it  is  too  acid  to  be  drunk.  These  numbers 
seem  rather  low.^ 

(4.)  The  amount  of  sugar.  The  best  modes  of  determining  this  have 
been  already  noticed. 

(5. )  It  may  be  sometimes  useful  to  determine  the  amount  and  kind  of 
ethers  by  fractional  distillation. 

Excessive  acidity  of  wine  can  be  corrected  by  adding  neutral  potassium 
tartrate.  Milk  is  also  often  used.  The  addition  of  the  carbonated  alkalies, 
or  of  chalk,  alters  the  bouquet  of  the  wine.  When  wine  becomes  stringy, 
in  which  case  acetic  and  lactic  acids  are  formed,  it  may  be  improved  by 
adding  a  little  tea  ;  about  1  ounce  of  tea  boiled  in  2  quarts  of  water  should 


■  This  was  the  case  in  some  Champagne  examined  by  Dr.  Hofmann. 

2  Report  on  Cheap  Wine,  by  R.  Druitt,  M.D.,  p.  178. 

^  From  thirteen  analyses  of  sound  ordinary  Port,  I  found  the  mean  acidity  to  be  1.97 
per  ounce;  in  some  samples  of  Sherry,  1.90;  Marsala,  1..5  ;  light  Claret,  '6.1  ;  in  a 
rather  sour  Claret,  4.0;  in  a  sample  of  Montilla,  a  fine  wine,  but  too  acid,  3.15. — • 
(F.  de  C.) 


BEVERAGES    AND    CONDIMENTS.  305 

be  added  to  about  40  gallons  of  wine.  Bitter  wine  is  treated  with  bard 
water  or  sulphur ;  bad-smelKng  wine  with  charcoal ;  too  astringent  wine 
with  gelatin ;  wine  which  tastes  of  the  cask  with  olive-oil.' 

Adulterations  of  Wine. 

1.  Water. — Known  by  taste  ;  amount  of  alcohol ;  specific  gravity  after 
elimination  of  alcohol 

2.  Distilled  Sjyirits. — Known  by  determining  the  amount  of  alcohol;  the 
normal  percentage  of  the  particular  kind  of  wine  being  known.  By  frac- 
tional distillations  the  peculiar-smelling  fusel  oils  may  be  obtained ;  or 
merely  rubbing  some  of  the  vnne  on  the  hand,  and  letting  it  evaporate, 
may  enable  the  smell  of  these  ethers  to  be  perceived. 

3.  Artificial  Coloring  Matters. — The  following  are  the  chief  coloring 
matters,  as  stated  by  Thudichum  and  Dupre,  Logwood  is  the  great 
coloring  material,  and  also  blackberries,  elderberries,  and  bilberries. 
There  are  no  good  methods  of  recognizing  these  substances  ;  salts  of  lead, 
ammonia,  and  ammonium  sulphide,  alum,  and  potassium  or  ammonium 
carbonate,  and  salts  of  tin,  have  been  used  as  re-agents.  The  most  useful 
test  appears  to  be  this  :  add  to  the  wine  about  :^th  volume  of  strong  solu- 
tion of  alum  ;  stii*  well,  and  then  add  about  an  equal  quantity  of  strong 
solution  of  ammonium  carbonate  ;  the  natiu'al  coloring  matter  of  the  wine, 
when  thrown  down  in  this  way,  has  a  greenish  or  dirty  bluish-green  color,- 
but  there  is  no  tinge  of  red  ;  ]og"wood  and  several  other  abnormal  colors, 
have  a  distinct  red  or  pur^Dhsh  tint.^  The  use  of  strips  of  gelatin,  as 
described  under  Alum  in  Bread,  is  also  recommended.  Fuchsine  or 
rosanihne  and  other  substances  have  also  been  used,  but  on  the  whole 
there  has  been  some  exaggeration,  whilst  the  coloiing  matters  employed 
are  mostly  harmless. 

4.  Lime  Salts. — The  so-called  "platrage"  of  wines  consists  in  the  addi- 
tion of  1^  ft)  to  7  ft)  of  a  mixtui'e  of  calcium  sulphate  (80  parts),  calcium 
carbonate  (12),  quicklime  and  sulphide  and  chloride  of  calcium  (8  parts)  to 
1  hectolitre  of  wine.  Calcium  sulphate  dissolves  in  large  proportion,  and 
then  interchanges  with  the  chloride  of  potassium,  and  chloride  of  calcium 
and  sulphate  of  potassium  are  formed.  The  chalk  forms  acetate  and  tar- 
trate of  calcium.  The  proportion  of  lime  salts  is  then  verj'  lai-ge.  The 
only  precise  way  of  detecting  this  adulteration  is  by  evaporating  to  diyness, 
incinerating,  and  determining  the  amount  of  liiue.  But  the  following 
method  is  shorter,  and  will  generally  answer.  The  natural  hme  salts  of 
wine  are  tartrate  and  sulphate  ;  when  hme  is  added,  an  acetate  of  calcium 
is  formed.  Evaporate  the  wine  to  y^th ;  add  twice  the  bulk  of  strong  al- 
cohol ;  the  calcium  acetate  is  dissolved,  but  not  the  sulphate  or  tartrate  ; 
filter  and  test  mth  oxalate  of  ammonium  ;  if  a  large  precipitate  occur,  hme 
has  probably  been  added. 

5.  Tannin  may  be  detected  either  by  chloride  of  ii'on  or  by  adding 

^  Wine  is  subject  to  several  diseases,  -wliich,  according  to  Pasteur,  depend  on  differ- 
ent kinds  oi:  ferments  (see  Review  on  Hygiene,  in  Army  Medical  Department  Reports, 
vol.  vii.,  p.  340).  By  heating  the  wine  to  about  125°-130"  Fahr.  these  "mycoderms" 
are  killed,  and  the  wine  undergoes  no  further  change.  The  microscope  may  be  em- 
ployed, as  in  the  case  of  Beer. 

-  Mulder  speaks  very  doubtfully  of  all  such  tests  ;  they  seem,  however,  better  than 
nothing.  Probably  the  spectrum  analysis  will  hereafter  afford  the  best  means  of  iden- 
tification. On  the  coloring  matter  of  wine,  see  Duclaux,  Comptes  Rendus  de  I'Acade- 
mie  des  Sciences,  t.  Ixxvii. ,  Xo.  16,  April,  1874,  p.  1159  ;  also  Report  on  Hygiene, 
Army  Med.  Reports,  vol.  xv. ,  p.  190. 
Von.  I.— 30 


306  PRACTICAL    HYGIENE. 

gelatin ;  but  as  tannin  exists  naturally  in  most  of  the  red  wines  (Port, 
Beauue,  Roussillon,  Hermitage,  etc),  the  question  becomes  often  one  of 
quantity.  The  amount  of  tannin  can  be  estimated  by  drying  the  tanno- 
gelatine  (100  grains  contain  40  of  tannin). 

6.  Alum. — This  is  detected  precisely  in  the  same  manner  as  in  bread. 
Evaporate  a  pint  of  the  wine  to  dryness  ;  incinerate,  and  then  proceed  as 
directed  in  Bre.\d. 

7.  Lead. — Evaporate  to  dinniess,  and  incinei-ate  ;  dissolve  in  dilute  nitric 
acid,  and  test  as  directed  in  the  Examination  of  Water. 

8.  Copper. — Decolorize  with  animal  charcoal,  and  test  at  once  with 
ferrocyanide  of  potassium. 

9.  Cider  and  Perry. — Evaporate  wine,  and  the  peculiar  smell  of  the 
hquids  will  be  perceived. 

Port  wine,  as  sold  in  the  market,  is  stated  to  be  a  mixture  of  true  Port, 
Marsala,  Bordeaux,  and  Cape  Avines  mth  brandy,  although  at  present  it  is 
probably  purer  than  it  used  to  be — purer,  perhaps,  than  most  other  wines. 
Inferior  kinds  are  still  adulterated  with  logAvood,  elderben'ies,  catechu, 
prune  juice,  and  a  little  sandalwood  and  alum.  Receipts  are  given  in  books 
for  all  sorts  of  imitation  wines. 

Sub-Section  HE. — Spirits. 

The  Queen's  Fegidaf  ions  for  the  Army  (1881,  sec.  15,  paragi-aph  60)  for- 
bid the  sale  of  spu-its  in  canteens  at  home,  but  permit  it  in  foreign  stations 
at  the  discretion  of  the  commanding  officer. 

Brandy  contains,  besides  alcohol,  cenanthic  ether,  acetic,  butyiic,  and 
valerianic  ethers.  Tannin,  and  coloring  matter  from  the  cask,  or  from 
caramel,  are  present.  If  sugar  is  present  in  any  quantity,  it  must  have 
been  added.  The  inferior  kinds  of  brandy,  prepared  from  potatoes  as 
well  as  grain,  contain  potato  fusel-oil.  Rum  contains  a  good  deal  of 
butjTic  ether,  to  which  the  aroma  is  chiefly  owing.  Gin,  besides  contain- 
ing the  oil  of  juniper,  is  flavored  with  various  aromatic  substances,  as 
Calamus  aromaticus,  coriander,  cardamoms,  cinnamon,  almond-cake,  and 
orange-peel ;  Cayenne  is  often  added.  Whiskey  often  derives  a  peculiar 
flavor  from  the  malt  being  dried  over  peat  fires,  or  by  the  direct  impreg- 
nation of  peat  smoke. '  Peach  stones  and  pine  sawdust  are  also  said  to  be 
added. 

'  It  may  te  worth  while  to  give  the  names  of  some  of  the  distilled  spirits  used  in 
different  parts  of  the  world,  as  the  army  surgeon  may  meet  with  them  in  the  course  of 
service : —  • 

Nations  by  whom  employed.  Name.  Obtained  from 

Hindus,  Malays,  etc Arrack.  Rice  or  Areca-nut. 

Greeks,  Turks,  etc    Raki.  Rice. 

Hindus Toddy.  Cocoa-nut. 

' '      (Mahrattafi) Bojah.  Eleusine  Corocana. 

"       (Sikkim) Murwa.  "  " 

Chinese Samshoo.  Rice. 

Japanese Sacie.  .... 

Pacific  Islanders Kawa.  Macropiper. 

Mexicans Pulque.  Agave. 

South  Americans Chica.  Maize. 

Tartars Koumiss.  Mares'  milk. 

Russians  and  Poles Voldki.  Potato. 

Abyssinians Talah.  Millet. 


BEVERAGES    AND    CONDIME^iTS. 


307 


Composition  of  Spirits. 
The  following  table  gives  the  chief  points  of  importance  :  * 


Name. 

Sp.  gr.  at 
62°  F. 

Alcohol 
per  cent, 

Solids            ,  , 

Acidity 

per  ounce, 

reckoned 

as  tartaric 

acid. 

Sugar 
per  cent. 

Brandy 

.929-.  934 

.930-.  944 
.915-.920 
.974-.  926 

50-60 

49-60 
50-60 
60-77 

1.2     .05  to  0.2 
0.2                 0.1 
0.6          trace 
1.0                 0.1 

1  grain 
0.2  " 
0.2  " 
0.5  " 

0  or  traces 

Gin 

Whiskey 

Bum 

1 
0 

0 

Alcohol  as  an  Article  of  Deet  ix  Health." 

In  endeavoring  to  deteiTaine  the  dietetic  value  of  alcoliolic  beverages, 
it  is  desirable  to  see,  in  the  lirst  place,  "what  are  the  effects  of  their  most 
important  constituent,  viz.,  alcohol. 

Thfee  sets  of  arguments  have  been  used  in  discussing  this  question, 
drawn,  namely,  from — 1,  the  physiological  action  of  alcohol ;  2,  experience 
of  its  use  or  abuse  ;  and  3,  moral  considerations. 

The  last  point  will  not  be  further  alluded  to,  for  without  undeiTating 
the  great  weight  of  the  argument  drawn  from  the  misery  which  the  use  of 
alcohol  produces, — a  miseiy  so  gi'eat  that  it  may  truly  be  said,  that  if  alco- 
hol were  unknown,  half  the  sin  and  a  lai'ge  pai't  of  the  jDOverty  and  un- 
happiness  in  the  world  would  disappear, — yet  this  part  of  the  subject  is  so 
obvious  that  it  seems  unnecessaiw  to  occupy  space  v*ith  it.  The  ar.guments, 
however,  which  are  strongest  for  total  abstinence,  are  di'awn  fi'om  this 
class.  Nor  does  any  one  entertain  a  moment's  doubt  that  the  effect  of 
intemperance  in  any  alcohohc  beverage  is  to  cause  prematiu'e  old  age, 
to  produce  or  predisjDose  to  numerous  diseases,  and  to  lessen  the  chance 
of  living  very  gi'eatly.  The  table  given  below,  ^  taken  fi'om  Xeison's  Vital 
Statistics,  puts  this  in  a  strong  hght. 

'  This  table  is  cMefly  taken  from  Bence  Jones'  Observations  ;  Appendix  to  Mulder 
on  Wine,  p.  889  ;  and  from  Hassall's  Food  and  Adulteration,  p.  645. 

^  The  subject  of  spirits  in  sickness  is  another  point  altogether.  Dr.  Parkes  believed 
they  were  often  of  great  use,  although,  like  every  other  strong  medicine,  they  require 
to  be  given  carefully. 

^Effects  of  Intemperance  (Xeison's  Statistics,  p.  217  et  seq.)  : — 

Batio  per  cent,  from  the  under-mentioned  CaiMss,  to  Deatfts  from  aU  Causes. 


Cause  of  Death. 

1847. 

Gotha  Life 
Office. 

Scottish 
Widows'  Fund. 

Intemperate 
Lives. 

Head  diseases  

9.710 

6.240 

88.150 

15.176 

8.377 
27.843 

20.720 

11.994 
23.676 

27.10 

Digestive  organs  (especially  those  ( 

of  the  liver) .' ) 

Eespiratory  organs 

23.3 
22.98 

' 

Total  of  above  three  classes . . . 

49.100 

51.396 

56.390 

73.38 

It  thus  appears  that  tbe  intemperate  have  a  much  greater  mortality  from  head  and 
digestive  diseases  than  other  classes. 


808 


PRACTICAL    HYGIENE. 


The  physiological  argument  for  the  nse  or  disuse  of  alcohol  requires 
to  be  used  with  caution,  as  our  knowledge  of  the  action  of  jxire  alcohol 
(much  more  of  the  alcoholic  beverages)  is  imperfect. 

"When  taken  into  the  stomach,  alcohol  is  absorbed  without  alteration, 
or  is  perhaps  in  some  small  degi'ee  converted  into  acetic  acid,  possibly  by 
the  action  of  the  mucus  or  secretion  of  the  stomach.  The  rate  of  absorp- 
tion is  not  known,  and  it  has  been  supposed  that  when  given  in  very 
large  c[uantities  it  may  not  be  absorbed  at  all.     It  has  not,  however,  been 


In  intemperate  persons  the  mortality  at  21-30  years  of  age  is  five  times  that  of  the 
temperate  ;  from  30-40  it  is  four  times  as  great.     It  becomes  gradually  less. 


A  Temperate  person's  chance 
of  living  is. 

At  20  =  44.2  years. 

.  "  30  =  36.0       " 

"  40  =  28.8       " 

«'  50  =  21.25     " 

"  68  =  14.285  " 


An  Intemperate  person's  chance 
of  living  is, 

At  20  =  15.6  vears. 
"  30  =  13.8  '   " 
"  40  =  11.6      " 
"  50  =  10.8      " 
"  60=    8.9      " 


All  these  deductions  appear  to  be  drawn  from  observations  on  357  persons,  with 
6,111.5  years  of  life.  The  tacts  connected  with  these  persons  are  well  authenticated, 
but  the  number  is  small. 

The  average  duration  of  life  after  the  commencement  of  the  habits  of  intemperance 
is  — 

Among  mechanics,  working  and  laboring  men 18  years. 

"        traders,  dealers,  and  merchants 17     " 

"       professional  men  and  gentlemen 15     " 

"       females 14     " 

Those  who  are  intemperate  on  spirits  have  a  greater  mortality  than  those  intemper- 
ate on  beer. 

Those  who  are  intemperate  on  spirits  and  beer  have  a  slightly  greater  mortality 
than  those  intemperate  on  only  spirits  or  beer,  but  the  difference  is  immaterial. 

Mortality  per  annum. 

Spirit  drinkers 5.996  per  cent,  (nearly  60  per  1,000). 

Beer  drinkers 4.597  per  cent,  (nearly  46  per  1,000). 

Spirit  and  beer  drinkers 6.194  per  cent,  (nearly  62  per  1,000). 

Very  striking  evidence  in  favor  of  total  abstinence,  as  contrasted  with  moderation, 
is  given  by  the  statistics  of  the  United  Kingdom  Temperance  and  General  Provident 
Institution.  One  section  consists  of  abstainers,  another  of  persons  selected  as  not 
known  to  be  intemperate.  The  claims  for  five  years  (1860-70),  anticipated  in  the  Tem- 
perance section,  were  £100,446  ;  but  there  were  actually  only  claims  for  £72,676.  In  the 
general  section,  the  anticipated  claims  were  £196,352  ;  and  the  actual  claims  M-ere  no 
less  than  £230,297.  The  much  greater  longevity  of  the  abstainer  is  better  seen  by  the 
amount  of  bonuses  paid  to  each  £1,000  whole-life  policy  in  the  two  sections  for  the 
same  five  years. 


Age  at  Entrance. 

Premiums  paid. 

Bonus  added  in 

Temperance 

Section. 

Bonus  added  in 
General  Section. 

15 

£     8.     d. 
83    3    6 
93    6    8 
106    9    2 
122    1    8 
138  19    2 
162    5  10 
188  10  10 
226    5    0 
284    3     4 

£    8.     d. 
61     1     0 
64    0    0 
68  10    0 
74    0    0 
78  19    0 
86    0    0 
92  18    0 
104    2    0 
122  14    0 

£    8.    d. 
35  10    0 

20 

37    0    0 

25 

40    0    0 

30........ 

35 0.... 

40 

43    0    0 
46    0    0 
50    4    0 

45 

54    0    0 

50 

60  13    0 

55 

71  11     0 

BEVERAGES    AKD    CONDIMENTS. 


309 


recovered  from  the  faeces  in  any  great  amount.  After  absorption  it  passes 
into  the  blood  and  then  throughout  the  body  ;  if  the  obseryations  of 
Schulinus  '  are  correct,  it  is  equally  distributed,  and  does  not  accumulate, 
as  was  formerly  supposed,  in  the  liver  and  nervous  tissue.  It  can  easily 
be  detected  in  all  the  organs  soon  after  it  is  taken.  It  commences  to 
pass  out  from  the  body  speedily,  as  it  may  be  detected  in  the  breath  soon, 
after  it  is  taken  ;  it  emerges  by  the  lungs,  by  the  skin,  in  smaller  quan- 
tities by  the  mine,  and  slightly  by  the  bowels,  or  this  may  be  merely 
from  unabsorbed  portions  passing  out.  The  amount  recoverable  fi'om  all 
these  channels  is  usually  small,'  but  occasionally,  when  verj^  large  quan- 
tities have  been  taken,  the  kidneys  excrete  it  largely,  so  that  the  specific 
gi-a^ity  of  the  mdne  has  been  below  that  of  water,  and  distillation  has 
given  an  inflammable  fluid.  ^ 

Much  debate  has  taken  place  as  to  whether  all  or  how  much  of  the 
alcohol  is  thus  eliminated,  and  whether  any  is  destroyed  in  the  body.  The 
experiments  of  Dr.  Percy,  and  subsequently  of  Strauch,  and  especially  of 
Masing  in  Buchheim's  laboratory  at  Dorpat,  followed  as  they  were  by  the 
confirmatory  observations  of  'yDl.  Perrin,  Lallemand,  and  Duroy,  seemed 
at  one  time  to  have  settled  the  question,  and  to  have  proved  that  alcohol 
is  very  httle  or  not  at  all  destroyed  in  the  body.  Since  then  the  criticisms 
and  experiments  of  Baudot,  and  especially  the  observations  of  Schvihnus,^ 
Anstie,"  Diiprie,  and  Subbotin,  have  again  altered  the  position,  and  al- 
though the  experimental  evidence  is  incomplete  (chiefly  on  account  of  the 
difficulty  of  collecting  the  amount  given  off  by  the  lungs  and  skin),  the 
opinion  that  some,  and  perhaps  much,  alcohol  disappears  in  the  body  is 
generally  admitted.  ° 


At  everv  age,  therefore,  tlie  abstainer  has  a  very  great  advantage,  ilr.  Vivian,  the 
President  of  the  Temperance  and  General  Provident  Institution,  brought  before  the 
British  Association  at  Bristol,  in  1875,  the  following  statistics  : 


Abstinence  Section. 

Greneral  Section. 

Expected. 

Actual. 

Expected. 

Actual. 

1866-70  (5  years) 

1871-74  (4  years) 

549 
561 

411 
390 

1,008 
994 

944 
1,033 

Totals  (9  years) 

1,110 

801 

2,002 

1,977 

On  the  Gold  Coast,  during  the  Ashantee  War,  the  evidence  (slight  as  it  was)  was  de- 
cidedly in  favor  of  the  teetotallers.  — (Parkes,  On  the  Issue  of  a  Spirit  Ration,  p.  28, 
1875. )' 

'  Archly  der  Heilk.,  1866,  p.  97. 

^  Experiments  on  this  point  by  Schulinus,  Anstie,  Dupre,  Thudichum,  and  others, 
prove  that  ordinarily  the  urinary  elimination  is  slight.  When  it  becomes  at  all  marked, 
or  even  when  it  occurs  at  all,  the  detection  of  alcohol  by  potassium  bichromate  and 
sulphuric  acid  has  been  proposed  by  Anstie  as  an  indication  of  the  point  when  as  much 
alcohol  has  been  taken  as  can  be  disposed  of  by  the  body. 

"  A  ffood  case  is  given  by  Dr.  Woodman  (Medical  Mirror,  July,  1865). 

^  Archiv  der  HeUk.,  1866. 

5  Lancet,  1868. 

^  The  amount  eliminated  by  these  channels  has  been  variously  stated.  The  latest 
observations  are  by  Dupre,'  Anstie,  and  Subbotin.*  According  to  Dupr^.  from  experi- 
ments on  himself,  the  amount  eliminated  by  the  urine  and  breath  (he  did  not  examine 

7  Proceedings  nf  Royal  Societv,  Xo.  138  (p.  SfiS,  1872). 

8  Zeitschrift  fUr  Boil.,  Band  vii.,  p.  361  (137S). 


310  PRACTICAL    HYGIENE. 

If  alcohol  is  destroyed  in  the  body,  through  what  stages  does  it  pass  ? 
The  statement  of  Duchek,  that  it  forms  aldehyde,  has  been  disproved.  Its 
easiest  transformation  out  of  the  body  is  into  acetic  acid  ;  but,  "when  ani- 
mals are  poisoned  Avith  alcohol,  Buchheim  and  Masing  could  detect  no 
acetic  acid  in  the  blood  ;  still,  the  amount  would  be  so  small  it  might  be 
overlooked,  or  the  acetic  acid  might  be  soon  transformed.  Lallemand, 
Perrin,  and  Duroy  could  find  no  oxalic  acid.  If  it  be  true  that  the  pul- 
monary carbonic  acid  is  lessened,  it  cannot  be  oxidized  to  carbonic  acid 
and  eliminated  by  the  lungs  unless  the  transformation  of  some  other 
substance  ordinarily  furnishing  carbonic  acid  is  arrested.  The  mode  of 
destruction  is,  in  fact,  unknown.  The  only  point  which  throws  any  light 
upon  it  is  the  slight  incx'ease  of  acidity  in  the  urine  during  the  use  of  al- 
cohol, which  looks  as  if  an  acid  of  some  kind  were  formed  out  of  it. 

Present  experiments  show,  then,  that  some  portion  passes  out,  and 
another,  and  probably  the  larger  portion,  is  gi-adually  destroyed.  The 
place  where  the  pai'tial  destruction  of  alcohol  occurs  is  yet  doubtful ;  but 
it  is  impossible  that  the  transformation  takes  place  in  the  various  gland- 
cells  in  which  almost  all,  or  all,  the  changes  in  the  body  take  place.  As 
the  change  out  of  the  body  which  most  easily  occiu's  is  the  formation  of 
acetic  acid,  it  seems  at  present  most  hkely  that  some  of  the  alcohol  is  thus 

the  skin)  is  only  a  minute  fraction  of  that  taken  in,  and  it  takes  place  chiefly  in  the 
first  nine  hours ;  subsequently  the  amount  is  excessively  small.  When  taken  day 
after  day  there  is  no  accumulation  of  alcohol,  so  that  the  inference  is,  that  as  so  little 
is  eliminated  almost  all  must  be  destroyed.  Subbotin's  experiments  were  on  rabbits 
enclosed  in  a  closed  chamber  through  which  the  air  was  slowly  drawn.  Like  Duprp, 
he  determined  the  amount  by  oxidizing  the  alcohol  obtained  into  acetic  acid  by  chromic 
acid  ;  but  he  found  that  not  inconsiderable  quantities  {niclit  unbeirdclitlklie  Menken) 
were  eliminated  through  the  lungs,  and  skin,  and  kidneys  in  the  first  five  hours.  Con- 
trary to  Perrin,  Lallemand,  and  Duroy,  he  found  twice  as  much  passed  from  skin  and 
lungs  as  from  the  kidneys.  In  11  hours  he  found  12. G  per  cent,  was  eliminated,  and 
in  24  hours  16  per  cent.,  and  he  gives  reasons  for  supposing  that  the  difficulties  of  the 
experiments  (viz.,  the  difficulty  of  changing  all  the  alcohol  into  acetic  acid  ;  of  obtain- 
ing the  alcohol  from  the  chamber ;  of  regulating  the  ventilation  ;  and  by  the  dimi- 
nution of  absorption  at  the  end  of  the  experiment,  and  by  the  limited  time  the  experi- 
ment could  be  carried  on)  made  the  amount  actually  recovered  far  less  than  it  should 
have  been.  Anstie  made  numerous  experiments  on  the  urine  and  sweat,  and  always 
found  the  qi;antities  very  minute. 

With  regard  to  the  length  of  time  the  elimination  goes  on,  Dupre  found  it  to  be 
finished  within  a  few  hours  ;  Subbotin  found  that  the  elimination  was  not  quite  ended 
in  24  ;  Perrin,  Lallemand,  and  Duroy,  found  it  to  go  on  for  82  hours.  The  late  Dr. 
Parkes  and  Count  W^oUowicz  found  that  minute  quantities  could  be  found  in  the  urine 
even  on  the  fifth  day  after  a  large  quantity  of  brandy  had  been  taken,  though  the 
elimination  by  the  lungs  ceased  much  sooner.  In  some  later  experiments,  with  small 
quantities  of  beer  and  wine,  Dr.  Parkes  found  the  elimination  to  be  finished  in  24 
hours. 

Lieben  noticed  some  years  ago,  that  a  substance  which  had  some  of  the  characters  of 
alcohol  was  found  in  the  urine  of  persons  and  animals  who  had  taken  none.  Dr. 
Parkes  and  Count  W'oUowicz  noticed  on  one  occasion  that  a  substance  which  slightly 
reduced  chromic  acid  was  obtained  from  the  sweat  of  a  man  who  had  taken  no  alco- 
hol,' though  in  other  cases  E.  Smith,  British  Medical  Journal,  November  2,  1861)  there 
is  certainly  no  substance  of  this  kind  in  the  sweat.  Dupre  also  found  in  the  urine  a 
substance  furnishing  acetic  acid,  forming  iodoform,  and  having  a  lower  specific  gravity 
and  a  higher  vapor  tension  than  pure  water.  The  amount  of  this  substance  is  so 
minute  that  its  nature  cannot  be  perfectly  made  out,  but  Lieben  considers  it  not  to  be 
alcohol,  but  perhaps  to  be  derived  from  the  odoriferous  principles  of  the  iirine. 
Dupre  doubts  this,  and  Dr.  Parkes'  observation  on  the  sweat  shows  that  it  can  hardly 
be  so,  unless  the  same  odorous  siibstances  are  passing  off  by  the  skin.  Dr.  Parkes 
doubted  whether  it  was  an  invariable  constituent  of  urine,  as  he  could  find  none  in  the 
urine  of  three  teetotallers  which  were  examined. 


»  Proceedings  of  Royal  Society,  No.  113,  p.  87  (IbTO). 


BEVERAGES    AND    CONDIMENTS.  311 

transformed.  The  acetic  acid  would  then  unite  with  the  soda  of  the  blood, 
and  a  carbonate  would  eventually  be  formed  which  would  be  eliminated 
with  the  urine,  as  in  the  case  when  acetates  are  taken. '  This  would  ac- 
count for  the  pulmonary  carbonic  acid  not  being  increased.  If  this  view 
be  correct,  the  use  of  alcohol  in  nutrition  would  be  limited  to  the  effects 
it  produces,  first  as  alcohol,  and  subsequently  as  acetic  acid,  when  it  neu- 
tralizes soda,  and  is  then  changed  into  carbonate. 

The  first  point  only  (its  effect  as  alcohol)  need  be  considered — 

Influence  of  Alcohol  on  the  Organs. 

1.  On  the  Stomach. — In  very  small  quantities  it  appears  to  aid  digeS' 
tion  ;  in  larger  amount  it  checks  it,  reddens  the  mucous  membrane,  and 
produces  the  "chronic  catarrhal  condition"  of  Wilson  Fox— ^iz.,  increase 
of  the  connective  tissue  between  the  glands ;  fatty  and  cystic  degeneration 
of  the  contents  of  the  glands,  and  finally,  more  or  less  atrophy  and  dis- 
appearance of  these  parts.  "^  Taken  habitually  in  large  quantities,  it  lessens 
appetite. 

2.  On  the  Liver. — The  action  of  small  quantities  on  the  amount  of  bile 
or  glycogenic  substances,  or  on  the  other  chemical  conditions  of  the  liver, 
is  not  known.  Applied  directly  to  the  liver  by  injection  into  the  portal 
vein,  it  increases  the  amount  of  sugar  (Harley).  Taken  daily  in  large 
quantities,  it  causes  either  enlargement  of  the  organ  by  producing  albumi- 
noid and  fatty  deposit,  or  it  causes  at  once,  or  following  enlargement,  in- 
crease of  connective  tissue,  and  finally,  contraction  of  Glisson's  capsule, 
and  atrophy  of  the  portal  canals  and  cells,  by  the  pressure  of  a  shrinking 
exudation.  The  exact  amount  necessary  to  produce  these  changes  in  the 
liver  and  stomach  has  not  yet  been  fixed  with  precision. 

3.  On  the  Spleen. — Its  action  is  not  known. 

4.  On  the  Lungs. — It  is  said  to  lessen  the  amount  of  carbon  dioxide 
(and  of  watery  vapor  ?)  in  the  air  of  expiration,^  though  there  are  some 
discrepancies  in  experiments  with  different  kinds  of  spirits.  E.  Smith,  for 
example,  found  the  expired  carbon  dioxide  lessened  by  brandy  and  gin, 
but  increased  by  rum.  It  is  very  important  these  experiments  should  be 
repeated,  but  they  show,  at  any  rate,  that  the  usual  effect  is  not  to  in- 
crease the  carbon  dioxide.*  In  large  quantities  habitually  taken  it  also 
alters  the  molecular  constitution  of  the  lungs,  as  chronic  bronchitis  and 
lobar  emphysema  are  certainly  more  common  in  those  who  take  much 
alcohol. 

'  In  experiments  on  large  quantities  of  alcohol,  Dr.  Parkes  foiind  the  acidity  of  the 
urine  slightly  increased.  This  would  quite  agree  with  the  above  view,  as  the  union  of 
the  acetic  acid  or  carbonic  acid  formed  fi'om  it,  with  some  of  the  alkali  ordinarily 
united  to  other  acids,  would  increase  the  urinary  acidity,  This  case  is,  of  course,  not 
parallel  with  that  of  acetate  of  potash  given  by  the  mouth,  which  makes  the  urine 
alkaline  from  carbonate,  as  some  alkali  in  that  case  is  introduced. 

'  These  changes  were  considered  by  Wilson  Fox  to  be  closely  allied  with  those 
occurring  in  cirrhosis  of  the  liver,  and  in  the  contracted  and  indurated  kidney.  See 
Diseases  of  the  Stomach,  3d  edition,  p.  125,  foot-note ;  and  also  Reynolds'  System  of 
Medicine,  vol.  ii.,  p.  §69,  and  foot-note. 

*  The  effect  of  red  and  white  French  wines  and  of  beer  has  been  very  carefully 
examined  by  Perrin  (Rec.  de  Mem.  de  M6d.  Mil.,  1865,  p.  82);  a  very  great  diminu- 
tion in  the  amount  of  carbonic  acid  (from  5.6  to  22  per  cent,  less  being  excreted)  was 
noticed  in  all  the  experiments.  The  effect  commenced  soon,  and  reached  its  maximum 
in  the  third  hour,  and  ceased  in  two  hours  more.  The  pulse  after  meals  with  and  with- 
out wine  had  equal  power,  but  after  a  time  the  pulse  fell  more  when  wine  was  not 
taken. 

*  See  Binz,  Journal  of  Anatomy  and  Physiology,  May,  1874. 


312  PRACTICAL    HYGIENE. 

5.  On  the  Heart  and  Blood- Vessels. — Alcohol  in  liealtliy  persons  at  first 
increases  the  force  and  the  quickness  of  the  heart's  action.  Dr.  Anstie' 
confirmed  this  opinion  by  careful  sphygmographic  observ^ations ;  these 
effects  are  still  more  marked  in  febrile  diseases  if  alcoliol  acts  favorably  (in 
some  febrile  cases  it  appears,  fi-om  Anstie's  observations,  not  to  increase 
the  power  of  the  heart j.  In  a  healthy  man,  Dr.  Parkes  foimd  that  brandy" 
augmented  the  rapidity  of  the  jDulse  13  per  cent.,  and  the  force  "was  also 
inci'eased  ;  taking  the  usual  estimate  of  the  heart's  work,  its  daily  excess  of 
work,  with  4.8  fluid  ounces  of  absolute  alcohol,  was  equal  to  15.8  tons 
lifted  one  foot.  "With  claret  the  results  were  almost  identical.  The  period 
of  rest  of  the  heart  was  shortened,  and  its  nutrition  must  therefore  have 
been  interfered  with.  In  another  man,  Dr.  Parkes  found  from  4  to  8 
ounces  of  brandy  produced  palpitation  and  breathlessness.  Alcohol  causes 
evident  dilatation  of  the  superficial  vessels,  as  shown  by  the  redness  and 
flushing  of  the  skin  ;  and  in  these  experiments  si^hygmographic  observa- 
tions also  proved  that  the  arteries  dilated  more  easily  before  the  fuller  cur- 
rent thrown  out  by  the  strongly  acting  heart.  If  it  were  not  for  this 
yielding  of  the  vessels  (produced  perhaps  by  jDaralysis  of  the  vasomotor 
nerves)  alcohol  would  be  a  most  dangerous  agent,  as  either  the  strong 
wave  would  break  the  vessel,  or  the  heart  would  not  be  properly  emptied 
of  the  blood  during  the  contraction.  It  seems  likely,  therefore,  that  there 
must  be  danger  in  the  use  of  alcohol  when  the  arteries  become  rigid  in 
advancing  life,  if  the  heart  is  then  susceptible  to  the  action  of  alcohol. 
Eventually  the  vessels  of  the  surface  pass  into  a  state  of  permanent  slight 
enlargement  and  tui-gescence  ;  the  skin  alters  in  appearance  ;  and  owing 
to  this,  persons  who  take  much  alcohol  soon  get  the  appearance  of  age.  In 
some  diseases,  alcohol  is  said  to  lessen  the  frequency  of  the  heart's  action ; 
and  Anstie  found  it  increase  arterial  tension.  In  such  cases  there  must  be 
peculiar  nervous  conditions  with  which  we  are  unacquainted.  Dr.  Parkes 
found  it  usually,  if  not  always,  increase  the  frequency  of  the  heart  in  dis- 
ease, and  in  some  patients  the  rapidity  of  the  heart's  action  was  simply 
owing  to  the  administration  of  alcohol.  Anstie  believed  its  principal 
action  was  on  the  sympathetic  nerve,  and  the  vascular  phenomena  seem  to 
strengthen  this  view,  while  others  think  it  acts  especially  on  the  vagus  and 
the  heart  alone. 

6.  On  the  Blood. — The  amount  of  fat  is  either  increased,  or  it  is  more 
visible.     The  chemical  changes  in  the  blood  ai*e  partially  arrested.^ 

7.  On  the  Nervous  Sj/slem. — In  most  persons  it  acts  at  once  as  an  anaes- 
thetic, and  lessens  also  the  rapidity  of  imjH'essions,  the  power  of  thought,  and 
the  perfection  of  the  senses.  In  other  cases  it  seems  to  cause  increased 
rapidity  of  thought,  and  excites  imagination  ;  but  even  here  the  power  of 
control  over  a  train  of  thought  is  lessened.  In  no  case  does  it  seem  to 
increase  accuracy  of  sight ;  nor  is  there  any  good  evidence  that  it  cjuickens 
hearing,  taste,  smell,  or  touch  ;  indeed,  Edward  Smith's  expeiiments  show 
that  it  diminishes  all  the  senses.  In  almost  all  cases  moderate  quantities 
cause  a  feeling  of  comfort  and  exhilaration,  which  ensues  so  quickly  as  to 

'  In  a  paper  read  before  tlie  British  Association  in  1868  (Medical  Times  and  Gazette, 
September,  1868).  This  paper  shows  that  the  sphrgmosraphic  indications  (combined 
with  the  urinary  test)  may  give  ns  a  clue  to  the  often  difficult  question,  whether  alco- 
hol is  doing  good  or  harm  in  disease. 

'  See  papers  bv  Dr.  Parkes  and  Count  WoUowicz,  in  Proceedings  of  Eoyal  Society, 
Nos.  120  and  132  ;  and  another  paper  by  Dr.  Parkes,  No.  136,  for  the  effect  of  alcohol 
on  the  heart  during  exercise. 

3  Harley,  Proceedings  of  Royal  Society,  March,  1865,  No.  62,  p.  160. 


BEVERAGES  AND  CONDIMEXTS.  313 

make  it  probable  the  local  action  on  the  nerves  of  the  stomach  has  at  first 
something  to  do  with  this.  Afterward  the  increased  action  of  the  heart 
may  have  an  effect.  Different  spirits  act  differently  on  the  nervous  sys- 
tem, owing  probably  to  the  presence  of  ethers  and  oils  ;  some,  as  sam- 
shoo '  and  rati,  produce  great  excitement,  followed  by  profound  tor- 
por and  depression.  Absinthe  is  also  especially  hurtful,  apparently  from 
the  presence  of  the  essential  oils  of  anise,  wormwood,  and  angehca,  as  well 
as  from  the  large  amount  of  alcohol.  It  appears  that  the  properties  of 
absinthe  are  somewhat  different  according  to  the  manner  in  which  water  is 
mixed  with  it,  i.e.,  suddenly  or  slowly  ;  in  the  latter  case  the  particles  of 
the  absinthe  are  more  divided,  are  absorbed  more  easily,  and  produce 
greater  effects.  In  all  these  cases  there  can  be  little  doubt  that  alcohol 
enters  into  temporary  combination  with  the  nervous  structure  ;  and  the 
evidence  from  the  impairment  of  special  sense  and  muscular  power,  im- 
phes  that  it  interferes  with  the  movements  of  the  nervous  currents. 

8.  On  the  Ifuscidar  System. — Voluntary  muscular  power  seems  to  be 
lessened,  and  this  is  most  marked  when  a  large  amount  of  alcohol  is  taken 
at  once  ;  the  finer  combined  movements  are  less  perfectly  made.  "WTiether 
this  is  by  direct  action  on  the  muscular  fibres,  or  by  the  influence  on  the 
nerves,  is  not  certain.  In  very  large  doses  it  paralyzes  either  the  respira- 
tory muscles,  or  the  neiwes  supplying  them,  and  death  sometimes  occiirs 
from  the  impau'ment  to  respiration. 

9.  On  the  Metamorphosis  of  Tissue. — This  is  usually  stated  to  be  les- 
sened, and  it  has  been  said  that  there  is  a  diminution  in  the  elimination  of 
nitrogen  (as  urea),  and  of  carbon  (as  carbon  dioxide).  But  the  experi- 
ments ah'eady  referred  to  by  Count  Wollowicz  and  Dr.  Parkes'  prove  that 
the  metamorphosis  of  the  nitrogenous  tissues  is  in  no  way  interfered  with 
by  dietetic  doses.  Whether  the  carbonic  dioxide  excretion  is  really  les- 
sened may  also  be  questioned. 

10.  On  the  Temperature  of  the  Body. — When  alcohol  is  given  to  healthy 
animals  in  fuU  but  not  excessive  doses,  the  temperature  of  the  body  falls. 
This  seems  to  be  shown  conclusively  by  the  experiments  of  Ringer  and 
Richards,  Richardson,  Binz,  Cuny-Bouvier,  and  Ruge.  In  healthy  men 
who  have  been  accustomed  to  take  alcohol  in  moderate  quantities,  the 
results  are  rather  contradictory.  In  a  man  accustomed  to  alcohol. 
Ringer  found  no  change  ;  in  two  men,  temperate,  but  accustomed  to  take 
beer  and  sometimes  spirits.  Dr.  Parkes  could  not  detect  any  raising  or 
lowering  of  the  thermometer  either  in  the  axilla  or  rectum.^  Dr.  Mainzer 
found  no  fall  of  temperature^  in  trials  on  himself,  but  a  slight  fall  in  an- 
other healthy  person.     Some  experiments  by  Obemier  °  and  by  Fokker  °  are 

^  Dr.  Dnpre  analyzed  for  Dr.  Parkes  a  specimen  of  the  best  samshoo  from  Singapore. 
It  contained  in  100  C.C.  23.91  per  cent,  of  alcohol  by  weight,  and  this  was  made  up  of 
23.874  parts  of  ethyl  alcohol,  and  .036  part  of  amylic  alcohol ;  the  amount  of  free  acid 
(almost  all  acetic)  was  .105  ;  of  residue  (sugar  almost  entirely),  6.01,  and  of  ash,  .06  per 
cent.  Cheap  samshoo  gave  nearly  the  same  result.  There  seems  to  be  nothing  dele- 
terious here  ;  and  from  inquiries  among  soldiers  who  have  served  at  Hong-Kong,  it 
seems  doubtful  whether  good  samshoo  does  produce  the  effects  ascribed  to  it.  It  is 
probably  the  adulterated  (with  opium,  etc.)  article  which  acts  so  violently.  The  Cape 
brandy  is  of  two  kinds— the  Cape  and  the  Boer  brandy;  the  latter  is  stronger,  and  is 
sometimes  called  peach  brandy ;  this  appears  to  be  the  hurtful  kind. 

^  Proceedings  of  Royal  Society,  Xos.  120-123  and  136. 

3  Ibid. 

^  Ueber  die  Einwirkung  des  Alkohols,  Inau.  Diss.  Bonn.,  1870. 

*  Archiv  fiir  die  ges.  Phys.,  Band  ii.,  p.  494. 

«  Quoted  by  Husemann,' Jahresb.  fiir  die  ges.  Med.,  1871,  Band  i.,  p.  334. 


314  PRACTICAL    HYGIENE. 

also  quite  negative.  On  the  other  hand,  Einger,  Binz,  and  Bouvier 
noticed  in  some  healthy  persons  a  decrease  of  temperature  ;  and  though 
some  of  the  experiments  are  evidently  rather  inaccurate,  and  though  the 
faU  of  temperatm-e  was  inconsiderable,  it  is  difficult  to  refuse  behef  that  in 
some  cases  there  may  be  a  shght  depression  of  temperature. ' 

In  febrile  cases  the  evidence  is  almost  equally  diAided.  In  a  man  on 
whom  Dr.  Parkes  was  expeiimenting,  an  attack  of  catan-h  came  on  with 
rise  of  temperature,  and  alcohol  did  not  apparently  affect  the  heat  in  the 
least.  O.  Weber,  Obernier,  and  Rabow  were  equally  unsuccessful  in  not- 
ing a  fall  in  temperature.  Binz  and  C.  Bou\-ier "  have,  however,  produced 
septic  fever  in  animals,  and  then  lowered  the  febrile  heat  by  large  doses  of 
alcohol,  in  what  appears  to  have  been  an  unmistakable  manner,  in  several 
cases. 

We  may  conclude  that  the  effect  of  moderate  doses  on  temperature  in 
healthy  men  is  extremely  slight ;  there  is  no  increase,  and  in  many  persons 
no  decrease.  In  those  in  whom  there  is  a  shght  decrease,  the  amount  is 
trifling. 

11.  On  the  Action  of  the  Eliminating  Organs. — The  water  of  the  urine 
and  the  acidity  are  sHghtly  increased  ;  but  Dr.  Parkes  found  other  ingre- 
dients were  unaffected.  The  condition  of  the  skin  is  not  certain.  Dr.  E. 
Smith  thought  the  perspiration  lessened,  but  Wej-rich  noticed,  after  spirits, 
beer,  and  wine,  a  large  increase  in  the  insensible  cutaneous  perspiration  ; 
and  the  eulai'gement  of  the  vessels  of  the  skin  would  probably  lead  to  in- 
creased transit  of  fluid. 

12.  Bemote  Effects  of  Alcohol. — The  degenerative  changes  which  occur 
so  frequently  in  the  stomach,  hver,  and  other  organs,  by  the  constant  in- 
troduction of  improper  quantities  of  alcohol  into  the  body,^  affect  also 
almost  all  parts  of  the  body.  The  brain  and  its  membranes,  and  its  vessels, 
suffer  early  and  principally  ;  and  Ki-emiansky'  has  pi'oduced  hemorrhagic 
meningitis  and  jDathological  changes  in  the  brain-vessels  and  membranes 
in  dogs  by  giving  them  alcohol.^  There  is  no  question  that  several  brain 
diseases,  including  some  cases  of  insanity,  are  produced  by  excess  of 
alcohoL*  So,  also,  degenerative  changes  in  the  stomach,  liver,  lungs,  and 
probably  in  the  kidneys,"  result  from  immoderate  use.  To  use  Dickinson's 
expressive  phrase,  alcohol  is  the  veiy  "genius  of  degeneration."  And 
these  alcoholic  degenerations  are  certainly  not  confined  to  the  notoriously 
intemperate.     They  have  been  seen  in  women  accustomed  to  take  wine  in 

'  Binz  doc.  cit. )  finds  that  small  (dietetic  ?)  doses  produce  no  change  ;  large  inebriat- 
ing doses  produce  a  fall  from  8.. 5  to  ~i  F.,  lasting  for  four  or  five  hours.  Habit, 
however,  produces  tolerance.  In  the  body,  after  death,  the  temperature  often  rises, 
but  if  alcohol  has  been  administered  previously  it  does  not  do  so ;  hence  Binz  con- 
cludes that  the  effect  is  arrest  of  chemical  changes  in  the  glands. 

-  See  especially  Pharmakologische  Studien  iiber  den  Alkohol,  von  C.  Bouvier, 
Berlin,  1872. 

^  A  very  striking  paper  on  this  subject  has  been  published  by  Dickinson  (Lancet, 
November,"  1872).  It  paints,  in  startling  colors,  the  immense  degenerative  power  of 
alcohol. 

■*  Virchow's  Archiv,  Band  xlii.,  p.  338. 

^  See  also  the  experiments  by  Magnan  (Sur  rAlcoolisme). 

^  Magnan  states  the  two  determinations  of  chronic  alcoholism  to  be  dementia  and  geii- 
eral  pandijisis. 

''  Anstie  and  Dickinson  have  denied  that  the  kidneys  suffer  in  alcoholism  in  any 
great  degree.  It  is  an  open  question  ;  hut  the  evidence  is  in  favor  of  kidney  degen- 
eration being  one  of  the  effects  of  alcoholism.  Dr.  George  Johnson  states  that  out 
of  200  patients  with  Bright's  disease,  from  all  causes,  he  found  no  less  than  58  were 
drunkards. 


BEVERAGES    AND    CONDIMENTS.  315 

quantities  not  excessive,  and  who  would  have  been  shocked  at  the  imputa- 
tion that  they  were  taking  too  much,  although  in  their  case  the  result 
proved  that  for  them  it  was  excess.  The  nature  of  the  degenerative 
changes  appears  to  be  in  all  cases  the  same,  viz.,  fibroid  and  fatty  changes. 
Considering,  also,  the  great  increase  in  the  action  of  the  heart,  and  the 
dilatation  of  the  vessels,  it  can  scarcely  be  doubted  that  alcohol  in  excess 
is  one  of  the  agencies  causing  disease  of  the  circulatory  organs. 

Is  Alcohol  desirable  as  an  Article  of  Diet  in  Health  ? 

This  question  is  so  large  and  difficult  that  a  satisfactory  answer  can 
hardly  be  given  with  our  present  knowledge.  The  data  for  passing  a  judg- 
ment are  partly  ph^'siological,  but  still  more  largely  empii-ical. 

The  obvious  useful  physiological  actions  of  alcohol  are  an  improvement 
in  appetite,  produced  by  small  quantities,  and  an  increased  activity  of  the 
circulation,  which,  within  certain  limits,  may  be  beneficial.  It  is  difficult 
to  perceive  proof  at  present  of  any  other  useful  action,  since  it  is  uncertain 
whether,  duiing  its  partial  destruction  in  the  system,  it  gives  rise  to 
energy.  In  cases  of  disease,  in  addition  to  its  effect  on  digestion  and  cir- 
culation, its  narcotizing  influence  on  the  nervous  system  may  be  some- 
times useful  Beale  suggests  that  it  may  restrain  the  rapidity  of  abnormal 
growth  or  development  of  multipljang  cells,  and  that  by  such  airest  it 
may  possibly  diminish  bodily  temperature  ;  but  proof  of  this  has  not  been 
given. 

The  dangerous  physiological  actions  in  health,  when  its  quantity  is 
larger,  are  evidently  its  influence  on  the  nervous  system  generally,  and  on 
the  regulating  nerve-centres  of  the  heart,  and  vaso-motor  nerves  in  par- 
ticular ; '-  the  imj)airment  of  appetite  produced  by  large  doses,  the  lessen- 
ing of  muscular  strength,  and  remotely  the  production  of  degenerations. 
Except  when  it  lessens  appetite,  it  does  not  alter  the  transformation  of  the 
nitrogenous  tissues,  and  the  elimination  of  nitrogen  ;  nor  can  it  be  held  to 
be  absolutely  proved  to  lessen  the  excretion  of  carbon.  If  it  did  so,  this 
effect  in  health  woiild  be  simply  injurious. 

It  is  a  matter  of  the  highest  importance  to  determine  when  the  Hmit  of 
the  useful  effect  of  alcohol  is  reached.  The  experiments  are  few  in  num- 
ber, but  are  tolerably  accurate.  From  experiments  made  by  Dr.  Anstie, 
an  amount  of  one  fluid  ounce  and  a  half  (42.6  C.C.)  caused  the  appearance 
of  alcohol  in  the  ui'ine,  which  Anstie  regards  as  a  sign  that  as  much  has 
been  taken  as  can  be  disposed  of  by  the  body.  The  late  Dr.  Parkes  and 
Count  Wollowicz  obtained  almost  precisely  the  same  result.  "WTaen  only 
one  fluid  ounce  of  absolute  alcohol  was  given,  none  could  be  detected  in 
the  urine.  They  found  that  in  a  strong,  healthy  man,  accustomed  to  alco- 
hol in  moderation,  the  quantity  given  in  twenty-four  hours  that  begins  to 
produce  effects  which  can  be  considered  injurious,  is  something  between 
one  fluid  ounce  (—  28.4  C.C.)  and  two  fluid  ounces  (56.8  C.C).  The  effects 
which  can  then  be  detected  are  slight,  but  evident  narcosis,  lessening  of 
appetite,  increased  rapidity  of  rise  in  the  action  of  the  heart,  greater  dila- 
tation of  the  small  vessels  as  estimated  by  the  sphygmograph,  and  the 

^  This  influence  is  probably  a  paralyzing  agency,  arising  from  a  direct  tbongh  transi- 
tory union  of  the  alcohol  with  the  nervous  substance.  Richardson  has  made  the  very 
important  discovery  that  the  alcohols,  such  as  the  butyl,  amyl,  and  hexyl  alcohols, 
which  contain  more  carbon,  produce  a  much  greater  effect  on  the  nervous  system  than 
methyl  and  ethyl  alcohol.  There  are  greater  muscular  tremors  and  stupor,  and  these 
effects  increase  regularly  with  the  increase  of  carbon  and  lessening  volatility. 


31  G  PRACTICAL    HYGIENE. 

appearance  of  alcohol  in  the  mine.  These  effects  manifestly  mark  the 
entrance  of  that  stage  in  the  gi-eater  degrees  of  which  the  poisonous  effect 
of  alcohol  becomes  manifest  to  all. 

It  may  be  considered,  then,  that  the  limit  of  the  useful  effect  is  pro- 
duced by  some  quantity  between  1  and  1^  fluid  ounce  in  twenty-four  hours. 
There  may  be  persons  whose  bodies  can  dispose  of  larger  quantities  ;  but  as 
the  experiments  were  made  on  two  powerful,  healthy  men,  accustomed  to 
take  alcohol,  the  average  amount  was  more  hkely  to  be  over  than  under 
stated.  In  women,  the  amount  requu'ed  to  produce  decided  bad  effects 
must,  in  all  probability,  be  less.  For  children  there  is  an  almost  univer- 
sal consent  that  alcohol  is  injurious,  and  the  very  small  quantity  which 
produces  symptoms  of  intoxication  in  them  indicates  that  they  absorb  it 
rapidly  and  tolerate  it  badly. 

Assuming  the  correctness  of  these  experimental  data,  v/hich,  though 
not  extensive,  are  yet  apparently  exact,  it  is  evident  that  moderation  must 
be  something  below  the  quantities  mentioned  ;  and  considering  the  dan- 
gers of  taking  excess  of  alcohol,  it  seems  wisest  to  assume  1  to  1^  fluid 
ounce  of  absolute  alcohol  in  twenty-four  hours  as  the  maximum  amount 
which  a  healthy  man  should  take.  It  must  be  admitted  that  this  is  pro- 
visional, and  that  more  experiments  are  necessary  ;  but  it  is  based  on  the 
only  safe  data  we  possess.  One  ounce  is  equivalent  to  2  fluid  ounces  of 
brandy  (containing  50  per  cent,  of  alcohol)  or  to  5  ounces  of  the  strong 
wines  (sherries,  etc.,  20  per  cent,  of  alcohol)  ;  or  to  10  ounces  of  the  weaker 
wines  (clarets  and  hocks,  10  per  cent,  of  alcohol)  ;  or  to  20  ouiices  of  beer 
(5  -per  cent,  of  alcohol).  If  these  quantities  are  increased  one-half,  1-^ 
ounce  of  absolute  alcohol  will  be  taken,  and  the  Umit  of  moderation  for 
strong  men  is  reached.  This  standard  appears  to  be  fairly  correct ;  since, 
from  inquuies  of  many  healthy  men  w^ho  take  alcohol  in  moderation.  Dr. 
Parkes  found  that  they  seldom  exceeded  the  above  amounts.  Women,  no 
doubt,  ought  to  take  less  ;  and  alcohol  in  any  shape  only  does  harm  to 
healthy  children. 

Another  question  now  arises,  to  which  it  is  more  difficult  to  reply.  Is 
alcohol,  even  in  this  moderate  amount,  necessary  or  desii-able  ;  are  men 
really  better  and  more  vigorous,  and  longer  lived  with  it  than  they  would 
be  without  any  alcohol  ?  If  distinctly  hurtful  in  large  quantities,  is  it  not 
so  in  these  smaller  amounts? 

There  is  no  difficulty  in  proving,  statistically,  the  vast  loss  of  health 
and  life  caused  by  intemperance  ;  and  the  remai'kable  facts  of  the  Provi- 
dent Institution  show  the  gTeat  advantage  total  abstainers  have  over  those 
who,  though  not  intemperate,  use  alcohol  more  freely.  But  it  is  almost 
impossible,  at  present,  to  compare  the  health  of  teetotallers  with  those  who 
use  alcohol  in  the  moderate  scale  given  above.  In  both  classes  are  found 
men  in  the  highest  health,  and  with  the  gi-eatest  vigor  of  mind  and  body  ; 
in  both  are  to  be  found  men  of  the  most  advanced  age.  If  the  question  is 
looked  at  simply  as  a  scientific  one,  it  is  hardly  possible  at  present  to  give 
an  answer.  Failing  in  accui-ate  information  on  this  point,  the  usual  argu- 
ments for  and  against  the  use  of  alcohol  cannot  be  held  to  settle  the  point. 
These  are — 

(a)  That  the  universality  of  the  habit  of  using  some  intoxicating  drink 
proves  utility.  This  seems  incorrect,'  since  whole  nations  (Mohammedan 
and  Hindoo)  use  no  alcohol  or  substitute ;  and  since  the  same  argument 

'  Most  nations,  however,  if  not  all,  use  some  sedative,  which  may  be  considered  to 
take  the  place  of  alcohol. — (F.  de  C.) 


BEVERAGES    AND    CONDIMENTS.  317 

miglit  prove  the  necessity  of  tobacco,  which  for  this  generation,  at  any 
rate,  is  clearly  only  a  luxury.  The  wide-spread  habit  of  taking  intoxicat- 
ing liquids  nierel}^  proves  that  they  are  pleasant. 

(6)  That  if  not  necessary  in  healthy  modes  of  life,  alcohol  is  so  in  our 
artificial  stage  of  existence  amid  the  pressure  and  conflict  of  modem  so- 
ciety. This  argument  is  very  questionable,  for  some  of  our  hardest  work- 
ers and  thinkers  take  no  alcohol.  There  are  also  thousands  of  persons 
engaged  in  the  most  anxious  and  incessant  occupations  who  are  total  ab- 
stainers, and,  according  to  their  own  account,  with  decided  benefit. 

(c)  That  though  it  may  not  be  nec^sary  for  perfectly  healthy  persons, 
alcohol  is  so  for  the  large  class  of  people  who  live  on  the  confines  of  health, 
whose  digestion  is  feeble,  circulation  languid,  and  nervous  system  too 
excitable.  It  must  be  allowed  there  are  some  persons  of  this  class  who 
are  benefited  by  alcohol  in  small  quantities,  and  chiefly  in  the  form  of  beer 
or  Hght  wine.  Unless  these  persons  wilfully  deceive  themselves,  they  feel 
better  and  are  better  with  a  httle  alcohol. 

(d)  That  common  experience  on  the  largest  scale  shows  that  alcohol  in 
not  excessive  quantities  cannot  be  an  agent  of  harm  ;  that  it  is  and  has 
been  used  by  millions  of  persons  who  aj)pear  to  suffer  no  injuiy,  but  to  be 
in  many  cases  benefited,  and  therefore  that  it  must  be  in  some  way  a  valu- 
able adjunct  to  food.  A  grand  fact  of  this  kind  must,  it  is  contended, 
override  all  objections  based  on  j)hysiological  data,  which  are  confessedly 
incomplete,  and  which  may  have  left  undiscovered  some  special  useful 
action.  It  must  be  admitted  that  this  is  a  very  strong  argument,  and  that 
it  seems  incredible  that  a  large  part  of  the  human  race  should  have  fallen 
into  an  error  so  gigantic  as  that  of  attributing  great  dietetic  value  to  an 
agent  which  is  of  httle  use  in  small  quantities,  and  is  hurtful  in  large.  At 
first  sight  the  common  sense  of  mankind  rcA^olts  at  such  a  supposition,  but 
the  argument,  though  strong,  is  not  conclusive  ;  and  unfortunately  we 
know  that  in  human  affau's  no  extension  of  behef,  however  wide,  is  per  se 
evidence  of  truth. 

(e)  That  though  a  man  can  do  without  alcohol  under  ordinary  circum- 
stances, there  are  certain  conditions  when  it  is  useful.  It  will  be  necessary 
to  see,  then,  what  is  the  evidence  on  this  point. 

Evidence  on  the  Use  of  Alcohol  under  certain  Conditions.^ 
Great  Cold. — There  is  singular  unanimity  of  opinion  on  this  point ;  all 
observers  condemn  the  use  of  spii'its,  and  even  of  wine  or  beer,  as  a  pre- 
ventive against  cold.  In  the  Arctic  regions  we  have  on  this  head  the  evi- 
dence of  Sir  John  Richardson,  Mr.  Goodsir  (in  Sir  J.  Franklin's  first  voy- 
age), Dr.  Iving,  Captain  Kennedy  (in  the  last  search  for  Su'  J.  Franklin, 
when  the  whole  crew  were  teetotallei's),  Dr.  Eae,  Dr.  Kane,  Dr.  Hayes  (sur- 
geon of  the  Kane  expedition),  and  others.  Dr.  Hayes,  indeed,  says  in  his 
last  paper  (1859),  that  he  will  not  only  not  use  spirits,  but  will  take  no 
man  accustomed  to  use  them;  and  that  if  "imperious  necessity  obhges 
him  to  give  spirits,  he  vrill  give  them  in  small  doses  frequently,  as  the  ex- 
citant action  is  followed  by  a  very  dangerous  depression.^     In  the  Antarc- 

'  See  Carpenter's  "  Essay  on  Temperance,"  and  his  other  -writings,  and  also  Spencer 
Thompson's  useful  work  on  the  same  subject,  as  well  as  many  other  writers. 

^  Some  Arctic  voyagers,  however,  are  strongly  impressed  with  the  value  of  rum 
under  certain  circumstances  (Admiral  Richards'.  The  experience  of  the  expedition  of 
1875-76  seems  to  have  shown  that  it  was  partially  useful  given  the  last  thing  at  night, 
as  enabling  the  men  to  get  off  their  frozen  clothing,  but  it  had  no  effect  in  warding  off 
scurvy.  Binz  says  that  alcohol  may  be  useful  in  damp  and  cold,  because  the  tissue 
change  is  greater,  and  we  can  thus  moderate  it. 


318  TRACTICAL    IIYGIEXE. 

tic  regions,  aud  in  the  cold  whaling  grounds,  we  have  the  strong  e^•idence 
of  Dr.  Hooker  to  the  same  purport,  and  the  customs  of  the  many  teetotal 
whalei-s.  Ulloa  long  ago  noticed  the  same  thing  in  the  ascent  of  Pichin- 
cha. '  In  North  America,  the  Hudson's  Bay  Company  entirely  excluded 
spirits,  partly,  no  doubt,  to  prevent  their  use  among  the  Indians,  but 
partly,  in  all  probability,  from  experience  of  theii-  inutility.  Dr.  Carpenter 
quotes  from  Dr.  Kniill  a  statement  that  the  Russian  army  on  the  march  in 
cold  weather  not  only  use  no  spirits,  but  no  man  who  has  lately  taken  any 
is  allowed  to  march.  The  guides  at  Chamouni  and  the  Oberland,  when 
out  in  the  winter,  have  invariably  found  spirits  hurtful ;  they  take  only  a 
Httle  light  Arine  (Forbes).  The  bathing  men  at  Dieppe,  who  are  much  ex- 
posed to  cold  from  long  standing  in  the  sea,  also  find  that  spirits  are  hurt- 
ful, and  take  only  a  little  weak  wine  (Lca-}'). 

Great  Heat. — The  eridence  here  also  is  almost  equally  conclusive 
against  the  use  of  spirits  or  beverages  containing  much  alcohoL  Dr.  Car- 
penter has  assembled  the  most  conclusive  testimony  from  India,  Brazil, 
Borneo,  Afi-ica,  and  Demerara.  The  best  authorities  on  tropical  diseases 
speak  as  strongly  ;  Robert  Jackson,  Ranald  Martin,  Henn'  Marshall,  and 
many  others.  It  seems  quite  certain,  also,  that  not  only  is  heat  less  well 
borne,  but  that  insolation  is  predisposed  to. 

The  common  notion  that  some  form  of  alcoholic  beverage  is  necessary 
in  tropical  climates  is  a  mischievous  delusion.  In  the  84th  Regiment,  in 
which  Dr.  Parkes  formerly  served,  which  from  the  yeai-s  1842  to  1850 
numbered  many  teetotallers  (at  one  time  more  than  400)  in  its  ranks,  the 
records  showed  that,  both  on  common  tropical  service  and  on  marches  in 
India,  the  teetotallers  were  more  healthy,  more  rigorous,  and  far  better 
soldiers  than  those  who  did  not  abstain."  The  experience  of  almost  every 
hunter  in  India  will  be  in  accordance  with  this. 

On  this  point  the  greatest  army  surgeons  have  spoken  strongly  (Jack- 
son especially,  and  Mai-tin)  ;  and  yet  ofiicers  may  still  be  heard,  both  in 
India  and  the  West  Indies,  to  assert  that  the  climate  requires  alcohol. 
These  are  precisely  the  climates  where  alcohol  is  most  hui-tful.^ 

With  regard  to  senice  and  exercise  in  the  tropics,  we  have  the  strong 
testimony  of  Ranald  Martin  that  warm  tea  is  the  best  beverage  ;  and  this 
wiU  be  corroborated  by  every*  one  who  has  made  long  marches,  or  hunt- 
ing excursions,  in  India,  and  has  carefully  observed  what  kind  of  diet  best 
suited  him. 

To  cite  a  well-known  indiridual  instance  of  great  exertion  in  a  hot 
climate,  Robert  Jackson  marched  118  miles  in  Jamaica,  carr\-ing  a  load 
equal  to  a  soldier's,  and  decided  that  "  the  English  soldier  may  be  rendered 
capable  of  going  through  the  severest  military  serrice  in  the  West  Indies  ; 
and  that  temperance  wiU  be  one  of  the  best  means  of  enabling  him  to  per- 

'  He  says  (Adams'  translation,  1807,  vol.  i.,  p.  219):  "At  first  we  imagined  that 
drinking  strong  liquors  would  diffuse  a  heat  through  the  body,  and  consequently  ren- 
der it  less  sensible  of  the  painful  sharpness  of  the  cold  ;  but  to  our  surprise  we  felt  no 
manner  of  strength  in  them,  nor  were  they  any  greater  preventative  against  the  cold 
than  common  water." 

*  See  Carpenter's  Physiology  of  Temperance  for  full  details.  The  officers,  who  by 
their  example  and  precept  produced  this  great  effect  in  a  regiment  in  India,  and 
proved  that  men  are  healthier  and  happier  in  India  without  any  alcoholic  beverage, 
were  Lieut. -Colonel  Willington,  Captain  (afterward  General  Sir  David)  Russell,  and 
Lieut,  aud  Adjutant  Seymour,  an  officer  of  the  greatest  promise,  who  died  from  dysen- 
tery, contracted  during  the  mutiny. 

*  Binz  holds  that  in  hot  climates,  or  in  hot  weather,  it  is  perniciouS;  as  interfering 
with  the  tissue  change,  which  is  already  insufficient. 


BEVERAGES    AND    CONDIMENTS.  319 

form  his  duty  with  safety  and  effect.  The  use  of  ardent  spirits  is  not 
necessary  to  enable  a  European  to  undergo  the  fatigue  of  marching  in  a 
chmate  whose  mean  temperature  is  fi-om  73°  to  80°.  I  have  always 
found  the  strongest  Hquors  the  most  enervating." 

Bodily  Labor. — A  small  quantity  of  alcohol  does  not  seem  to  produce 
much  effect,  but  more  than  two  fluid  ounces  manifestly  lessens  the  power 
of  sustained  and  strong  muscular  work.  In  the  case  of  a  man  on  whom 
Dr.  Parkes  experimented,  4  fluid  ounces  of  brandy  (=1.8  fluid  ormce  of  abso- 
lute alcohol)  did  not  apparently  affect  labor,  though  it  could  not  be  affirmed 
it  did  not  do  so ;  but  4  ounces  more  given  after  four  hours,  when  there 
must  have  been  some  elimination,  lessened  muscular  force  ;  and  a  third  4 
ounces,  given  four  hours  afterward,  entirely  destroyed  the  power  of 
work.  The  reason  was  evidently  twofold.  There  was,  in  the  first  place, 
narcosis  and  blunting  of  the  nervous  system — the  will  did  not  properly  send 
its  commands  to  the  muscles,  or  the  muscles  did  not  respond  to  the  will ; 
and  secondly,  the  action  of  the  heart  was  too  much  increased,  and  induced 
palpitation  and  breathlessness,  which  put  a  stop  to  labor.  The  inferences 
were,  that  even  any  amount  of  alcohol,  although  it  did  not  produce 
symptoms  of  narcosis,  would  act  injuriously  by  increasing  unnecessarily 
the  action  of  the  heart,  which  the  labor  alone  had  sufficiently  augmented.  ^ 
These  experiments  are  in  accord  with  common  experience,  which  shows 
that  men  engaged  in  very  hard  labor,  as  iron-puddlers,  glass-blowers,  nav- 
vies on  piece-work,  and  prize-fighters  during  training,  do  their  work  more 
easily  without  alcohol. 

In  the  exhaustion  following  great  fatigue,  alcohol  may  be  useful  or 
hurtful  according  to  circumstances.  If  exertion  must  be  resumed,  then 
the  action  of  the  heart  can  be  increased  by  alcohol  and  more  blood  sent  to 
the  muscles  ;  of  coiarse,  this  must  be  done  at  the  expense  of  the  heart's 
nutrition,  but  circumstances  may  demand  this.  In  the  case  of  an  army, 
for  example,  called  on  to  engage  the  enemy  after  a  fatiguing  march, 
alcohol  might  be  invigorating.  But  the  amount  must  be  small,  i.e.,  much 
short  of  producing  narcosis  (not  more  than  |-  fluid  ounce  of  absolute 
alcohol),  and,  if  possible,  it  should  be  mixed  with  Liebig's  meat  extract, 
which,  perhaps  on  account  of  its  potash  salts,  has  a  great  power  of  remov- 
ing the  sense  of  fatigue. 

About  two  ounces  of  red  claret  wine  with  two  teaspoonfuls  of  Liebig's 
extract  and  half  a  pint  of  water  is  a  very  reviving  draught,  and  if  it  could 
be  issued  to  troops  exhausted  by  fatigue,  would  prove  a  most  useful  ally. 

But  when  renewed  exertion  is  not  necessary  it  would  appear  most 
proper  after  great  fatigue  to  let  the  heart  and  muscles  recruit  themselves 

1  In  experimenting  on  another  healthy  man  the  following  interesting  result  was 
obtained.  The  exercise  and  diet  being  uniform  during  a  period  of  ten  days,  the 
mean  daily  pulse  (nine  two  hourly  observations)  was  70.65.  Severe  exercise  being  then 
taken  during  another  period  of  ten  days  for  two  hours  in  the  morning,  in  addition  to 
what  had  previously  been  taken,  the  pulse  in  those  two  hours  was  augmented  16  beats 
per  minute  over  the  corresponding  period ;  it  fell,  however,  in  the  subsequent  hours 
below  the  mean  of  the  corresponding  period,  so  that  the  mean  pulse  of  the  day  was 
70.42  per  minute,  the  same  as  in  the  ten  days'  period  before  the  additional  exercise. 
The  heart,  in  fact,  completely  compensated  itself,  and  the  work  done  by  it  was  the 
same  on  days  of  moderate  and  of  severe  exercise.  Now  alcohol  would  have  disturbed 
this  adjustment,  and  would  have  kept  the  heart  beating  more  rapidly  than  it  should 
do.  The  compensation  would  not  have  been  produced.  In  more  recent  experiments, 
in  which  the  eifects  of  rum,  meat  extract,  and  coffee  were  observed,  it  was  found  that 
marching  was  done  least  easily  with  rum,  the  stimulant  effect  passing  quickly  otf,  and 
leaving  the  man  less  able  to  finish  the  work  before  him,  — (On  the  Issue  of  a  Spirit  Ra- 
tion in  the  Ashantee  Campaign,  Parkes,  1875.) 


320  PRACTICAL    HYGIENE. 

by  rest ;  to  gi\e  digestible  food,  but  to  avoid  unnecessary  and  probably 
hvu'tful  quickening  of  the  heart  by  alcohol. 

Mental  Work.— In  spite  of  much  large  experience,  it  is  uncertain 
whether  alcohol  really  increases  mental  power.  The  brain  ciiTulation  is 
no  doubt  augmented  in  rapidity  ;  the  nervous  tissues  must  receive  more 
nutriment,  and  for  a  time  must  work  more  strongly.  Ideas  and  images 
may  be  more  plentifully  produced,  but  it  is  a  question  whether  the  power 
of  clear,  consecutive,  and  continuous  reasoning  is  not  always  lessened.  In 
cases  of  great  exhaustion  of  the  nervous  system,  as  when  food  has  been 
withheld  for  many  hoiu's  and  the  mind  begins  to  work  feebly,  alcohol  re- 
vives mental  power  greatly,  probably  from  the  augmented  circulation.  But, 
on  the  whole,  it  seems  questionable  whether  the  brain  finds  in  alcohol  a 
food  which  by  itself  can  aid  in  mental  work. 

Deficiency  of  Food. — When  there  is  want  of  food,  it  is  generally  con- 
sidered that  alcohol  has  a  sustaining  force,  and  possibly  it  acts  pai'tly  by 
keeping  up  the  action  of  the  heart,  and  partly  by  deadening  the  suscepti- 
bihty  of  the  nerves.  It  was  formerly  sui:)posed  that  it  lessened  tissue -change, 
and  thus  cui-tailed  the  waste  of  the  bod}- ;  but  this  is  not  true  of  the  nitro- 
genous tissues,  and  is  not  yet  quite  certain  in  respect  of  the  carbonaceous. 
It  seems  unhkely  that  alcohol  would  be  appHed  differently  dui'ing  starvation 
and  during  usual  feeding. 

Cases  are  recorded  in  which  persons  have  Hved  for  long  periods  on 
almost  nothing  but  wine  and  spuits.  In.  most  cases,  however,  some  food 
has  been  taken,  and  sometimes  more  than  was  supposed,  and  in  all  instances 
there  has  been  great  quietude  of  mind  and  body.  It  seems  veiy  doubtful 
whether  in  any  case  nothing  but  alcohol  has  been  taken ;  and,  in  fact,  we 
may  fairly  demand  more  exact  data  before  weight  can  be  given  to  this 
statement. 

T'ue  Exposures  and  Exertions  of  War. — On  this  point  also  there  is  con- 
siderable unanimity  of  opinion.  The  gi'eatest  fatigues,  both  in  hot  and 
cold  chmates,  have  been  well  boi-ne — have  been,  indeed,  best  borne — by 
men  who  took  no  alcohol  in  any  shape,  and  some  instances  may  be  quoted. 

In  the  American  "War  of  Independence  in  1783,  Lord  CornwaUis  made 
a  march  over  2,000  miles  in  Yii-ginia,  under  the  most  trying  cii'cumstances 
of  exposure  to  cold  and  wet  ;  yet  the  men  were  remarkably  healthy,  and 
among  the  causes  for  this  health,  Chisholm  states  that  the  necessaiy  absti- 
nence from  strong  Hquors  was  one. 

In  1794-95  occurred  the  Maroon  War  in  Jamaica,  where  almost  forthe 
first  time  in  West  Indian  warfare  the  troops  were  remarkably  healthy, 
though  the  campaign  was  very  arduous,  and  in  the  rainy  season,  and  there 
were  no  tents.  The  perfect  health  of  the  troops  may  pai-tly  have  been 
owing  to  the  climate  of  the  hills  (2,000  feet  above  the  sea),  but  it  was  chiefly 
attributed  to  the  fact  that  the  men  could  obtain  no  spirits  or  alcohoHc 
liquid  of  any  kind. 

In  1800  an  English  army  proceeding  from  India  to  Egyj)t,  to  join  Sir 
Ralph  Abercromby,  marched  across  the  desert,  fi-om  Kossier  on  the  Red  Sea, 
and  descended  the  Nile  for  400  miles.  Sir  James  M'Grigor  '  says  that  the 
fatigue  in  this  march  has  perhaps  never  been  exceeded  by  any  army,  and 
goes  on  to  remai-k : — 

"  We  received  still  further  confirmation  of  the  very  great  influence  which 
intemperance  has  as  a  cause  of  disease.     We  had  demonstration  how  verj' 

'  Medical  Sketches  of  the  Expedition  to  Egypt,  p.  10. 


BEVERAGES    AND    CONDIMENTS.  321 

little  spirits  are  required  in  a  liot  climate  to  enable  a  soldier  to  bear  fatigue, 
and  liow  necessary  a  regular  diet  is. 

"  At  Ghenne,  and  on  the  voyage  down  the  Nile  (on  account  of  the  dif- 
ficulties of  at  first  conveying  it  across  the  desert),  the  men  had  no  spirits 
deUvered  out  to  them,  and  I  am  convinced  that  from  this  not  only  did  they 
not  suffer,  but  that  it  even  contributed  to  the  uncommon  degree  of  health 
which  they  at  this  time  enjoyed.  From  two  boats  the  soldiers  one  day 
strayed  into  a  village,  where  the  Arabs  gave  them  as  much  of  the  spirit 
which  they  distil  from  the  juice  of  the  date-tree  as  induced  a  kind  of  furious 
delirium.  It  was  remarked  that,  for  three  months  after,  a  considerable 
number  of  these  men  were  in  the  hospitals." 

Dr.  Mann,'  one  of  the  few  American  surgeons  in  the  war  of  1813-14  who 
have  left  any  account  of  that  contest,  thus  writes  : — 

"  My  opinion  has  long  been  that  ardent  spirits  are  an  unnecessary  part 
of  a  ration.  Examples  may  be  furnished  to  demonstrate  that  ardent  spirits 
are  a  useless  part  of  a  soldier's  ration.  At  those  periods  during  the  revo- 
lutionary war,  when  the  army  received  no  pay  for  their  services,  and  pos- 
sessed not  the  means  to  procure  spirits,  it  was  healthy.  The  4th  Massachu- 
setts Regiment,  at  the  eventful  period  when  I  was  the  surgeon,  lost  in  three 
years  by  sickness  not  more  than  five  or  six  men.  It  was  at  a  time  when  the 
army  was  destitute  of  money.  During  the  winter  1779-80  there  was  only 
one  occurrence  of  fever  in  the  regiment,  and  that  was  a  pneumonia  of  a  mild 
form.  It  was  observable  in  the  last  war,  from  December,  1814,  to  April, 
1815,  the  soldiers  at  Plattsburg  were  not  attacked  with  fevers  as  they  had 
been  the  preceding  winters.  The  troops  during  this  period  were  not  paid 
— a  fortiraate  circumstance  to  the  army,  arising  from  want  of  funds.  This 
embarrassment,  which  was  considered  a  national  calamity,  proved  a  blessing 
to  the  soldier.  When  he  is  found  poor  in  money,  it  is  always  the  case 
that  he  abounds  in  health — a  fact  worth  recording." 

No  testimony  can  be  stronger  than  that  given  by  the  late  Inspector- 
General  Sir  John  Hall,  K.C.B.     He  says ' : — 

"  My  opinion  is,  that  neither  spirit,  wine,  nor  malt  liquor  is  necessary 
for  health.  The  healthiest  army  I  ever  served  with  had  not  a  single  drop 
of  any  of  them  ;  and  although  it  was  exposed  to  all  the  hardships  of  Kaffir 
warfare  at  the  Cape  of  Good  Hope,  in  wet  and  inclement  weather,  without 
tents  or  shelter  of  any  kind,  the  sick-list  seldom  exceeded  one  per  cent.  ; 
and  this  continued  not  only  throughout  the  whole  of  the  active  operations 
in  the  field  during  the  campaign,  but  after  the  men  were  collected  in  stand- 
ing camps  at  its  termination  ;  and  this  favorable  state  of  things  continued 
until  the  termination  of  the  war.  But  immediately  the  men  were  again 
quartered  in  towns  and  fixed  posts,  where  they  had  free  access  to  spirits,  an 
inferior  species  of  brandy  sold  there,  technically  called  '  Cape  Smoke,'  num- 
erous complaints  made  their  ajopearance  among  them. 

"  In  Kaffraria  the  troops  were  so  placed  that  they  had  no  means  of  ob- 
taining liquor  of  any  kind  ;  and  all  attempts  of  the  '  Winklers'  to  infringe 
the  police  regulations  were  so  summarily  and  heavily  punished  by  fines  and 
expulsion,  that  the  illicit  trade  was  effectually  suppressed  by  Colonel  Mac- 
kinnon,  the  Commandant  of  British  Kaffraria  ;  and  the  consequence  was, 
that  drunkenness,  disease,  crime,  and  insubordination  were  unknown  ;  and 
yet  that  army  was  frequently  placed  in  the  very  position  that  the  advocates 
for  the  issue  of  spirits  would  ha\'e  said  required  a  dram. 

^  Hamilton,  Military  Surgery,  p.  61. 

^  Medical  History  ot  the  War  in  the  Crimea,  vol.  i. ,  p.  504, 
Vol.  I.— 31 


322  PEACTICAL    HYGIENE. 

"  Small  as  the  amount  of  sickness  and  mortality  was  in  the  Crimea,  dur- 
ing the  winter  1855-56,  they  wovdd  have  been  reduced  one-half,  I  am  quite 
sure,  could  the  rule  that  was  observed  in  Kaffirland  have  been  enforced 
there." 

In  the  same  Kafl^  war  (1852),  a  march  was  made  by  200  men  from 
Graham's  Town  to  Bloemfontein,  and  back  ;  1,000  miles  were  covered  in 
seventy-one  days,  or  at  the  rate  of  nearly  15  miles  daily  ;  the  men  were 
almost  naked,  were  exposed  to  great  variations  of  temperatiu-e  (excessive 
heat  dui'ing  day  ;  while  at  night  water  froze  in  a  bell-tent,  with  twenty-one 
men  sleeping  in  it)  ;  and  got  as  rations  only  biscuit,  meat  l^ft,  and  what 
game  they  could  kill.  For  drink  they  had  nothing  but  water.  Yet  this 
rapid  and  laborious  march  was  not  only  perfoi-med  easily,  but  the  men  were 
"  more  healthy  than  they  had  ever  been  before  ;  and  after  the  first  few  days, 
ceased  to  care  about  spirits.  No  man  was  sick  till  the  end  of  the  march, 
when  two  men  got  dysentery,  and  these  were  the  only  two  who  had  the 
chance  of  getting  any  hquor." 

In  the  last  New  Zealand  war.  Dr.  Neill  (Staff  Assistant-Surgeon)  found 
that  the  troops  marched  better,  even  when  exposed  to  wet  and  cold,  when 
no  spirits  were  issued,  than  when  there  was  a  spirit  ration. 

In  the  expedition  to  the  Ked  Eiver,  under  Sir  Garnet  Wolseley,  no  alco- 
hoHc  liquid  was  issued.  Two  accounts  of  this  remarkable  march  have  been 
published — one  by  Captain  Huyshe, '  and  the  other  by  an  officer  who  wrote 
an  interesting  account  of  the  mai'ch  in  Blackwood's  Magazine."^  Captain 
Huyshe  says : — 

"  Although  it  was  an  unheard-of  thing  to  send  off  an  expedition  into  a 
wilderness  for  five  months  without  any  spirits,  still  as  the  backwoodsman 
was  able  to  do  haixl  work  without  spirits,  it  was  rightly  thought  that  the 
British  soldiers  could  do  the  same.  The  men  Avere  allowed  a  lai-ge  daily 
ration  of  tea,  1  oz.  per  man — practically  as  much  as  they  could  di-ink  ;  and, 
as  I  am  now  on  this  subject  of  bohea  versus  grog,  I  may  as  well  state  that 
the  experiment  was  most  successful.  The  men  of  no  previous  expedition 
have  ever  been  called  upon  to  perform  harder  or  more  continuous  labor 
for  over  four  months.  .  .  .  They  were  always  cheeiy,  and  worked  with 
a  zealous  will  that  could  not  be  sm-passed.  This  expedition  would  have 
been  a  bright  era  in  our  military  annals  had  it  no  other  result  than  that  of 
proring  the  fallacy  hitherto  beHeved  in  of  the  necessity  of  proriding  our 
men  when  in  the  field  with  intoxicating  liquors." 

The  writer  in  Blackwood's  Magazine  says  : — 

"The  men  were  pictures  of  good  health  and  soldier-like  condition 
whilst  stationed  at  Prince  Arthur's  Landing  and  the  other  larger  camps. 
The  men  had  fresh  meat,  bread,  and  jjotatoes  every  day.  No  spirits  were 
allowed  throughout  the  journey  to  Fort  GaiTy,  but  all  ranks  had  daily  a 
largQ  ration  of  tea.  This  was  one  of  the  very  few  miHtary  expeditions  ever 
undertaken  by  English  troops  where  intoxicating  liquors  formed  no  pari 
of  the  daily  ration.  It  was  an  experiment  based  upon  the  practice  common 
in  Canada,  where  the  lumbermen,  who  spend  the  whole  winter  in  the  back- 
woods, employed  upon  the  hardest  labor,  and  exposed  to  a  freezing  tem- 
perature, are  allowed  no  spirits,  but  have  an  unlimited  quantity  of  tea. 
Our  old-fashioned  generals  accept,  without  any  attempt  to  question  its 
tnith,  the  traditional  theory  of  rum  being  essential  to  keep  the  British 
soldier  in  health  and  humor.     Let  us  hope  that  the  experience  we  have 

'  Journal,  United  Service  Institution,  1871,  vol.  xv.,p.  74. 
*  January,  1871,  p.  64. 


BEVERAGES    AND    CONDIMENTS.  323 

acquired  during  the  Eed  River  expedition  may  have  buried  for  ever  this 
old-fogyish  superstition.  Never  have  the  soldiers  of  any  nation  been  called 
upon  to  perform  more  unceasingly  hard  work,  and  it  may  be  confidently 
asserted  without  dread  of  contradiction,  that  no  men  have  ever  been  more 
cheerful  or  better  behaved  in  every  respect.  No  spirit  ration  means  no 
crime  ;  and  even  the  doctors  who  anticipated  serious  illness  from  the 
absence  of  liquor,  will  allow  that  no  troops  have  ever  been  healthier  than 
they  were  from  the  beginning  to  the  end  of  the  operation.  With  the  ex- 
ception of  slight  cases  of  dian-hoea,  arising  from  change  of  diet,  it  may  be 
said  that  sickness  was  unknown  amongst  us." 

Sir  Garnet  Wolseley,'  who  commanded  in  this  remarkable  expedition, 
speaks  very  strongly  against  the  rum  ration,  and  says  that,  by  substituting 
tea  for  rum,  the  health  and  efficiency  of  the  men  are  increased,  "  their  dis- 
cipline will  improve  as  their  moral  tone  is  raised,  engendering  a  manly 
cheerfulness  that  spii-it-drinking  armies  know  nothing  of." 

In  the  Ashantee  campaign  of  1874  observations  were  carefully  recorded 
by  several  officers."  The  conclusions  arrived  at  were— 1.  That  abstinence 
did  not  render  those  who  abstained  more  sickly  as  a  whole  or  more  liable 
to  malarious  fever  ;  nor  did  it  interfere  with  their  powers  of  marching.  2. 
The  issue  of  a  ration  of  rum  seemed  to  do  good  when  given  at  the  end  of 
the  day  before  going  to  rest.  3.  That  the  quantity  (2^  oz.)  was  amply 
sufficient.  On  the  whole  the  necessity  for  the  ration  was  by  ho  means 
proved,  although  some  officers  returned  rather  shaken  in  their  previous 
behef  that  alcohol  was  absolutely  unnecessary  in  a  military  expedition. 

In  sieges,  which  are  perhaps  more  trying  to  men  than  campaigning  in 
the  open  field,  the  advantage  of  temperance  has,  on  two  occasions,  been 
very  marked.  In  the  great  siege  of  Gibraltar,  Sir  George  Eliott,  who  was 
a  teetotaller,  enforced  the  most  rigid  temperance,  and  the  long  and  arduous 
blockade  was  passed  through  T\ith  remarkably  little  sickness.  At  the  siege 
of  Jellalabad,  in  Afghanistan,  the  "  illustrious  ganison  were  quite  destitute 
of  all  alcohoHc  Hquors  ;  and,  to  the  astonishment  of  the  officers,  the  Europe- 
ans never  had  been  so  healthy,  cheerful,  martial,  and  enduring  and  free 
from  crime.  During  the  Indian  mutiny  many  regiments  were  debaiTcd 
from  spirits  for  a  long  time,  and  were  much  healthier  than  when  they  got 
them. 

In  fact,  it  may  be  confidently  asserted  that  in  "v\'ar,  spirits  especially,  and 
indeed  aU  alcohoHc  liquors,  are  better  avoided  ;  and  the  phrase  of  an 
American  army  surgeon  in  the  civil  war,  who  noticed  how  great  was  the 
improvement  when  spirit  prohibition  was  enforced,  is  fully  justffied  by  oru* 
cvsTi  experience — "  The  curse  of  an  army  is  intoxicating  hquors ;  the  spirit 
ration  is  the  source  of  all  this  mischief." 

When  debaiTed  from  spirits  and  fermented  liquids,  men  are  not  only 
better  behaved,  but  are  far  more  cheerful,  are  less  iiTitable,  and  endure 
better  the  hardships  and  perils  of  war.  The  courage  and  endiu-ance  of  a 
drunkard  are  always  lessened  ;  but  in  a  degree  far  short  of  di-unkenness, 
spirits  lower,  while  temperance  raises,  the  boldness  and  cheerfulness  of 
spirit  which  a  true  soldier  should  possess.' 


'  Soldiers'  Pocket  Book,  2d  edition,  p.  172. 

2  On  the  Issue  of  a  Spirit  Ration  during  the  Ashantee  Campaign  of  1874  (Parkes). 

^  The  custona  of  giving  rations  of  spirits  to  soldiers  and  sailors  (even  now  not  alto- 
gether discontinued),  was  one  of  those  incredible  mistakes  which  are  only  made  worse 
by  the  explanation  that  it  was  done  to  please  the  men,  and  cover  neglect  in  other  ways. 
If  any  one  wishes  to  see  what  our  army  was  in  former  days,  and  how  dreadful  military 
regulations  made  men  drunkards  in  spite  of  themselves,  they  may  refer  to  an   old 


324  PRACTICAL    HYGIENE. 

Looking  back  to  this  evidence,  it  may  be  asked,  Are  there  any  circum- 
stances of  the  soldier's  life  in  which  the  issue  of  spmts  is  advisable,  and  if 
the  qiiestion  at  any  time  hes  between  the  issue  of  spirits  and  total  abstinence, 
which  is  the  best  ? 

There  seems  but  one  answer.  If  spirits  neither  give  strength  to  the 
body,  nor  sustain  it  against  disease — are  not  protective  against  cold  and  wet, 
andaggravate  rather  than  mitigate  the  effects  of  heat — if  their  use  even  in 
moderation  increase  crime,  injure  discipline,  and  impair  hope  and  cheer- 
fulness— if  the  severest  trials  of  war  have  been  not  merely  borne,  but  most 
easily  borne,  Avithout  them — if  there  is  no  evidence  that  they  are  protective 
against  malaria  or  other  diseases — then  the  medical  officer  will  not  be  jus- 
tified in  sanctioning  their  issue  under  any  circumstances. 

The  terrible  system  which  in  the  East  and  West  Indies  made  men 
drunkards  in  spite  of  themselves,  and  which  by  the  issue  of  the  morning 
dram  did  more  than  anything  else  to  shatter  the  constitutions  of  the  young 
soldiers,  is  now  becoming  a  thing  of  the  past.  But  the  soldier  is  still  per- 
mitted to  get  spirits  too  easily,  and  is  too  ignorant  of  their  fatal  influence 
on  his  health.  Still  the  British  army  bears  the  unhappy  character  of  the 
most  intemperate  army  in  Europe,  and  it  is  ceiiain  that  its  moments  of 
misconduct  and  misfortune  have  been  too  frequently  caused  by  the  unre- 
strainable  passion  for  drink.  Kemembering  all  these  things,  and  how 
certainly  it  has  been  proved  that  dmnkenness  increases  the  spread  of  syph- 
ilis, it  is  not  too  much  to  say  that  the  repression  of  this  vice  should  be  one 
of  the  chief  duties  of  every  officer  in  the  army.  Moderation  should  be 
encouraged  by  precept  and  example  ;  wholesome  beer  and  hght  wine  should 

Peninsular  surgeon's  (William  Fergusson's)  Notes  and  Recollections  of  a  Professional 
Life  (1846).  "During  the  last  war"  (he  says,  p.  74),  "  our  sailors  and  soldiers  appeared 
to  live  for  the  purpose  of  getting  drunk  ;  with  them  it  seemed  to  be  the  chief  article 
of  their  creed— the  chief  end  of  life.  .  .  .  'Grog,  grog,' was  still  the  cry  ;  I  have 
seen  it,  as  it  were,  forced  down  the  throats  of  the  innocent  negro  boy  and  the  uncorrupted 
young  recruit.  We  seemed  to  believe  that  the  term  aqua  tit(P  was  its  true  designation. 
Every  one  was  to  have  it ;  no  matter  what  the  age,  the  color,  the  country,  or  the  breed- 
ing. Our  Portuguese  allies  in  the  Peninsula  were  the  soberest  of  mankind.  Ihey 
liked  their  own  weak  country  wine  to  dilute  their  food,  but  that  would  not  do  for  us. 
We  actually  sent  for  the  rum  of  the  West  Indies  and  gave  it  them  ;  and  at  the  battle  of 
Busaco,  I  saw  a  party  of  Portuguese  artillery,  as  soon  as  the  rum  ration  was  served,  as 
if  they  had  been  possessed  by  a  devil  (and  they  actually  were  possessed  by  a  devil  in 
the  shape  of  alcohol),  draw  their  SAVords  and  fight  with  one  another,  when  actually 
under  the  fire  of  the  enemy  "  (p.  85). 

He  cites  numerous  most  lamentable  facts,  and  well  concludes  that  "our  canteen 
system  will  in  after-times  be  viewed  with  horror  and  astonishment,  at  its  folly,  corrup- 
tion, and  wickedness." 

These  opinions  are  not  recalled  without  a  motive.  There  is  too  much  reason  to  fear 
that  many  officers  still  believe  that  soldiers  must  have  spirits.  Fergusson  says  that 
"the  exceeding  vulgarity  of  the  prejudice  that  ardent  spirits  impart  strength  and 
vigor  to  the  human  frame  is  disgraceful  to  educated  men  ;  "  and  yet  this  belief  is  still 
actually  held  by  persons  in  authority.  Although  in  the  army  drinking  is  the  great 
source  of  all  crime  and  insubordination  ;  although  even  within  late  years  we  have  had 
one  if  not  more  instances  that,  even  during  an  assault,  men  will  sacrifice  anything,  even 
their  honor,  to  obtain  spirits  ;  although  the  best  oflicers  know  that  this  is  the  one  point 
on  which  they  cannot  depend  on  their  men,  far  too  little  has  been  done  to  make  our 
army  temperate.  This  does  not  mean  that  nothing  has  been  done ;  on  the  contrary, 
in  this,  as  in  all  things,  progress  has  been  made,  but  the  measures  are  not  sufficient  to 
control  an  evil  so  gigantic.  It  is  the  same  thing  in  civil  life  ;  there  is  no  question  that 
more  disease  is,  directly  and  indirectly,  produced  by  drunkenness  than  by  any  other 
cause,  and  that  the  moral  as  well  as  the  physical  evils  proceeding  from  it  are  beyond 
all  reckoning  ;  and  yet  the  attempts  of  the  Legislature  to  set  some  bounds  to  intem- 
perance have  been  and  are  opposed  with  a  bitterness  which  could  only  be  justified  if 
the  degradation  and  not  the  improvement  of  mankind  was  desired. 


BEVEEAGES    AND    CONDIMENTS.  325 

be  invariably  substituted  for  spirits,  and  if  these  cannot  be  procured,  it 
may  safely  be  said  that  the  use  of  tea,  coffee,  or  simple  water  is  preferable 
to  spirits  under  all  circumstances  of  the  soldier's  life. 

Eedstance  to  Disease. — Malaria. — There  are  instances  for  and  against  the 
view  that  spuits  are  useful  against  malaria.  On  both  sides  the  evidence  is 
defective  ;  but  there  are  so  many  cases  in  which  persons  have  been  attacked 
with  malarious  disease  who  took  spirits,  that  it  is  impossible  to  consider  the 
preventive  powers  great,  even  if  they  exist  at  all.  On  the  other  hand,  when 
teetotallers  have  escaped  malaria  (as  in  the  instance  recorded  by  Drake),' 
there  have  been  other  circumstances,  such  as  more  abundant  food  and  better 
lodging,  which  will  explain  their  exemption.  The  probability  is,  that  the 
reception  and  action  of  malaria  are  not  influenced  by  the  presence  or  absence 
of  alcohol  in  the  blood  unless  the  amount  of  alcohol  is  so  great  as  to  lessen 
the  amount  of  food  taken. 

Yelloio  Fever. — It  is  a  general  opinion  in  New  Orleans  and  Mobile  that 
the  victims  of  yellow  fever  are  chiefly  those  who  drink  freely  (Drake).  The 
old  West  Indian  experience  is  to  the  same  eftect. 

Cholera. — Intemperance,  per  se,  has  no  influence,  and  teetotaUsm  does 
not  guard  against  cholera.  When  a  regiment  is  attacked  with  cholera,  and 
the  men  take  to  drinking,  a  number  of  pseudo-cases  come  into  hospital  of 
vomiting  and  cramps,  which  are  often  returned  as  cholera,  but  they  seldom 
if  ever  pass  into  true  cholera. 

Dysentery.  — It  has  been  supposed,  from  some  statistics  for  1847,  pub- 
lished in  the  Fort  George  Gazette,  that  teetotallers  were  more  subject  to 
dysentery,  but  the  error  was  committed  of  not  estimating  sufficiently  the 
influence  of  a  particular  station  (Secunderabad),  where  it  so  happened  a 
number  of  teetotallers  were  stationed  during  an  outbreak  of  dysentery.  The 
conditions  of  the  station  were  to  blame,  not  the  habits  of  the  men. 

In  none  of  the  conditions  now  enumerated  is  there  any  evidence  that 
alcohol  is  desirable. 

Conclusion  as  to  the  Use  of  Alcohol. 

The  facts  now  stated  make  it  difficult  to  avoid  the  conclusion  that  the 
dietetic  value  of  alcohol  has  been  much  over-rated.  It  does  not  appear 
possible  at  present  to  condemn  alcohol  altogether  as  an  article  of  diet  in 
health  ;  or  to  prove  that  it  is  invariably  hui'tf ul,  as  some  have  attempted  to 
do.  It  produces  effects  which  are  often  useful  in  disease  and  sometimes 
desirable  in  health,  but  in  health  it  is  certainly  not  a  necessity,  and  many 
persons  are  much  better  without  it.  As  now  used  by  mankind  (at  least  in 
our  own,  and  in  many  other  countries),  it  is  infinitely  more  powerful  for  evil 
than  for  good  ;  and  though  it  can  hardly  be  imagined  that  its  dietetic  use 
will  cease  in  oar  time,  yet  a  clearer  view  of  its  effects  must  surely  lead  to  a 
lessening  of  the  excessive  use  which  now  prevails.  As  a  matter  of  public 
health,  it  is  most  important  that  the  medical  profession  should  throw  its 
great  influence  into  the  scale  of  moderation  ;  should  explain  the  limit  of 
the  useful  power,  and  show  how  easily  the  line  is  passed  which  carries  us 
from  the  region  of  safety  into  danger,  when  alcohol  is  taken  as  a  common 
article  of  food.^ 

^  On  the  Interior  Valley  of  North  America. 

^  A  great  evil  is  growing  iip  in  India,  which  now  could  be  checked,  but  which  we 
shall  be  powerless  to  meet  in  a  few  years.  The  Hindoos,  formerly  the  most  temperate 
oE  races,  are  rapidly  becoming  addicted  to  drink.  This  is  said  to  be  partly  owing  to 
the  regulations  of  the  Government  permitting,  and  even  encouraging  the  sale  of  spirits, 


326  PRACTICAL    HYGIENE. 


Dietetic  Use  of  Alcoholic  Beverages. 

In  the  previous  remarks,  the  effect  of  alcohol  only  has  been  discussed, 
but  beer  and  wine  contain  other  substances  besides  Jilcohol. 

In  wine  there  are  some  albuminous  substances,  much  sugar  (in  some 
wines),  and  other  carbo-hydrates,  and  abundant  salts.  Whether  it  is  that 
the  amount  of  alcohol  is  small,  or  whether  the  alcohol  be  itself,  in  some  way, 
different  from  that  prepared  by  distillation,'  or  whether  the  coexistence  of 
carbo-hydrates  and  of  salts  modifies  its  action,  certain  it  is  that  the  moderate 
use  of  wdne,  which  is  not  too  rich  in  alcohol,  does  not  seem  to  lead  to  those 
profound  alterations  of  the  molecular  constitution  of  organs  which  follow 
the  use  of  sj^irits,  even  when  not  taken  largely.  Considering  the  large 
amounts  of  vegetable  salts  which  most  wines  contain,  it  may  reasonably 
be  supposed  that  they  play  no  unimportant  part  in  giving  dietetic  value  to 
wine.  Indeed,  it  is  quite  certain  that,  in  one  point  of  view,  they  are  most 
valuable  ;  they  are  highly  anti-scorbutic,  and  the  arguments  of  Lind  and 
Gillespie,  for  the  introduction  of  red  wine  into  the  royal  navy  instead  of 
spirits,  have  been  completely  justified  in  our  own  time  by  both  French 
and  English  experience.  It  is  now  certain  that  with  the  same  diet,  but 
giving  in  one  case  red  wine,  in  another  rum,  the  persons  on  the  latter 
system  will  become  scorbutic  long  before  those  w^ho  take  the  wine.  This 
is  a  most  imj^ortant  fact,  and  in  a  campaign  the  issue  of  red  wines  should 
never  be  omitted.  The  ethers  may  also  be  important  if,  as  indicated  by 
Bernard,  and  I'eceutly  j^ointed  out  by  Dr.  B.  Forster,"  they  excite  the  flow 
of  the  pancreatic  secretion,  and  thereby  promote  the  absorption  of  fat. 

In  beer  there  api:)ear  to  be  four  ingredients  of  importance,  viz.,  the  ex- 
tractive matters  and  sugar,  the  bitter  matters,  the  free  acids,  and  the  alcohol. 
The  first,  no  doubt,  ai'e  carbo-hydrates,  and  play  the  same  part  in  the  system 
as  starch  and  sugar,  appropriating  the  oxygen,  and  savmg  fat  and  albuminates 
from  destruction.  Hence,  one  cause  of  the  tendency  of  jDersons  who  drink 
much  beer  to  get  fat.  The  bitter  matters  are  sui:)posed  to  be  stomachic 
and  tonic  ;  though  it  may  be  questioned  whether  we  have  not  gone  too  far 
in  this  direction,  as  many  of  the  highest-priced  beers  contain  now  little  else 
than  alcohol  and  bitter  extract.  The  action  of  the  free  acids  is  not  known  ; 
but  their  amount  is  not  inconsiderable  ;  and  they  are  mostly  of  the  kind 
which  form  carbonates  in  the  system,  and  which  seem  to  jilay  so  useful  a 
part.  The  salts,  especially  potassium  and  magnesium  phosphates,  are  in 
large  amount. 

It  is  e\ddent  that  in  beer  we  have  a  beverage  which  can  answer  several 
purposes,  viz.,  can  give  a  supply  of  carbo-hydrates,  of  acid,  of  important 
salts,  and  of  a  bitter  tonic  (if  such  be  needed)  independent  of  its  alcohol, 
but  whether  it  is  not  a  very  expensive  way  of  giving  these  substances  is  a 
question. 

In  moderation,  it  is  no  doubt  well  adapted  to  aid  digestion,  and  to 
lessen  to  some  extent  the  elimination  of  fat.  It  may  be  infeixed  that  beer 
wUl  cause  an  increase  of  weight  of  the  body,  by  increasing  the  amount  of 


although  the  alcoholic  liquors  form  no  part  of  the  ordinary  food  of  the  people,  and  there- 
fore their  prohibition  is  not  difficult ;  and  partly  from  the  bad  example  of  the  Europeans 
in  India,  who,  as  the  dominant  race,  are  impressing  more  and  more  the  nations  whom 
they  control.  It  seems  a  matter  which  our  statesmen  may  well  look  into,  for  it  involves 
the  happiness  of  many  nations. 

'  Thudichum  and  Dupre  could  not,  however,  trace  any  difference  between  the  alcohol 
in  wines  and  that  derived  from  other  sources. 

•■^  Brit.  Med.  Journal,  November,  1868. 


BEVERAGES    AND    CONDIMENTS.  327 

food  taken  in,  and  by  slightly  lessening  metamorpliosis  ;  and  general 
experience  confirms  those  inferences.  When  taken  in  excess,  it  seems  to 
give  rise  to  gouty  affections  more  readily  even  than  wine. 

In  spirits,  alcohol  is  the  main  ingi'edient,  chiefly  in  the  form  of  ethyl- 
alcohol,  though  there  are  small  amounts  of  propyl-,  butyl-,  and  in  some 
cases  amyl-alcohols.  In  addition,  there  are  sometimes  small  quantities  of 
ether  ;  and,  in  some  cases,  essential  oils  (as  apparently  in  absinthe,  and  in 
one  kind  of  Cape  brandy),  which  have  a  powerful  action  on  the  nerves. 
But  spirits  are,  for  the  most  part,  merely  flavored  alcohol,  and  do  not  con- 
tain the  ingredients  which  give  dietetic  value  to  wine  and  beer.  They  are 
also  more  dangerous,  because  it  is  so  easy  to  take  them  undiluted,  and 
thus  to  increase  the  chance  of  damaging  the  structure  and  nutrition  of  the 
albuminous  structures  with  which  they  come  first  in  contact.  There  is 
every  reason,  therefore,  to  discourage  the  use  of  spirits,  and  to  let  beei^ 
and  wines,  with  moderate  alcohoUc  power,  take  their  place. 


SECTION  n. 

NON-ALCOHOLIC  BEVERAGES. 

Sub-Section  L — Coffee. 

Unroasted  coffee  contains  much  cellulose  (34  per  cent.),  fat  (10  to  13 
per  cent.),  sugar  and  dextrin,  and  vegetable  acid  (15.5),  and  legumin  (10  per 
cent. ).  There  is  also  a  solid  acid,  aromatic  oil  in  small  quantities,  caffein, 
and  ash,  the  chief  ingredients  of  which  are  potash  and  phosphoric  acid. 
The  total  amount  of  caffein  (free  and  combined),  according  to  Payen,  is 
about  1.736  per  cent.  ;  but  this  is  more  than  other  observers  have  found. 
In  roasted  coffee  berries  the  average  of  Boutron  and  Eobiquet's  analyses 
gives  .238  per  cent,  of  caffein.  Aubert'  has  given  the  amount  as  from 
.709  to  .849  per  cent.,  and  Witte  makes  it  .666  per  cent.  ;  Graham,  Sten- 
house,  and  Campbell  state  it  as  .87  per  cent.  It  may  be  assumed  to  be 
.75  per  cent,  on  an  average.  Aubert  found  that  roasting  coffee  to  any 
extent  caused  very  little  loss  of  caffein.  The  caffein  is  extracted  easily  by 
benzol  or  by  chloroform.^ 

When  coffee  is  roasted  it  swells,  but  becomes  lighter  (15  to  even  25  per 
cent.,  if  the  coffee  is  dark  roasted).  The  sugar  is  changed  into  caramel, 
the  peculiar  aroma  is  developed,  the  union  between  the  caffein  and  the 
caffeo-tannic  acid  is  broken  up  ;  several  gases  are  formed,  viz.,  carbon 
dioxide  (in  gTeatest  amount),  carbon  monoxide,  and  nitrogen.  It  is  owing 
to  these  gases  that  the  roasted  coffee  swells  so  much.^  In  the  infusion 
almost  all  the  caffein  is  found,  according  to  Aubert,  whUe  others  say  about 
one-half  is  lost.  Aubert  has  found  that  in  a  cup  of  coffee  made  with 
16.66  grammes,  or  .587  ounce  avoirdupois  (1  Prussian  loth),  there  aro 

^  Arctiv.  fiir  die  ges.  Phys. ,  Band  v.,  p.  589. 

*  CaSein  and  thein  are  the  same  substance.  Theobromine  belongs  to  the  same 
series,  and  has  apparently  identical  effects.  In  the  leaves  of  the  Paraguay  tea  {Ilex 
paraguayensis,  the  tea  is  called  Mate  in  Paraguay),  which  are  used  to  make  tea  in  the 
Argentine  confederation,  and  throughout  the  southern  part  of  Brazil,  there  is  also  an 
alkaloid  identical  with  thein.  In  dietetic  properties,  Paraguay  tea  is  thought  to  stand 
between  coffee  and  Chinese  tea,  but  to  be  more  like  coffee.  The  alkaloid  in  guarana  is 
also  thein,  according  to  Stenhouse. 

3  Coulier,  Recueil  de  M^moires  de  Med.  Mil.,  Juin,  1864,  p.  508. 


828  PRACTICAL    HYGIET^-E. 

from  .1  to  .12  gramme  (  =  1.5  to  1.9  grain  of  caffein).  In  a  cup  of  tea 
made  from  5  to  6  gi-ammes  (=  77  to  92  grains)  of  tea,  about  the  same 
amount  of  caffein  is  contained. 

As  an  article  of  diet,  coffee  stimulates  the  nervous  system,  and  in  large 
doses  produces  tremors.  Caffein  given  to  animals  augments  reflex  action, 
and  may  produce  tetanus,  or  peculiar  stiffness  of  muscles.  It  increases 
the  frequency  of  the  pulse  in  men,  and  removes  the  sensation  of  com- 
mencing fatigue  during  exercise.  It  has  been  said  (J.  Lehmann  and 
others)  to  lessen  the  amount  of  urea  and  phosphoric  acid,  but  this  is 
doubtful. '  It  appears,  however,  to  increase  the  m-inary  water.  The  pul- 
monary carbon  dioxide  is  said  to  be  increased  (E.  Smith).  It  increases  the 
action  of  the  skin. 

In  animals  (frogs,  dogs,  and  rabbits)  caffein  produced  the  following 
▼effects,  as  determined  by  Aubei-t  and  others  : — Inci-eased  reflex  action  ;  a 
.  peculiar  stiffness  of  the  muscles,  sometimes  tetanus  ;  no  lessening  of  ner- 
vous excitability ;  an  invariable  increase  in  pulse-frequency,  and  a  lessening 
of  the  blood-pressure  (in  dogs).  This  effect  on  the  cu-culation  is  peculiar 
and  complex.  Aubert  is  conrinced  that  the  work  of  the  heart  is  less,  in 
spite  of  the  increased  beats  ;  there  is  not  time  for  perfect  contraction,  and 
this  lessened  power  shows  itself,  he  thinks,  in  the  lessened  blood-pressure. 
Aubert  considers  that  the  lessened  heart-pressure  is  deiDendent  on  a  moi-e 
or  less  marked  paralysis  of  the  nein-es  passing  to  the  heart  from  the 
gangha ;  the  increased  frequency  must  be  dependent  either  on  paralysis 
of  the  regulating  or  excitation  of  the  contractive  heart  nei-ves,  and  of  this 
alternative  he  adoj^ts  the  latter.  He  thinks  it  uncertain  whether  coffee 
owes  its  dietetic  vidue  to  the  caffein. 

Coffee  is  a  most  important  article  of  diet  for  soldiers,"  as  not  only  is  it 
invigorating,  without  producing  subsequent  collapse,  but  the  hot  infusion 
is  almost  equally  serviceable  against  both  cold  and  heat :  in  the  one  case, 
the  w\armth  of "  the  infusion,  in*  the  other,  the  action  on  the  skin,  being 
useful,  while  in  both  cases  the  nei-vous  stimulation  is  veiy  desii-able. 
Dr.  Hooker  tells  us  that  in  the  Antarctic  expedition  the  men  all  pre- 
ferred coffee  to  spu'its,  and  this  was  the  case  in  the  Schleswig-Holstein  war 
of  1849. 

The  experience  of  Algeria  and  India  (where  coffee  is  coming  more  and 
more  into  use)  proves  its  use  in  hot  climates. 

It  has  been  asserted  to  be  protective  against  malaria.  The  eridence  is 
not  strong,  but  still  is  svifficient  to  authoi-ize  its  use  in  malarious  districts. 

Making  of  Coffee. — Roasted  and  ground  coffee  must  be  served  out  to 
troops,  as  the  delicate  operation  of  roasting  can  never  be  performed  by 
soldiers.  Exposed  to  the  ah',  the  roasted  and  ground  coffee  loses  its 
aroma  in  from  two  to  four  months  ;  but  if  packed  in  tins,  it  will  keep  it 
for  several  months.     The  tins  should  not  be  too  large,  so  that  no  more 

*  While  Hoppe  found  a  decrease  in  dogs,  Voit  found  no  alteration  of  urea ;  and 
some  very  careful  experiments,  made  by  Dr.  Squarey  of  University  College,  do  not 
confirm  Lehmann's  observations  on  men  so  far  as  the  iirea  is  concerned.  Dr.  Squarey's 
experiments  are  far  more  complete  than  those  of  Lehmann ;  the  urea  was  not  affected 
even  by  very  large  quantities  of  coffee.  It  would  be  interesting  to  examine  the  urine 
again  after 'the  use  of  the  Erythroxylon  coca.  The  late  work  of  M.  Moreno  of  Maiz 
(Paris,  1868)  confirms  the  previous  statements  of  the  removal  of  the  sensation  of  hun- 
ger by  this  substance.  The  cold  infusion  increases,  he  affirms,  the  arterial  tension. 
Dr.  Ldmonstone  Charles  has  lately  called  attention  to  its  power  of  preventing  thirst. 

■  The  ration,  one  ounce,  is  generally  too  small,  and  might  advantageously  be  doubled 
at  least.  See  experiments  recorded  in  The  Issue  of  a  Spirit  Ration  (Farkes,^,  Appendix 
I.,  p.  39  et  seq. 


BEVEEAGES  AND  CONDIMENTS. 


than  necessary  may  be  exposed  to  the  air.  It  has  been  said  that  the  tin  is 
acted  upon,  but  this  does  not  appear  to  be  the  case  for  some  time.  The 
amount  should  be  at  least  y\ths  of  an  ounce  for  each  person  per  meai 


Pig.  5f5.  — Testa  of  Raw  Coffee,  x  170  ,  the  ns^ht  hand  figure  shows  the  double  spiral  fibres  in  the  raphe  of 

the  berry,  x  50U. 

The  coffee  must  not  be  boiled,  or  the  aroma  is  in  part  dissipated  ;  but 
if  made  with  water  of  180^  or 
200^,  the  coifee  only  gives  u]d  19 
to  25  par  cent.,  whereas  it  ought 
to  yield  30  to  35  per  cent.  In 
order  to  get  the  fuU  benefit  of  the 
coffee,  therefore,  after  the  infu- 
sion has  been  poured  off,  the 
grounds  should  be  well  boiled  in 
some  more  water,  and  the  hot  de- 
coction poured  over  fresh  coffee, 
so  that  it  may  take  up  aroma ; 
the  coffee  thus  partially  exhausted 
can  be  used  on  the  next  occasion 
for  boiling. 

The  infusion  of  coffee  has  a 
specific  gravity  of  about  1008  to 
1010  ;  the  oil,  caffein,  sugar,  dex- 
trin, and  mineral  matters  are 
taken  up  by  water. 

Choice  of  Coifee. — This  is  de- 
termined entirely  by  the  aroma 
and  taste  of  the  roasted  coffee  and  of  the  infusion. 


Fig,  57. — Raw  Coffee-berry;  transverse  section, 


If  the  coffee  has  been 


330 


PRACTICAL    HYGIENE. 


damaged  (as  by  sea-wafer,  -wlien  the   berries  are  washed  in  fresh  water 
and    redried),    there  is  always  a   disagreeable   taste   even  after  roasting 


Fig.  58.— Roasted  Coffee ;  the  dark  cells,  containing  air,  Bhow  the  spiral  fibre. 


(Chevallier).     The  berries  give  up  less  than 


Fig.  59. — Eoa=ted  Coffee-berry  ;  transverpe  section. 


usual  to  water  (twelve  per 
cent.).' 

Adulterations. — The  mi- 
croscope detects  adiiltera- 
tions  with  the  greatest  fa- 
cility. 

The  structure  of  the  cof- 
fee-beriy  is  shown  in  the 
di'awings. 

The  long  cells  of  the  testa 
(Figs.  5G  and  58)  are  very 
marked.  The  interior  of  the 
berrv'  also  presents  charac- 
ters which  are  quite  erident ; 
an  iiTCgular  areolar  tissue 
contains  light  or  dark  yellow 
angular  masses  and  oil  glob- 
ules, which  are  very  difl'er- 
ent  from  any  adulterations. 
The  little  corkscrew-hke  un- 
rolled spiral  fibres  are  chiefly 
found  in  the  bottom  of  the 
raphe.      The  usual  adultera- 


'  With  regard  to  the  choice  of  the  coffee  berrv  some  caution  must  he  used.  The 
best  coffee,  that  of  Yemaii,  originally  the  Abyssinian  berry,  is  a  moderately  large  iv\\ 
berry  (according  to  Palgrave),  the  inferior  sorts  being  small  and  shrivelled.  In  India 
the  same  rule  does  not  seem  to  hold  good,  and  I  have  been  told  by  officers  of  expeii- 


BEVERAGES    AND    CONDIMENTS. 


831 


tions  of  coffee  are  roasted  chiccory, '  cereal  grains  or  beans,  potatoes,  and 
sugar. 

1,  Chiccory  is  discovered  by  its  smell ;  by  yielding  a  darker  and  denser 
infusion  of  a  specific  gravity  of  1018  to  1020  ;  and  by  its  niicroscoj)ic 
characters.  It  also  sinks  at  once  in  water  when  roasted,  whereas  coffee 
floats  for  a  long  time,  in  consequence  of  the  develojDment  of  gas  during 
roasting,  or  from  the  non-absorbent  character  of  the  perisperm  and  hard 
yellow  granules  of  the  cellulose.  The  microscopic  test  is  the  most  impor- 
tant, and  both  the  cells  and  dotted  ducts  of  chiccory  are  quite  characteristic, 
at  least  nothing  Like  them  exists  in  coffee.^  The  percentage  of  ash  has  been 
suggested  as  a  means  of  detection.  Coffee  yields  about  4  jDer  cent.,  of 
which  four-fifths  are  soluble  in  water :  chiccory  yields  about  5  per  cent.,  of 
which  only  one-third  is  soluble. 

Chiccory  contains  a  notable  amount  of  sugar  (12  to  14  per  cent), 
whereas  coffee  never  has  more  than  1  per  cent.  Wanklyn  has  proposed  to 
make  this  a  basis  of  detection,  using  the  standard  copper  solution. 


Fig.  60. — Chiccory  Root ;  cells  and  dotted  ducts. 

2.  Roasted  corn  or  beans  are  at  once  known  by  the  starch-grains,  which 
frequently  preserve  the  precise  character  of  wheat  or  barley  or  beans. 
Iodine  turns  them  at  once  blue.  The  infusion  also  gives  a  blue  with 
iodine. 

3.  Potato  starch  is  also  at  once  detected ;  there  is  nothing  like  it  in 
coffee.     Sago  starch,  which  is  sometimes  used,  is  easily  detected. 

4.  Sugar  is  detected  by  solution,  and  by  the  copper  solution  which  it 
reduces,  as  the  kind  of  sugar  is  almost  always  glucose.  If  caramel  or  burnt 
sugar  be  present,  make  an  infusion,  evaporate,  dry,   and  taste  ;  if  the  ex- 

ence  that  in  that  country  the  best  coffee  is  often  a  shrivelled  and  uninviting-looking 
article,  whilst  the  fuller  and  apparently  finer  samples  are  really  inferior  for  use  as  a 
beverage  — (F.  de  C.) 

'  Chiccory  is  itself  adulterated  with  roasted  barley  and  wheat  grain,  acorns,  mangold- 
wurzel,  saw  dust,  and  beans  and  peas. 

^  Various  vegetable  substances  are  now  permitted  to  be  sold  as  substitutes  for  coffee, 
provided  they  are  properly  labelled  and  made  up  in  ^  lb  packets. 


332  PRACTICAL    HYGIENE. 

tract  be  brittle,  dai'k  colored,  and  bitter  to  the  taste,  caramel  has  been 
added  (Hassall). 

5.  Pereii'a'  has  given  a  long  list  of  adulterations  of  chiccory,  and  HassaU, 
has  also  detected  mixture  with  mangold-wurzel,  parsnij),  carrot,  acorn,  and 
saw-dust.  The  cells  of  mangold-wurzel  are  like  chiccory,  but  much  larger  ; 
those  of  caiTot  and  parsnip  are  something  like  chiccoiy,  but  contain  starch- 
cells  ;  the  stai'ch-grains  of  the  acorn  are  round  or  oval,  with  a  deep  cul- 
vert depression,  or  hilum.  The  infusion  of  chiccory  is  not  turned  blue  by 
iodine  ;  when  incinerated  the  ash  of  chiccory  shoiild  not  be  less  than  6  per 
cent. 

6.  Kecently  date-stones  gi-ound  have  been  mixed  with  coffae  and  chic- 
cory, and  sold  as  date  coffee.  They  can  be  detected  by  the  microscope,  which 
shows  numerous  sclerogen  cells.  ^ 


Sub-Section  II. — Tea. 

The  chief  kinds  of  black  tea  are  Souchong,  Congou,  Oolong,  and  Pekoe. 
Bohea  is  not  now  found  in  the  market.  The  chief  green  teas  ai-e  Hyson, 
Hyson-stem,  Twankay,  Caper,  and  Gunpowder. 

Dry  tea  contains  about  1.8  per  cent,  of  thein,  2.6  of  albumen,  9.7  of 
dextrin,  22  of  cellulose,  15  of  tannin,  20  of  extractives,  5.4  of  ash,  as  well 
as  other  matters,  such  as  oil,  wax,  and  resin. 

In  some  good  teas  the  amount  of  thein  is  much  greater.  PeHgot 
found  as  much  as  6.21  per  cent,  in  dry  tea.  The  thein  is  combined  with 
tannic  acid. 

Black  tea  contains  from  6  to  10  per  cent,  of  water — more  often  the  latter 
quantity  ;  gi'een  tea  about  8  per  cent. 

The  ash^  consists  piincipally  of  potash,  soda,  magnesia,  phosphoric  acid, 
chlorine,  carbonic  acid,  iron,  and  silica. 

There  is  rather  more  tannic  acid,  and  more  thein  and  ethereal  oil,  in 
gi-een  than  black  tea,  and  less  cellulose  :  otherwise  the  composition  is  much 
the  same  (Mulder). 

Black  tea  jields  to  boiling  water 29-45  per  cent. 

As  a  mean 38        " 

Green 40-48 

As  a  mean 43        " 

About  4ths  of  the  soluble  matters  are  taken  up  by  the  first  infusion 
with  hot  water.  ^ 

If  water  contain  much  Hme  or  iron,  it  will  not  make  good  tea  ;  in  each 
case  the  water  should  be  well  boiled  \dth.  a  little  carbonate  of  soda  for  15 
or  20  minutes,  and  then  poured  on  the  leaves. 

In  the  infusion  are  found  dextiin,  glucose,  tannin,  and  thein.  About 
47  per  cent,  of  the  nitrogenous  substances  pass  into  the  infusion,  and  53 

'  Materia  Medica,  vol.  ii.,  p.  1578  (1863). 

^  Analysis  and  Adulteration  of  Foods,  by  James  Bell,  1881. 

*  The  Society  of  Public  Analysts  have  adopted  8  per  cent,  of  ash  as  the  maximum 
of  perfectly  dry  tea.  The  amount  in  ordinary  tea  is  about  5  to  6  per  cent.,  of  whicli 
about  3  per  cent,  is  soluble.  The  ash  of  spent  tea  is  only  about  3  per  cent.,  of  which 
0. 5  is  soluble. 

•*  There  appears  now  to  be  very  little  green  tea  in  the  market,  since  it  has  been  de- 
cided that  "facing"  is  an  adulteration. 

=  The  Society  of  Public  Analysts  have  adopted  30  per  cent,  as  the  minimum  ex- 
tract in  genuine  tea ;  Wauklyn  takes  32,  and  certainly  good  genuine  tea  yields  this  at 
least. 


BEVERAGES    AND    CONDIME^^TS.  833 

per  cent,  remain  undissolved.  If  soda  is  added,  a  still  greater  amount  is 
given  to  water. 

The  green  tea  (now  little  sold)  is  either  natural,  or  colored  (faced)  with 
indigo,  Prussian  blue,  clay,  carbonate  and  acetate  of  copper,  curcuma, 
gypsum,  and  chalk. 

Scraping  the  tea-leaves  and  microscopic  examination  at  once  detect  the 
shining  blue  jDarticles  of  indigo  and  Prussian  blue  ;  and  the  addition  of  an 
acid  indicates  which  is  indigo.  ^  Copper  is  at  once  detected  by  solution 
in  an  acid  and  addition  of  ammonia.  Letheby  stated  that  black  lead  is 
used  to  give  a  bloom  to  black  teas. 

As  an  Article  of  Did. — Tea  seems  to  have  a  decidedly  stimulative  and 
restorative  action  on  the  nervous  system,  which  is  perhaps  aided  by  the 
warmth  of  the  infusion.  No  depression  follows  this.  The  pulse  is  a  Uttle 
quickened.  The  amount  of  pulmonary  carbon  dioxide  is,  according  to  E. 
Smith,  increased.^  The  action  of  the  skin  is  increased,  that  of  the  bowels 
lessened.  The  kidney  excretion  is  Httle  affected,  perhaps  the  ui'ea  is  a  Uttle 
lessened,  but  this  is  uncertain.^ 

As  an  article  of  diet  for  soldiers,  tea  is  most  useful.  The  hot  infusion, 
like  that  of  coffee,  is  jDotent  both  against  heat  and  cold  ;  is  most  useful  in 
great  fatigue,  especially  in  hot  chmates  (Eanald  Martin)  ;  and  also  has  a 
great  piuifying  effect  on  water.  Tea  is  so  light,  "is  so  easily  carried,  and 
the  infusion  is  so  readily  made,  that  it  should  form  the  drink  par  excellence 
of  the  soldier  on  service.  There  is  also  a  behef  that  it  lessens  the  suscej)- 
tibility  to  malaria,  but  the  evidence  on  this  point  is  imperfect. 

Choice  of  Tea. — The  tea  should  not  be  too  much  broken  up,  or  mixed 
up  -^ith  dii't.  Spread  out,  the  leaves  should  not  be  all  large,  thick,  dark, 
and  old,  but  some  should  be  small  and  young.  There  will  always  be  in  the 
best  tea  a  good  deal  of  stalk  and  some  remains  of  the  flower.  In  old  tea 
much  of  the  ethereal  oil  evaporates,  and  the  aroma  is  less  marked. 

The  infusion  should  be  fragTant  to  smell,  not  harsh  and  bitter  to  taste, 
and  not  too  dark.  The  buyers  of  tea  seem  especially  to  depend  on  the 
smell  and  taste  of  the  infusion. 

Structure  of  the  Tea  Leaf. — The  border  is  seiTated  nearly,  but  not  quite 
to  the  stalk  ;  the  primary  veins  run  out  from  the  midrib  nearly  to  the  bor- 
der, and  then  turn  in,  so  that  a  distinct  space  is  left  between  them  and  the 
border.  The  leaf  may  vary  in  point  of  size  and  shape,  being  sometimes 
broader,  and  sometimes  long  and  narrow.  The  appearance  under  the 
microscope  of  the  ujoper  and  under  surfaces  is  seen  in  the  drawing.  The 
border  and  the  jjrimaiy  venation  distingniish  it  from  all  leaves,*    The  leaves 

'  The  brick  tea  of  fhe  Tartars  consist  of  old  tea  leaves,  mixed  with,  the  leaves  and 
stems  of  RJuimnus  theezans,  Rlwdodendron,  Chrysanthemum,  Rosa  canina,  and  other 
plants,  mixed  with  ox's  or  sheep's  blood.     It  is  much  used  to  purify  water. 

-  Phil.  Transactions,  1859. 

3  The  evidence  with  respect  to  the  urine  is  very  contradictory  ;  but,  on  the  whole, 
the  action  seems  to  be  inconsiderable.  Dr.  Edward  Smith  considers  that  "  tea  pro- 
motes all  vital  actions,  and  increases  the  action  of  the  skin. "  It  is,  perhaps,  impossible 
at  present  to  express  its  action  in  so  succinct  a  form. 

•*  The  structure  of  the  serrature  is  rather  peculiar,  showing  an  apparently  abortive 
leaf-bud  just  within  the  point.  This  organ  can  be  seen  distinctly  with  an  ordinary 
pocket  lens,  and  consists  of  a  cylindrical  basal  portion  and  a  more  or  less  cone-shaped 
apical  part.  From  the  reticulated  bodv  of  the  venation,  a  distinct  little  funiculus  may 
be  traced  into  each  of  tlie  minute  bud-fflse  bodies  which  are  situated  just  loitMn  the  tip  of 
the  serrature.  This  latter  particular  is  of  importance,  for,  as  might  be  expected,  some- 
what similar  appendages  may  be  found  in  other  serrated  leaves,  but  in  all  cases  hith- 
erto examined  by  us,  they  occur  at  instead  of  withm  the  point  of  the  serratures.     No 


334 


PEACTICAL    HYGIENE. 


■which  it  is  said  have  been  mixed  with  or  substituted  for  tea  in  this  coun- 
try are  the  willow,  sloe,  oak,  Valonia  oak,  plane,  beech,  elm,  poplar,  haw- 
thorn, and  chestnut ;  and  in  China,  Chloranthui^  inco)isjncuus  and  Camellia 
Sasanqua  are  said  to  be  used.  Of  these  the  willow  and  the  sloe  are  the 
only  leaves  which  at  all  resemble  tea  leaves.  The  willow  is  more  irregularly, 
and  the  sloe  is  much  less  pei-fectly  and  uniformly  serrated. 

To  examine  the  leaves,  make  an  infusion,  and  then  spread  out  a  number 
of  leaves  ;  if  a  leaf  be  placed  on  a  glass  slide,  and  covered  with  a  thin  glass, 
and  then  held  up  to  the  light,  the  border  and  venation  can  usually  be  well 
seen. 

Tlie  leaves  of  the  Valonia,  if  used,  are  at  once  detected  by  acicular  crys- 
tal being  found  under  the  microscope. 

Sometimes  exhausted  tea  leaves  are  mixed  with  catechu  or  with  a  coarse 
powder  of  a  reddish-brown  color,  consisting  chiefly  of  powdered  catechu, 


Upper  Surface. 


Under  Surface. 
+  2S5. 


Fig.  61.— Dried  Black  Tea  Leaf. 


and  called  "  La  Veno  Beno."  Gum  and  starch  are  added,  the  leaves  being 
steeped  in  a  strong  solution  of  gum,  which,  in  drying,  contracts  them. 
The  want  of  aroma,  and  the  collection  at  the  bottom  of  the  infusion  of 
powdered  catechu,  or  the  detection  of  particles  of  catechu,  will  at  once  in- 
dicate this  falsification,  which  is,  however,   very  uncommon.     Sand  and 


notice  appears  to  have  been  taken  of  this  fact  by  structural  botanists  ;  bnt  Dr.  Mac- 
donald,  who  first  called  attention  to  it,  refers  the  bodies  themselves  to  the  category  of 
marginal  buds. — (F.  de  C.) 


Plate  VIII.— A. 


Leaves  and  stalks  of  best  Tea  brought  from  China  (1861)  by  private  hand  ;  natural 
size.  Generally  in  Commercial  Tea,  the  leaves  are  much  larger  and  thicker,  and  often 
are  cut  transversely  into  two  or  three  parts.  Some  stalks  and  remains  of  ilowers  are 
found  in  all  Tea,  even  the  best. 


"WiUqw 


Ka-wtliom. 


IVillQW 


Plate  VIII —B. 


Camellia  Sasanqua. 


Chloranthus  Inconspicuus. 


Leaves  Used  in  the  Adulteration  op  Tea. 

The  Sloe,  Willow,  Oak,  Beech,  Elder,  and  Hawthorn  have  been  nature-printed  and 
then  lithographed.  The  drawings  of  the  Chloranthus  Inconspicuus  and  the  Camellia 
Sasanqua,  which  are  said  to  be  used  by  the  Chinese,  are  copied  from  Hassall.  The 
leaves  of  the  Elm  Poplar  Plane  are  said  to  be  sometimes  used  in  England.  Falsifica- 
tion with  any  kind  of  leaf  is,  however,  now  decidedly  uncommon  in  this  country. 


BEVERAGES    AND    CONDIMEISTTS.  835 

magnetic  oxide  of  iron  are  added  by  the  Chinese.  At  first  the  latter  was 
mistaken  for  iron  fihngs,  and  when  it  was  proved  to  be  really  magnetic 
oxide  it  was  suggested  that  it  came  accidentally  from  the  soil  where  the 
tea  was  cultivated.  Hassall,  however,  gives  good  reasons  for  its  being  a 
wilful  addition.' 

Extraction  of  Jliein. 

Occasionally  it  may  be  desu-ed  to  determine  the  quantity  of  thein. 
Take  10  grammes  of  tea,  exhaust  ^\^.th  boiling  water,  and  add  solution  of 
subacetate  of  lead  ;  filter  ;  pass  hydrosulphmic  acid  through  to  get  rid  of 
excess  of  lead  ;  filter  ;  evaporate  to  small  bulk,  and  add  a  little  ammonia  ; 
add  more  water,  decolorize  with  animal  charcoal,  and  evaporate  slowly  to 
small  bulk.  White  feathery  crystals  of  thein  form,  which  should  be  collected 
on  filtering  paper,  dried  at  a  veiy  low  heat,  and  weighed. 

Determination  of  Tannin. 

Make  an  infusion  and  add  solution  of  gelatine  ;  collect  precipitate,  dry 
and  weigh — 100  =  40  of  tannin  (Mai-cet). 

Examination  of  Tea. 

Judge  of  the  aroma  of  the  dry  tea  and  infusion  ;  taste  infusion  ;  spread 
out  leaves  and  see  their  characters  ;  collect  anything  like  mineral  powder, 
and  examine  under  microscope.  The  microscope  will  also  show  if  the  tea 
has  deteriorated  by  keeping  ;  sometimes  acari,  fungi,  and  bacteria  may  be 
found. 

To  make  the  infusion,  take  10  grammes  of  tea,  and  infuse  in  500  C.C. 
of  boiling  distilled  or  rain  water. '^  Let  it  stand  five  or  six  minutes  before 
smeUing  and  testing  it.  Exhaust  the  leaves  by  boiling  with  successive 
portions  of  water,  until  no  color  is  given  up  to  the  water.  Measure  the 
total  amount  of  the  infusion;  take  100  C.C.  and  dry  it  in  a  water-bath,^ 
and  weigh.     Calculate  out  the  percentage. 

Example. — The  total  quantity  of  the  infusion  from  10  grammes  of  tea 
was  1,890  C.C.    ;    100  C.C.  taken  and  dried  yielded  0.21  of  extract ;   then 

-    -  -   X  0.21  =  3.969    of   extract   in    10    grammes  ;    this   multiplied  by 

10  =  29.69  per  cent. 

The  exhausted  leaves  may  also  be  dried  and  weighed,  the  loss  repres- 
enting the  amount  of  extract,  which  ought  to  correspond  with  the  amount 
obtained  directly. 

The  ash  should  also  be  determined  ;  5  or  10  grammes  are  to  be  incin- 
erated ;  the  ash  is  generally  gray,  sometimes  slightly  greenish.     Any  excess 

'  I  have  found  minute  quantities  in  two  instances  in  tea  supplied  to  Netlej  Hospital ; 
in  one  the  ash  was  6.054  per  cent.  ;  in  the  other,  6.220.  Hassall  states  that  he  has 
never  found  it  except  in  tea  that  has  been  undoubtedly  adulterated  and  yielded  a  very 
Bauch  greater  amount  of  ash. — (F.  de  C.) 

'■*  The  dealers  usually-take  as  much  tea  as  is  equal  in  weight  to  a  new  sixpence  for 
the  infusion.  This  is  equal  to  about  3  grammes  ;  it  is  dissolved  in  a  cupful  of  water, 
about  5  ounces  or  140  C.C. 

■^  Mr.  Wanklyn  suggests  a  simple  form  of  water-bath  ;  an  ordinary  tin  oil-can  about 
three-parts  full  of  water  ;  this  is  boiled  over  a  lamp,  and  the  dish  witli  infusion  to  be 
dried  held  over  the  narrow  mouth  in  the  ring  of  a  retort  stand.  The  drying  is  soon 
completed  in  the  steam. 


336 


PEACTICAL    HYGIENE. 


above  6  per  cent,  is  suspicious  ;  if  above  8  per  cent,  on  ^e  perfectly  dry  tea, 
adulteration  is  certain."  About  one-half  of  the  ash  is  soluble  in  water  ;  the 
solution  is  often  (but  not  always)  pink,  from  the  presence  of  manganese. 
The  amount  and  character  of  the  ash  form  good  means  of  detecting  the  use 
of  exhausted  leaves. 

The  acidity  of  the  infusion,  and  the  amount  of  tannin  and  thein  may 
also  be  determined  ;  as  also  the  chlorine,  alkalinity  and  u-on  of  the  ash. 
The  best  tests  of  the  quality  of  the  tea  are  the  aroma  and  the  physical 
chai'acters. 

Sub-Section  HE. — Cocoa. 

Gomposition. — Although  the  theobromin  of  cocoa  closely  resembles 
thein  and  caffein,  the  composition  of  cocoa  removes  it  widely  from  tea  and 
coffee.  The  quantity  of  fat  is  large  ;  it  varies  even  in  the  same  sort  of 
cocoa,  but  is  usually  fi'om  45  to  49  per  cent,'     The.  theobromin  is  1.2  to 


-I 4 ; 1 1 H 


Fig.  62.  —Cocoa,  Outer  Coat 


1.5  per  cent.  ;  the  protein  substances  13  to  18  per  cent.     The  ash  contains 
a  large  quantity  of  phosphate  of  potassium. 

As  an  Article  of  Diet. — The  large  quantity  of  fat  and  albuminoid  sub- 
stance makes  it  a  very  nourishing  article  of  diet ;  and  it  is  therefore  use- 
ful in  weak  states  of  the  system,  and  for  healthy  men  under  cu'cumstances 
of  great  exertion.     It  has  been  even  compared  to  milk.     In  South  America 


'  The  Society  of  Public  Analysts  have  adopted  20  per  cent,  of  cocoa  butter  as  the 
miuimum  admissible. 


BEVERAGES    AXD    CON"DLMENTS. 


337 


cocoa  and  maize  cakes  are  used  loy  ti-avellers  ;  and  the  large  amount  of 
agi'eeable  nouiisliment  in  small  bulk  enables  several  days'  supplies  to  be 
easily  carried  (Humboldt;. 

By  roasting,  the  starch  is  changed  into  dextrin  ;  the  amount  of  mar- 
garic  acid  increases,  and  an  empyreumatic  aromatic  substance  is  formed. 

The  changes  depend  on  the  amount  of  roasting  ;  the  lighter-colored 
nuts  contain  more  unchanged  fat,  and  less  aroma  ;  the  strongly  roasted 
and  dark  cocoas  hare  more  aroma  and  bitterness. 

Choice  and  Adulterations. — In  commerce,  cereal  grains,  starches,  arrow- 
root, sago,  or  potato  starch  and  sugar,  are  veiy  commonly  mixed  with 
cocoa  ;  and  some  of  the  so-called  homoeopathic  cocoas  are  rightly  named, 
for  the  amount  of  cocoa  is  very  small.  Brick-dust  and  peroxide  of  iron 
are  sometimes  used  (Noimandy).^  The  structure  of  the  cocoa  is  very 
marked. 


Fig  65.  —Cocoa,  TJnder  Parts,  iGddle  Coat   x   190, 


The  starch-grains  of  cocoa  are  small,  and  embedded  usually  in  the  cells. 
The  presence  of  starch-gTains  of  cereals,  arrowroot,  sago,  or  other  kinds  of 
starch,  is  at  once  detected  by  the  microscope.  Sugar  can  be  detected  by 
the  taste,  and  by  solution.  ^Mineral  substances  are  best  detected  by  in- 
cineration, digesting  in  an  acid  and  testing  for  iron,  lead,  etc. 


'  Hassall  examined  54  samples  ;  8  were  geniuiie,  43  contained  sugar,  and  46  starch. ; 
39  out  of  68  samples  contained  earthy  coloring  matter,  as  reddle,   Venetian  red,  and 
umber. — On  Adulteration,  p.  166. 
Vol.  I.— 22. 


338  PRACTICAL    HYGIENE. 

SECTION  m. 

CONDIMENTS. 
Sub-Section  I. — Vinegar. 

As  an  Article  of  Diet. — Robert  Jackson  was  of  opinion  that  the  use  of 
vinegar  was  too  restricted  in  the  army.  This  ojjinion  he  appears  to  have 
formed  from  considering  the  great  use  of  vinegar  made  by  the  Romans. 
Whatever  may  have  been  the  source  of  the  opinion,  there  is  no  doubt  of 
its  correctness.  Acetic  acid  plays  that  double  part  in  the  body  which 
seems  so  important,  of  first  an  acid  of  a  neutral  salt,  and  then,  in  the  form 
of  carbonic  acid,  as  the  acid  of  an  alkaline  salt.  But  this  valuable  dietetic 
quality  is  partly  counterbalanced  in  English  vinegar  by  the  unfortimate 
circumstance  that  sulphuric  acid  (y  ^^y^th  in  weight)  is  allowed  to  be  added 
to  \'inegar,  and  thus  a  strong  acid  is  taken  into  the  body,  which  is  not  only 
not  useful  in  nutrition,  but  is  hurtful  from  the  tendency  to  form  insoluble 
salts  of  lime.  As  the  addition  of  sulphuric  acid  is  not  necessary,'  and, 
indeed,  is  not  permitted  on  the  Continent,  it  is  to  be  hoped  the  legislature 
will  soon  alter  a  system  which  has  the  effect  only  of  injuring  an  important 
article  of  diet.  The  amount  of  vinegar  which  may  be  used  may  be  from 
one  to  several  ounces.  On  marches,  the  Romans  mixed  it  with  water  as  a 
beverage. 

Examination  of  Vineqar. — Several  kinds  of  vinegar  are  in  the  market, 
known  by  the  Nos.  16, 'l8,  20,  22,  and  24.  Nos.  22  and  24  are  the  best, 
and  contain  about  5  per  cent,  of  pure  glacial  acetic  acid.  The  weakest  kinds 
contain  less  than  3  per  cent.  The  Society  of  Public  Analysts  have  adopted 
3  per  cent,  as  the  minimum  admissible. 

Quality. —  1.  Take  specific  gravity  ;  of  the  best,  =  1022  ;  of  the  worst,  ::= 
1015.     If  below  this,  water  has  been  added. 

2.  Determine  acidity  of  10  C.C.  with  the  alkaline  solution.''  It  is  generally 
best  to  dilute  the  vinegar  ten  times  with  distilled  water,  and  to  take  10 
C.C.  of  the  diluted  vinegar.  Multiply  the  C.C.  of  alkahne  solution  used 
by  0.6,  the  result  is  acetic  acid  per  cent. 

Example. — 10  C.C.  of  diluted  vinegar  took  8  C.C.  of  alkaline  solution : 
8  X  0.6  =  4.8  per  cent,  of  acetic  acid. 

The  acidity  of  English  vinegar  is  chiefly  caused  by  acetic  and  sulphuric 
acids,  but  it  is  usually  calculated  at  once  as  glacial  acetic  acid.  If  it  falls 
below  3  per  cent.^  water  has  probably  been  added.  (The  lowest  noted  by 
Hassall  in  33  samples  was  2.29.)  If  the  specific  gi'avity  be  low,  and  the 
aciditj^  high,  excess  of  sulphuric  acid  may  have  been  added. 

Sodium  carbonate  of  ammonia  gives  a  pui-plish  precipitate  in  imie  vin- 
egar, but  not  in  malt  vinegar. 

If  excess  of  sulphuric  acid  be  suspected,  it  must  be  determined  by 
baryta  ;  this  requires  care,  as  sulphates  may  be  introduced  in  the  water. 
Hydrochloric  acid  and  barium  chloride  are  added  ;  the  sulphate  of  barium 
collected,  dried,  weighed,  and  multiplied  by  .34305. 

'  The  absence  of  Anguillula  Aceti  has  been  by  some  attributed  to  the  use  of  sul- 
phuric acid.  See  Micrographic  Dictionary,  article  "Anguillula."  In  a  sample  I  ex- 
amined, which  swarmed  with  anguillulse,  there  was  only  a  trace  of  sulphuric  acid. — 
(F.  de  C.) 

"  See  Appendix  A,  Vol.  II.  ^  Hassall  says  3  5  per  cent. 


BEVERAGES    AND    C02^DIMEXTS. 


339 


Adulterations. — Water  ;  sulphuric  acid  in  excess  ;'  hydrocliloric  acid 
(uncommon)  ;  or  common  salt  (detected  by  nitrate  of  silver  and  dilute  ni- 
tric acid)  ;  pyroligneous  acid  (distil  and  re-distil  the  distillate,  the  residue 
will  have  the  smell  of  p^Toligneous  acid)  ;  lead  ;  copper  from  vessels  (evap- 
orate to  di-yness,  incinerate,  dissolve  in  weak  nitric  acid,  diride  into  two 
■Darts,  pass  SH„  thi'ough  one,  and  test  for  copper  in  the  other  by  ammonia, 
jr  by  a  piece  of  iron  \dve)  ;  corrosive  sublimate  (pass  SH,  through,  collect 
precipitate)  ;  capsicum,  pellitory,  or  other  pungent  substances  (evaporate 
nearly  to  dryness,  and  dissolve  in  boiling  alcohol,  evaporate  to  syrup,  taste  ; 
burnt  sugar  gives  a  bitter  taste  and  a  dark  color  to  the  syrup). 

The  presence  of  copper  in  the  vinegar  used  for  pickles  may  be  easily 
detected  by  simply  inserting  the  bright  blade  of  a  steel  knife. 


SuB-SeCTIOX     n. MuSTAIlD. 

Good  mustard  is  known  by  the  shai-p  acrid  smell  and  taste.  It  is 
adulterated  vdih.  turmeric  (detected  by  microscope  and  liquor  potassfe), 
wheat  or  barley  starch  (detected  by  microscope  and  iodine),  and  linseed 
(detected  by  microscope).     Many  samples  of  mustard  are  still  mixed  with 


Fig.  64. — White  ITustard  Seed.     Cuticle  consisting  of  a  perforated   cellular  epiderm  and  mticilage-oelIs>, 
some  by  expansion  esciiping  through  the  cuticular  openings  after  being  placed  in  water. 


turmeric  and  starch  of  some  kind,  but  this  has  very  much  lessened  since 
the  passing  of  the  Adulteration  Act.  Clay  and  plaster-of-Paris  are  some- 
times added,  and  cayenne  is  added  to  bring  up  the  sharpness,  if  much  flour 
is  used. 

The  microscopic  characters  of  mustard  are  well  marked.  The  outer 
coat  of  the  white  mustard  consists  of  a  stratum  of  hexagonal  cells,  perfo- 
rated in  the  centre,  and  other  cells  which  occupy  the  centre  portion  of  the 

^  The  presence  of  sulpMTric  acid  may  be  detected  qualitatively,  by  adding  a  few 
drops  of  the  vinegar  to  a  piece  of  cane  sugar,  and  evaporating  on  the  water-bath.  The 
solution  becomes  black  in  proportion  to  the  mineral  acid  present. — HdssaU. 


340 


PRACTICAL    HYGIENE. 


hexagonal  cells,  and  escape  through  the  opening  -when  swollen  from  imbi- 
bition of  water ;  these  cells  are  believed  to  contain  the  mucilage  which  is 


Fig.  65. — ^White  Mustard  Seed.     1.  Outer  coat,  cuticle mncilage-cella.     2.  Fibrous  reticular.    3.  Small  an- 
gular cells.    4.  Large  cells  and  verj'  delicate  membrane.    5.  Interior  of  seed  with  a  few  minute  oil-globules. 

obtained  when  mustard  is  placed  in  water.     There  are  two  internal  coats 
made  up  of  small  angular  cells ;  the  structure  of  the  seed  consists  of  nu- 


^^  \ 


j^^^'*  /f/ 


€ 


:.^ 


'A 


^^»pv^^^^ 


m^ 


1000 

—i ^■ 


Fig.  66. — White  Mustard  Seed,  central  part,  x  2C5. 


merous  cells  containing  oil,  but  no  starch.     The  black  mustard  has  the 
same  characters,  without  the  infundibuliform  cells. 


BEVERAGES  AND  CONDIMENTS. 


341 


Sub-Section  Hf. — Peppee. 

Pepper  is  adulterated  witli  linseed,  mustard  husks,  wheat  and  pea  flour, 
rape  cake,  and  ground  rice.  The  microscope  at  once  detects  these  adul- 
terations. 

The  microscopic  characters  of  pepper  are  rather  complicated  ;  there  is 
a  husk  composed  of  four  or  five  layers  of  cells  and  a  central  part.  The 
cortex  has  externally  elongated  cells,  placed  vertically,  and  provided  with 


Fig.  67.— Section  of  Black  Pepper  Berry,  central  portion. 


a  central  cavity,  from  which  lines  radiate  toward  the  circumference  ;  then 
come  some  strata  of  angular  cells,  which,  toward  the  interior,  are  larger, 
and  filled  with  oil.  The  third  layer  is  composed  of  woody  fibre  and  spiral 
cells.  The  fourth  layer  is  made  up  of  large  cells,  which  toward  the  inte- 
rior become  smaller  and  of  a  deep  red  color ;  they  contain  most  of  the  es- 
sential oil  of  the  pepper.  The  central  part  of  the  berry  is  composed  of 
large  angular  cells,  about  twice  as  long  as  broad.  Steeped  in  water, 
some  of  those  cells  become  yellow,  others  remain  colorless.  It  has  been 
supposed  that  the  yellow  cells  contain  piperine,  as  they  give  the  same 
reactions  as  piperine  does  ;  the  tint,  namely,  is  deepened  by  alcohol  and 
nitric  acid,  and  sulphiiric  acid  appHed  to  a  dry  section  causes  a  reddish 
hue  (Hassall). 

White  pepper  is  the  central  pai-t  of  the  seed,  but  some  small  particles  (  f 
cortex  are  usually  mixed  with  il  It  is  composed  of  cells  containing  very 
small  starch-grains.  Hassall  says  that  the  central  white  cells  are  so  hard 
they  may  be  mistaken  for  particles  of  sand.  A  little  care  would  avoid  this. 
The  starch-grains  are  easily  detected,  however  small,  by  iodine. 


343 


PRACTICAL    HYGIENE. 


Pepper  dust  is  merely  the  sweepings  of  the  warehouses.  Eape  or  lin- 
seed cake,  cayenne  and  mustai'd  husks,  are  mixed  Avith  pejiper  dust,  and 
it  is  then  sold  as  pepper. 


Fig.  68. — Transverse  Section  of  Black  Pepper  Berry. 


Sub-Section  IV. — Salt. 


The  goodness  of  salt  is  known  by  its  whiteness,  fine  crystalline  charac- 
ter, dryness,  complete  and  clear  solution  in  water.  The  coarser  kinds, 
containing  often  chloride  of  magnesium,  and  perhaps  lime  salts,  are  darker 
colored,  more  or  less  dehquesceut,  and  either  not  thorougloly  crystallized 
or  in  too  large  crystals. 


SECTION  IV. 
LEMON  AND  LBIE  JUICE. 

These  juices  contain  free  acids  in  large  quantities,  chiefly  citric,  and  a 
little  mahc  acid,  sugar,  vegetable  albumen,  and  mucus. 

The  exj^ressed  juice  of  the  ripe  fniit  of  the  Citrus  L/'monum,  as  ordered 
by  the  British  Pharmacopoeia,  is  said  to  have  a  specific  gra\dty  of  1.039, 


BEVERAGES   AND    COi!TDBrENTS.  343 

and  to  contain  on  an  average  32.5  grains  of  citric  acid  in  one  fluid  ounce/ 
The  fresh  juice  of  the  hme  [Citrus  Limetta,  or  Citrus  acida)  has  a  rather 
less  specific  gravity  (1.037),  and  contains  less  acid  (32.22  grains  per 
ounce).  ^ 

The  veiy  important  Merchant  Shipping  Act/  which  regulates  the  issue 
of  lemon  juice  on  board  merchant  vessels,  does  not  define  the  strength ; 
but  it  has  been  stated  by  ]Mi*.  Stoddart,''  that  the  Board  of  Trade  standard 
is  a  specific  gi-avity  of  1030  without  spuit,  and  30  gi-ains  of  citric  acid  per 
ounce.     It  occasionally  is  as  high  as  1050. 

As  found  in  commerce,  for  merchant  shijojiiiig,  or  used  in  the  Royal 
Navy,  the  hme  or  lemon  juice  is  chiefly  prepared  in  Sicily  or  the  West 
Indies  ;  it  is  mixed  with  spirit  (usually  brandy  or  whiskey,  which  gives  it 
a  sHghtly  greenish-yellow  hue),  and  olive  oil  is  poui'ed  on  the  top. 

Sugar  is  added  to  it  when  issued,  to  make  it  more  agi-eeable  to  taste,  in 
the  proportion  of  half  its  weight.  Lemon  juice  is  usually  issued  in  bottles 
containing  three  to  four  pints,  not  cjuite  filled,  and  is  covered  ■v\-ith  a  layer 
of  olive  oil.  About  1  ounce  of  brandy  is  added  to  each  10  ounces  of  juice. 
Sometimes  the  juice  is  boiled,  and  no  brandy  is  added  ;  the  former  kind 
keeps  best  (Armstrong).  Both  are  equal  in  anti-scorbutic  power  (Arm- 
strong). Good  lemon  juice  wiU  keep  for  some  years,  at  least  thi-ee  years 
(Armstrong)  ;  bad  juice  soon  becomes  tui-bid,  and  then  stringy  and  mucil- 
aginous, and  the  citric  and  mahc  acids  decompose,  glucose  and  carbon 
dioxide  being  formed.  Some  turbidity  and  precipitate  do  not,  however, 
destroy  its  powers. 

As  found  in  the  market,  it  is  frequently  mixed  vith  water,  and  some- 
times with  other  acids.  In  20  samples  examined  in  1868  by  !Mr.  Stoddart, 
7  were  geniiine,  5  were  watered,  and  8  were  ai-tificial ;  tartaric  acid  being 
present  in  one,  and  sulphuric  acid  in  another  samjDle.^ 

In  the  examination  the  points  which  seem  of  consequence,  in  addition 
to  the  determination  of  the  free  acidity,  are  the  fragTancy  of  the  extract 
and  the  alkalinity  of  the  ash,  proving  the  existence  of  some  alkaline  citrate. 
The  latter  could,  however,  be  imitated,  but  the  fragi'ancy  cannot  be  so. 

Examination  of  Levion  Juice. 

1.  Pour  into  a  glass,  and  mark  physical  characters  ;  turbidity,  precipi- 
tate, stringiness,  etc.  The  taste  should  be  pleasant,  acid,  but  not  bitter. 
Add  lime  water,  and  boil ;  if  free  citric  acid  is  present,  a  large  precipitate 
of  calcium  citrate  is  formed,  which  redissolves  as  the  solution  cools. 
Evaporate  very  carefully  to  extract,  to  test  the  fragxancy,  etc. 

^  Mr.  Stoddart  (Pharm.  Jour. ,  October,  1868)  points  out  that  the  specific  gravity  is 
too  high  for  the  quantity  of  acid  stated ;  there  may,  however,  be  other  ingredients. 
He  gives  himself  the  specific  gravity  as  1.040  to  1.045,  and  the  citric  acid  as  89  to  46 
grains  per  ounce  (citric  acid  CeHeO,).  ]VIr.  Stoddart  mentioned  that  when  lemons  are 
kept  the  citric  acid  decomposes,  and  glucose  and  carbon  dioxide  arise.  But  yet  citric 
acid  is  made  from  damaged  fruit. 

■^  Stoddart,  op.  cit.,  p   205.  ^  The  Merchant  Shipping  Act,  1867. 

*  Pharm.  Jour.,  October,  1868,  p.  204. 

^  The  lime  juice  used  in  the  Arctic  Expedition,  1875-76,  gave  on  analysis  27  grains 
of  citric  per  ounce  as  issued,  that  is,  after  being  fortified  with  about  15  per  cent,  of 
proof-spirit.  Before  fortifying  it  contained  82  grains.  (See  analyses  by  Professor  Att- 
field  and  Mr.  Bell,  Report  of  Committee  on  Scurvy,  pages  xliii.  and  li.).  Samples  ana- 
lyzed at  Xetley  showed  a  specific  gravity  of  1023  as  issued,  and  1085.7  after  driving  off 
the  alcohol ;  the  extract  was  about  8+  per  cent.  The  unfortified  juice  froze  at  25"  F. , 
the  fortified  remained  liquid  down  to  15°  F.  Prolonged  freezing  at  a  temperature  of 
nearly  0'  F.  produced  no  change  in  the  character  or  amount  of  the  constituents. 


344  PRACTICAL    HYGIENE. 

2.  Take  the  specific  gravity,  remembering  that  spirit  is  present ;  then, 
if  necessary,  evaporate  to  one-half  to  drive  oflf  alcohol,  dilute  to  former 
amount,  and  take  si^ecific  gravity  at  G0°  Fahr. 

3.  Determine  acidity  by  alkahne  solution.'  Express  the  acidity  as 
citric  acid  (C^H^O.)  ;  1  C.C.  of  the  alkaline  solution  =  0.4  milhgrammes 
of  citric  acid.  As  the  acidity  is  considerable,  the  best  Avay  is  to  take  10 
C.C  of  the  juice,  add  90  C.C.  of  water,  and  take  10  C.C.  of  the  dilute  fluid, 
which  will  give  the  acidity  of  1  C.C.  of  the  undiluted  juice.  If  the  num- 
ber of  C.C.  used  for  the  diluted  juice  is  multiplied  by  2.8  it  gives  the  acid- 
ity in  grains  per  ounce.  ' 

4.  Test  for  adulteration,  viz  : — 

(a)  Tartaric  Acid. — Dilute  and  filter,  if  the  lime  juice  be  turbid  ;  add  a 
Httle  solution  of  acetate  of  potash  ;  stu*  well,  without  touching  the  sides  of 
the  glass,  and  leave  for  twenty-foiu*  hours  ;  if  tartaric  acid  be  present  the 
potassium  tartrate  will  fall. 

(b)  Sulphuric  Acid. — Add  baiium  chloride  after  filtration,  if  necessary  ; 
if  any  precipitate  falls,  add  a  httle  water  and  a  few  drops  of  dilute  hy- 
drochloric acid  to  dissolve  the  barium  citrate,  which  sometimes  causes  a 
turbidity. 

(c)  Hydrochloric  Acid. — Test  with  silver  nitrate  and  a  few  drops  of 
dilute  nitric  acid. 

{d)  Nitric  Acid. — This  is  an  uncommon  adulteration  ;  the  iron  or  bru- 
cine  test  can  be  used  as  in  the  case  of  water. 

Factitioxis  Lemon  Juice. 

It  is  not  easy  to  distinguish  weU-made  factitious  lemon  juice  ;  about 
552  grains  of  crystallized  citric  acid  are  dissolved  in  a  wine  pint  of  water, 
which  is  flavored  with  essence  of  lemon  dissolved  in  spirits.  This  coiTe- 
sponds  to  about  19  or  20  grains  of  diy  citric  acid  per  ounce.  The  flavor 
is  not,  howevei',  like  that  of  the  real  juice,  and  the  taste  is  sharper.  Evap- 
oration detects  the  falsification. 

Use  of  Lemon  Juice. 

In  military  transports,  the  daily  issue  of  one  ounce  of  lemon  juice  per 
head  is  commenced  when  the  troops  have  been  ten  days  at  sea,  and  by  the 
Merchant  Shipping  Act  (1867)  the  same  rule  is  ordei-ed,  except  when  the 
ship  is  in  harbor,  and  fresh  vegetables  can  be  procui-ed.  It  is  mixed  with 
sugar. 

If  dried  vegetables  can  be  procured,  half  the  amount  of  juice  will  per- 
haps do. 

In  campaigns,  when  vegetables  are  deficient,  the  same  i-ules  should  be 
enforced.  On  many  foreign  stations,  where  dysentery  takes  a  scorbutic 
type  (as  formerly  in  Jamaica,  and  even  of  late  years  in  China),  lemon  juice 
should  be  regularly  issued. 

Substitutes  for  Lemon  Juice. 

Citric  acid  is  the  best,  or  citrate  of  potassium  ;  then  perhaps  vinegar, 
though  this  is  inferior,  and  lowest  of  all  is  nitrate  of  potassium.^     The  tar- 

'  See  Appendix  A,  Vol.  II. 

'  On  this  point  see  Bryson's  paper  in  the  Medical  Times  and  Gazette,  1850.  Ref- 
erence may  also  be  made  to  a  review  on  scurvy,  which  Dr.  Parkes  contributed  to  the 
British  and  Foreign  Medico-Chirurgical  Review,  in  October,  1848,  for  evidence  on  the 
point. 


BEVEEAGES    AND    CONDIMENTS.  345 

trates,  lactates,  and  acetates  of  the  alkalies  may  all  be  used,  but  there  are 
no  good  experiments  on  their  relative  antiscorbutic  powers  on  record. 
If  milk  is  procui-able,  it  may  be  allowed  to  become  acid,  and  the  acid  then 
neutralized  with  an  alkah.  The  fresh  juices  of  many  plants,  especially 
species  of  cacti,  can  be  used,  the  plant  being  crushed  and  steeped  in 
water  ;  and  in  case  neither  vegetables,  lemon  juice,  nor  any  of  the  substi- 
tutes can  be  procured,  we  ought  not  to  omit  the  trial  of  such  plants  of 
this  kind  as  may  be  obtainable. 


CHAPTER  VIII. 
SOILS. 

TOPOGRAPHICAL  REPORTS  AXD  CHOICE  OF  SITES. 

The  term  soil  is  used  here  in  a  large  sense,  to  express  all  the  portion  of 
the  cinist  of  the  earth  -which  by  any  propert}'  or  condition  can  affect  health. 
The  subdivision  into  surface  soil  and  subsoil  is  often  verj''  usefvil ;  and 
these  terms  need  no  definition. 

SECTION  L 
CONDITION  OF  SOIL  AFFECTING  HEALTH. 

Soil  consists  of  mineral,  vegetable,  and  often  animal  substances,  in  the 
interstices  of  which  are  also  air  and  often  water. 

In  reviewing  the  conditions  which  affect  health,  it  will  be  convenient  to 
commence  with  the  aii'  and  the  water  in  soils. 

Scb-Sectiox  I. — The  Am  rs  the  Soil. 

The  hardest  rocks  alone  are  perfectly  free  fi-om  air  ;  the  greater  number 
even  of  dense  rocks,  and  all  the  softer  rocks,  and  the  loose  soils  covering 
them,  contain  ah-.  The  amount  is  in  loose  sands  often  40  or  50  per  cent.  ; 
in  soft  sandstones,  20  to  40  per  cent.  The  loose  soil  turned  up  in  agri- 
cultural operations  may  contain  as  much  as  2  to  10  times  its  own  volume 
of  air. 

The  nature  of  the  air  in  soils  has  been  examined  by  a  good  many  ob- 
servei-s ;  it  is  mostly  veiy  rich  in  carbon  dioxide,  is  very  moist,  and  proba- 
bly contains  eflfluvia  and  organic  substances,  derived  from  the  animal  or 
vegetable  constituents,  but  which  have  not  been  properly  examined.  Oc- 
casionally it  contains  carburetted  hydrogen,  and  in  most  soils,  when  the 
water  contains  sulj^hates,  a  Uttle  hydrogen  sulphide  may  be  found.  It  has 
been  examined  by  Nichols'  in  America,  Fleck*  in  Dresden,  Fodor^  in  Buda- 
Pesth,  Le-vs-is  and  Cunningham  ''  in  Calcutta,  and  many  others.  Nichols 
made  his  expeiiments  in  the  Back-bay  lands  of  Boston,  Massachusetts, 
land  made  by  throwing  gravel  upon  sea  mud.  His  first  series  of  experi- 
ments was  upon  air  drawn  from  depths  of  3f  to  54-  feet.  There  was  no 
hydrogen  sulphide,  and  only  a  little  ammonia  ;  the  CO,,  was  from  1.49  to 
2.26  volumes  per  1,000,  and  varied  inversely  as  the  height  of  the  grovmd- 

'  Sixtt  Report  of  the  Board  of  Health,  Massachusetts,  1875. 

^  4''=''  and  o''^''  Jahresbericht  der  Chemischen  Centralstelle,  Dresden.  1876. 

'Deutsche  Yierteljahrschrifffiir  offentliche  Gesundheit.,  Band  vii.,  p.  205,1875; 
also  Hygienische  Untersuchungen  ueber  Luft,  Boden  und  Wasser,  von  Dr.  Josef  Fodor, 
Braunschweig,  1882. 

■*  The  Soil  in  its  Relation  to  Disease,  Calcutta,  1875. 


SOILS.  347 

water,  wMch  was  very  near  the  surface.  This  relation,  however,  was  not 
constant  at  a  depth  of  6  to  10  feet.  Fleck  found  at  2  metres  the  CO,  29.9 
per  1,000,  and  the  oxygen  163.3  ;  at  6  metres,  the  CO^  79.6,  and  the  oxy- 
gen 148.5.  Fodor  found  (out  of  13  observations)  at  1  metre  from  8.99  to 
10.89  of  C0„,  and  oxygen  from  187.97  to  213.35  ;  at  4  metres  (11  obser- 
vations) from  26.31  to  54.45  CO,,  and  oxygen  from  179.06  to  185.32.  The 
great  amount  of  CO,  points  to  very  intense  chemical  changes  in  the  ground, 
especially  in  the  deep  strata,  but  at  the  same  time  it  may  be  very  variable 
in  different  places.  The  amount  of  oxygen  was  in  a  measure  inversely  as 
the  CO,.  At  a  depth  of  4  metres  (13  feet)  the  air  would  be  irrespirable, 
and  would  extinguish  a  light.  (How  many  cellars  go  as  deep  as  13  feet 
into  the  ground,  and  the  cellar  air  feeds  the  house  with  air !)  From_  the 
examination  of  the  organic  matter,  he  comes  to  the  conclusion  that  it  is 
not  necessarily  its  oxidation  on  the  spot  that  produces  the  CO,,  and  that 
therefore  the  latter  cannot  be  taken,  except  under  certain  conditions,  as  a 
measure  of  impurity,  depending  as  it  does  to  a  large  extent  upon  the  per- 
meability of  the  soil'  He  found  no  hydrogen  sulphide,  biit  a  good  deal 
of  nitric  acid  and  ammonia,  the  relative  quantities  depending  upon  free 
access  of  air  or  otherwise.  As  regards  moisture,  the  mean  percentage  of 
humidity  was  80.7  at  2  metres  and  93.8  at  4.  Lewis  and  Cunningham,  in 
their  observations  at  Calcutta,  found  results  somewhat  similar  to  those  of 
Fodor,  the  CO,  being  greatest  at  the  lower  strata  examined.  The  compo- 
sition of  soil  air  differs  at  different  times  and  seasons,  the  absolute  and 
relative  amounts  of  the  constituents  varying  under  varying  conditions. 

Tke  amount  of  air,  in  soils  can  be  roughly  estimated,  in  the  case  of 
rather  loose  rocks,  by  seeing  how  much  water  a  given  bulk  will  absorb, 
which  can  be  done  by  the  following  plan  : — Weigh  a  piece  of  dry  rock, 
and  caU  its  weight  W  :  then  weigh  it  in  water  and  call  this  weight  W^  : 
then  take  it  out  of  the  water  saturated  with  moisture,  and  weigh  it  again  : 
call  this  weight  W,.     We  then  have — 

(W„-W)100  ,  „    . 

^—'r — „T — =  percentage  oi  air. 

W         -  W; 

■  When  the  soil  is  loose,  Pettenkofer  adopts  the  following  plan  : — Dry 
the  loose  soil  at  212°  Fahr.  (100°  Cent.),  and  powder  it,  but  without  crush- 
ing it  very  much  ;  put  it  into  a  burette,  and  tap  it  so  as  to  expel  the  air 
from  the  interstices  as  far  as  possible  ;  connect  another  burette  by  means 
of  an  elastic  tube  with  the  bottom  of  the  first  burette  and  clamp  it  on  ; 
pour  water  into  No.  2  burette,  and  then,  by  pressing  the  clamp,  allow  the 
water  to  rise  through  the  soil  until  a  thin  layer  of  water  is  seen  above  it  ; 
then  read  off  the  amount  of  water  thus  gone  out  of  the  second  burette. 
The  calculation — 

Amount  of  water  used  x  100_  -!    •    2 

Cubic  centimetres  of  dry  soil  '^ 

'  Fodor  attempts  to  distinguish  (but  hardly  successfully)  between  porosity  andpe?-- 
meoibility. 

^  Renk's  plan  is  very  simple.  Take  a  measured  quantity  of  soil,  say  50  C.C. ,  shaken 
well  together,  so  as  to  represent  its  natural  condition  as  much  as  possible,  and  put  it 
into  a  200  C.C.  graduated  glass  measure  :  then  pour  in  100  C.C.  of  water,  and  shake 
well  so  as  to  expel  all  air.  Allow  it  to  stand  a  little,  and  read  ol  the  point  at  which 
the  water  stands.  Suppose  it  stands  at  125  C.C,  then  the  50  C.C.  of  soil  and  the  100 
C.C.  of  water,  when  shaken  together,  only  occupy  a  space  of  125  C.C,  the  difference, 
25  C.C,  representing  the  bulk  of  air  displaced  from  the  50  C.Cs.  of  soil:  therefore 
25 
^  X  100  =  50  per  cent,  of  air  or  porosity  in  the  sample  of  soil. 


348  PRACTICAL   HYGIENE. 

The  sifoterranean  atmosphere  thus  existing  in  many  loose  soils  and 
rocks  is  in  continual  movement,  especially  "uhen  the  soils  are  dry  ;  the 
chief  causes  of  movement  are  the  diui-nal  changes  of  heat  in  the  soil,  and 
the  faU  of  rain,  which  must  rapidly  disjDlace  the  air  from  the  supei-ficial 
layers,  and  at  a  later  date,  by  raising  the  level  of  the  ground  water,  will 
slowly  throw  out  large  quantities  of  air  from  the  soil.  Fodor  considers 
the  temperature  of  the  air,  the  ground  temperature,  the  action  of  the 
winds,  rainfall,  barometric  pressure,  and  level  of  ground  water  to  be  all 
influential  in  causing  movement  of  the  gi'ound  air,  and  consequent  relative 
change  in  its  constituents.  As  far  as  the  C0„  was  concerned,  Lewis  and 
Cunningham  found  that  the  ah'  temperature  and  wind  were  both  inopera- 
tive, whilst  the  moisture  had  the  gi'eatest  influence  on  the  uj^per  strata,  and 
the  ground-water  on  the  lower. 

Local  conditions  must  also  influence  the  movement  ;  a  house  artificially 
wai'med  must  be  continually  fed  with  air  from  the  ground  below,  and 
doubtless  this  air  may  be  drawn  from  great  depths.  Coal  gas  escajjing 
from  i^ipes,  and  prevented  fi'om  exuding  by  frozen  earth  on  the  surface, 
has  been  known  to  pass  sideways  for  some  distance  into  houses.'  The  air 
of  cessj)ools  and  of  i^orous  or  broken  drains  will  thus  pass  into  houses,  and 
the  examination  of  drains  alone  often  fails  to  detect  the  cause  of  effluvia  in 
the  house. 

The  unhealthiness  of  houses  built  on  "  made  soils,"  for  some  time  after 
the  soils  ai-e  laid  down,  is  no  doubt  to  be  attributed  to  the  constant  ascent 
of  impure  aii'  from  the  impure  soil  into  the  warm  houses  above. 

To  hinder  the  ascent  of  air  from  below  into  a  house  is  therefore  a  sani- 
tary point  of  importance,  and  should  be  accompHshed  by  paving  and  con- 
creting the  basement,  or,  in  some  cases,  by  raising  the  house  on  arches  off 
the  gi'ound.  The  improvement  of  the  health  of  towns,  after  they  are  well 
paved,  may  partly  be  owing  to  lessening  of  effluvia,  though  partly  also  to 
the  greater  ease  of  removing  surface  impuiities.  Li  some  malarious  dis- 
tricts great  benefit  has  been  obtained  by  coveiing  the  ground  with  gi-ass, 
and  thus  hindering  the  ascent  of  the  miasm. 

As  a  iTile,  it  is  considered  that  loose  porous  soils  are  healthy,  because 
they  are  diy,  and,  with  the  quahfication  that  the  soil  shall  not  furnish  nox- 
ious effluria  from  animal  or  vegetable  impregnation,  the  rule  appears  to 
be  coiTect.  It  is,  however,  undoubted  that  diy  and  apparently  tolerably 
pui*e  soils  are  sometimes  malarious,  and  this  arises  either  from  the  soils 
being  really  mipure,  or  from  their  porosity  allowing  the  transference  of  air 
from  considerable  distances.  Even  on  the  jDurest  soils  it  is  desirable  to 
observe  the  nile  of  cutting  off  the  subsoil  au*  from  ascent  into  houses. 

The  diseases  which  have  been  attributed  to  telluric  effluria  are — 


Paroxysmal  fevers. 
Enteric  (typhoid)  fever. 
Yellow  fever. 


Bihous  remittent  fever. 

Cholera. 

Dvsenters'. 


The  questions  connected  with  these  effluvia  will  be  noticed  farther  on. 

The  Water  ix  the  Soil. 

The  water  present  in  soils  is  divided  into  moisture  and  gi'ound  water. 
When  air  as  well  as  water  is  present  in  the  interstices,  the  soil  is  merely 
moist.  The  ground  water  must  be  defined,  with  Pettenkofer,  as  that  con- 
dition in  which  all  the  interstices  ai'e  filled  with  water,  so  that,  except  in 

'Lancet,  1873,  vol.  ii.,  p.  592. 


SOILS.  349 

so  far  as  its  particles  are  separated  by  solid  portions  of  soil,  there  is  a  con- 
tinuous sheet  of  Avater.  Other  definitions  of  gTOund  water  have  been 
given,  but  it  is  in  this  sense  it  is  spoken  of  here. 

Moisture  of  Soil. — The  amount  of  moisture  depends  on  the  power  of  the 
soil  to  absorb  and  retain  water,  and  on  the  supply  of  water  to  the  soil 
either  from  rain  or  giound  water.  With  respect  to  the  first  point,  almost 
all  soils  will  take  uj)  water.  Pf aff '  has  sho\^Ta  that  di-ied  quartz  sand  on  a 
filter  can  take  up  as  much  as  20  per  cent,  of  water,  and  though  in  the  natural 
condition  in  the  soil  the  absorption  would  not  be  so  great,  there  is  no 
doubt  that  even  the  hardest  sands  retain  much  moisture.  After  several 
months  of  long-continued  drought,  Mr.  Church  found  a  light  calcareous 
clay  loam  subsoil  to  contain  from  19  to  28  per  cent,  of  water. 

A  loose  sand  may  hold  2  gallons  of  water  in  a  cubic  foot,  and  ordinaiy 
sandstone  may  hold  1  gallon.  Chalk  takes  13  to  17  per  cent. ;  clay,  if  not 
very  dense,  20  ;  humus,  as  much  as  40  to  60,  and  retains  it  strongly.  The 
so-called  "cotton  soil"  of  Central  India,  which  is  derived  from  trap  rock, 
absorbs  and  retains  water  with  gi'eat  tenacity ;  the  driest  granite  and 
marbles  will  contain  from  .4  to  4  per  cent,  of  water,  or  about  a  jjint  in  each 
cubic  yard. 

The  moisture  in  the  soil  is  derived  partly  fi-om  rain,  to  which  no  soil  is 
absolutely  impermeable,  as  even  granite,  clay  slate,  and  hard  limestone 
may  absorb  a  little.  Practically,  however,  soils  may  be  divided  into 
the  impermeable  (unweathered  gTanite,  trap  and  metamorjDhic  rocks,  clay 
slate,  dense  clays,  hard  oolite,  hard  limestone  and  dolomite,  etc.)  and  per- 
meable (chalk  sand,  sandstone,  vegetable  soils,  etc.).  The  amount  of  rain, 
passing  into  the  soil  is  influenced,  however,  by  other  circumstances— by 
the  declivity  and  inclination  of  the  soil ;  by  the  amount  of  evaporation, 
which  is  increased  in  summer  ;  by  hot  winds  ;  and  by  the  rapidity  of  the 
fall  ('f  rain,  which  may  be  greater  than  the  soil  can  absorb.  On  an  aver- 
age, in  this  countiy,  about  25  per  cent,  of  the  rain  penetrates  into  the  sand 
rock,  42  per  cent,  into  the  chalk,  and  from  60  to  96  per  cent,  into  the  loose 
sands.  The  rest  evaporates  or  runs  off  the  surface  by  the  hues  of  natural 
drainage.  The  rapidity  ydih.  which  the  rain  water  sinks  through  soil  evi- 
dently varies  with  circumstances  ;  in  the  rather  dense  chalks  it  has  been 
supposed  to  move  3  feet  downward  every  yeai',  but  in  the  sand  its  move- 
ment must  be  much  quicker. 

The  moisture  of  the  soil  is  not,  however,  derived  solely  from  the  rain  ; 
the  ground  water,  by  its  own  movement  of  rising  and  falling,  and  evapora- 
tion from  the  sui'face  of  the  subterranean  water-sheet,  and  capillary  attrac- 
tion, makes  the  upper  layers  of  the  soil  wet.  By  these  several  agencies 
the  ground  near  the  surface  is  in  most  parts  of  the  world  kept  more  or  less 
damp. 

Determination  of  Moisture  in  the  Soil. — By  di'ying  10  grammes  at  a  tern- 
perature  of  220"^  Fahr.  (104.4°  Cent.),  then  weighing,  exjDOsing  to  air,  and 
observing  the  increase  of  weight,  an  idea  is  formed  of  the  amount  of  moist- 
ui'e,  and  of  the  hygrometric  properties  of  the  soil.  If  the  dried  soil  is  put 
over  water  under  a  bell  jar,  it  will  be  exposed  to  aii-  saturated  with  moisture, 
or  by  observing  the  dry  and  wet  bulb  thermometers,  the  humidity  of  the 
air  at  the  time  can  be  noted. 

The  Ground  or  Subsoil  Water. — The  subterranean  sheet  of  water  is  at 
very  different  depths  below  the  surface  in  different  soils  ;  sometimes  it  is 
only  2  or  3  feet  from  the  surface,  in  other  cases  as  man;y  hundi-eds.     This 

'  Zeitsch.  fiir  Biologie,  Band  iv. ,  p.  249. 


350  PRACTICAL    HYGIENE. 

depends  on  the  compactness  or  permeability  of  the  soil,  the  ease  or  diffi- 
culty of  outflow,  and  the  existence  or  not  of  an  impermeable  stratum  near 
or  far  from  the  surface.  The  underground  sheet  of  water  is  not  necessarily 
horizontal,  and  in  some  places  it  may  be  brought  nearer  to  the  surface 
than  others  by  peculiarities  of  ground.  The  water  is  in  constant  move- 
ment, in  most  cases  flowing  toward  the  nearest  watercourses  or  the. 
sea  ;  the  rate  of  movement  has  not  yet  been  perfectly  determined.  In 
Munich,  Pettenkofer  reckons  its  rate  as  15  feet  daily  ;  the  high  water  in 
the  Elbe  moves  the  ground  water  in  the  vicinity  at  the  rate  of  about  7  or  8 
feet  dail}'.  Fodor'  gives  the  mean  rate  at  Buda-Pesth  as  53  metres  (174 
feet),  with  a  maximum  of  6G  metres  (216  feet)  in  twenty-four  hours,  reckon- 
ing by  the  rise  of  the  wells  following  the  rise  of  the  Danube. 

The  rate  of  movement  is  not  influenced  solely  by  compactness  or  po- 
rosity of  soil,  or  inclination.  The  roots  of  trees  exert  a  great  influence  in 
lessening  the  flow ;  and,  on  the  other  hand,  water  i-uns  off  more  rapidly 
than  before  in  a  district  cleared  of  trees.  The  level  of  the  ground  water 
is  constantly  changing.  It  rises  or  falls  more  or  less  rapidly,  and  at  different 
rates  in  different  places  ;  in  some  cases  its  movement  is  only  a  few  inches 
either  way,  but  in  most  cases  the  limits  between  its  highest  and  lowest 
levels  in  the  year  are  several  feet  (in  Munich  about  10).  In  India  the 
changes  are  greater.  At  Saugor,  in  Central  India,  the  extremes  of  the  soil 
water  are  from  a  few  inches  from  surface  (in  the  rains)  to  17  feet  in  May. 
At  Jubbulpore  it  is  from  2  feet  from  the  surface  to  ]  2  or  15. 

The  causes  of  change  in  the  level  of  the  ground  water  are  the  rainfall, 
pressure  of  water  from  rivers  or  the  sea,  and  alterations  in  outfall,  either 
increased  obstmction  or  the  reverse.  The  effect  of  the  rainfall  is  sometimes 
only  traceable  weeks  or  even  months  after  the  fall,  and  occasionally,  as  in 
plains  at  the  foot  of  hills,  the  level  of  the  ground  water  may  be  raised  by 
rainfalls  occurring  at  great  distances.  The  pressure  of  the  water  in  the 
Khine  has  been  shown  to  affect  the  water  in  a  well  1,670  feet  away.  The 
pressure  of  the  Danube  at  Buda-Pesth  is  fovmd  to  influence  a  w^ell  at  a 
distance  of  2,700  feet  (Fodor). 

In  a  place  near  the  Hamble  River  (Hampshire)  the  tide  was  found  to 
affect  the  water  of  a  well  at  a  distance  of  2,240  feet ;  the  well  itself  being 
83  feet  deep  and  140  feet  above  mean  water-level.^ 

Diseases  connected  loith  Moisture  and  Ground  Water. — Dampness  of  soil 
may  presumably  affect  health  in  two  ways — 1st,  by  the  effect  of  the  water, 
per  se,  causing  a  cold  soil,  a  misty  air,  and  a  tendency  in  persons  living  on 
such  a  soil  to  catarrhs  and  rheumatism  ;  and  2d,  by  aiding  the  evolution 
of  organic  emanations.  The  decomposition  which  goes  on  in  a  soil  is 
owing  to  four  factors,  \'iz.,  presence  of  decomposable  organic  matters  (ani- 
mal or  vegetable),  heat,  air,  and  moisture.  These  emanations  are  at  pres- 
ent known  only  by  their  effects  ;  they  may  be  mere  chemical  agencies,  but 
there  is  increasing  reason  to  believe  that  they  are  low  forms  of  life  which 
grow  and  propagate  in  these  conditions.  At  any  rate,  moisture  appears  to 
be  an  essential  element  in  their  production.  The  ground  water  is  presumed 
to  affect  health  by  rendering  the  soil  above  it  moist,  either  by  evaporation 
or  capillary  atti*action,  or  by  alternate  wettings  and  dryings. 

A  moist  soil  is  cold,  and  is  generally  believed  to  predispose  to  rheuma- 
tism, catarrh,  and  neuralgia.  It  is  a  matter  of  general  expeiience  that  most 
persons  feel  healthier  on  a  dry  soil. 

'  Op.  cit.,  Bd.  ii.,  p.  98. 

'  Lectures  on  State  Medicine,  by  F.  de  Chaumont  (Smith  &  Elder),  p.  91,  1875. 


SOILS.  351 

In  some  way  wMch  is  not  clear,  a  moist  soil  produces  an  unfavorable 
effect  on  the  lungs :  at  least  in  a  number  of  English  towns,  which  have 
been  sewered,  and  in  which  the  ground  has  been  rendered  much  drier, 
Buchanan  has  shown  that  there  has  been  a  diminution  in  the  number  of 
deaths  from  "phthisis."'  Dr.  Bowditch  of  Boston  (U.S.),  and  Dr.  Middle- 
ton  of  Salisbury,  noticed  the  same  fact  some  years  ago.  Buchanan's  evi- 
dence is  very  strong  as  to  the  fact  of  the  connection,  but  the  nature  of  the 
link  between  the  two  conditions  of  drying  of  soil  and  lessening  of  certain 
pulmonary  diseases  is  unknown.  It  is  curious  how  counter  the  observation 
runs  to  the  old  and  erroneous  view,  that  in  malarious  (and  therefore  wet) 
places  there  is  less  phthisis. 

A  moist  soil  mfluences  greatly  the  development  of  the  agent,  whatever 
it  may  be,  which  causes  the  paroxysmal  fevers.  The  factors  which  must 
be  present  to  produce  this  agent  are  heat  of  soil  (which  must  reach  a  cer- 
tain point  =  isotherm  of  65 ""  Fahr.  of  summer  air  temperature),  air,  moist- 
ure, and  some  impurity  of  soil,  which  in  all  probabihty  is  of  vegetable 
nature.  The  rise  and  fall  of  the  ground  water,  by  supplying  the  requisite 
degree  of  moisture,  or,  on  the  contrary,  by  making  soil  too  moist  or  too 
dry,  evidently  plays  a  large  part  in  producing  or  controlling  periodical  out- 
breaks of  paroxysmal  fevers  in  the  so-called  malarious  countiies.  The  de- 
velopment of  malaria  may  be  connected  either  with  rise  or  with  fall  of  the 
ground  water.  An  impeded  outflow  which  raises  the  level  of  the  ground 
water  has,  in  malarious  soils,  been  productive  of  immense  spread  of  parox- 
ysmal fevers.  In  the  making  of  the  Ganges  and  Jumna  Canals,  the  outflow 
of  a  large  tract  of  country  was  impeded,  and  the  course  and  extent  of  the 
obstruction  was  traced  by  Dempster  and  Taylor  by  the  almost  universal 
prevalence  of  paroxysmal  fevers  and  enlarged  spleens  in  the  inhabitants 
along  the  banks."  The  severe  and  fatal  fever  which  has  prevailed  in  Burd- 
wan,  in  Lower  Bengal,  for  a  number  of  years  past,  appears  to  be  in  part 
owing  to  the  obstruction  to  the  natural  drainage  from  mills  and  from 
blockage  of  watercourses.^  In  some  cases  relative  obstruction  comes  into 
play  ;  i.e.,  an  outfall  sufficient  for  comparatively  dry  weather  is  quite  inade- 
quate for  the  rainy  season,  and  the  ground  water  rises.  At  Pola,  in  Istria, 
for  example,  there  are  no  marshes,  but  in  the  summer  sometimes  half, 
sometimes  90  per  cent,  of  all  cases  are  malarious  ; .  the  reason  is,  that  a 
dense  clay  lies  a  little  below  an  alluvial  soil,  and  the  only  exit  for  the 
rain  is  through  two  valley-troughs,  which  cannot  carry  off  the  water  fast 
enough  in  the  wet  season,^  from  February  to  May. 

A  remarkable,  instance  of  excessive  rainfall,  causing  an  outbreak  of 
malarial  disease,  occurred  at  Kurrachee,  in  Scinde,  in  1869.     The  average 

'  Buchanan :  Ninth,  and  Tenth  Eeports  of  the  Medical  Officer  to  the  Privy  Conncil, 
1866,  p.  48,  and  1867,  p.  57.  As  the  term  "phthisis"  is  a  general  one,  and  includes 
all  the  fatal  diseases  of  the  lungs,  with  destruction  of  lung-tissue  (tuberculous  and  in- 
flammatory), as  well  as  other  cases  of  wasting,  with  pulmonary  symptoms,  it  would  be 
well  to  translate  the  word  "  phthisis  "  by  the  phrase  "  wasting  diseases  of  the  lungs." 

^  The  observations  of  Dempster  and  Taylor  on  the  Jumna  Canal  have  been  more 
recently  confirmed  by  Ferguson  (Sanitary  Administration  of  the  Punjab  for  1871,  Ap- 
pendix IV.),  who  has  investigated  the  effect  on  malarious  disease  on  the  Ba'ri  Dodb 
Canal  District ;  he  found  canal  irrigation  increased  malarious  fever,  and  apparently  by 
raising  the  soil-water  levels. 

"  Dr.  Derby  (Third  Report  of  the  State  Board  of  Health  of  Massachusetts,  Boston, 
1872)  points  out  how  ague  has  been  produced  by  obstructions  to  outflow,  such  as  tide- 
mills,  etc.  So  long  ago  as  1828,  authority  to  remove  a  dam  was  obtained  on  account  of 
injury  to  health.  See  also  case  recorded  by  Dr.  Cattell  in  Natal,  Army  Medical  Re- 
ports, vol.  xiii.,  1871,  p.  178,  produced  by  natural  causes. 

*  Dr.  Jilck,  in  Archiv  der  Heilk.,  1870,  p.  493. 


352  PRACTICAL   HYGIENE. 

annual  rainfall  in  Scinde  in  11  years  (1856-66)  was  only  6.75  inches  ; 
and  the  gi'eatest  rainfall  in  that  time  was  13.9  inches  (1863).  In  1867  the 
rainfall  was  2.73,  in  1868  it  was  3.36  inches ;  while  in  1869  it  reached  the 
unprecedented  amount  of  28.45  inches,  of  which  13.18  feU  in  July  and 
8.39  inches  in  September.  Ajiiil,  May,  October,  November,  and  December 
were  rainless.  The  1st  Batt.  21st  Kegiment  had  the  following  attacks  of 
paroxysmal  fever  per  1,000  of  strength  : — In  April,  none  ;  in  May,  9  ;  in 
June,  39  ;  in  Jiily,  30  ;  in  August,  93  ;  in  September,  105  ;  in  October,  198  ; 
in  November,  1,004  ;  and  in  December,  644.  In  December  the  regiment 
was  embarked  for  Madras,  as  it  had  "thoroughly  lost  heart."  The  disease 
was  not  fatal,  as  the  death-rate  for  the  year,  from  all  causes,  was  only  25.7 
per  1,000.  At  Kurrachee,  as  the  rainfall  is  usually  so  small,  the  ground 
dries  fast,  and  is  then  non-malaiHous.  The  ground  is  flat,  and  there  is  no 
subsoil  drainage.  In  1866,  when  there  was  heays'  rainfall  (13.75  inches), 
there  was  also  a  development  of  malarial  disease,  which  was  continued 
in  1867. 

The  oj^posite  resvdt,  viz.,  an  increased  outflow  lowering  the  subsoil 
water,  has  been  observed  in  drainage  operations,  and  very  malaiious  places 
have  been  rendered  quite  healthy  by  this  measure,  as  in  Lincolnshire,  and 
many  parts  of  England.  The  case  of  Boufaric,  in  Algeria,  is  a  good  in- 
stance ;  successive  races  of  soldiers  and  colonists  had  died  off,  and  the  sta- 
tion had  the  worst  reimtation.  Deep  drainage  was  resorted  to ;  the  level 
of  the  gi'ound  water  was  lowered  less  than  2  feet.  This  measure,  and  a 
better  suj^jily  of  diinking-water,  have  reduced  the  mortality  to  one-third. 

A  case  mentioned  by  Pettenkofer '  is  also  very  striking  as  to  the  effect 
of  subsoil  di-ainage  on  some  kind  of  fever  in  horses.  Two  royal  stables 
near  Munich,  with  the  same  aiTangements  as  to  stalls,  food,  and  attend- 
ance, and  the  same  class  of  horses,  suffered  veiw  luiequally  fi'om  fever ; 
horses  sent  from  the  unhealthy  to  the  healthy  stables  did  not  communicate 
the  disease.  The  difference  between  the  two  places  was,  that  in  the 
healthy  stables  the  ground  water  was  5  to  6  feet,  in  the  unhealthy  only  24- 
feet  from  the  surface.  Draining  the  latter  stables,  and  reducing  the 
ground  water  to  the  same  height,  made  these  stables  as  healthy  as  the 
others. 

Typhoid  (enteric)  fever  has  also  been  supposed  to  be  connected  with 
changes  in  moisture  of  the  soil,  owing  to  rising  and  falling  of  the  gTound 
water.  Professor  Pettenkofer's  obseiwations  on  the  weUs  of  Munich  led 
Buhl  to  the  discovei-y  that  in  that  city  there  is  a  veiy  close  relation  between 
the  height  of  the  gi-ound  water  and  the  fatal  cases  of  tjiihoid  ;  ^  the  out- 
breaks of  t%-phoid  fever  occun-ed  when  the  gi-ound  water  was  lowest,  and 
especially  when,  after  hariug  risen  to  an  unusual  height,  it  had  rapidly 
fallen.  Pettenkofer  has  repeated  and  extended  the  inquiry  with  the 
same  results.  The  point  has  been  also  numerically  investigated  by  Seidel ' 
in  Munich  and  Leipzig  for  the  years  1856-64  and  1865-73,  and  from  a 
mathematical  consideration  of  the  numbers  he  concludes  that,  according 
to  the  theory  of  probabilities,  it  is  36,000  to  1  that  there  is,  in  each  pe- 
riod, a  connection  between  the  two  occurrences.*     Other  observations  in 

'  Quoted  by  Kirchner,  Lehrb.  der  Mil. -Hygiene,  1869,  pp.  217,  218. 

'  Zeitschrift  fiir  Bioloe:ie,  Band  i. ,  p.  1. 

3  Ibid.,  Band  i.,  p.  221,  and  Band  ii.,  p.  14.5. 

••  Ranke,  however,  points  out  that  no  typhoid  exists  in  the  neighborhood  of  Munich, 
but  what  is  imported  from  Mianich,  although  soil  and  ground  water  are  the  same. 
Munich  has  a  soil  consisting  of  fine  sand,  with  a  peculiar  power  of  holding  nitrogenous 
substances ;  it  is  provided  with  cesspools,  from  which  more  than  90  per  cent,  of  the 


SOILS.  353 

Germany  are  confirmatory/  but  in  this  country  the  connection  has  not 
been  traced.  In  some  outbreaks  of  enteric  fever,  the  ground  water  has 
been  rising  and  not  falling.  Fodor  ^  says  that  at  Buda^Pesth  the  rise  of 
enteric  fever  mortality  accompanies  the  rising  ground  water,  and  the  two 
fall  together.  In  other  instances  the  attacks  have  been  traced  to  impure 
drinking-water  or  milk,  to  sewer  emanations,  or  to  personal  contagion,  and 
the  agency  of  the  ground  water  has  appeared  to  be  quite  negative.  Dr. 
Buchanan  ^  has  quoted  a  case,  in  which  the  sinking  of  the  ground  water 
and  the  outbreak  of  fever  were  coincident,  and  yet  the  connection  was,  so 
to  speak,  accidental,  for  the  efficient  cause  of  the  outbreak  was  the  poison- 
ing of  the  di-inking- water  with  typhoid  evacuations.  And  he  also  j)oint8 
out  that  when  the  ground  water  has  actually  been  lowered  in  certain  Eng- 
lish towns  by  drainage  operations,  typhoid  fever  has  not  increased  as  it 
should  do,  according  to  theory,  but  has  diminished,  owing  to  the  intro- 
duction of  pure  water  from  a  distance.  He  thus  thinks  that,  while  a  con- 
nection between  the  j^revalence  of  typhoid  fever  and  sinking  of  the  ground 
water  must  be  admitted  to  exist,  it  is  indii-ect,  and  the  true  cause  of  the 
fever  is  impurity  of  the  diinking-water.  Pettenkofer  has  replied  to  this 
view,"  and  denies,  from  actual  analysis,  the  fact  of  the  contamination  of  the 
driaking-water  in  tj'phoid  outbreaks. 

At  the  present  moment  the  observations  of  Pettenkofer,  and  the  case  of 
the  barracks  at  Neustift,  recorded  by  Buxbaum,  are  certainly  in  favor  of 
the  ojDinion  that  a  direct  connection  may  exist  in  some  cases  between  the 
sinking  of  the  ground  water  and  outbreaks  of  tj'phoid ;  but  the  frequency 
and  extent  of  the  connection  remains  to  be  detennined,  and  in  this  country, 
at  any  rate,  the  other  conditions  of  spread  of  typhoid  appear  to  be  far 
more  common. 

Assuming  the  truth  of  the  connection,  the  other  conditions  which 
Pettenkofer  considers  necessary,  besides  a  rapid  sinking  of  ground  water 
after  an  unusual  rise,  are  impurity  of  the  soil  from  animal  impregnation, 
heat  of  soil,  and  the  entrance  of  a  specific  germ.^ 

A  very  similar  view  is  held  by  Pettenkofer  in  respect  of  cholera,  and  he 
has  advanced  many  striking  arguments  "  to  show  that  while  sporadic  cases 

contents  soak  into  the  surrounding  soil,  and,  as  the  streets  are  well  paved,  the  houses 
are  the  only  outlets  for  the  foul  soil-air. 

Virchow,  in  his  Report  on  the  Sewerage  of  Berlin,  shows  that  the  mortality  is  great- 
est in  July  and  August,  the  curve  corresponding  accurately  with  the  variation  of  the 
ground  water,  the  death-rate  being  greatest  at  the  lowest  level ;  this  is  chiefly  due  to 
deaths  under  one  year.  At  the  lowest  level  there  is  every  year  a  little  epidemic  of 
typhoid.  At  Zurich  in  1872  the  results  were  directly  opposed  to  Pettenkofer's  views 
(see  Lectures  on  State  Medicine,  p.  101).  Geissler  considers  the  influence  of  the  rise 
and  fall  of  the  ground  water  a  local  matter,  and  agrees  with  Rudolph  Rath  in  attribu- 
ting the  typhoid  of  Berlin  to  contaminated  water.  The  case  of  water  transmission 
(which  he  quotes  from  Htigler)  in  the  village  of  Lausen  is  a  very  conclusive  one. 
(Schmidt's  Jahrbiich.,  1874,  No.  2,  185  ;  also  Archiv  fiir  Klin.  Medicin,  1873,  p.  237  ; 
see  also  an  abstract  in  the  Report  on  Hygiene,  Army  Med.  Reports,  vol.  xv.,  p.  197.) 

Vogt  of  Bern  (Trinkwasser  oder  Bodengase)  strongly  supports  Pettenkofer's  views, 
and  considers  the  propagation  by  drinking-water  as  illusory. 

'  Buxbaum,  "  Der  Typhus  in  der  Kaserne  zxa  Xeustift,"  Zeitsch.  fiir  Biologie,  Band 
vi.,  p.  1.     This  seems  strong  evidence  in  favor  of  Pettenkofer's  view. 

2  Op.  cit. 

2  Medical  Times  and  Gazette,  March,  1870. 

^  Ibid.,  June,  1870  ;  and  Vierteljahrschrift  fiir  offentliche  Gesundsheitspflege,  1870, 
Band  ii.,  pp.  176,  197. 

^  Vierteljahrschrift  fiir  ofFentl.  Ges.,  Band  ii.,  p.  181. 

°  Among  his  many  essays,  special  reference  may  be  made  to  his  Analysis  of  the 
"  Reasons  of  the  Immunity  of  Lyons  from  Cholera,"  Zeitsch.  fiir  Biol.,  Band  iv.,  p.  400. 
Vol.  I.-23 


354  PRACTICAL    HYGIENE. 

of  cholera  may  occur,  that  there  will  be  no  \\ide-spread  epidemic,  unless 
certain  conditions  of  soil  are  present,  viz.,  an  impxu-e  porous  soil,  which  has 
recently  been  rendered  moist  by  a  rise  of  grouud  water,  and  then  has  been 
penetrated  by  air  during  the  faU  of  ground  water,  and  into  which  the  spe- 
cific germ  {Keim)  of  cholera  has  found  its  way. ' 

In  Germany  Pettenkofei-'s  A-iews  on  the  spread  of  cholera  have  not  met 
"uith  universal  acceptance,"  though  there  are  several  instances  in  support. 
In  India  the  weight  of  the  e^•idence  is  at  present  against  Pettenkofer's 
views  ;^  but  as  investigations  are  now  going  on  which  will  in  a  few  yeai's 
settle  the  point,  it  is  desirable  at  present  to  refrain  from  forming  a  decided 
opinion,  except  in  so  fai-  that  we  may  feel  sure  that  the  singularly  localized 
outbreaks  wliieh  sometimes  occur  in  India  are  qviite  unconnected  with  any 
subsoil-water  variations. 

In  the  report  of  ]M]\I.  Lewis  and  Cunningham  (op.  cit.)  it  is  shown  that 
the  cholera  at  Calcutta  in  1873-74  followed  the  cui-ve  of  the  ground  water- 
level  inversely,  exactly  in  accordance  with  Pettenkofer's  views. 

Dj'sentery  and  the  so-called  bilious  remittent  fevers,  which  occur  in  foul 
camps  and  on  the  ground  largely  contaminated  by  animal  impurities,  may 
be  conjectured  to  be  also  influenced  by  variations  in  the  gi-ound  water,  but 
satisfactory  CA-idence  has  not  yet  been  given.  In  the  Calcutta  Report,  above 
cited,  the  maximum  of  fever  corresponded  with  the  maximum  of  C0„  in  the 
soil  atmosphere,  and  with  the  highest  gi-ound  water-level.  Dysentery,  on 
the  other  hand,  showed  two  maxima,  one  at  the  rise  of  the  water-level,  and 
the  other  at  the  corresponding  point  of  the  faU, 

Fodor'*  states  that  at  Buda-Pesth  cliolera,  enteritis,  and  intei-mittent 
fever  apj^ear  to  be  connected  with  the  processes  which  go  on  in  the  upper 
layer  of  the  soil,  and  cholera  mortahty  rises  and  falls  inversely  with  the 
grouud  water-level,  according  to  Pettenkofer's  riew.  Enteric  fever,  on  the 
other  hand,  appears  to  be  connected  with  the  processes  which  go  on  in  the 
lowest  stratum  of  the  soil,  its  mortahty  vai^'ing  du-ectly  vnih.  the  ground 
water-level.  The  lowest  lying  parts  of  the  city  have  the  most  impure  soil, 
and  are  specially  subject  to  cholera,  enteritis,  and  tji^hoid  fever  ;  whilst 
measles,  scarlet  fever,  croup,  and  diphtheria  appear*  to  invade  all  parts  of 
the  city  indiflferently. 

Measurement  of  the  Ground  Water. — The  height  at  which  water  stands 
in  wells  is  considered  to  give  the  best  indication  of  the  height  of  the 
grouud  water.  Professor  Pettenkofer  uses  a  rod  on  which  are  fixed  a 
number  of  httle  cups,  and  when  let  down  into  the  weU  and  drawn  up  again, 
the  uppermost  cup  which  contains  water,  marks,  of  coui'se,  the  height  of  the 
water  ;  the  length  of  the  cord  or  rod  used  for  letting  down  the  cups  being 

'  It  is,  of  course,  to  be  understood  that  the  impurity  which  aids  in  producing  cholera 
is  derived  from  persons  ill  with  the  disease.  For  a  discussion  on  Pettenkofer's  views 
on  this  point,  see  Report  on  Hygiene  for  lb72,  in  the  Army  Med.  Department  Report, 
vol.  xiii.  (1873) ;  and  for  his  latest  views,  vol.  xxii.  (1882),  pp.  251  et  seq. 

■^  A  careful  analysis  of  this  subject  is  contained  in  F.  Kiichenmeister's  work  (Verbrei- 
tung  der  Cholera,  1872),  and  the  work  by  F.  Sander  (Unters  iiber  die  Cholera,  1872). 
Dr.  Frank  (health  officer  of  Munich)  believes  that  the  cholei:a  in  1873-74  was  imported 
from  Vienna,  and  points  out  that  in  1873  the  ground  water  and  death-rate  were  not  in 
accordance  with  Pettenkofer's  theory.  (See  Report  on  Hygiene,  Army  Med.  Report, 
vol.  XV. ,  p.  203). 

^  Townsend's  Reports  on  the  Cholera  in  Central  India  contain  so  many  cases  where 
ground  water  could  have  had  no  influence,  that  it  appears  impossible  to  accept  Petten- 
kofer's theory.  In  Dr.  Cornish's  Eeport  for  1871  are  some  good  observations  on  sub- 
soil water,  which  if  carried  out  in  the  same  way  for  a  few  years  will  decide  this  ques- 
tion. *  Op.  cit. 


SOILS.  355 

known,  tlie  changing  level  of  the  well  can  be  estimated  to  within  half  an 
inch.  Some  precautions  are  necessary  in  making  these  observations  ;  if  a 
rope  is  used,  it  may  stretch  with  use,  or  in  a  hot  dry  wind,  pr  contract  in 
wet  weather,  and  thereby  make  the  observation  incorrect ;  local  conditions 
of  wells,  proximity  to  rivers,  etc.,  must  be  learnt,  else  what  may  be  termed 
local  alterations  in  a  well  may  be  wrongly  supposed  to  mean  changes  in  the 
general  level  of  the  ground  water.  It  is  necessaiy,  therefore,  to  make  the 
observations  simultaneously  in  many  wells  and  over  a  considerable  district. 
The  observations  should  be  made  not  less  often  than  once  a  fortnight,  and 
oftener  if  possible,  and  be  carried  on  for  a  considerable  time  before  any 
conclusions  are  drawn. 

Pettenkofer  also  uses  a  large  float  which  is  suspended  by  a  chain 
travelling  over  a  pulley  :  this  supports  an  indicator  at  its  other  end,  which 
marks  the  height  on  a  fixed  scale. 

Method  of  rendering  Soil  Drier. — There  are  two  plans  of  doing  this, — 
deep  drainage  and  opening  the  outflow.  The  laying  down  of  sewers  often 
carries  off  water  by  leaving  sjDaces  along  the  course  of  the  sewers,  but  this 
is  a  bad  plan  ;  it  is  much  better  to  have  special  di-ains  for  ground  water 
laid  by  the  side  of  or  under  the  sewers.  Deep  soil  drainage  (the  drains  being 
from  8  to  12  feet  deep  and  10  to  20  feet  apart)  is  useful  in  all  soils  except 
the  most  impermeable,  and  in  the  tropics  should  be  carried  out  even  on 
what  are  apparently  dry  sandy  plains. 

In  some  cases  soil  may  be  rendered  drier  by  opening  the  outflow.  This 
is  an  engineering  problem  which  physicians  can  only  suggest.  The  clear- 
ing of  water-courses,  removal  of  obstinictions,  and  formation  of  fresh 
channels,  are  measures  which  may  have  an  effect  over  very  large  areas 
which  could  not  be  reached  by  ordinary  drainage. 

Sub-Section  IL — Solid  Constituents  of  the  Soil. 

There  are  certain  general  features  which  can  be  conveniently  considered 
first. 

1.  Conformation  and  Elevation. — The  relative  amounts  of  hill  and  plain  ; 
the  elevation  of  the  hills  ;  their  direction  ;  the  angle  of  slope  ;  the  kind, 
size,  and  depth  of  valleys ;  the  chief  water-sheds,  and  the  direction  and 
discharge  of  the  watercourses  ;  the  amount  of  fall  of  plains,  are  the  chief 
points  to  be  considered. 

Among  the  hills,  the  unhealthy  spots  are  enclosed  valleys,  punch-bowls, 
any  spot  where  the  air  must  stagnate ;  ravines,  or  places  at  the  head  or 
entrance  of  ravines. 

In  the  tropics  especially  ravines  and  nullahs  are  to  be  avoided,  as  they 
are  often  filled  with  decaying  vegetation,  and  currents  of  air  frequently 
traverse  them.  During  the  heat  of  the  day  the  cuiTent  of  air  is  up  the 
ravine  ;  at  night  down  it.  As  the  hiUs  cool  more  rapidly  than  the  surround- 
ing plains,  the  latter  current  is  especially  dangerous,  as  the  air  is  at  once 
impure  and  cold.  The  worst  ravine  is  a  long  narrow  vaUey,  contracted  at 
its  outlet,  so  as  to  dam  up  the  water  behind  it.  A  saddleback  is  usually 
healthy,  if  not  too  much  exposed  ;  so  are  positions  near  the  top  of  a  slope. 
One  of  the  most  difiicult  points  to  determine  in  hilly  regions  is  the  probable 
direction  of  winds  ;  they  are  often  deflected  from  theu'  course,  or  the 
rapid  cooling  of  the  hills  at  night  produces  alteration. 

On  plains  the  most  dangerous  points  are  generally  at  the  foot  of  hills, 
especially  in  the  tropics,  where  the  water,  stored  up  in  the  hills,  and  flowing 
to  the  plain,  causes  an  exuberant  vegetation  at  the  border  of  the  hills. 


356  PEACTICAL    HYGIENE. 

A  plain  at  the  foot  of  hills  may  be  healthy,  if  a  deep  ravine  cuts  off 
completely  the  drainage  of  the  hill  behind  it. 

The  next  most  dangerous  spots  are  depressions  below  the  level  of  the 
plain,  and  into  which  therefore  there  is  draiuage.  Even  gravelly  soils  may 
be  damp  from  this  cause,  the  water  rising  rajiidly  through  the  loose  soil 
from  the  pi*essure  of  higher  levels. 

Elevation  acts  chiefly  by  its  effect  in  lessening  the  pressure  of  the  air, 
and  in  increasing  the  rapidity  of  evaporation.  It  has  a  powei'ful  effect  on 
marshes  ;  high  elevations  lessening  the  amount  of  malaria,  partly  from  the 
rapid  evaporation,  partly  from  the  greater  production  of  cold  at  night.  Yet 
malarious  marshes  may  occur  at  great  elevations,  even  6,000  feet  (Erzeroiim 
and  Mexico). 

2.  Vegetation. — The  effect  of  vegetation  on  gi'ound  is  veiy  important. 
In  cold  climates  the  sun's  rays  are  obstinicted,  and  evaporation  from  the 
gi'ound  is  slow  ;  the  ground  is  therefore  cold  and  moist,  and  the  removal 
of  Avood  renders  the  climate  milder  and  drier.  The  extent  to  which  trees 
impede  the  passage  of  water  through  the  soil  is  considerable. 

In  hot  countries  vegetation  shades  the  ground,  and  makes  it  cooler. 
The  evaporation  fi*om  the  surface  is  lessened  ;  but  the  evaporation  from  the 
vegetation  is  so  gi-eat  as  to  pi'oduce  a  perceptible  lowering  effect  on  the 
temperature  of  a  place.  Pettenkofer  has  calculated  that  an  oak  tree  Avhich 
had  711,592  leaves,  had  during  the  summer  months  (May-October)  an 
evaporation  equal  to  539.1  centimetres  (=  212  inches),  while  the  rainfall  was 
only  65  centimetres  (=  25.6  inches)  ;  so  that  the  evaporation  was  8^  times 
the  rainfall  ;  this  shows  how  much  water  was  abstracted  from  the  soil,  and 
how  the  air  must  have  been  moistened  and  cooled.  Observations  in  Algeria 
(Gimbert)  have  shown  that  the  Uucalyj^tus  globulus  absorbs  and  evaporates 
11  times  the  rainfall,  extremely  malarious  places  being  rendered  healthy  in 
this  way  in  four  or  five  years. 

The  hottest  and  driest  places  in  the  tropics  are  those  divested  of  trees.' 

Vegetation  produces  also  a  great  effect  on  the  movement  of  air.  Its 
velocity  is  checked  ;  and  sometimes  in  thick  clusters  of  trees  or  unden\'Ood 
the  air  is  almost  stagnant.  If  moist  and  decaying  vegetation  be  a  coin- 
cident condition  of  such  stagnation,  the  most  fatal  forms  of  malarious  dis- 
ease are  produced. 

Vegetation  may  thus  do  harm  by  obstructing  the  movement  of  aii* ;  on 
the  other  hand,  it  may  guard  from  the  ciu'rents  of  impure  air.  The  pro- 
tective influence  of  a  belt  of  trees  against  malaria  is  most  striking. 

In  a  hygienic  point  of  view,  vegetation  must  be  divided  into  herbage, 
brushwood,  and  trees ;  and  these  should  be  severally  commented  on  in 
reports. 

Herbage  is  always  healthy.  In  the  tropics  it  cools  the  ground,  both  by 
obstructing  the  sun's  rays,  and  by  aiding  evaporation  ;  and  nothing  is  more 
desirable  than  to  cover,  if  it  be  possible,  the  hot  sandy  plains  of  the  trof»ics 
with  close-cut  grass. 

Brushwood  is  frequently  bad,  and  should  often  be  removed.  There  is, 
however,  evidence  that  the  removal  of  bmshwood  from  a  marsh  has  increased 
the  evolution  of  malaria,  and  that,  like  trees,  brushwood  may  sometimes 

'  It  has  been  proposed  (by  Mr.  Milne  Home)  to  plant  trees  at  Malta,  with  the  view 
of  improving  and  regulating  the  water-supply. 

Mr.  Robert  L.  Stevenson  has  considered  the  thermal  influence  of  forests,  in  a  paper 
in  the  Proceedings  of  the  Royal  Society  of  Edinburgh  (May  19,  1873).  Single  trees 
act  as  bad  conductors ;  the  air  of  forests  is  generally  cooler  than  free  air,  and  certainly 
cooler  than  cleared  lands  ;  forests  heat  the  air  during  the  day  and  chill  it  at  night. 


SOILS. 


357 


offer  obstruction  to  the  passage  of  malaria.  It  must  also  be  remembered 
that  its  removal  will  sometimes,  on  account  of  the  disturbance  of  the  ground, 
increase  malarious  disease  for  the  time  ;  and  therefore,  in  the  case  of  a 
temporary  camp  in  a  hot  malarious  country,  it  is  often  desirable  to  avoid 
disturbing  it.  When  removed,  the  work  should  be  carried  on  in  the  heat 
of  the  day,  i.e.,  not  in  the  early  morning  or  in  the  evening. 

Trees  should  be  removed  with  judgment.  In  cold  countries  they  shelter 
from  cold  winds ;  in  hot,  they  cool  the  ground  ;  in  both,  they  may  protect 
from  malarious  currents.  A  decided  and  pernicious  interference  with  the 
movement  of  air  should  be  almost  the  only  reason  for  removing  them.  In 
some  of  the  hottest  countries  of  the  world,  as  in  Southern  Burtoah,  the  in- 
habitants place  their  houses  under  the  trees  with  the  best  effects ;  and  it 
was  a  rule  with  the  Romans  to  encamp  their  men  under  trees  in  all  hot 
countries. 

The  kind  of  vegetation,  except  as  being  indicative  of  a  damp  or  dry  soil, 
does  not  appear  to  be  of  importance. 

Absorption  of  Heat. — The  heat  of  the  sun  is  absoi'bed  in  different 
amounts  by  different  soils  equally  shielded  or  unshielded  by  vegetation. 
The  color  of  the  soil  and  its  aggregation  seem  chiefly  to  determine  it.  The 
dark,  loose,  incoherent  sands  are  the  hottest ;  even  in  temperate  climates 
Arago  found  the  temperature  of  sand  on  the  surface  to  be  122°  Fahr.,  and 
at  the  Cape  of  Good  Hope  Herschel  observed  it  to  be  no  less  than  159°.' 
The  heating  power  of  the  sun's  rays  is  indeed  excessive.  In  India,  the 
thermometer  j)laced  on  the  ground  and  exposed  to  the  sun  will  mark  160° 
(Buist),  while  2  feet  from  the  gTound  it  will  only  mark  120°.  Buist  thinks 
that  if  protected  from  currents  of  air  it  would  mark  212°.  when  placed  on 
the  ground.  The  absorbing  and  radiating  powers  of  soil  are  not  necessarily 
equal,  though  they  may  be  so.  Generally  the  radiating  power  is  more 
rapid  than  the  absorbing  ;  soils  cool  more  rapidly  than  they  heat.  Some 
of  the  marshes  in  Mexico  cool  so  rapidly  at  night  that  the  evolution  of 
malaria  is  stopped,  and  the  marsh  is  not  dangerous  during  the  night.  A 
thermometer  marked  32°  Fahr.  on  the  ground,  while  16  feet  above  the 
ground  it  marked  50°  Fahr.  (Jomxlanet). 

In  Calcutta,  Lewis  and  Cunningham^  found  that  the  temperature  of 
the  soil  varied  with  the  season.  In  hot  weather  the  thermometer  stood 
highest  in  the  air,  next  highest  in  the  upper  stratum  of  the  soil,  and  lowest 
in  the  lower  stratum.  Li  cold  weather  the  conditions  were  exactly  reversed, 
the  air  being  coolest  and  the  lowest  stratum  of  soil  the  hottest.  During 
rain,  however,  these  relations  were  not  constant. 

With  regard  to  absorbing  power,  the  following  table  by  Schtibler  con- 
tains the  only  good  experiments  at  present  known : — 

Power  of  retaining  Heat ;  100  being  assumed  as  the  Standard. 


Clayey  earth 68.4 

Pure  clay 66.7 

Fine  chalk 6L8 

Humus 49.0 


Sand  with  some  Ume 100.0 

Pure    sand 95.6 

Light  clay 76.9 

Gypsum , 72.2 

Heavy  clay 71.11 

The  great  absorbing  power  of  the  sands  is  thus  evident,  and  the  com- 
parative coldness  of  the  clays  and  humus.     Herbage  lessens  greatly  the  ab- 


'  Meteorology,  p.  4. 


Op.  cit. 


358  PKACTICAL    HYGIENE. 

Borbing  power  of  the  soil,  and  radiation  is  more  rapid.  On  the  Orinoco,  a 
naked  gi'anite  rock  has  been  known  to  have  a  temperature  of  118°  Fahr., 
while  an  adjacent  rock,  covered  withgi'ass,  had  a  temperature  32°  lower. 

In  cold  countries,  therefore,  the  clayey  soils  are  cold,  and  as  they  are 
also  damp,  they  favor  the  production  of  rheumatism  and  catan-hs  ;  the 
sands  are,  therefore,  the  healthiest  soils  in  this  respect.  In  hot  countries 
the  sands  are  objectionable  from  their  heat,  unless  they  can  be  covered 
with  grass.  They  sometimes  radiate  heat  slowly,  and  therefore  the  air  is 
hot  over  them  day  and  night. 

The  sun's  rays  cause  two  currents  of  heat  in  soil :  one  wave  diumal, 
the  heat  passing  down  in  temperate  climates  to  about  4  feet  in  depth  dur- 
ing the  day,  and  receding  dm-ing  the  night — the  depth,  however,  var}-ing 
with  the  nature  of  the  soil,  and  with  the  season  ;  the  other  Avave  is  annual, 
and  in  temperate  cUmates  the  wave  of  summer  heat  reaches  from  50  to  100 
feet.  The  hue  of  unifox*m  yearly  temperature  is  from  57  to  99  feet  below 
the  surface  (Forbes). 

Not  only  does  the  amount  of  radiation  differ  in  different  soils,  but  a 
change  is  produced  in  the  heat  by  the  kind  of  soil.  The  remarkable  re- 
searches of  T}Tidall  have  shown,  that  the  heat  radiated  from  granite  passes 
through  aqueous  vapor  much  more  readily  than  the  heat  radiated  by 
water  (though  the  passage  is  much  more  obsti'ucted  than  in  dry  air).  In 
other  words,  the  himinous  heat  rays  of  the  sun  pass  fi-eely  through  aqueous 
vapors,  and  fall  on  water  and  granite  ;  but  the  absorption  produces  a 
change  in  the  heat,  so  that  it  issues  again  from  water  and  granite  changed 
in  quality  ;  it  will  be  most  important  for  physicians  if  other  soils  are  found 
to  produce  analogous  changes. 

With  regard  to  the  effect  of  temperature  of  the  soil  on  disease,  it  can 
hardly  be  doubted  that  it  powerfully  influences  malaria,  and  probably  also 
aids  the  progress  of  cholera. 

Rejiection  cf  Light. — This  is  a  matter  of  color  ;  the  white  glaring  soils 
reflect  light,  and  such  soils  are  generally  also  hot,  as  the  rays  of  heat  are 
also  reflected.  The  effect  of  glare  on  the  eyes  is  obvious,  and  in  the  tropics 
this  becomes  a  very  important  point.  If  a  spot  bare  of  vegetation,  and 
with  a  white  sm-face,  must  be  used  for  habitations,  some  good  result  might 
be  obtained  by  coloring  the  houses  pale  blue  or  green. 


Chemical  Composition  of  the  Solid  Parts  of  Soil. 

Vegetable  Matters. — Almost  aU  soils  contain  vegetable  matter.  It  exists 
in  three  chief  forms — deposits,  vegetable  debris,  and  incinistations.  De- 
posits occur  in  tracts  of  land  which  have  been  covered  by  silt  brought 
down  by  floods,  or  which  have  been  submerged  by  subsidence  ;  forests  have 
been  thus  buried,  and  again  elevated.  In  the  marshes  of  the  Tuscan  Ma- 
remma,  and  in  many  other  cases,  the  vegetable  forms  can  be  ti-aced  with- 
out difficulty  to  a  considerable  depth,  and  the  structure  is  even  sometimes 
little  changed,  although  so  vast  a  period  of  time  has  elajDsed.  Vegetable 
debris  produced  by  the  decay  of  plants  lies  on,  or  is  washed  into,  the  soil, 
and  in  this  way  the  ground  may  be  penetrated  to  gi'eat  depths.  In  some 
cases,  especially  in  sandy  plains  at  the  foot  of  hills,  the  rain  brings  down 
yery  finely  divided  debris,  and  is  filtered  as  it  passes  through  the  soil,  so 
that  each  particle  of  sand  becomes  coated  over  or  incrusted  with  a  film  of 
vegetable  matter.  If  such  a  plain  be  subjected  to  alternate  wettings  and  dr\^- 
ings,  and  to  heat,  the  conditions  of  development  of  malaiia  may  be  present 


SOILS.  859 

in  great  intensity ;  although  there  is  not  only  no  marsh,  but  the  sand  is  to 
all  appearance  dry  and  pui"e. 

Animal  matters. — The  remains  of  animals  are  found  in  aU but  the  oldest 
rocks  ;  generally  the  animal  constituents  have  disappeared,  but  it  is  re- 
markable how  in  some  cases,  even  in  geological  formations  as  old  as  the 
tertiary  strata,  some  animal  matter  may  be  found.  On  the  surface  there  is 
perhaps  no  soil  which  does  not  contain  some  animal  matters  derived  from 
dead  animals  or  excreta,  although,  except  in  special  cases,  the  amount  is 
small.  The  soil  of  countries  which  have  been  long  settled  is,  however,  often 
highly  impure  in  the  neighborhood  of  habitations  from  the  refuse  (animal 
and  vegetable)  which  is  thrown  out.  In  some  loose  soils  cess-pits  used  for 
fifty  years  have  never  been  emptied,  and  are  still  not  full,  owing  to  soakage. ' 
Pettenkofer  conjectures  that  in  Munich  90  per  cent,  of  the  excretions  pass 
into  the  ground.  In  clayey  soil  there  is,  of  course,  much  less  infiltration 
than  in  sandy,  and  often  scarcely  any.  In  India,  the  nitrification  of  vast 
tracts  of  land  is  for  the  most  part  owing  to  the  oxidation  of  animal  refuse. 

A  means  of  purification  from  animal  impregnation  has  been,  however, 
provided  by  oxidation,  and  the  influence  of  growing  vegetation.  In  aU 
soils,  except  the  hottest  and  driest,  animal  refuse,  under  the  influence  of 
minute  fermenting  organisms,  passes  into  nitrates,  nitrites,  and  ammonia 
and  fatty  hydrocarbons,  rather  rapidly,  and  these  are  eagerly  absorbed  by 
vegetation.  A  means  is  therefore  pointed  out  which  may  keep  the  soil 
clear  from  dangerous  animal  impregnations,  and  this  is  no  doubt  one  rea- 
son why  improvement  in  public  health  follows  improved  cultivation.  It  has 
become  quite  clear  that  in  the  plans  for  the  disposal  of  the  human  and  ani- 
mal excreta  of  towns,  whether  by  wet  or  dry  methods,  an  essential  part  of 
the  plan  is  to  submit  these  excreta  to  the  influence  of  growing  plants  as 
soon  as  possible. 

Mineral  matters,- — An  immense  number  of  mineral  substances  are 
scattered  through  the  crust  of  the  earth,  but  some  few  are  in  great  prej)on- 
derance,  viz.,  compounds  of  silicon,  aluminum,  calcium,  iron,  carbon, 
chlorine,  phosphorus,  potassium,  and  sodium. 

In  examining  the  constituents  of  the  soU  round  any  dwellings,  the  im- 
mediate local  conditions  are  of  more  importance  than  the  extended  geolo- 
gical generalizations  ;  it  is,  so  to  speak,  the  house  and  not  the  regional 
geology  which  is  of  use.  Still  the  general  geological  conditions,  as  influen- 
cing conformation  and  the  movement  of  water  and  air  through  and  over 
the  country,  are  of  great  importance. 

1.  The  Granitic,  Metamorphic,  and  Trap  Bocks. — Sites  on  these  forma- 
tions are  usually  healthy  ;  the  slope  is  great,  water  runs  off  readily  ;  the  air 
is  comparatively  dry  ;  vegetation  is  not  excessive  ;  marshes  and  malaria 
are  comparatively  infrequent,  and  few  impurities  pass  into  the  drinking 
water. 

When  these  ro.cks  have  been  weathered  and  disintegrated,  they  are 
supposed  to  be  unhealthy.  Such  soil  is  absorbent  of  water  ;  and  the  dis- 
integrated granite  of  Hong-Kong  is  said  to  be  rapidly  permeated  by  a 
fungus ;  ^  but  evidence  as  to  the  efi'ect  of  disintegrated  granite  or  trap  is 
really  wanting. 

In  Brazil  ^  the  syenite  becomes  coated  with  a  dark  substance,  and  looks 
like  plumbago,  and  the  Indians  believe  this  gives  rise  to  "  calentura,"  or 

'  Gottisheim  in  Basel  (Das  unterirdisclie  Basel,  1868). 

'^  Ost.  Asiens,  von  C.  Friedel,  1863. 

2  M'Williams  on  Yellow  Fever  in  Brazil,  j).  7. 


oGO  PRACTICAL    HYGIENE. 

fevers.  The  dark  granitoid  or  metamoi-pliic  trap,  or  homblendic  rocks  in 
Mysore,  are  also  said  to  cause  periodic  fevers  ;  and  iron  liornbleude  espe- 
cially ^as  affirmed  by  Dr.  He^-ne  of  Madras  to  be  dangerous  in  this  respect. 
But  the  observations  of  Kichter  '  on  similar  rocks  in  Saxony,  and  the  fact 
that  stations  on  the  lower  spurs  of  the  Himalayas  on  such  rocks  are  quite 
healthy,  negative  Heyne's  opinion. 

2.  The  Clay  Slate. — These  rocks  precisely  resemble  the  granite  and 
granitoid  formations  in  their  effect  on  health.  They,  have  usually  much 
slope  ;  are  veiy  impermeable  ;  vegetation  is  scanty  ;  and  nothing  is  added 
to  air  or  to  drinking-water. 

They  are  consequently  healthy.  Water,  however,  is  often  scarce  ;  and, 
as  in  the  gi-anite  districts,  there  are  swollen  brooks  during  rain,  and  diy 
watercoiu'ses  at  other  times  swelling  rapidly  after  rains. 

3.  Tlie  Limestone  and  Magnesian  Limestone  Bocks. — These  so  Tar  resem- 
ble the  former,  that  there  is  a  good  deal  of  slope,  and  rapid  passing  off  of 
water.  Marshes,  however,  are  more  common,  and  may  exist  at  gi-eat 
heights.  In  that  case  the  marsh  is  probably  fed  with  water  from  some 
of  the  large  cavities,  which,  in  the  coiu'se  of  ages,  become  hollowed  out  in 
the  hmestone  rocks  by  the  cai-bonic  acid  of  the  rain,  and  form  reservou's  of 
water-. 

The  drinking-water  is  hard,  sparkling,  and  clear.  Of  the  various  kinds 
of  limestone,  the  hard  oohte  is  the  best,  and  magnesian  is  the  worst ;  and 
it  is  desu'able  not  to  jiut  stations  on  magnesian  hmestone  if  it  can  be 
avoided. 

4.  The  Chalk. — The  chalk,  when  unmixed  with  clay  and  permeable, 
forms  a  very  healthy  soil.  The  air  is  joure,  and  the  water,  though  charged 
with  calcium  carbonate,  is  clear,  sj^arkling,  and  pleasant.  Goitre  is  not 
nearly  so  common,  nor  apparently  calculus,  as  in  the  limestone  districts. 

If  the  chalk  be  marly,  it  becomes  impermeable,  and  is  then  often  damp 
and  cold.  The  lower  parts  of  the  chalk,  which  are  underlaid  by  gault  clay, 
and  which  also  receive  the  drainage  of  the  parts  above,  are  often  veiy  ma- 
larious ;  and  in  America,  some  of  the  most  marshy  districts  are  on  the 
chalk. 

5.  The  Sajulsfones. — The  permeable  sandstones  are  veiy  healthy  ;  both 
soil  and  au-  are  dry  ;  the  drhiking-water  is,  however,  sometimes  impure. 
If  the  sand  be  mixed  with  much  clay,  or  if  clay  underhes  a  shallow  sand- 
rock,  the  site  is  sometimes  damp. 

The  hard  millstone  giit  formations  are  very  healthy,  and  their  conditions 
resemble  those  of  granite. 

6.  Gravels  oi  any  dei)th  are  always  healthy,  except  when  they  are  much 
below  the  general  surface,  and  water  rises  through  them.  Gravel  hillocks 
are  the  healthiest  of  all  sites,  and  the  water,  which  often  flows  out  in 
springs  near  the  base,  being  held  up  by  underhing  clay,  is  veiy  pure. 

7.  Sands.~Th.ere  are  both  healthy  and  unhealthy  sands.  The  healthy 
are  the  pure  sands,  which  contain  no  organic  matter,  and  are  of  consider- 
able depth.  The  air  is  jiure,  and  so  is  often  the  drinking-water.  Some- 
times the  di-inking-water  contains  enough  iron  to  become  hard,  and  even 
chalybeate.  The  unhealthy  sands  are  those  which,  like  the  subsoil  of  the 
Landes,  in  Southwest  France,  are  composed  of  siliceous  particles  (and 
some  iron),  held  together  by  a  vegetable  sediment. 

In  other  cases  sand  is  unhealthy,  from  underMng  clay  or  laterite  near 
the  surface,  or  from  being  so  placed  that  water  rises  through  its  permeable 

'  Schmidt's  Jahrbiich,  1864,  No.  5,  p.  240. 


SOILS.  .861 

soil  from  liigher  levels.  Water  may  then  be  found  within  3  or  4  feet 
of  the  surface  ;  and  in  this  case  the  sand  is  unhealthy,  and  often  malarious. 
Impurities  are  retained  in  it,  and  effluvia  traverse  it. 

In  a  third  class  of  cases,  the  sands  are  unhealthy  because  they  contain 
soluble  mineral  matter.  Many  sands  (as,  for  example,  in  the  Punjab)  con- 
tain much  magnesium  carbonate  and  lime  salts,  as  well  as  salts  of  the 
alkalies.  The  drinking-water  may  thus  contain  large  quantities  of  sodium 
chloride,  sodium  carbonate,  and  even  lime  and  magnesian  salts  and  iron. 
Without  examination  of  the  water,  it  is  impossible  to  detect  these  points. 

8.  Clay,  Dense  Marls,  and  Alluvial  Soils  generally. — These  are  always  to 
be  regarded  with  suspicion.  Water  neither  runs  off  nor  runs  through ;  the 
air  is  moist  ;  marshes  are  common  ;  the  composition  of  the  water  varies, 
but  it  is  often  impure  with  lime  and  soda  salts.  In  alluvial  soils  there  are 
often  alternations  of  thin  strata  of  sand,  and  sandy  impermeable  clay  ;  much 
vegetable  matter  is  often  mixed  with  this,  and  air  and  water  are  both  impure. 
Vast  tracts  of  ground  in  Bengal  and  in  the  other  parts  of  India,  along  the 
course  of  the  great  rivers  (the  Ganges,  Brahmaputra,  Indus,  Nerbudda, 
Krishna,  etc.),  are  made  up  of  soils  of  this  description,  and  some  of  the  most 
important  stations  even  up  country,  such  as  Cawnpore,  are  placed  on  such 
sites. 

The  deltas  of  great  rivers  present  these  alluvial  characters  in  the  highest 
degree,  and  should  not  be  chosen  for  sites.  If  they  must  be  taken,  only 
the  most  thorough  drainage  can  make  them  healthy.  It  is  astonishing, 
however,  what  good  can  be  effected  by  the  drainage  of  even  a  small  area, 
quite  insufficient  to  affect  the  general  atmosphere  of  the  place  ;  this  shows 
that  it  is  the  local  dampness  and  the  effluvia  which  are  the  most  hurtful. 

9.  Cultivated  Soils. — Well-cultivated  soils  are  often  healthy,  nor  at 
present  has  it  been  proved  that  the  use  of  manure  is  hurtful.  Irrigated 
lands,  and  especially  rice  fields,  which  not  only  give  a  great  surface  for 
evaporation,  but  also  send  up  organic  matter  into  the  air,  are  hurtful.  In 
Northern  Italy,  where  there  is  a  very  perfect  system  of  irrigation,  the  rice 
grounds  are  ordei-ed  to  be  kept  14  kilometres  (  =  8.7  miles)  from  the  chief 
cities,  9  kilometres  (=5.6  miles)  from  the  lesser  cities  and  the  forts,  and 
1  kilometre  (=1,094  yards)  from  the  small  towns.  In  the  rice  countries  of 
India  this  point  should  not  be  overlooked. 

10.  Made  Sods. — The  inequalities  of  ground  which  is  to  be  built  upon 
are  filled  up  with  whatever  happens  to  be  available.  Very  often  the  refuse 
of  a  town,  the  cinders,  or  dust-heaps,  after  being  raked  over,  and  any  sala- 
ble part  being  removed,  are  used  for  this  purjpose.  In  other  cases,  chem- 
ical or  factory  refuse  of  some  kind  is  employed.  The  soil  under  a  house 
is  thus  often  extremely  impure.  It  appears,  however,'  that  the  organic 
matters  in  soil  gradually  disappear  by  oxidation  and  removal  by  rain,  and 
thus  a  soil  in  time  puiifies  itself.  The  length  of  time  in  which  this  occurs 
will  necessarily  depend  on  the  amount  of  impurity,  the  freedom  of  access 
of  air,  and  the  ease  with  which  water  passes  through  the  soil.  In  the  soil 
at  Liverpool,  made  from  cinder  refuse,  vegetable  matters  disappeared  in 
about  three  years  ;  textile  fabrics  were,  however,  much  more  permanent ; 
wood  and  straw,  and  cloth,  were  rotten  and  partially  decayed  in  three 
years,  but  had  not  entirely  disappeared.  In  any  made  soil,  it  should  be  a 
condition  that  the  transit  of  water  through  its  outlet  from  the  soil  shall  be 
unimpeded.  The  practice  of  filling  up  inequalities  is  certainly,  in  many 
cases,  very  objectionable,  and  should  only  be  done  under  strict  supervision. 

^  See  Report  on  the  Health  of  Liverpool,  by  Dr.  Burdon  Sanderson,  and  the  late 
Dr.  Parkes,  p.  9  et  seq. 


362  PRACTICAL    HYGIENE. 


Sub-Section  HL 

Malarious  Soils. — Doubts  have  been  expressed  whether  those  parox- 
ysmal fevers,  which  ai'e  ciu-able  by  quinine,  are  produced  either  by  telluric 
efflu^^.a,  or  by  substances  passing  from  the  soil  into  the  drinking-water. 
The  e\idence,  however,  appears  conclusive  in  favor  of  both  these  modes  of 
entrance  into  the  body. 

If  it  be  asked,  What  exact  chemical  conditions  of  soil  favor  the  produc- 
tion of  the  malaria  which  causes  periodical  fevers  ?  the  answer  cannot  be 
given,  because  no  gi-eat  chemist  has  ever  systematically  prosecuted  this 
inquuy,  and,  in  fact,  it  may  be  said  that,  singularly  enough,  there  are  few 
good  analyses  of  malarious  soils,  although  no  problem  is  perhaps  more  im- 
portant to  the  human  race.  It  seems  pretty  clear  that  the  mineral  constit- 
uents of  the  soil  are  of  Httle  or  no  consequence.  Malaria  will  prevail  on 
chalk,  Hmestone,  sand,  and  even,  under  special  conditions,  on  gi'auite  soils. 

The  following  soils  have  been  known  to  cause  the  evolution  of  the 
agent  causing  periodical  fevers  in  the  malai^ious  zone  : — 

1.  Marshes. — Except  these  with  peaty  soils,  those  which  are  regularly 
overflowed  by  the  sea  (and  not  occasionally  inundated),  and  the  marshes 
in  the  southern  hemisphere  (Austraha,  New  Zealand,  New  Caledonia),  and 
some  American  marshes,  which,  from  some  as  yet  unknoAvn  condition,  do 
not  produce  malaria. 

The  chemical  characters  of  well-marked  marshes  are  a  large  percentage 
of  water,  but  no  flooding  ;  a  large  amount  of  organic  matter  (10  to  45  per 
ceni )  with  variable  mineral  constituents  ;  sihcates  of  aluminum  ;  calcium, 
magnesium,  and  alkaline  sulphates  ;  calcium  carbonate,  etc.  The  surface 
is  flat,  with  a  slight  drainage  ;  vegetation  is  generally  abimdant. 

The  analyses  of  the  worst  malarious  marshes  show  a  large  amount  of 
vegetable  organic  matter.  A  marsh  in  Trinidad  gave  35  f>er  cent.  ;  the 
middle  layer  in  the  Tuscan  Maremma,  30  per  cent.  The  organic  matter  is 
made  up  of  humic,  ulmic,  crenic,  and  apocrenic  acids — all  substances  which 
require  renewed  investigation  at  the  hands  of  chemists.  Vegetable  matter 
embedded  in  the  soil  decomj^oses  very  slowl}^ ;  in  the  Tuscan  Maremma, 
which  must  have  existed  many  centuiies,  if  not  thousands  of  j'ears,  many  of 
the  plants  are  still  luidestroyed.  The  slow  decomposition  is  much  aided 
by  heat,  which  makes  the  soil  alkaline  from  ammonia  i^Angns  Smith),  and 
retarded  by  cold,  which  makes  the  gi'ound  acid,  especially  in  the  case  of 
peaty  soils. 

It  would  now  seem  tolerably  certain  that  the  growing  vegetation  cover- 
ing marshes  has  nothing  to  do  with  the  development  of  malaria. 

2.  Alluvial  Soils. — Many  allurial  soils,  especially,  as  lately  pointed  out 
by  Wenzel,'  those  most  recently  formed,  give  out  malaria,  although  they 
are  not  marshy.  It  is  to  be  presumed  that  the  newest  allurium  contains 
more  organic  matters  and  salts  than  the  older  formations.  Many  alluAaal 
soils  have  a  flat  surface,  a  bad  outfall,  and  are  in  the  vicinity  of  streams 
which  may  cause  gi-eat  variations  in  the  level  of  the  ground  water.  Mud 
banks  also,  on  the  side  of  large  streams,  especially  if  only  occasionally  cov- 
ered with  water,  may  be  highly  malarious  ;  and  this  is  the  case  also  with 
deltas  and  old  estuaries. 

3.  The  soils  of  Tropical  Valleys,  Ravines  and  Nullahs. — In  many  cases 
large  quantities  of  vegetable  matter  collect  in  valleys,  and  if  there  is  any 
naiTowing  at  the  outlet  of  the  vaUey,  the  overflow  of  the  rains  may  be  im- 

'  Quoted  by  Hirsch,  Jaitresb.  fur  die  Ges.  Med.,  1870,  Band  ii.,  p.  209. 


SOILS.  363 

peded.     Sucli  valleys  are  often  very  raalarious,  and  the  air  may  drift  up  to 
the  height  of  several  hundred  feet. 

4.  Sandy  i^lains,  especially  when  situated  at  ih&  foot  of  tropical  hills,  and 
covered  -with  vegetation,  as  in  the  case  of  the  "  Terai"  at  the  base  of  some 
parts  of  the  Himalayan  range.  In  other  cases,  the  sandy  plains  are  at  a 
distance  from  hills,  and  are  appai'eutly  dry,  and  not  much  subjected  to  the 
influence  of  variations  in  the  gi'ound  water.  The  analysis  of  such  sand 
has  not  yet  been  properly  made,  but  two  conditions  seem  of  importance. 
Some  sands,  which  to  the  eye  appear  quite  free  from  organic  admixture, 
contain  much  organic  matter.  Faure  has  pointed  out  that  the  sandy  soil 
of  the  Landes  in  Southwest  France  contains  a  large  amount  of  organic 
matter,  which  is  slowly  decomposing,  and  passes  into  both  au-  and  water, 
causing  periodical  fevers.  This  may  reasonably  be  conjectured  to  be  the 
case  with  other  malarious  sands.  Then,  under  some  sands,  a  few  feet  from 
the  surface,  there  is  clay,  and  the  sand  is  moist  from  evaporation.  Under 
a  great  heat  a  small  quantity  of  organic  matter  may  thus  be  kept  in  a  state 
of  change.  This  is  especially  the  case  along  the  dried  beds  of  water- 
coxu'ses  and  toiTents ;  there  is  always  a  subterranean  stream,  and  the  soil 
is  impregnated  with  vegetable  matter.  In  other  cases  the  sands  may  be 
only  malarious  duiing  rains  when  the  upper  stratum  is  moist. 

5.  Certain  hard  rocks  {granitic  and  metamorphic)  have  been  ah'eady 
noticed  (p.  359),  especially  when  weathered,  to  have  the  reputation  of  being 
malarious;  more  evidence  is  requu^ed  on  this  point.  As  Friedel  justly 
remarks  of  Hong-Kong,  it  is  not  the  disintegrated  gTanite,  per  se,  which 
causes  the  fever,  but  the  soil  of  the  woods  and  dells,  and  the  clefts  in  the 
rocks,  which  were  derived  from  the  granite,  and  are  soon  filled  with  a 
cryptogamic  vegetation. 

The  magnesian  limestone  rocks  which  have  been  subjected  to  vol- 
canic action  have  also  been  supposed  to  be  especially  malarious  (Kirk, 
who  instances  the  rocks  at  Sukkar),  but  the  evidence  has  not  been  yet 
coiToborated. 

6.  Iron  Soils. — Sir  Eanald  Martin  has  directed  attention  to  the  fact  that 
many  reputed  malarious  soils  contain  a  large  proportion  of  iron.  No  good 
evidence  has  been  adduced  that  this  is  connected  with  malaria,  but  the  point 
requu'es  further  examination.  The  red  soil  from  Sierra  Leone,  which  con- 
tains more  than  30  per  cent,  of  oxides  of  iron,  shows  nothing  which  ap- 
pears hkely  to  cause  malaria.'  The  peroxide  of  u-on  is  a  strong  oxidizing 
agent,  readily  yielding  oxygen  to  any  oxidizable  substance,  and  regaining 
oxygen  fi'om  the  air.  It  may,  therefore,  assist  in  the  oxidation  of  vegetable 
matter  in  an  ii'on  soil.^ 

7.  In  certain  cases,  attacks  of  paroxysmal  fever  have  arisen  from  quite 
localized  conditions  unconnected  with  soil,  which  seem,  however,  to  give  some 
clue  to  the  nature  of  the  process  which  may  go  on  in  malarious  gi'ound. 

Friedel  ^  mentions  that  in  the  Marine  Hospital  at  Smnemtinde,  near 
Stettin,  a  large  day-ward  was  used  for  convalescents.     As  soon  as  any  man 

^  Analysis  of  the  Red  Earth,  of  Sierra  Leone,  by  Assistant-Surgeon  J.  A.  B.  Horton, 
M.D.,  Army  Medical  Reports,  vol.  viii.,  p.  333. 

-  The  surface  soil  of  the  Gold  Coast  (Connor's  Hill,  Cape  Coast  Castle),  has  also  been 
analyzed  by  Mr.  J.  H.  Warden,  F.C.S.  (Indian  Medical  Service).  It  contained  only  3.28 
per  cent,  of  ferric  oxide,  and  a  trace  of  ferrous  oxide ;  the  organic  matter  was  only 
4.4  per  cent.  The  surface  soil  is  only  eight  inches  thick,  and  below  this  is  a  stratum 
of  a  dark  red  color,  like  burnt  bricks,  probably  containing  more  iron.  The  sample 
above-mentioned  was  brought  home  by  Surgeon-Major  J.  Fleming,  A.M.D. — Army 
Medical  Reports,  vol.  xiv.,  p.  264. 

»  Ost.  Asiens,  p.  338.     Berlin,  1868. 


364  PRACTICAL    HYGIENE. 

liad  been  in  this  wai'd  for  two  or  three  days,  he  got  a  bad  attack  of  tertian 
ague.  In  no  other  ward  did  this  occiu-,  and  the  origin  of  the  fever  was  a 
mysteiy,  until,  on  close  insj)ection,  a  large  rain-cask  full  of  rotten  leaves 
and  binishwood  was  found  ;  this  had  overflowed,  and  formed  a  stagnant 
marsh  of  4  to  6  square  feet  close  to  the  doors  and  windows  of  the  room, 
Avhich,  on  account  of  the  hot  weather,  were  kept  open  at  night.  The  nature 
of  the  effluvium  was  not  determined. 

Dr.  Holden '  relates  an  instance  in  which,  on  board  a  ship  at  sea,  eight 
cases  of  ague  occurred  from  the  emanations  of  a  large  quantity  of  mould 
which  had  formed  in  some  closed  store-rooms,  which  were  exposed  to  the 
bilge-water.^ 

SECTION  n. 

EXAMINATION   OF   SOIL. 

Mechanical  Condition  of  Soil. — The  degi-ee  of  density,  friability,  and 
penetration  by  water  should  be  determined  both  in  the  surface  and  subsoil. 
Deep  holes,  6  to  12  feet,  should  be  dug,  and  water  poui-ed  on  portions  of 
the  soil.  Holes  should  be  dug  after  rain,  and  the  dej^th  to  which  the  rain 
has  penetrated  observed.  In  this  way  the  amount  of  di'jTiess,  the  water- 
level,  and  the  permeability  can  be  easily  ascertained. 

The  surface  or  subsoil  can  also  be  mechanically  analyzed  by  taking  a 
weighed  quantity  (100  grammes),  drying  it,  and  then  picking  out  all  the 
large  stones  and  weighing  them,  passing  through  a  sieve  the  fine  particles, 
and  finally  sej^arating  the  finest  particles  fi-om  the  coarser  by  mixing  with 
water,  allowing  the  denser  jDarticles  to  subside,  and  pouring  oif  the  finer 
suspended  particles.  The  w^eight  of  the  large  stones,  plus  the  weight  of 
the  stones  in  the  sieve  and  of  the  dried  coarser  particles,  deducted  from 
the  total  weight,  gives  the  amount  of  the  finely  divided  substance,  which 
is  probably  sihcate  of  aluminum. 

Temperature. — The  temperature  at  a  depth  of  2  or  3  feet,  at  two  to 
foui'  o'clock  in  the  afternoon,  would  be  an  important  point  to  deteiToine  in 
the  tropics,  and  also  the  temperatui-e  in  early  morning.  At  present  such 
observations,  though  very  easily  taken,  and  obviously  very  instructive,  ai-e 
seldom,  if  ever,  made,  although  a  commencement  in  that  dii'ection  has  been 
made  in  the  investigations  of  Messrs.  Lewis  and  Cimningham  at  Calcutta.' 
It  might  also  be  useful  to  take  a  certain  depth  of  soil,  sa}-  6  inches,  and, 
placing  a  thermometer  in  it,  determine  the  height  of  the  thermometer  on 
exposure  to  the  sun's  rays  for  a  given  time  at  a  certain  hour. 

Chemical  Examination. — The  chemical  constituents  of  soil  are,  of  course, 
as  numerous  as  the  elements  ;  more  than  500  minerals  have  been  actually 
named.  But  certain  substances  are  very  rare,  and,  for  the  physician,  the 
chief  constituents  of  soils  are  the  following  substances  or  combinations : — 
Silica,  alumina,  Ume,  iron,  magnesia,  chlorine,  carbonic  acid,  phosphoric 
acid,  nitric  acid.  A  few  simple  tests  are  often  very  useful,  if  we  are  un- 
certain what  kind  of  rock  we  have  to  deal  with.  Few  persons  could  mis- 
take granite,  trap,  gneiss,  or  rocks  of  that  class  ;  or  clay-slate  or  cijstalline 
limestone.  But  fine  white  sandstones,  or  fi'eestoue,  or  even  fine  millstone 
gi'it,  might  be  confoimded  with  lime  rocks,  or  magnesian  hmestone.     A 

'  American  Journal  of  the  Med.  Sciences,  January,  1866. 

'^  Staff-Surgeon  P.  Mansfield,  R.N.,  recounts  an  outbreak  of  yellow  remittent  fever 
on  board  ship  at  Rio,  coincident  with  the  growth  of  an  enormous  qiiautity  of  gigantic 
fungus  in  the  hold.  It  seems  unlikely,  however,  that  this  was  more  than  a  coinci- 
dence. •  "  Op.  cit. 


SOILS.  365 

few  drops  of  hydrochloric  acid  will  often  settle  the  question,  as  it  causes 
efifervescence  in  the  calcium  .carbonate  and  magnesian  rocks. ' 

A  more  complete  examination  should  include  the  following  points : 

1.  Percentage  of  Water.  — Take  10  grammes  of  a  fair  sample  of  soil,  and  dry 
at  a  heat  of  220°  ;  weigh  again  ;  the  difference  is  water  or  volatile  substance. 

2.  Percentage  of  Volatile  Matters  {including  Water)  destroyed  by  Incinera- 

'  It  may  be  useful  to  give  (from  Page's  Handbook,  of  Geological  Terms)  a  few  com- 
positions, and  to  define  a  few  of  the  common  mineralogical  words  used  in  geology. 

Quartz. — Crystallized  silica. 

Ifelspar. — Silica,  alumina  (akiminnm  trisilicate),  potash,  or  soda,  and  a  little  lime, 
magnesia,  and  ferric  oxide,  crystallized  or  amorphous. 

Mica. — Silica,  alumina,  ferric  oxide  and  potash,  or  magnesia,  or  lime,  or  lithia. 

Chlorite. — Mica,  but  with  less  silica  and  more  magnesia  and  iron. 

Granite. — Composed  of  quartz,  felspar,  and  mica. 

Syenite. — Hornblende  instead  of  mica. 

Syeyiitio  granite. — Quartz,  felspar,  mica,  and  hornblende. 

Gneiss. — Same  elements  as  granite,  but  the  crystals  of  quartz  and  felspar  are  broken 
and  indistinct. 

Hornblende. — A  mineral  entering  largely  into  granite  and  trappean  rocks,  composed 
of  silica  (47  to  60),  magnesia  (14  to  28),  lime  (7  to  14),  with  a  little  alumina,  fluor- 
ine, and  ferrous  oxide. 

Augite. — Like  hornblende,  only  less  silica  (does  not  resist  acids). 

Hypersthene. — Like  augite,  only  with  very  little  lime  ;  it  contains  silica,  magnesia, 
and  iron ;  resists  acids. 

Greenstone. — Hard  granular  crystalline  varieties  of  trap,  felspar,  and  hornblende, 
or  felspar  and  augite. 

Basalt. — Augite  and  felspar,  olivine,  iron  pyrites,  etc. 

Trap. — Tabular  greenstone  and  basalt. 

Schist. — A  term  applied  to  the  rocks  mentioned  above,  when  they  are  foliated  or 
split  up  into  irregular  plates. 

Clay-Slate. — Argillaceous  arenaceous  rocks,  with  more  or  less  marked  cleavage. 

Limestone. — All  varieties  of  hard  rocks,  consisting  chiefly  of  calcium  carbonate. 

Oolite. — Limestone  made  up  of  small  rounded  grains,  compact  or  crystalline,  like 
the  roe  of  a  fish. 

Chalk. — Soft  calcium  carbonate. 

Magnesian  Limestone.  — Any  limestone  containing  20  per  cent,  of  a  salt  of  magnesia, 
frequently  not  crystallized.  < 

Dolomite. — Crystallized  magnesian  limestone. 

Kunkar. — A  term  used  in  India  to  denote  nodular  masses  of  impure  calcium  carbonate. 

Gypsum — Selenite.  — Calcium  sulphate. 

Gravel. — Water-worn  and  rounded  fragments  of  any  rock,  chiefly  quartz;  size, 
from  a  pea  to  a  hen's  egs,. 

Sand. — Same,  only  particles  less  than  a  pea. 

Sandstone.  — Consolidated  sand  ;  the  particles  held  together  often  by  lime,  clay,  and 
ferric  oxide. 

Freestone.  — Any  rock  which  can  be  cut  readily  by  the  builder ;  usually  applied  to 
sandstone. 

Millstone  grit. — Hard,  gritty  sandstone  of  the  carboniferous  series,  used  for  mill- 
stones. Grit  is  the  term  generally  used  when  the  particles  are  larger  and  sharper 
than  in  ordinary  sandstone. 

Clay. — Aluminum  silicate. 

Greensand.  — Lower  portion  of  the  chalk  system  in  England  ;  sand  colored  by  chlo- 
ritous  iron  silicate. 

Marl. — Lime  and  clay. 

Laterite. — A  term  much  used  in  India  to  denote  a  more  or  less  clayey  stratum  which 
underlies  much  of  the  sand  in  Bengal,  some  parts  of  Burmah,  Bombay  presi- 
dency, etc. 

Conglomerate. — Rocks  composed  of  consolidated  gravels  (^'.e.,  the  fragments  water- 
worn  and  rounded). 

Breccia. — Rocks  composed  of  angular  (not  water-worn)  fragments  (volcanic  breccia, 
osseous  breccia,  calcareous  breccia). 

Shale. — A  term  applied  to  all  clayey  or  sandy  formations  with  lamination  ;  it  is  often 
consolidated  and  hardened  mud. 


366  PEA.CTICAL    HYGIENE. 

tion. — Take  another  weighed  portion  of  soil  and  incinerate  at  a  full  red 
heat ;  recarbonate  with  carbonic  acid  solution,  or  with  ammonium  car- 
bonate ;  heat  to  expel  excess  of  ammonia  ;  di-y  and  weigh. 

3.  Absorption  of  Water. — Place  the  dried  soil  in  a  still  atmosphere,  on 
a  plate  in  a  thin  layer,  and  reweigh  in  twenty-foiu-  hoiu*s  ;  the  increase  is 
the  absorbed  water.  An  equal  portion  of  pure  sand  should  be  treated  in 
the  same  way  as  a  standaixl.  It  would  be  well  to  note  the  humidity  of  the 
air  at  the  time. 

4.  Power  of  holding  Water. — Thoroughly  wet  100  grammes,  drain  off  water 
as  far  as  possible,  and  weigh  ;  the  experiment  is,  however,  not  j^recise. 

5.  Snhstances  taken  xq)  by  Water. — This  is  important,  as  indicating 
whether  di'inking- water  is  likely  to  become  contaminated.  Eub  thoroughly 
10  grammes  in  pvu-e  cold  water,  filter  and  test  for  organic  matter  by  chlor- 
ide of  gold,  or  by  evaporation  and  careful  incineration  ;  test  also  for  chlor- 
ine, sulphiu'ic  acid,  lime,  alumina,  iron,  nitric  acid. 

6.  Substances  taken  up  by  Hydrodiloric  ylciV/.^WTiile  water  takes  up 
alkahne  chlorides  and  sulphates,  nitrates,  etc.,  the  greater  part  of  the  lime, 
magnesia,  and  alumina  are  left  undissolved.  The  quantity  can  be  best  de- 
termined by  solution  in  pure  hydi'ochloric  acid. 

(a)  To  40  grammes  of  the  soil  add  30  C.C.  of  pure  hydrochloric  acid, 
and  heat;  note  effervescence.  Add  about  100  C.C.  of  water.  Digest  for 
twelve  hours.     T>vy  and  weigh  the  undissolved  portion. 

(6)  To  the  acid  solution  add  ammonia.  Alumina  and  oxide  of  iron  are 
thrown  down.     Dry  and  weigh  joreciiDitate. 

(c)  To  the  solution  filtered  from  {b)  add  ammonium  oxalate.  Diy  ;  wash 
and  burn  the  calcium  oxalate.     Weigh  as  carbonate. 

{d)  To  the  solution  filtered  from  (c)  add  sodium  phosphate.  Collect ; 
dry  and  weigh  (100  parts  of  the  precipitate  =  71)  parts  of  magnesiuml  car- 
bonate) ;  or  determine  as  pyrophosphate. 

The  portion  insoluble  in  hydrochloric  acid  consists  of  quartz,  clay,  and 
silicates  of  aluminum,  iron,  calcium,  and  magnesium.  If  it  is  wished  to 
examine  it  further,  it  should  be  fused  with  three  times  its  weight  of  sodium 
carbonate,  then  heated  with  dilute  hydi-ochloric  acid.  The  residue  is  silica. 
The  solution  may  contain  iron,  hme,  magnesia,  and  alumina.     Test  as  above. 

7.  Iron. — Ii'on  can  be  determined  by  the  potassium  dichromate,  or  by 
the  permanganate.  As  the  latter  solution  is  used  for  other  purposes,  it  is 
convenient  to  employ  it  in  this  case. 

Dissolve  10  gi-ammes  of  the  soil  in  ptu-e  hydrochloric  acid  fi'ee  from 
iron  by  aid  of  heat 

Add  a  little  pure  zinc,  and  heat  to  convert  ferric  into  ferrous  salts. 
Poiu'  off  the  solution  from  the  zinc  that  is  still  undissolved,  and  determine 
iron  by  potassium  permanganate  ;  i.e.,  heat  to  140°  and  then  drop  in  the 
solution  of  jjermanganate  tiU  a  permanent  but  shghtly  pink  color  is  given. 
1  C.C.  =  0.7  milligramme  of  pvu-e  iron.' 

3Iicroscopic  Examination. — Attention  must  now  be  paid  to  this,  although 
it  has  not  hithei-to  been  much  studied.  Bacteria  of  various  kinds  have 
been  found,  and  they  have  been  obsei-ved  to  be  more  numerous  in  the 
most  hnpui'e  and  unhealthy  soils,  as  might  have  been  anticipated.  Some 
forms,  however,  are  beneficial,  as  it  is  under  their  influence  that  the  oxida- 
tion (nitrification)  of  nitrogenous  organic  matte::  is  carried  on.  Either 
samples  of  th  soil  itself  may  be  examined,  or  the  air  may  be  dra^vNTi  out  of 
the  soil  at  different  depths  by  means  of  an  aspu*ator. 

'  See  Appendix  A,  Vol.  11. 


SOILS.  367 

SECTION  m. 

METHOD  OF  EXAMTXIXa  A  LOCALITY  FOE  MILITARY  PURPOSES. 

A  place  sliould  be  seen  at  all  times  of  the  year,  in  the  wet  as  well  as  m 
the  drv  seasons,  in  the  autumn  and  "winter  as  well  as  in  the  spiing,  and 
at  night  as  well  as  by  day.  The  following  order  will  be  found  a  con- 
venient one  : — 

1.  Conformation. — Height  above  sea-level  and  elevation  of  hills  above 
the  plain.  (Determine  by  mereinial  bai'ometer  or  aneroid,  or,  if  possible, 
get  the  heights  fi'om  an  engineer. )  Angle  of  dechvity  of  hills  ;  amount 
of  hill  and  plain  ;  number,  course,  and  chai-aeters  of  valleys  and  ravines  in 
hills ;  dip  of  strata  ;  geological  formation ;  watei^heds  and  coui'ses  ;  ex- 
posure to  winds  ;  situation,  amount  and  chai-acter  of  winds  ;  sunlight, 
amount  and  diu'ation  ;  rain,  amount  and  frecj^uency  ;  dust. 

2,  Coinposition. — lilineralogical  characters.  Presence  of  animal  or 
vegetable  substances  ;  amoiuit  and  characters. 

3,  Covering  of  soil  by  trees,  bnishwood,  gi-ass,  etc. 

4.  Points  for  special  Examination. — Amount  of  air  ;  of  moisture.  Height 
of  subsoil  water,  at  the  wettest  and  driest  seasons.  Changes  in  level,  and 
rapidity  of  change  of  subsoil  or  ground  water.  Condition  of  vegetable 
constituents  ;  examination  of  substances  taken  up  by  water,  etc. 

Such  a  complete  examination  demands  time  and  appai'atus,  but  it  is 
quite  necessary. 

A  fail-  opinion  can  then  be  formed  ;  but  if  a  krge  permanent  station  is 
to  be  erected,  it  is  always  desirable  to  recommend  that  a  temporary  sta- 
tion should  be  put  up  for  a  year,  and  an  intelligent  officer  should  be 
selected  to  observe  the  effect  on  health,  to  take  meteorological  observa- 
tions, and  to  examine  the  water  at  different  times  of  the  year.  Some- 
times a  spot  more  ehgible  than  that  originally  chosen  may  be  found 
within  a  short  distance,  and  the  officer  should  be  instructed  to  keep  this 
point  in  view. 

The  medical  officer  has  nothing  to  do  with  mihtaiy  considei-ations  or 
questions  of  supply,  but  if  he  is  able  to  suggest  anything  for  the  informa- 
tion of  the  authorities,  he  should  of  course  do  so. 

The  opinion  of  Lind,  whose  large  experience  probably  surpassed  that 
of  his  contemporaries,  and  of  our  own  time,  should  be  remembered : — 
"  The  most  healthy  countries  in  the  world  contain  spots  of  gTound  where 
strangers  are  subject  to  sickness.  There  is  hardly  to  be  found  any  lai'ge 
extent  of  continent,  or  even  any  island,  that  does  not  contain  some  places 
where  Euroj)eans  may  enjoy  an  uninteri-upted  state  of  health  dui'itig  all 
seasons  of  the  year."  ' 

In  choosing  a  site  for  a  temporaiy  camp,  so  elaborate  an  examination 
is  not  possible.  But  as  far  as  possible  the  same  rules  should  be  attended 
to.  There  is,  however,  one  difference — in  a  permanent  station  water  can 
be  brought  from  some  distance  ;  in  a  temporeiry  station  the  water  supply 
must  be  near  at  hand,  and  something  must  be  given  up  for  this.^  The 
banks  of  rivers,  if  not  marshy,  may  be  chosen,  care  being  taken  to  assign 
proper  spots  for  watering,  washing,  etc.  A  river  with  marshy  banks  must 
never  be  chosen  in  any  climate,  except  for  the  most  imperative  miLitai-y 
reasons  ;  it  is  better  to  have  the  extra  labor   of    cai-rving  water   from 


'  Lind,  Diseases  of  Europeans  in  Hot  Climates.  4ttL  edition,  p.  200. 
"^  See  remarks  on  this  point,  in  the  Eegnlations  and  Instructions  for  Encampments, 
p.  3. 


368  PRACTICAL    HYGIENE. 

a  distance.     A  site  under  trees  is  good  in  hot  countries,  but  brushwood 
must  be  avoided. 

SECTION  IV. 
PREPARATION  OF  SITE  FOR  MILITARY  PURPOSES. 

In  any  locahtv  intended  to  be  permanently  used,  the  gi'ound  should  be 
drained  with  pipe  di'ains.  Even  in  the  di'iest  of  the  loose  soils  this  is 
desu-able,  especially  in  hot  climates,  where  the  rainfall  is  heavy.  In  im- 
permeable rocky  districts  it  is  less  necessary.  The  size,  depth,  and  dis- 
tance of  the  drains  will  be  for  the  engineer  to  detennine  ;  but  generally 
deep  drains  (■!  to  8  feet  in  depth,  and  12  to  18  feet  apart)  are  the  best. 
If  there  is  no  good  fall,  it  has  been  proposed  to  drain  into  deep  j)its  ;  but 
usually  an  engineer  will  get  a  fall  ^^ithout  such  an  expedient.  A  good 
outfall,  however,  should  be  a  point  always  looked  to  in  choosing  a  station. 
These  di'ains  are  intended  to  carry  off  subsoil  water,  and  not  surface  water. 
This  latter  should  be  proAided  for  by  shallow  drains  along  the  natm-al 
outfalls  and  valleys.  As  far  as  drainage  is  concerned,  we  have  then  to 
provide  for  mere  surface  water,  and  for  the  water  which  passes  below  the 
sui-face  into  the  soil  and  subsoil. 

Brushwood  should  usually  be  cleared  away,  but  trees  left  until  time  is 
given  for  consideration.  In  clearing  away  binishwood,  the  gi'ound  in  the 
tropics  should  be  distiu*bed  as  httle  as  possible  ;  and  if  it  can  be  done,  aU 
cleared  spots  should  be  soon  sown  with  gi'ass.  Bnishwood  should  not  be 
removed  from  a  marsh. 

In  erecting  the  buildings,  the  ground  should  be  excavated  as  little  as 
possible  ;  in  the  trojDics  esj^ecially  hills  should  never  be  cut  away.  The 
surface  should  be  levelled,  holes  filled  in,  and  those  poriions  of  the  sur- 
face, on  which  rain  can  fall  from  buildings,  well  paved,  -n-ith  good  side 
gutters.  This  is  especially  necessaiy  in  the  troj^ics,  where  it  is  of  im- 
portance to  prevent  the  groimd  under  buildings  from  becoming  damp  ; 
but  the  same  jDrinciples  apply  eveiwwhere. 

In  a  temporary  camp  so  much  cannot  be  done ;  but  even  here  it  is  de- 
sirable to  trench  and  drain  as  much  as  jiossible.  It  not  unfrequently  hajD- 
pens  in  war  that  a  camp  intended  to  stand  for  two  or  three  days  is 
kept  up  for  two  or  three  weeks,  or  even  months.  As  soon  as  it  is  clear 
that  the  occupation  is  to  be  at  all  prolonged,  the  same  plans  should  be 
adopted  as  in  peiTaanent  stations. 

The  great  point  is  to  carrs'  off  water  rapidly,  and  it  is  astonishing  what 
a  few  well-planned  surface  di-aius  will  do. 

The  rules  for  imj^ro'sing  the  healthiness  of  a  site  may  be  thus  sum- 
marized : — 

1.  Drain  subsoil  and  lower  the  level  of  the  gi'oiuid  water. 

2.  Pave  tmder  houses,  so  as  to  prevent  the  au-  from  rising  from  the 
ground. 

3.  Pave  or  cover  with  shori  grass  aU  ground  neai'  buildings  in  mala- 
rious districts. 

4.  Keep  the  soil  from  the  penetration  of  impurities  of  aU  kinds  by 
proper  aiTangements  for  carrying  away  rain,  sui-face,  and  house  water  and 
house  impuiities. 

End  of  Vol.  I. 


A    MANUAL 


PRACTICAL  HYGIENE 


EDMUND   A.   PARKES,   M.D.,  F.R.S. 

LATE   PROFESSOR   OF   MILITARY  HYGIENE   IN   THE    ARMY   MEDICAL   SCHOOL  ;    MEIVIBEE   OF   THE   GENERAL 

COUNCIL   OP   MEDICAL  EDUCATION  ;    FELLOW   OF   THE   SENATE    OF   THE    UNIVERSITY   OF   LONDON  ; 

EMERITUS  PBOFESSOB  OF  CLINICAL  MEDICINE  IN  UNIVERSITY  COLLEGE,   LONDON 


EDITED   BY 

F.  S.  B.  FRANgOIS  DE   CHAUMONT,   M.D.,  F.R.S. 

FELLOW  OF   THE   ROYAL  COLLEGE   OF   SURGEONS    OF   EDINBURGH  ;    FELLOW   AND   CHAIRMAN   OF   COUNCIL 

OF   THE   SANITARY   INSTITUTE   OF   GREAT   BRITAIN  ;    PROFESSOR   OF   MILITARY 

HYGIENE   IN   THE   ARMY   MEDICAL    SCHOOL 


FROM   THE    LAST    LONDON    EDSTBON 

WITH  AN   APPENDIX 
Giving  the  American  Practice  in  Matters  Relating  to  Hygiene 

PREPAllED   BY  AND   UNDER   THE    SUPERVISION   OF 

FREDERICK    N.   OWEN 

CIVIL  AND  SANITARY  ENGINEER 

TWO     VOLUMES    IN    ONE 

Volume  II. 

NEW  YORK 
WILLIAM    WOOD     &    COMPANY 

56  &  58  Lafayette  Place 

1884 


COPYKIOHT 

WILLIAil    WOOD  &,  COilPANY 

ItitSS 


TROW  9 

PRINTING  AND  BOOKeiNDrNG  COMPANY, 

HCW  YORK. 


CONTENTS. 


BOOK   I. — Continued. 


CHAPTER  IX. 

PAGE 

Habitations 1 

Section       I. — General  conditions  of  health 1 

Mode  of  examining  healthiness 3 

Section     II. — Hospitals 6 


CHAPTER  X. 

Removal  of  Excreta 16 

Section       I.  — Amount  of  excreta 16 

Section     II. — Methods  of  removal 18 

Sewers, 18 

Removal  by  water 20 

Influence  of  sewers  on  the  death-rate  of  towns 41 

Dry  methods  of  removal 45 

Comparison  of  the  different  methods 52 

CHAPTER  XI. 

Waeming  of  Houses 54 

Section       I. — Degree  of  warmth 54 

Section     II. — Kinds  of  warmth 55 

CHAPTER  XIL 

Exercise 60 

Section       I. — Effects  of  exercise 60 

Section     II.  — Amount  of  exercise  70 

Section   III.— Training 73 

CHAPTER  XIII. 

Clothing 74 

Materials  of  clothing 74 


IV 


CONTENTS. 


CHAPTER   XIV, 

PAGE 

Climate 80 

Section       I.  — Temperature 83 

Section     II. — Humidity 87 

Section    III. — Movement  of  air ^9 

Section    IV. — Weight  of  air 89 

Section      V. — Composition  of  air  (ozone,  malaria) 93 

Section    VI. — Electrical  condition— light 95 

CHAPTER  XV. 

Meteorology 96 

Section         I. — Thermometers 97 

Section       II. — Hysrrometers 103 

Section      III. — Barometer 106 

Section      IV.— Rain 113 

Section       V. — Evaporation 114 

.    Section      VI.— Wind 115 

Section    VII. —Clouds 116 

Section  VIIL  — Ozone 117 

Section      IX. — Electricity 118 

Section        X. — Thermometer  stand 118 

Section      XI. — Weather 119 

Section     XII. — Diseases  and  meteorological  conditions 119 

CHAPTER  XVI. 
Individual  Hygienic  Management 120 

CHAPTER  XVII. 
Disposal  op  the  Dead 124 

CHAPTER   XVIII. 

On  the  Prevention  of  some  Common  Diseases 128 

Section       I. — Specific  diseases — 

Paroxysmal  fevers 129 

Yellow  fever 130 

Dengue 133 

Cholera 134 

Typhus 140 

Plague. 140 

Enteric  fever 141 

Relapsing  fever 1 41 

Bilious  remittent  fevers : 143 

Cerebro  spinal  meningitis 143 

The  eruptive  fevers 143 

Erysipelas 143 

Hospital  gangrene 143 


CONTENTS.  V 

PAGE 

Section     II. — Non-specific  diseases — 

Dysentery  and  diarrhoea  144 

Liver  diseases  (Indian)   146 

Insolation  , 148 

Phthisis 148 

Scurvy 150 

Military  ophthalmia 153 

Venereal  diseases  in  the  army 155 

CHAPTER  XIX. 

Disinfection  and  Deodoeization 161 

Nature  of  the  nontagia 163 

The  media  in  which  the  contagia  are  spread 165 

Effects  of  heat  as  a  disinfectant 166 

Disinfecting  chambers 167 

Effects  of  chemical  agents , 169 

Purification  of  clothes 166,  169 

Purification  of  the  air  by  chemical  methods 169 

Purification  of  rooms  after  infectious  diseases 173 

Disinfection  in  various  diseases „ 175 

Exanthemata 175 

Typhus    176 

Plague 177 

Enteric  fever , 177 

Cholera 177 

Yellow  fever 178 

Dysentery 178 

Cattle  plague 179 

Deodorization  of  sewage , 179 

CHAPTER  XX. 

Statistics , 185 

Section       I.  — A  few  elementary  points 185 

Section     II. — Army  statistics 191 


BOOK  II. 

THE   SERVICE  OF   THE  SOLDIER. 

CHAPTER   I. 
The  Reckuit ... 195 

CHAPTER   IL 

Conditions  under  -which  the  Soldier  is  Placed 201 

Section        I. — Barracks  at  home 201 

Barracks  in  hot  climates 210 

Wooden  huts... , 216 

War  huts 216 

Tents 218 

Camps 232 

Hospital  encampment 226 


VI  COIfTENTS. 

PAGK 

Section     II.— Food  of  the  soldier 226 

Section    III. — Clothing  of  the  soldier 234 

Section    IV. — Articles  of  clothing 237 

Section      V. — Equipments 243 

Section     VI. — Carriage  of  necessaries  and  armaments 249 

Section  VII.— Work  of  the  soldier 253 

Gymnastic  exercises 254 

Marches 258 

Duty  of  medical  officers  during  marches 266 

Marching  in  India 268 

Canada 26& 


CHAPTER    IIL 

Effects  of  Military  Service 270 

Section       I.  — Loss  of  strength  per  annum 271 

By  death 271 

By  invaliding 285 

Section     II. — Loss  of  service  from  sickness 286 

Section  III.  — General  conclusions 290 


CHAPTER  IV. 

Foreign  Service 29.3 

Gibraltar 293 

Malta 298 

Cyprus 303 

West  Indies 303 

Jamaica 307 

Trinidad 310 

Barbadoes 312 

St.  Lucia , . . 314 

British  Guiana 314 

Bahamas  and  Hondui'as 316 

Bermuda 316 

North  American  stations 317 

Canada 317 

St.  Helena 321 

West  Coast  of  Africa 321 

Cape  of  Good  Hope 325 

Mauritius 327 

Ceylon 330 

India 333 

China 358 


CHAPTER  V. 

Service  on  Board  Ship , 361 

Section       I. — Transports  for  healthy  troops 361 

Section      II. — Transports  for  sick  troops 361 

Section    III. — Hospital  ships 363 


CONTENTS.  Vll 


CHAPTER  VI. 

PAQB 

War 365 

Section       I. — Preparation  for  war  during  peace 366 

Section     II. — Entry  on  war 369 

Section    III.— Actual  war 370 

Army  medical  regulations  in  war 370 

Causes  of  sickness  and  mortality 371 

Duties  of  sanitary  officer 372 

Hospitals  in  war 373 

Sieges 379 

Appendix .* 380 


CONTENTS   OF   THE   AMERICAN  APPENDIX. 

Introduction 391 

Water 400 

The  Characters  and  Distribution  op  American  Soils 485 

Cli&latology  and  Meteorology 443 

Ventilation  and  Warming 465 

Removal  op  House- Waste 475 

Food  Adulteration 503 

DiSINPECTION  AND  DeODORIZATION 518 

Vital  Statistics 523 

Some  Hints  to  Sanitary  Inspectors 524 

INDEX 529 


PRACTICAL  HYGIENE 


^00ll     ^»     (CONTINUED). 

CHAPTER  IX. 

HABITATIONS. 

Whoever  considers  carefully  the  record  of  the  mediseval  epidemics,  and 
seeks  to  interpret  them  by  our  present  knowledge  of  the  causes  of  disease, 
will  surely  become  convinced  that  one  great  reason  why  those  epidemics 
were  so  frequent  and  so  fatal  was  the  compression  of  the  population  in 
faulty  habitations.  Hi-contrived  and  closely  packed  houses,  with  narrow 
streets,  often  made  winding  for  the  purpose  of  defence  ;  a  very  poor 
supply  of  water,  and  therefore  a  universal  uncleanliness  ;  a  want  of  all 
appliances  for  the  removal  of  excreta ;  a  population  of  rude,  careless,  and 
gross  habits,  living  often  on  innutritions  food,  and  frequently  exposed  to 
famine  from  their  imperfect  system  of  tillage, — such  were  the  conditions 
which  almost  throughout  the  whole  of  Europe  enabled  diseases  to  attain  a 
range,  and  to  display  a  virulence,  of  which  we  have  now  scarcely  a  con- 
ception. The  more  these  matters  are  examined,  the  more  shall  we  be 
convinced  that  we  must  look,  not  to  grand  cosmical  conditions  ;  not  to 
earthquakes,  comets,  or  mysterious  waves  of  an  unseen  and  poisonous  air ; 
not  to  recondite  epidemic  constitutions,  but  to  simple,  familiar,  and 
household  conditions,  to  explain  the  spread  and  fatahty  of  the  mediseval 
plagues. 

SECTION  I. 

GENERAL  CONDITIONS  OF  HEALTH. 

The  diseases  arising  from  faulty  habitations  are  in  great  measure,  per- 
haps entirely,  the  diseases  of  impure  air.  The  site  may  be  in  fault ;  and 
from  a  moist  and  malarious  soil  excess  of  water  and  organic  emanations 
may  pass  into  the  house.  Or  ventilation  may  be  imperfect,  and  the  ex- 
halations of  a  crowded  population  may  accumulate  and  putrefy ;  or  the 
excretions  may  be  allowed  to  remain  in  or  near  the  house ;  or  a  general 
uncleanliness,  from  want  of  water,  may  cause  a  persistent  contamination 
Vol.  II.— 1 


2  PRACTICAL    HYGIENE. 

of  the  air.     And,  on  the  contraiy,  these  five  conditions  insure  healthy 
habitations  : — 

1.  A  site  diy  and  not  malarious,  and  an  aspect  which  gives  Hght  and 

cheerfulness. 

2.  A  system  of  ventilation  which  carries  off  all  respiratory  impurities. 

3.  A  system  of  immediate  and  perfect  sewage  removal,  which  shall 

render  it  impossible  that  the    aii'  shall  be  contaminated  from 
excreta. 

4.  A  pure  supph'  and  proper  removal  of  water  ;  by  means  of  which 

perfect  cleanliness  of  all  parts  of  the  hovise  can  be  insured. 

5.  A  condition  of  house  construction  which  shall  insvu'e  perfect  dryness 

of  the  foundation,  walls,  and  roof. 

In  other  words,  perfect  purity  and  cleanliness  of  the  air  are  the  objects 
to  be  attained.  This  is  the  fundamental  and  paramount  condition  of 
health}'  habitations  ;  and  it  must  override  aU  other  conditions.  After  it 
has  been  attained,  the  architect  must  engraft  on  it  the  other  conditions 
of  comfort,  convenience,  and  beauty. 

The  inquiries  which  have  been  made  for  the  last  forty  years  in  England 
have  sho-oTi  how  badly  the  poorer  classes  are  lodged,  both  in  town  and 
countiy,  and  how  urgent  is  the  ^necessity  for  improvement.  Vai-ious  Acts' 
have  been  passed  for  the  purjDOse  of  improving  laborers'  cottages  and 
other  small  dwellings,  but  either  from  the  powers  being  insufficient,  or 
from  the  difficulty  of  proving  that  a  dwelling  is  injurious  to  health,  unless 
it  is  in  extremely  bad  condition,  these  Acts  have  had  only  partial  effect. 

Uj^  to  a  certain  point,  there  is  no  difficulty  in  insuring  that  a  small 
house  shaU  be  as  healthy  as  a  large  one.  The  site  and  foundations  can  be 
made  as  diy,  the  drains  as  well  arranged,  the  walls  and  roofs  as  sound, 
and  the  water  supply  as  good  as  a  house  of  much  lai'ger  rental.  In  fact, 
in  one  respect,  the  houses  of  the  poor  are  often  superior  to  those  of  the 
rich,  for  the  sewers  do  not  open  directly  into  the  houses,  and  sewer  air  is 
not  breathed  during  the  night.  But  the  difficulty  in  the  houses  of  the 
poor  is  the  overcrowding,  and  the  impregnation  of  the  AvaHs  with  foul  ef- 
fluria  and  deposits.  Considerations  of  cost  wiU  probably  always  prevent 
our  poor  class  of  houses  from  ha'sing  sufficient  floor  and  cubic  space. 
These  two  special  difficulties  must  be  met  by  improved  means  of  warming 
and  ventilation,  and  by  covering  the  interior  walls  with  a  cement  which  is 
non-absorbent,  and  which  can  be  washed.  Perhaps,  also,  imj^rovements  in 
using  concrete,  or  other  plans,  "will  eventually  so  lessen  the  cost  of  build- 
ing that  larger  rooms  can  be  given  for  the  same  rental,  and  the  poor  be 
taught  to  prize  the  boon  of  an  abimdant  allowance  of  air,  and  not  seek  to 
lessen  it  by  crowding  and  tmderletting. 

Dr^mess  of  the  foundation  and  walls  of  a  house  is  secured  by  draining 
the  subsoil,  4  to  9  feet  below  the  foundation,'  and,  in  very  wet  clay  soil, 
by  pacing  or  cementing  under  the  enth'e  house.  ^  The  walls  are  kept  diy 
by  being  embedded  in  concrete,  which  is  brought  up  to  the  ground  level, 
or  by  the  insertion  in  the  walls  themselves  of  a  waterproof  course  of  slate, 

'  Laboring  Classes  Dweiiing-house  Act,  1866  ;  An  Act  to  provide  better  Dwellings 
for  Artisans  and  Laborers,  1868  ;  Artisans  Dwellings  Act,  1875  ;  various  clauses  in  the 
different  Public  Health  Acts. 

■■'  Even  the  walls  of  old  rickety  cottages  may  be  thoroughly  dried  by  this  means 
(Rogers  Field). 

^  For  a  good  diagram  of  a  plan  for  avoiding  damp,  see  Bailey  Denton's  Sanitary  En- 
gineering, Plate  I.,  p.  56. 


HABITATIOITS.  3 

asphalt,  or,  what  is  better,  of  ventilating  vitrified  thin  bricks  (as  devised 
by  IVIi-.  Taylor). 

On  wet  damp  soils,  when  a  house  has  no  cellar,  the  flooring  ought  to 
be  raised  2  feet  above  the  ground,  and  the  space  below  should  be  well  ven- 
tilated. In  the  tropics,  the  houses  are  often  raised  on  arches  3  to  5  feet 
above  the  ground.  If  this  plan  were  universal,  it  would  vastly  improve  the 
health  of  the  community.  Dryness  of  walls  is  best  secured  by  hollow 
walls,  ^  or  coating  the  walls  vd.th  cement,  which  is  kept  painted,  or  with 
slates.  Terra-cotta  slabs  have  been  used,  and  liquid  preparations  (chiefly 
alkaline  sihcates)  have  been  brushed  over  the  surface  of  brick  and  stone. 
Bricks  are  often  extremely  porous,"  and  a  brick  wall  will  absorb  many  gal- 
lons of  water.  ^ 

Dryness  of  the  roof  should  be  carefully  looked  to  in  every  case,  as 
water  often  gets  to  the  walls  through  a  bad  roof,  and  the  whole  house  be- 
comes damp. 

The  condition  of  the  basements  or  cellars,  if  they  exist,  requires  atten- 
tion, as  the  air  of  the  house  is  often  drawn  dii-ectly  from  them.  They 
should  be  dry,  and  thoroughly  well  ventilated,  and  the  house  pipes,  if  they 
run  down  to  the  basement,  should  be  always  uncovered  so  as  to  be  easily 
inspected,  and  any  bad-fitting  joint,  or  crack,  or  imperfect  trap,  if  there 
be  one  inside  the  house,  be  at  once  remedied. 

The  carrying  off  of  rain  water,  so  as  not  to  sinlc  into  the  ground  near 
the  house,  is  a  matter  of  importance. 

The  other  points  which  are  necessary  to  secure  a  healthy  house  are 
discussed  in  their  resjDective  chapters. 

In  examining  a  house  to  discover  the  sources  of  unhealthiness,  it  is 
best  to  begin  at  the  foundation,  and  to  consider  first  the  site  and  base- 
ments, then  the  living  and  sleeping  rooms  (as  to  size,  cubic  contents,  and 
number  of  persons,  and  condition  of  walls  and  floors),  ventilation,  water 
supply,  and  plans  of  waste  and  sewer-water  removal,  in  regular  order. 

The  following  memorandum  as  to  the  way  in  which  engineers  examine 
a  house  has  been  kindly  fui-nished  by  IVIr.  WilUam  Eassie,  C.E. : — 


IHEM0KA2TDIIM. 

What  is  usually  done  by  Sanitary  Engineers  ichen  inspecting  a  House. 

Sanitary  engineers  consider  that  an  unusual  smell  is  generally  the  first 
evidence  of  something  wrong,  and  that,  traced  to  its  source,  the  evil  is  haK 
cured.  They  inspect  first  the  drainage  arrangements.  If  the  basement 
generally  smells  offensive^,  they  search  for  a  leaking  drain-pipe,  i.e.,  a  pipe 
badly  jointed  or  broken  by  settlement,  and  these  will  often  show  them- 
selves by  a  dampness  of  the  paving  around.  If,  upon  inquiry,  it  turns  out 
that  rats  are  often  seen,  they  come  to  the  conclusion  that  the  house  drain 
is  in  direct  communication  with  the  sewer,  or  some  old  brick  barrel-drain, 

'  Jenning's  patent  Bonding  Brick  is  a  good  plan  for  preventing  moisture  penetrat- 
ing from  the  outer  to  the  inner  skin  of  a  hollow  wall.  It  is  a  hollow,  vitrified  brick, 
curved  upward  at  an  angle  of  45°,  so  that  no  water  can  pass  along  it. 

•^  An  ordinary  brick  will  hold  about  16  oz.  of  water. 

'  Bricks  imperfectly  burned  on  the  outside  of  the  kiln  are  termed  Place,  or  Samel, 
or  Sandel  bricks.  They  absorb  much  water.  The  sun-dried  bricks  of  India  are  very 
damp,  and  absorb  water  from  the  air.  Many  sandstones  are  very  porous  ;  water  beats 
into  them  and  rises  high  by  capillary  attraction.  Lime  made  from  chalk  absorbs 
water.     Piso  is  compressed  earth,  and,  unless  covered  with  cement,  is  moist. 


4  PEACTICAL    HYGIENE. 

and  therefore  examine  the  traps  and  lead  bends  which  join  the  drain-pipes 
to  see  if  they  are  gnawed  or  faulty.  If  the  smell  arises  from  any  j^articu- 
lar  sink  or  traji,  it  is  plain  to  them  that  there  is  no  ventilation  of  the  drain, 
and  more  especially  no  disconnection  between  the  house  and  the  sewer,  or 
no  flap-trap  at  the  house-drain  delivery  into  the  sewer.  If  a  country  house 
be  under  examination,  a  smell  at  the  sink  will,  in  nearly  every  case,  be 
traced  to  an  unventilated  cesspool  ;  and,  in  opening  up  the  drain  undei 
the  sink,  in  such  a  state  of  things,  they  will  take  care  that  a  candle  is  nol 
brought  near,  so  as  to  cause  an  explosion.  If  the  trap  is  full  of  foul  blact 
water,  impregnated  with  sewer  air,  they  partly  account  for  the  smell  by 
the  neglect  of  flushing.  If  the  sink,  and  kitchen,  and  scullery  wastes  are 
in  good  order  and  the  smell  is  still  obsen'able,  they  search  the  other  cellar 
rooms,  and  frequently  find  an  old  floor-trap  without  water,  broken  and 
open  to  the  drain.  If  the  smell  be  ammoniacal  in  character,  they  trace 
the  stable-drains  and  see  if  they  lead  into  the  same  pit,  and  if  so,  argue  a 
weak  pipe  on  the  route,  especially  if,  as  in  some  London  mansions,  the 
stable-drains  run  from  the  mews  at  the  back,  through  the  house  to  the 
front  street  sewer. 

Should  a  bad  persistent  smell  be  complained  of  mostly  in  the  bedroom 
floor,  they  seek  for  an  untrapped  or  defective  closet,  a  burst  soil-jnj^e,  a 
bad  junction  between  the  lead  and  the  cast-iron  portion  of  the  soil-pij^e 
behind  the  casings,  etc.,  or  an  improj)er  connection  with  the  drain  below. 
They  will  examine  how  the  soil-pipe  is  jointed  there,  and,  if  the  joint  be 
inside  the  house,  will  carefully  attend  to  it.  The}'  will  also  remove  the 
closet  framing,  and  ascertain  if  any  filth  has  overflowed  and  saturated  the 
flooring,  or  if  the  safe  underneath  the  apparatus  be  full  of  any  liquid.  If 
the  smell  be  only  occasional,  they  conclude  that  it  has  arisen  when  the 
closet  handle  has  been  lifted  in  ordinary  use  or  to  empty  slops,  and  satisfy 
themselves  that  the  soil-pipe  is  unventilated.  They,  moreover,  examine 
the  bath  and  lavatoiy  waste-pipes,  if  they  are  untrapj^ed,  and  if  trapped  by 
a  sigmoidal  bend,  whether  the  trapping  water  is  not  always  withdrawn 
owing  to  the  siphon  action  in  the  full  running  pipe.  They  Avill  trace  all 
these  water-pipes  down  to  the  sewer,  ascertain  if  they  wrongly  enter  the 
soil-pipe,  the  closet-trap,  or  a  rain  water-pipe  in  connection  with  the 
sewer. 

If  the  smell  be  perceived  for  the  most  part  in  the  attics,  and,  as  they 
consider,  scarcely  attributable  to  any  of  the  foregoing  evils,  they  will  see 
whether  or  not  the  rain  water  pipes  which  terminate  in  the  gutters,  are 
soleh-  acting  as  drain  ventilators,  and  blowing  into  the  dormer  windows. 
They  will  also  examine  the  cistei^ns  of  rain  Avater,  if  there  be  any  in  the 
other  portions  of  the  attics,  as  veiy  often  they  are  full  of  piitridity. 

A  slight  escape  of  impure  air  from  the  drains  may  be  difiicult  to  detect, 
and  the  smell  may  be  attributed  to  want  of  ventilation,  or  a  comphcation 
of  matters  may  arise  from  a  slight  escape  of  gas.  Neither  are  all  danger- 
ous smells  of  a  foul  natui-e,  as  there  is  a  close  sweet  smell  which  is  even 
worse.  Should  the  drains  and  doubtful  places  have  been  previously 
treated  by  the  inmates  to  strongly  smelling  disinfectants,  or  the  vermin 
killed  by  j^oison,  the  insjjectors  of  nuisances  will  find  it  difiicult  to  separate 
the  smells.  In  such  a  case,  however,  they  will  examine  the  state  of  the 
ground  under  the  basement  flooring,  and  feel  certain  that  there  are  no  dis- 
used cesspools  or  any  sewage  satui'ation  of  any  sort.  They  will  also  ascer- 
tain if  there  be  any  stoppage  in  the  drain-pipes,  by  taking  up  a  yard  trap 
in  the  line  of  the  drain  march,  and  noting  the  reappearance  of  the  lime 
water  which  they  had  thrown  down  the  sinks.     Arid  invariably,  after  ef- 


HABITATIONS.  5 

fecting  a  cirre  for  any  evil  wliicli  lias  been  discovered,  tliey  will  leave  the 
traps  cleaned  out  and  the  drains  well  flushed. 

A  thoroughly  drained  house  has  always  a  disconnection  chamber  placed 
between  thS  house  drain  and  the  sewer  or  other  outfall.  This  chamber  is 
formed  of  a  raking  siphon,  and  about  two  feet  of  oj^en  channel  j)ipe,  built 
around  by  brickwork  and  covered  by  an  ii'on  man-hole.  Fresh  air  is  taken 
into  this  chamber  by  an  open  gi'ating  in  the  man-hole,  or  by  an  under- 
ground pipe,  and  the  air  thus  constantly  taken  into  the  chamber  courses 
along  inside  the  drain,  and  is  as  continuously  discharged  at  the  ventilated 
continuations  of  the  soil-pipes,  which  are  left  untrapped  at  the  foot,  or  at 
special  ventilating  j^ipes  at  each  end  of  the  drain.  This  air  current  in  the 
drain  prevents  all  stagnation  and  smell. 

When  a  house  is  undergoing  examination,  it  is  mse  to  test  for  lighting 
gas  leakages,  and  there  is  only  one  scientific  method  of  doing  so,  which  is 
as  follows  : — Eveiy  burner  is  plugged  up,  save  one,  and  to  that  is  attached 
a  tube  in  connection  with  an  air  force-pump  and  gauge— the  meter  having 
been  previously  disconnected.  Air  is  then  pumped  into  the  whole  system 
of  pipes,  and  the  stop-cock  turned,  and  if,  after  working  the  pump  for  some 
time,  and  stopjDing  it,  the  gauge  shows  no  sign  of  sinking,  the  pipes  may 
be  taken  as  in  safe  condition  ;  but  if  the  mercury  in  the  gauge  falls,  owing 
to  the  escape  of  air  from  the  gas-tubes,  there  is  a  leak  in  them,  which  is  dis- 
coverable by  pouring  a  Httle  ether  into  the  pipe  close  by  the  gauge,  and  re- 
commencing pumping.  Very  minute  holes  can  be  detected  by  lathering 
the  pipes  with  soap  and  water,  and  making  use  of  the  pump  to  create  soap 
bubbles. 

Besides  the  drainage,  they  ^vill,  especially  if  they  detect  a  bad  and  dank 
smell,  see  if  it  arises  from  the  want  of  a  damp-proof  course  or  of  a  dry  area, 
see  if  there  be  a  wet  soil  under  the  basement  floor,  a  faulty  pipe  inside  the 
wall,  an  unsound  leaden  gutter  on  the  top  of  the  wall,  or  an  ovei'flowing 
box  gutter  in  the  roof,  a  leaky  slatage,  a  porous  wall,  a  wall  too  thin,  and 
so  on. 

They  will  also  keep  an  eye  upon  the  condition  of  the  ventilating  ar- 
rangements, and  whether  the  evils  complained  of  are  not  mainly  due  to 
defects  there.  The  immediate  surroundings  of  the  house  "^ill  also  be  noted, 
and  any  nuisances  estimated. 

S  mitary  inspectors,  whilst  examining  into  the  condition  of  the  drains, 
always  examine  the  water  cisterns  at  the  same  time,  and  discover  whether 
the  cistern  which  yields  the  drinking  water  supplies  as  well  the  flushing 
water  of  the  closets.  They  will  also  ascertain  if  the  overflow  pipe  of  this 
cistern,  or  of  a  separate  drinking  water  cistern,  passes  directly  into  the  di'ain. 

If  the  overflow  pipe  be  siphon-trapped  and  the  water  rarely  changed  in 
the  trap,  or  only  when  the  ball-cock  is  out  of  order,  they  vrill  point  out  the 
fallacy  of  such  trapping  ;  and,  speaking  of  traps  generally,  they  will  look 
suspiciously  on  every  one  of  them,  endeavor  to  render  them  supererogatory 
by  a  thorough  ventilation  and  disconnection  of  the  drains.^ 

'  Much  useful  information  -svill  also  be  obtained  from  Sanitary  Arrangements  for 
Dwellings,  by  W.  Eassie,  C.E.,  and  from  Sanitary  Engineering,  by  J.  Bailey  Denton, 
C.E.  See  also  Tlie  Habitation  in  Eelation  to  Health,  by  F.  de  Chaumont,  Christian 
Knowledge  series;  Our  Homes,  and  how  to  keep  them  Healthy,  Cassell,  Fetter  & 
Galpin. 


6  PRACTICAL    HYGIENE. 

SECTION  n. 

HOSPITALS. 
General  Remarks. 

Of  late  years  a  great  number  of  works  (English,  French,  German,  and 
American)  have  been  written  on  the  construction  of  hospitals.  This  has 
been  especially  owing  to  the  celebrated  Notes  on  Hosjyitals,  pubHshed  by 
Miss  Nightingale,  after  the  Crimean  war — a  work  the  importance  of  which 
it  is  impossible  to  over-rate — and  to  the  very  useful  pamphlets  of  Mr. 
Roberton,  of  Manchester.  Among  military  writers,  Robert  Jackson  in  this, 
as  in  all  other  points,  takes  the  first  rank,  and  his  observations  on  the  con- 
struction of  hospitals  are  conceived  entii'ely  in  the  sjiirit  of  the  best  writings 
of  the  present  day.  In  the  short  space  wliich  can  be  given  to  the  subject 
here,  we  can  merely  condense  what  has  been  best  said  on  the  subject,  as 
applied  especially  to  military  hospitals. '  In  the  first  place,  however,  a  few 
words  are  necessary  on  the  general  question. 

Although  the  establishment  of  hospitals  is  a  necessity,  and  marks  the  era 
of  an  advanced  civilization,  it  must  always  be  remembered  that  if  the  crowd- 
ing of  healthy  men  has  its  danger,  the  bringing  together  within  a  confined 
area  many  sick  persons  is  far  more  jDerilous.  The  risks  of  contamination  of 
the  air,  and  of  impregnation  of  the  materials  of  the  building  with  morbid 
substances,  are  so  greatly  increased,  that  the  greatest  care  is  necessary  that 
hospitals  shall  not  become  pest-houses,  and  do  more  harm  than  good.  We 
must  always  remember,  indeed,  that  a  number  of  sick  persons  are  merely 
brought  together  in  order  that  medical  attendance  and  nursing  may  be  more 
easily  and  perfectly  performed.  The  risks  of  aggregation  are  encountered 
for  this  reason  ;  othei'wise  it  would  be  far  better  that  sick  persons  should 
be  separately  treated,  and  that  there  should  be  no  chance  that  the  rapidly 
changing,  and  in  many  instances  putrefying  stxbstances  of  one  sick  body 
should  pass  into  the  bodies  of  the  neighboring  patients.  There  is,  indeed, 
a  continual  saci'ifice  of  life  from  diseases  caught  in,  or  aggravated  by  hos- 
pitals. The  many  advantages  of  hospitals  more  than  counterbalance  this 
sacrifice,  but  it  should  be  the  first  object  to  lessen  the  chance  of  injury  to 
the  utmost.  The  risk  of  transference  or  aggravation  of  disease  is  least  in 
the  best  ventilated  hospitals.  A  great  supply  of  air,  by  immediately  dilute 
ing  and  rapidly  carrying  away  the  morbid  substances  evolved  in  such 
quantities  from  the  bodies  and  excretions  of  the  sick,  reduces  the  risk  to  its 
minimum,  and  perhaps  removes  it  altogether.  But  the  supply  of  air  must 
be  enormous  ;  there  must  be  a  minimum  of  not  less  than  4,000  cubic  feet 
per  head  per  hour  for  ordinary  cases  ;  and  the  sujDply  must  be  practically 
unlimited  for  the  acute  and  febrile  diseases. 

The  causes  of  the  greater  contamination  of  the  air  of  hospitals  are 
these  : — 

'  For  fuller  details,  Captain  Galton's  work  on  Hospitals  sliould  be  consulted.  See 
also  Five  Essays  on  Hospital  Plans,  contributed  for  the  Joljns  Hopkins  Hospital  Scheme 
(Wood  &  Co.,  New  York);  Report  on  the  Manchester  Royal  Infirmary,  by  J.  Netten 
Radcliffe,  Esq.  ;  Reports  on  St.  Mary's  Hospital,  Paddington,  by  F.  de  Chaumont,  M.D  ; 
chapter  in  Roth  and  Lex,  Milit.  Gesundheitspflege  ;  paper  in  the  Practitioner,  March, 
1877;  article  "Hospital,"  Encyclopaedia  Britannica,  9th  edition;  Das  Allgemeine 
Krankenhaus  der  stadt  Berlin  im  Friedrichshain,  von  A.  Hagemeyer,  Berlin,  1879. 


HABITATIONS.  7 

1.  More  organic  effluvia  are  given  off  from  the  bodies  and  excretions  of 
sick  men.     These  are  only  removed  by  the  most  complete  ventilation. 

2.  The  medical  and  surgical  management  of  the  sick  necessarily  often 
exposes  to  the  air  excretions,  dressings,  foul  poultices,  soiled  clothes,  etc., 
and  the  amount  of  substances  thus  added  to  the  aii-  is  by  no  means  incon- 
siderable, even  w^ith  the  best  management. 

3.  The  vsralls  and  floors  of  hospitals  absorb  organic  matters  and  retain 
them  obstinately,  so  that  in  some  cases  of  repeated  attacks  of  hospital 
gangrene  in  a  ward  it  has  been  found  necessary  to  destroy  even  the  whole 
wall.  Continual  drippings  on  the  floor  of  substances  which  soak  into  the 
boards  and  through  cre^dees,  and  collect  under  the  floor,  also  occiir,  and 
thus  collections  exist  of  putrefying  matters  which  constantly  contaminate 
the  air. 

4.  The  bedding  and  furniture  also  absorb  organic  substances,  and  are  a 
great  cause  of  insalubrity. 

5.  Till  very  recently,  even  in  the  best  hospitals,  the  water-closets  and 
urinals  were  badly  arranged,  and  air  passed  from  these  places  into  the 
wards. 

In  addition  to  the  necessary  amount  to  dilute  and  remove  these  sub- 
stances, the  freest  supply  of  air  is  also  now  known  to  be  a  curative  means  of 
the  highest  moment ;  in  the  cases  of  the  febrile  diseases,  both  specific  and 
symptomatic,  it  is  indeed  the  first  essential  of  treatment ;  sometimes,  es- 
pecially in  typhus  and  small-pox,  it  even  lessens  dviration,  and  in  many  cases 
it  renders  convalescence  shorter.  ^ 

There  can  be  no  doubt,  that  the  necessity  for  ah  unlimited  supply  of 
air  is  the  cardinal  consideration  in  the  erection  of  hospitals,  and,  in  fact, 
must  govern  the  construction  of  the  buildings.  For  many  diseases,  es- 
pecially the  acute,  the  merest  hovels  with  plenty  of  air  are  better  than  the 
most  costly  hospitals  without  it.  It  is  ill-judged  humanity  to  overcrowd 
febrile  patients  into  a  building,  merely  because  it  is  called  a  hospital,  when 
the  very  fact  of  the  overcrowding  lessens  or  even  desti'oys  its  iisefulness. 
In  times  of  war,  it  should  never  be  forgotten  by  medical  officers  that  the 
rudest  shed,  the  sHghtest  covering,  which  wiU.  j^rotect  from  the  weather,  is 
better  than  the  easy  plan  so  often  suggested  and  acted  on,  of  putting  the 
beds  a  little  closer  together. 

The  recognition  that  the  ample  supply  of  pure  air  is  the  first  essential 
of  a  good  hospital,  led  Miss  Nightingale  to  advocate  with  so  much  energy 
and  success  the  view  which  may  be  embodied  in  the  two  following 
rules :  — 

1.  The  sick  should  be  distributed  over  as  large  an  area  as  possible,  and 
each  sick  man  should  be  as  far  removed  as  possible  from  his  neighbor. 

2.  The  sick  should  be  placed  in  small  detached  and  perfectly  ventilated 
buildings,  so  that  there  should  be  no  great  number  of  persons  in  one 
building,  and  no  possibihty  of  the  polluted  air  of  one  ward  passing  into 
another. 

How  is  this  perfect  Purity  of  Air  to  be  secured? 

This  is  a  matter  partly  of  construction,  partly  of  superintendence. 

{a)  There  should  be  detached  buildings,  so  disposed  as  to  get  the  freest 
4ir  and  the  greatest  light.  They  should  be  at  considerable  distances  apart, 
so  that  1,000  sick  should  be  spread  like  a  village  ;  and  in  the  wards  each 

'  For  examples  of  the  value  of  a  great  supply  of  fresh  air  on  some  diseases,  see  note 
in  former  editions  of  this  work. 


8  PRACTICAL    HYGIENE. 

man  ought  to  have  not  less  than  100,  if  possible  120,  feet  of  superficial, 
and  from  1,500  to  2,000  feet  of  cubic  space.  With  detached  buildings,  the 
size  of  a  hospital,  as  pointed  out  by  Miss  Nightingale,  is  dependent  merely 
on  the  facihty  of  administration.  When  the  hospitals  consist  of  a  single 
building  the  smallest  hospitals  are  the  best. 

(b)  The  ventilation  should  be  natural,  i.e.,  dependent  on  the  movement 
of  the  outer  air,  and  on  inequalities  of  weight  of  the  external  and  internal 
air.  The  reason  of  this  is,  that  a  much  more  efficient  ventilation  can  be 
obtained  at  a  cheaper  cost  than  by  any  artificial  means.  Also,  by  means 
of  open  doors  and  windows,  we  can  obtain  at  any  moment  any  amount  of 
ventilation  in  a  special  ward,  whereas  local  alterations  of  this  kind  are  not 
possible  in  any  artificial  sj'stem.  The  amount  of  air,  also,  which  any  arti- 
ficial system  can  cheaply  give  is  comparatively  limited.  The  amount  of  air 
should  be  restricted  only  by  the  necessity  of  not  allowing  its  movement  to 
be  too  perceptible. 

The  best  arrangements  for  natural  ventilation  for  hospitals  appear  to 
be  these — 1st.  Opposite  windows  reaching  nearly  to  the  ceihng,  on  the 
sides  of  a  ward  (not  wider  than  24  feet,  and  containing  only  two  rows  of 
beds)  and  a  large  end  window.  2d.  Additional  openings,  to  secure,  as 
far  as  possible,  a  vertical  movement  of  the  air  from  below  upward  ;  and 
this  will  be  best  accomj^lished  as  follows  : ' — 

A  tube  opening  at  once  to  the  external  air  should  run  transversely 
along  the  floor  of  the  ward  to  each  bed,  and  should  end  in  a  box  placed 
under  the  bed,  and  provided  with  oj^enings  at  the  top  and  sides,  which  can 
be  more  or  less  closed.  In  the  box,  coils  of  hot- water  pipes  should  be  in- 
troduced to  warm  the  air  when  necessary.  The  area  of  the  tube  should 
not  be  less  than  72  square  inches  to  each  bed  ;  and  the  area  of  the  open- 
ings in  the  box  at  least  four  times  larger.  The  fresh  air,  warmed  to  any 
degree  and  moistened,  if  necessary,  by  placing  wet  cloths  in  the  box,  or 
medicated  by  placing  chlorine,  iodine,  or  other  substances,  will  then  pass 
under  each  bed,  and  ventilate  that  sjiace  so  often  unaired  ;  and  then,  as- 
cending round  the  sides  of  the  bed,  will  at  once  dilute  and  carry  up  the 
products  of  respiration  and  transpiration  to  the  ceihng.  It  would  be  a 
simple  matter  so  to  arrange  the  hot-water  pipes  as  to  be  able  to  cut 
off  all  or  some  of  the  pipes  under  a  particvilar  bed  from  the  hot-water  cur- 
rent if  desired,  and  so  to  give  a  fever  patient  air  of  any  temperature,  from 
cold  to  hot,  desired  by  the  physician.  In  the  low  and  exhausted  stages  of 
fever  warm  air  is  often  desii*able.  By  this  simple  plan,  we  could  deal  more 
effectually  with  the  atmosphere  round  our  patients,  as  to  warmth,  dryness, 
humidity,  and  medication,  than  by  any  other.  At  the  same  time,  the  open  fire- 
place and  chimney,  and  the  open  doors  and  windows,  might  be  preserved.^ 

For  the  exit  of  the  foul  air,  channels  in  the  ridge  sliould  be  provided, 
warmed  by  gas  if  possible. 

To  facilitate  this  system  of  ventilation,  it  is  desirable  to  have  the  build- 
ings one-storied  only  ;  but  it  can  be  applied  with  two  stories.  Only  then 
the  discharge  tubes  must  be  placed  at  the  sides,  and  run  up  in  the  thick- 
ness of  the  walls.  ^ 

1  A  plan  similar  to  this  has  been  devised  by  Dr.  S.  Hale,  and  adopted  in  some  of 
the  Australian  hospitals.  It  is  an  excellent  arrangement,  bnt  seems  rather  unneces- 
sarily complicated  by  taking  the  air  under  the  floor,  and  elevating  the  beds  on  a  dais. 

'■'  The  introduction  of  vertical  tubes  is  also  useful,  as  giving  the  air  an  uj^ward  di- 
rection and  allowing  a  considerable  supply  without  draughts. 

^  When  the  ceiling  is  flat  the  outlets  may  be  advantageously  placed  at  the  sides  close 
to  the  ceiling,  but  with  a  one-storied  or  upper  ward  an  open  roof  is  better. 


HABTTATIOlSrS.  9 

But  not  only  should  there  be  good  ventilation,  but  the  wards  ought  to 
be  every  year  empty  for  two  or  three  weeks,  and  during  the  time  thoroughly 
exposed  to  the  air,  every  door  and  window  being  open. 

(c)  The  strictest  rules  should  be  laid  down  with  regard  to  the  imme- 
diate removal  from  the  wards  of  all  excreta,  dirty  dressings,  foul  linen,  etc. 

Nothing  that  can  possibly  give  off  anything  to  the  air  should  be  allowed 
xo  remain  a  single  moment.  Dressings  of  foul  wounds  should  be  sprinkled 
with  deodorants. 

(d)  The  walls  should  be  of  impermeable  material.  Cements  of  different 
kinds  are  now  vised,  especially  Parian  ;  large  slabs  of  properly  colored 
tiles,  joined  by  a  good  cement,  and  good  Portland  cement  well  painted, 
would,  however,  be  better.  Pai-ian  cracks  and  spaces  form  behind  it. 
Ceiling  should  be  either  cemented  or  frequently  limewashed.  Great  care 
should  be  taken  with  the  floors.  On  the  whole,  good  oak  laid  on  concrete 
seems  the  best  material ;  but  the  joinings  should  be  perfect,  so  that  no 
fluid  may  pass  through  and  collect  below  the  floor.  Possibly  it  might  be 
well  to  cover  the  floor  with  a  good  oil-cloth,  or  material  of  the  like  kind, 
which  would  prevent  substances  from  sinking  into  the  boards,  and  would 
lessen  the  necessity  of  washing  the  floors,  but  might  be  itself  removed,  and 


Fig.  69. — Ward  for  Twenty  Ward-beds.    A,   ward  ;  B,  nurse's-room,  with  warJ-window  ;  C,   scullery  ;  D, 
water-closet  and  ward-sink ;  E,  bath-room  and  abhition-room  ;  F,  ventilated  lobbies. 

frequently  washed.  The  practice  of  waxing  and  dry-rubbing  the  floors,  and 
other  similar  plans,  is  intended  to  answer  the  same  purpose.  Dr.  Langstaff, 
of  Southampton,  strongly  recommends  solid  paraffin.  The  paraffin  is  melted 
and  then  poured  on  the  floor,  and  ironed  into  it  with  a  box-iron,  heated 
from  the  interior  by  burning  charcoal ;  it  penetrates  about  a  quarter  of  an 
inch  into  the  wood.  The  excess  of  paraffin  is  scraped  off,  and  the  floor  is 
brushed  Avith  a  hard  brush  ;  a  little  paraffin  in  turijentine  is  then  put  on, 
and  the  flooring  is  good  for  years.' 

(e)  The  furniture  in  a  ward  should  be  reduced  to  the  minimum ;  and 
as  far  as  possible,  everything  should  be  of  iron.  The  bedding  should 
also  be  reduced  in  size,  as  much  as  can  be.  Thick  mattresses  should  be 
discarded,  and  thin  mattresses,  made  easy  and  comfortable  by  being 
placed   on  springs,  employed.^     The  material  for  mattresses   should  be 

'  An  experience  of  some  years  in  the  Southampton  Infirmary  has  proved  the  advan- 
tage of  this  fiiooring.  It  has  also  heen  introduced  with  satisfactory  results  into  the  Bris- 
tol Infirmary,  according  to  information  received  from  Mr.  Eassie,  C.B. 

'■'  The  wire  mattress  bedstead,  as  arranged  by  Dr.  Reed,  in  use  in  the  Manchester 
Royal  Infirmary,  and  made  by  Messrs.  Chorlton  &  Dugdale,  seems  an  excellent  and 
very  comfortable  form. 


10 


PRACTICAL    HYGIENE. 


horse-hair  (18  lb  weight  to  each  mattress),  or  coir  fibre,  which,  on  the 
whole,  are  least  absorbent.  Straw,  which  absorbs  veiy  little,  is  bulky, 
and  is  said  to  be  cold.  All  flock  and  woollen  mattresses  should  be  discarded. 
Blankets  and  coverlets  should  be  white  or  yellowish  in  color,  and  should 

be  frequently  thoroughly  aired,  fumigated, 
and  washed. 

(/)  The  arrangement  of  the  water-closets 
and  urinals  is  a  matter  of  the  greatest  mo- 
ment. Ever}^  ward  should  have  a  urinal, 
so  that  the  common  practice  of  retaining 
urine  in  the  utensils  may  be  discontinued. 
If  the  urine  is  kept  for  medical  inspec- 
tion, it  should  be  in  closed  vessels.  The 
removal  of  excreta  must  be  by  water.  In  hospitals,  nothing  else  can  be 
depended  upon,  as  regards  certainty  and  ra2:)idity.  The  best  arrangement 
for  closets  is  not  the  handle  and  plug,  whicth  very  feeble  patients  will  not 
lift  ;  but  a  self-acting  water  supply  connected  Avith  the  door,  and  flowing 
when   it  is  open.     This  plan  is  better  than  the  self-acting  spring  seat. 


Fig.  70.— Section  of  Ward  to  show  the  Bed. 


Fig.  71. — Dran-ing  to  show  Beds  and  Windows. 

which  is  not  always  easily  depressed  by  a  thin  patient  ;  and  also,  by 
leaving  the  open  door,  it  gives  us  the  means  of  pouiing  in  any  quantity  of 
water,  and  of  thoroughly  flushing  the  pan  and  pipe.  The  closets  are  best 
arranged  in  nearly  detached  lobbies,  at  one  end  of  the  ward,  and  separated 
from  it  by  a  thorough  cross  ventilation,  as  shown  in  the  plan  which  is  cop- 
ied from  jNIiss  Nightingale's  work. '  A  further  imjorovement  may  be  made 
by  thro-tting  the  closets  still  further  out,  with  an 
intercepting  lobby,  as  shown  in  Fig.  72. 

Li  this  way,  provided  the  site  of  the  hospital  is 
originally  well  chosen,  perfect  purity  of  air  can  be 
obtained,  and  the  first  requisite  of  a  good  hospi- 
tal is  secured. 

Next  to  the  supply  of  pure  air,  and  to  the 
measures  for  preventing  contamination  (which  em- 
brace construction,  ventilation,  cleanliness,  and  la- 
trine arrangements),  come  the  arrangements  for 
medical  treatment. 

Medical  treatment  includes — 
1.  Supply  of  Food. — The  diet  of  the  sick  is  now 
becoming  a  matter  of  scientific  precision  ;  and  it  is 
probable  that  every  year  greater  and  greater  importance  will  be  attached 
to  it.     Hence  the  necessity  of  a  perfect  central  kitchen,  and  of  means  for 

'  Dr.  Buchanan  has  suggested  a  plan  of  vertical  ventilation  in  the  vestibule,  in 
cases  where  cross  ventilation  is  not  available.  Tliis,  of  course,  need  not  to  be  in  a  new 
building,  although  it  might  be  useful  in  the  adaptation  of  an  existing  one.  The  addition 
of  a  slop  sink,  for  the  emptying  of  bed-pans,  etc.,  would  also  be  useful. 


WARD 


Fig.  72.— Closets  (W.  C.) 
and  Lavatory  (L.)  with  inter- 
vening ventilated  lobbies  (/.). 


HABITATIONS.  11 

the  rapid  supply  of  food  at  all  times.  There  is  more  difficulty  in  doing 
this  than  at  first  appears,  as  the  central  kitchen  cannot  supply  everything  ; 
and  yet  there  must  be  no  cooking  in  the  wards,  or  even  near  them,  as  the 
time  of  the  attendants  should  be  occupied  in  other  ways.  Probably  the 
best  arrangement  is  to  have  hot  closets  close  to  the  wards,  where  the  food 
sent  from  the  kitchen  can  be  kept  warm,  and  ready  for  use  at  all  hours  of 
the  day  and  night. 

2.  The  Supply  of  Water. — ^Hot  and  cold  water  must  be  supplied  every- 
where, and  baths  of  all  kinds  should  be  available.  The  supply  of  water  for 
all  purposes  shoald  be  40  to  50  gallons  per  head  daily. 

3.  The  Supply  of  Drugs  and  Apparatus. — The  chief  point  is  to  econo- 
mize the  time  of  attendants,  and  to  enable  drugs  and  apparatus  to  be  pro- 
cured without  delay  when  needed. 

4.  The  Nursing  and  Attendance,  including  the  Supply  of  Glean  Linen,  etc. — 
The  time  and  labor  of  the  attendants  should  be  expended,  as  far  as  pos- 
sible, in  nursing,  and  not  in  other  duties.  Every  contrivance  to  save 
labor  and  cleaning  should  therefore  be  employed.  Lifts,  shafts,  tramways, 
and  speaking-tubes  to  economize  time  ;  wards  arranged  so  as  to  allow  the 
attendants  a  view  of  every  patient ;  wards  not  too  large  nor  too  small,  for 
Miss  Nightingale  has  conclusively  shown  that  wards  of  from  20  to  32  beds 
are  best  suited  for  economy  of  service. 

5.  Means  of  Open-air  Exercise  for  Patients. — This  ought  properly  to  be 
considered  as  medical  treatment.  As  soon  as  a  patient  can  get  out  of  his 
ward  into  the  open  air  he  should  do  so  ;  therefore,  open  verandas  on  the 
sunny  sides  of  the  wards,  and  sheltered  gardens,  are  most  important.  For 
the  same  reason  hospitals  of  one  story  are  best,'  as  the  patients  easily  get 
out ;  if  of  two  stories,  the  stairs  should  be  shallow. 

6.  In  addition  to  all  these,  the  supply  of  air  medicated  with  gases,  or 
fine  powders,  or  various  amounts  of  watery  vapor,  is  a  mode  of  treatment 
which  is  sure  to  become  more  common  in  certain  diseases,  and  special 
wards  will  have  to  be  provided  for  these  remedies. 

The  parts  of  a  military  hospital  are'^ — 

Patients'  Rooms,  Wards,  and  Day-rooms,  if  possible  ;  the  wards  of  two 
sizes, — large,  i.e.,  from  20  to  32  beds,  and  small,  for  one  or  two  patients. 
It  is  desirable  to  have  the  small  wards  not  close  to  the  large  ones,  but  at 
some  little  distance.  Attached  to  the  wards  are  attendants'  rooms,  scul- 
lery, bath  and  ablution  rooms,  small  store-room,  urinal,  closets  (one  seat 
to  eveiy  eight  men). 

Operating-room — Dead-house — Administration. — Surgeons'  rooms  ;  case- 
book and  instrument  room  ;  offices  and  officers'  room. 

Pharmacy. — Dispensary  ;  store-room  ;  dispenser's  room. 

'  The  late  Dr.  Parkes  wrote  : — "I  had  never  properly  estimated  the  Importance  of 
patients  getting  into  the  air,  and  the  desirability  of  one-storied  buildings  for  this  pur- 
pose, till  I  served  at  Renkioi,  in  Turkey,  during  the  Crimean  war.  The  hospital  was 
composed  of  one-storied  wooden  houses  connected  by  an  open  corridor.  As  soon  as  a 
man  could  crawl  he  always  got  into  the  corridor  or  between  the  houses,  and  the  good 
effects  were  manifest.  Some  of  the  medical  officers  had  their  patients'  beds  carried  out 
into  the  corridor  when  the  men  could  not  walk.  In  the  winter  greatcoats  were  pro- 
vided for  the  men  to  put  on,  and  they  were  then  encouraged  to  go  into  the  corri- 
dor." 

^  Hospital  space  is  to  be  provided  for  10  per  cent,  of  the  force.  Lately,  since  the 
health  of  the  army  has  been  so  much  improved  on  home  service,  it  has  been  proposed 
to  reduce  it  to  7  per  cent.,  but  it  would  appear  desirable  always  to  have  a  large  hos- 
pital space  for  emergencies  and  for  war.  For  the  duties  of  administrative  medical 
officers  with  regard  to  hospitals,  see  the  Medical  Regulations,  1878. 


1^ 


PRACTICAL    HYGIENE. 


Culinary. — Store-room  ;  wine  and  beer  room  ;  larder  and  meat  room  ; 
kitchen  ;  room  for  arranging  diets  ;  scullery  ;  cook's  room. 

Ifas/an^.— Waslihouse  ;  diiiy  linen  store  ;  baking  and  fumigating  room ; 
cleaning  room  for  mattresses. 

Steward's  Department— O^ces,  furniture,  linen,  utensil,  and  pack  stores  ; 
rooms  for  cleaning. 


""    " '^-"-^ — ^M 


O  to 

>.2 


The  amoTint  for  storage  room  is,  for  an  hospital  of  100  sick — 

Fuel  store  =  250  square  feet. 

Foul  linen  store  =120  " 

Pack  store  =  200  " 

(In  military  hospitals.) 

Fig.  73  shows  the  arrangement  of  closets  and  lavatory  in  a  mihtary 
hospital 


Bedding  and  store  =  200  square  feet. 
Clothing  store  =100  " 

Utensil  store  =  160-200   " 

Provision  store         =  100  " 


HABITATIONS. 


13 


The  two  following  plans  show  the  arrangement  of  the  Lariboisiere 
Hospital  in  Paris,'  which  circumstances  have  made  the  type  of  the  so- 
called  "block  or  pavihon  plan  ;  and  of  the  Herbert  Hospital,  which  is  the 
best  mihtary  hospital  in  this  country,  or  perhaps  anywhere. 

The  Herbert  Hospital  at  Woolwich  consists  of  fovir  double  and  three 
single  pavihons  of  two  floors  each,  all  raised  on  basements.  There  is  a 
convalescents'  day-room  in  the  centre  paviUon.  The  administration  is  in  a 
separate  block  in  front.  The  axis  of  the  wards  is  a  Uttle  to  the  east  of  north. 
There  is  a  corridor  in  the  basement,  through  which  the  food,  medicines, 
coals,  etc.,  are  conveyed,  and  then,  by  a  series  of  lifts,  elevated  to  the  wards. 
The  terraces  in  the  corridor  afford  easy  means  of  open-air  exercise  for  the 


Fig.  74. — Lariboisiere  Hospital  at  Paris. 

patients  in  the  upper  ward.  The  wards  are  warmed  by  two  central  open 
fire-places,  vrith  descending  flues,  round  which  are  air-passages,  so  that  the 
entering  air  is  warmed.  The  floors  are  iron  beams,  filled  in  with  concrete, 
and  covered  with  oak  boarding.* 

The  usual  shape  of  ward  is  oblong,  the  standard  vridth  26  feet  (in  the 
army)  to  30  feet  (St.  Thomas's,  for  instance),  and  the  length  being  deter- 
mined by  the  number  of  beds.  Mr.  John  Marshall  ^  has,  however,  advo- 
cated a  system  of  circular  wards,  which  he  thinks  have  certain  advantages, 

'  The  new  Hotel-Dieu  is  on  the  same  general  plan. 

^  The  arrangement  of  the  pavilions  may  be  varied  in  many  ways ;  for  different 
forms  of  arrangement,  see  the  works  already  cited.  It  has  been  thought  unnecessary 
to  take  up  space  by  inserting  plans,  which  vary  merely  in  detail. 

3  On  a  Circular  System  of  Hospital  Wards,  by  John  Marshall,  F.R.S.,  etc.  London, 
Smith  &  Elder,  1878. 


14 


PRACTICAL    HYGIENE. 


and  a  similar  plan  has  been  actually  can-ied  out  in  the  new  hospital  at 
Antwerp,  which  will  probably  be  ready  for  occupation  by  the  end  of  this 
year  (1882).' 

Hospitals  in  the  Tropics. 

The  Barrack  and  Hospital  Commission,  in  caiTjdug  out  the  plans  of  the 
Royal  Indian  Sanitary  Commission,  suggest'^  for  each  sick  man — 

Supei-ficial  area  =  100  square  feet,  up  to  120  in  unhealthy  districts. 

Cubical  space  —  1,500  feet,  or,  in  unhealthy  districts,  2,000  feet. 

It  is  also  directed  that  hospitals  should  consist  of  two  divisions — 1st, 
for  sick  ;  and  2d,  for  convalescents.  This  latter  division  to  hold  25  per 
cent,  of  the  total  hosj^ital  inmates. 


'  ■JSea.Za  'of  rest 
Fig.  75. — Ground  Plan  of  the  Herbert  Hospital,  Woolwich  (from  Miss  Nightingale's  book). 

Each  hospital  is  to  be  built  in  blocks,  to  consist  of  two  floors,  the  sick 
and  convalescents  to  sleep  on  the  upper  floors  only ;  each  block  to  hold 
only  20  to  24  beds. 

The  principles  and  details  are,  in  fact,  identical  with  those  already  or- 
dered for  the  home  stations. 

Hospitals  for  Infectious  Diseases. 

Fever  and  small-pox  hospitals  have  been  long  established  in  many  large 
English  towns  ;  but  within  the  last  few  years  it  has  become  usual  for  all 
towns  of  any  size  to  put  up  some  temporary  hospitals  during  an  outbreak 
of  cholera,  small-pox,  relajjsing  fever,  and  typhus,  and  to  remove  persons 
ill  with  these  diseases  at  once  from  their  dwellings.  In  this  way,  if  there 
is  early  discovery  of  the  cases,  the  chances  of  spread  of  the  disease  are 
greatly  lessened.^ 

'  British  Medical  Journal,  August  26,  1882,  on  p.  350  a  ground  plan  is  given  ;  see 
also  London  Medical  Record,  July  15,  1881,  p.  296  ;  and  Charitable  and  Parochial  Es- 
tablishments, by  Saxon  Snell,  F.R.I.B.A.,  for  similar  plans.  *  Op.  cit.,  p.  27. 

^  That  such  hospitals  may,  however,  be  themselves  centres  of  infection  has  been 
shown  by  the  Report  of  the  Hospitals  Commission,  1882,  which  may  be  consulted  for 
much  valuable  iiiformation. 


HABITATIOIS^S.  15 

Tlie  Medical  Department  of  the  Privy  Council  issued  a  Memorandum 
in  1872,'  pointing  out  that  power  is  given  under  the  37th  section  of  the 
Sanitary  Act,  1866,^  to  the  local  board,  improvement  commissioners,  town 
council,  or  vestry,  to  provide  "hospitals  or  temporary  places  for  the  recep- 
tion of  the  sick."  It  is  pointed  out  that  villages  should  have  the  means  of 
accommodating  instantly  four  cases  of  infectious  disease  in  at  least  two 
separate  rooms,  and  it  is  considered  that  a  good  cottage  would  answer  this 
purpose.  In  towns  a  permanent  provision  is  advised  to  be  made,  and  the 
following  suggestions  are  made  : — The  situation  to  be  convenient ;  ward 
cubic  space,  2,000  feet  per  head  ;  ward  floor-space  per  head,  144  square 
feet ;  good  provision  for  ventilation  ;  precautions  against  entrance  of  foul 
air  (as  from  privies  or  sinks) ;  warming  in  winter  to  60°  Fahr.  ;  keeping 
cool  in  summer  ;  means  of  disposal  of  excrements  and  slops  ;  and  for  clean- 
ing and  disinfecting  linen. 

For  temporary  emergencies,  tents  (army  hospital  marquees)  are  recom- 
mended, or  huts  are  advised.  The  huts  are  described  at  some  length, 
and  plans  are  given  of  the  huts  and  of  the  arrangement.  As  these  are 
very  similar  to  those  used  by  the  army  in  war,  reference  is  made  to  that 
section. 

*  Memorandum  on  Hospital  Accommodation  to  be  given  by  Local  Authorities  (signed 
John  Simon,  July  8,  1872). 

^  Now  under  the  131st  and  following  clauses  of  the  Public  Health  Act  of  1875. 


CHAPTER  X. 

REMOVAL  OF  EXCRETA. 

We  have  seen  that  a  regulai*  supply  of  pure  aii' — in  other  words,  efficient 
ventilation — is  requu-ed  to  remove  the  excreta  of  the  lungs  and  the  volatile 
products  of  the  skin.  The  sohd  and  fluid  excreta  from  the  bowels  and  the 
kidneys  ought  to  be  as  rapidly  and  as  completely  removed  as  the  gaseous 
impurities. 

It  is  highly  probable  that  to  barbarous  and  inefficient  modes  of  remov- 
ing the  excreta  of  men  and  of  animals  we  must  partly  trace  the  gi-eat  prev- 
alence of  disease  in  the  middle  ages,  and  there  is  no  doubt  that  many  of 
the  diseases  now  prevaihng  in  our  large  towns  are  owing  to  the  same 
cause. 

When  men  hve  in  thinly  populated  countries,  following,  as  they  will 
then  do,  an  agricultural  or  nomade  life,  they  will  not  experience  the  conse- 
quences of  insufficient  removal  of  excreta.  The  sewage  matter  returns  at 
once  to  that  great  deodorizer  the  soil,  and  fertilizing  it,  becomes  a  benefit 
to  man,  and  not  a  danger.  It  is  only  when  men  collect  in  communities 
that  the  disposal  of  excreta  becomes  a  matter  Hterally  of  Hfe  and  death, 
and  before  it  can  be  settled  the  utmost  skill  and  energy  of  a  people  may  be 
taxed. 

The  question  of  the  proper  mode  of  disposal  of  sewage  has  been  some- 
what peii^lexed  by  not  keeping  apart  two  separate  considerations.  The 
object  of  the  jDhysician  is  to  remove  as  rapidly  as  possible  all  excreta  from 
dwellings,  so  that  neither  air,  water,  nor  soil  shall  be  made  imjiure.  The 
agiiculturist  wishes  to  obtain  from  the  sewage  its  fertilizing  powers.  It 
is  not  easy  to  satisfy  both  parties,  but  it  will  probably  be  conceded  that 
Bafety  is  the  first  thing  to  be  sought,  and  that  profit  must  come  afterward. 

SECTION  L 
AMOUNT  AND  PRODUCTS  OF  THE  SOLID  AND  FLUID  EXCRETA. 

Amount  of  the  Solid  and  Fluid  Excreta. 

The  amount  of  the  bowel  and  kidney  excreta  vary  in  different  persons 
and  with  different  modes  of  life.  On  an  average,  in  Europe,  the  daily  sohd 
excreta  are  about  4  ovmces  by  weight,  and  the  daily  fluid  excreta  50  ounces 
by  measure  for  each  male  adult.  Women  and  children  pass  rather  less. 
Vegetable  pass  more  sohd  excreta  than  animal  feeders,  but  this  is  chiefly 
owing  to  a  large  proportion  of  water. '     Taking  all  ages  and  both  sexes  into 

'  Mr.  Fawcus's  experiments  on  Bengalee  prisoners  give  an  average  bowel  excretion 
of  12  ounces,  and  in  Bombaj  Dr.  Hewlett  found  the  alvine  discharges  to  be  quite  as 
large. 


REMOVAL    OF    EXCRETA.  17 

consideration,  we  may  estimate  the  daily  amovmt  per  bead  of  population  in 
Europe  at  2|-  ounces  of  fsecal,  and  40  ounces  of  urinary  discharge,  A  popu- 
lation of  1,000  persons  would  thus  pass  daily  156  lb  of  soHds  and  260  gallons 
of  urine,  or  in  a  year  25  tons  of  faeces,  and  91,250  gallons  (14,646  cubic 
feet)  of  urine.  Letbeby  gives  the  mean  amount  per  bead  as  2.784  ounces 
of  faeces  and  31.851  ounces  of  urine.  In  a  mixed  population  of  1,000  per- 
sons of  different  sexes  and  ages,  Letbeby  has  calculated  that  the  daily  dis- 
cbarge of  the  whole  town  will  be  2,266  tb  avoir,  of  urine  and  177.5  ft)  of 
faeces. 

Frankland  estimates  the  mean  daily  amount  per  head  as  3  ounces  of 
faeces  and  nearly  40  ounces  by  measure  of  urine.  In  adult  males  the 
quantity  of  nitrogen  daily  discharged  by  the  bowels  and  kidneys  amounts 
to  from  250  to  306  grains,  representing  304  and  372  grains  of  ammonia. 
Taking  the  whole  population,  however,  the  amount  must  be  considerably 
less  than  this.  Dr.  Parkes  calculated  it  as  153  grains  of  nitrogen,  and 
Letbeby  gave  it  as  155.8  grains,  or  from  186  to  189  grains  of  ammonia,  i.e., 
the  mean  excretion  of  aU.  the  population  is  very  nearly  half  the  excretion  of 
the  adult  male. 

Decomposition  of  Sewage  Matter. 

Fresh  healthy  faecal  matter  fi'om  persons  on  mixed  diet,  unmixed  with 
urine,  has  an  acid  reaction,  and  this  it  retains  for  a  considerable  time ;  it 
then  becomes  alkaline  from  ammonia.  If  free  from  urine,  it  usually  decom- 
poses slowly,  and  in  hot  weather  often  dries  on  the  surface,  and  subse- 
quently changes  but  little  for  some  time.  The  urine,  when  unmixed  with 
faecal  matter,  also  retains  its  natural  acidity  for  a  variable  number  of  days, 
sometimes  three  or  four  ;  sometimes  eight  or  ten,  or  even  longer,  and  then 
becomes  alkaline  from  ureal  decomposition.  When  the  faeces  and  urine 
are  mixed,  the  formation  of  ammonium  carbonate  fi'om  ureal  decomposi- 
tion is  much  more  rapid  ;  the  solid  excreta  seem  to  have  the  same  sort  of 
action  as  the  bladder  mucus,  and  the  mixed  excreta  become  alkaline  in 
twenty-four  hours,  while  the  separate  excreta  are  stiU  acid.  And  in  its 
turn  the  presence  of  the  urine  seems  to  aid  the  decomposition  of  the  soUd 
matter,  or  this  may  be  perhaps  from  the  effect  of  the  fluid,  as  pure  water 
seems  to  act  almost  as  rapidly  as  luine  in  this  respect.  Pappenheim'  states 
that  the  absorption  of  oxygen  by  the  faeces  is  greatly  increased  when  urine 
is  added.  When  the  solid  excreta  and  mine  are  left  for  two  or  three  weeks, 
the  mixture  becomes  usually  extremely  viscid,  and  this  occurs,  though  to  a 
less  extent,  when  an  equal  quantity  of  pure  water  takes  the  place  of  urine. 
The  viscidity  is  prevented  by  carboUc  acid. 

When  the  soHd  excreta  (unmixed  with  urine)  begin  to  decompose,  they 
give  out  very  fetid  substances,  which  are  no  doubt  organic  ;  hydrogen 
sulphide  is  seldom  detected,  at  any  rate  by  the  common  plan  of  suspend- 
ing paper  soaked  in  lead  solution  above  the  decomposing  mass.  When 
heated,  a  large  quantity  of  gas  is  disengaged,  which  is  inflammable,  and 
consists  in  great  measure  of  carburetted  hydrogen.  When  (instead  of  being 
dry)  urine  is  present,  ammonia  and  fetid  organic  matters  are  disengaged 
in  large  quantity.  When  water  is  also  present,  and  if  the  temperatm-e  of 
the  air  is  not  too  low,  not  only  organic  matters  but  gases  are  given  out, 
consisting  of  light  carburetted  hydrogen,  nitrogen,  and  carbon  dioxide. 
Hydrogen  sulphide  can  be  also  disengaged  by  beat,  and  is  almost  always 

1  Handb.  der.  San.  Pol.,  2d  edit.,  Band  L,  p.  72. 
Vol.  II.— 3 


18  PRACTICAL   HYGIENE. 

found  in  the  liquid,  usually  in  combination  with  ammonia,  from  which  it  is 
sometimes  liberated  and  then  passes  into  the  air. 


,  SECTION  n. 

METHODS  OF  REMOVAL  OF  EXCRETA. 

While  all  will  agree  in  the  necessity  of  the  immediate  removal  of  excreta 
from  dwellings,  the  best  modes  of  doing  so  are  by  no  means  settled.  The 
fact  is  that  several  methods  of  removing  sewage  are  applicable  in  different 
circumstances,  and  their  relative  amounts  of  utility  depend  entii'ely  on  the 
condition  of  the  particular  place. 

The  different  plans  may  be  conveniently  divided  into' — 

1.  The  water  method. 

2.  The  dry  methods. 

Before  noticing  these  plans,  it  will  be  convenient  to  make  a  few  general 
observations  on  sewers. 

Sewers. 

Sewers  are  conduits  employed  to  remove  waste  water  and  waste  pro- 
ducts suspended  in  water  from  houses,  or  to  carry  away  rain.  Among  the 
waste  products  may  be  the  solid  and  liquid  excreta  of  men  and  animals, 
or  the  refuse  of  trade  and  factory  operations.  Or  sewers  may  be  used 
merely  for  the  conveyance  of  dirty  house  water,  without  the  admixture  of 
excreta  or  trade  refuse. 

It  is  quite  impossible  that  any  town  or  even  any  single  large  house 
can  be  projDerly  freed  of  its  waste  house  water  without  sewers,  and  in  a 
more  or  less  perfect  condition  they  are  to  be  found  not  only  in  all  ruodern, 
but  in  most  ancient  cities.  Originally,  no  doubt,  they  were  mere  surface 
channels,  as  they  are  still  in  many  towns ;  but  for  the  sake  of  ajopearance 
and  inoffensiveness,  the  custom  must  have  soon  arisen  of  placing  them 
underground,  nor  in  modern  towns  could  they  now  be  an-anged  other- 
wise. In  some  large  towns  there  are  even  hundreds  of  miles  of  sewers, 
constructed  often  with  great  skill  and  science,  and  they  serve  in  some  in- 
stances as  the  channels  not  only  for  rain,  but  for  natui'al  streams  which 
have  been  enclosed. 

The  sewers  form  thus  in  the  subsoil  of  towns  a  vast  network  of  tubes, 
connecting  every  house,  and  converging  to  a  common  outlet  where  their 
contents  may  be  discharged. 

In  some  towns  the  sewers  carry  away  none  of  the  soHd  excreta,  though 
probably  urine  enters  in  all  cases.  In  most  towns,  however,  solid  excreta, 
in  greater  or  less  quantity  enter,  owing  especially  to  the  prevalent  use  of 
water-closets,  or  to  the  drainage  of  middens  and  manure  heaps. 

Whether  the  solid  excreta  pass  in  or  not,  the  liquid  in  the  sewers  must 
always  contain  either  suspended  or  dissolved  ainimal  and  vegetable  matters 
derived  from  the  refuse  of  houses.     It  is  generally  warmer  than  the  water 

'  Dr.  Corfield's  work  (A  Digest  of  Facts  relating  to  the  Treatment  and  Utilization 
of  Sewage,  by  W.  H.  Corfield,  2d  edit.,  1871)  will  be  found  to  give  a  good  summary  of 
this  subject.  See  also  Report  of  a  Committee  appointed  by  the  President  of  the  Local 
Government  Board  to  inquire  into  the  several  modes  of  treating  Town  Sewage,  Lon- 
don, Eyre  &  Spottiswoode,  1876;  see  also  "Die  Menschliche  Abfallstoffe,"  von  Dr. 
Ferd.  Fischer,  Supplement  zur  Deutschen  Viertelj.  f.  Offt.  Gesundh.,  1882. 


EEMOVAL    OF   EXCRETA.  19 

of  streams,  and  is  of  no  constant  composition  ;  sometimes  it  is  very  turbid, 
and  higlily  impui-e  ;  in  other  cases  it  is  hardly  more  impure  than  the  water 
of  surface  wells.  The  suspended  matters  are,  however,  generally  in  larger 
proportion  than  the  dissolved. 

In  some  cases  the  sewer  water  is  in  greater  amount  than  the  water 
supplied  to  the  town  and  the  rainfall  together.  This  arises  from  the  sub- 
soil water  finding  its  way  into  the  sewers. 

One  ton  of  London  or  Rugby  sewage  contains  only  from  2  Bb  to  3  ft)  of 
solid  matter  (Lawes).' 

The  average  composition  of  sewer  water  in  towns  with  water-closets  is, 
organic  matter,  27.72;  nitrogen,  6.21;  phosphoric  acid,  1.57;  potash, 
2.03  grains  per  gallon.'^ 

The  Elvers  Pollution  Commissioners  give  7.28  grains  of  organic  ni- 
trogen per  100,000  parts,  or  5.41  grains  per  gallon  ;  the  mean  amount  of 
ammonia  is  6.703  per  100,000,  or  4.695  gi-ains  per  gallon. 

Under  the  microscope,  sewer  water  contains  various  dead  decaying 
matters^  and  in  addition  multitudes  of  Bacteria  and  amoebiform  bodies,  as 
well  as  some  ciUated  infusoria,  especially  Paramecia,  Fungi  (spores  and 
mycelium)  are  seen,  but  there  are  few  Diatoms  or  Desmids,  and  not  many 
of  the  higher  animals,  such  as  Rotifera. 

A  controversy  is  stUl  going  on,  whether  the  solid  excreta  ought  to  be 
admitted  into  the  sewers.  The  point  is  virtually  practically  decided  in 
many  towns  in  this  country  by  the  general  use  of  water-closets,  which 
cannot  now  in  these  towns  be  superseded  by  any  plan  yet  proposed.  It 
is,  however,  quite  an  open  question,  whether,  if  all  the  arrangements 
could  be  commenced  de  novo,  the  admission  of  the  solid  excreta  would  be 
proper. 

The  arguments  for  and  against  this  view  will  presently  be  stated. 

Whether  the  solid  excreta  are  allowed  to  pass  in  or  not,  it  is  clear  that 
the  dirty  water  of  the  sewers  must  in  some  way  be  disposed  of.  It  is  in 
every  case  more  or  less  impure,  containing  animal  and  vegetable  sub- 
stances in  a  state  of  commencing  decay,  which  passes  readily  into  putre- 
faction. The  readiest  mode  of  getting  rid  of  it  is  to  pass  it  into  streams, 
where  it  is  at  once  subjected  to  the  influence  of  a  large  body  of  water,  and 
where  the  solid  matters  become  either  slowly  oxidized,  or  form  food  for 
fishes  or  water  plants,  or  subside.  Although  from  an  early  period  streams 
were  thus  contaminated  and  their  water  originally  pure  was  thus  rendered 
unfit  for  use,  it  is  only  lately  that  a  strong  opposition  has  arisen  to  the 
discharge  into  streams.  This  is  owing  partly  to  the  greater  pollution  and 
nuisance  caused  by  the  more  common  use  of  water-closets  and  the  largely 
increasing  trade  of  the  country,  which  causes  more  refuse  to  be  sent  in, 
and  partly  to  the  evidence  which  has  been  lately  brought  forward  "of  the 
diseases  which  are  caused  by  drinking  water  made  impure  in  this  waj'. 
To  prevent  the  nuisance  and  danger  caused  by  the  pollution  of  streams, 
many  actions  at  law  have  been  brought,  and  in  some  cases  special  Acts  of 
Parhament  have  forbidden  the  discharge  of  sewer  water  into  certain  rivers 
until  after  efficient  purification.  The  Elvers  Pollution  Act  of  1876  now 
deals  with  the  question,  its  provisions  having  come  into  operation  on 
August  15,  1877. 


'  For  the  composition  of  sewer  water  see  Way,  Second  Report  of  Common  Sewage 
of  Towns,  1861,  p.  69  et  seq.;  Letheby,  The  Sewage  Question,  1872,  p.  135  ;  Report  on 
Town  Sewage,  1876  ;  Rivers  Pollution  Commissioners'  Report. 

^  Letheby,  op.  cit.,  p.  138. 


20  PRACTICAL    HYGIENE. 

Up  to  a  certain  point,  there  "would  probably  be  a  general  agreement  as 
to  the  priucijile  on  -which  this  difficult  question  should  be  dealt  ■with. 
Animal  substances  in  a  state  of  decay  can  be  best  jjrevented  from  con- 
taminating the  air,  the  soil,  or  the  water  of  streams,  by  imitating  the 
operations  of  nature.  In  the  endless  cycle  of  physical  change,  decaying 
animal  matters  are  the  natural  food  of  2:>lants,  and  plants  again  form  the 
food  of  animals. 

It  so  hapjDens  that,  -with  the  exception  of  some  mineral  trades,  the 
■waste  products  of  "n-hich  are  hvu-tful  to  agriculture,  many  of  the  substances 
contained  in  the  se^ner  ■water  of  our  towns  are  adapted  for  the  food  of 
plants,  and  we  seem  on  sure  ground  when  we  decide  that  it  must  be  cor- 
rect to  submit  these  matters  to  the  action  of  plant  life,  and  thus  to  con- 
vert them  from  dangerous  impmities  into  wholesome  food. 

The  difficulty  is,  however,  with  the  application  of  the  principle,  and  at 
the  present  moment  there  is  the  utmost  diversity  of  opinion  on  this  point. 
It  seems,  however,  that  we  may  di-vide  the  opinions  into  two  classes. 
According  to  one  opinion,  the  proper  mode  is  to  bring  the  waste  water  of 
towns,  when  it  contains  fertilizing  matters,  at  once  to  the  ground,  and 
after  the  aiTest  of  substances  which  may  block  the  pipes,  to  pour  it  over 
the  land  in  such  a  way  as  may  be  best  adapted  to  free  it  from  its  impuri- 
ties, and  to  bring  it  most  raj)idly  and  efficiently  under  the  influence  of 
growing  plants. 

The  other  opinion  objects  to  this  course  on  two  grounds  :  first,  that 
the  substances  are  not  brought  to  the  ground  in  the  most  convenient  foi-m 
for  agriculture,  and  also  that  the  plan  entails  e^vils  of  its  own,  arising  from 
the  immense  quantity  of  water  brought  upon  the  land  and  from  the  diffi- 
culty of  efficient  management.  The  advocates  of  this  second  view  would, 
therefore,  use  some  plan  of  separating  the  impurities  of  the  water,  and 
would  then  apply  them  in  a  solid  form  to  the  land,  or  use  them  for  some 
other  purpose,  as  in  General  Scott's  plan  of  adding  the  materials  for 
cement  and  then  making  this  substance.  The  puiified  water  would  then 
be  filtered  through  land,  or  passed  into  streams,  without  fui'ther  treat- 
ment. 

In  the  case  of  the  sewage  water  containing  materials  not  adapted  for 
agriculture,  both  parties  would  deal  with  it  in  the  same  way,  ■viz.,  purify  it 
by  chemical  agencies  or  filtration,  and  then  allow  the  water  to  flow  off  into 
streams,  while  the  solid  products  would  be  disposed  of  in  the  most  con- 
venient way. 

These  general -views  apply  to  any  sewer  water,  whether  it  contains  solid 
excreta  or  not,  although  if  these  exci'eta  can  be  perfectly  excluded  the 
sewer  water  is  less  offensive.  It  has  hitherto  been  often  pom-ed  into 
streams  -^-ithout  pre^sious  purification,  though  now  this  practice  is  pro- 
hibited by  law,  with  certain  reservations. 

The  sewers  of  a  town  are  for  the  most  pai't  used  also  to  cairy  off  the 
rainfaU,  and,  indeed,  before  the  introduction  of  water-closets,  they  were 
used  only  for  this  pm-pose,  and  for  taking  away  the  slop  and  sink  water  of 
houses.  In  countries  with  heavj'  rainfall,  and  in  this  country  in  certain 
cases,  the  rainfall  channels  are  distinct  from  the  sewers,  and  the  outfaUs 
may  be  in  an  entu-ely  different  direction.  This  is  sometimes  called  the 
"  separate  system." 

Removal  of  Excreta  by  Water. 

This  is -the  cleanest,  the  readiest,  the  quickest,  and  in  many  cases  the 
most  inexpensive  method.     The  water   supplied  for  domestic  pui-poses. 


EEMOVAL    OF   EXCEETA.  21 

whicli  lias  possibly  been  raised  to  some  height  by  steam  or  horse  power, 
gives  at  once  a  motive  force  at  the  cheapest  rate  ;  while,  as  channels  must 
necessarily  be  made  for  the  conveyance  away  of  the  waste  and  dii'ty  water, 
which  has  been  used  for  domestic  purposes,  they  can  be  used  with  a  little 
alteration  for  excreta  also.  It  would  be  a  waste  of  economy  to  allow  this 
water  to  pass  off  mthout  applying  the  force  which  has  been  accumulated 
in  it  for  another  purpose. 

But  if  this  is  obvious,  it  is  no  less  so  that  certain  conditions  of  success 
must  be  present,  without  which  this  plan,  so  good  in  principle,  may  utterly 
fail.  These  conditions  are,  that  there  shall  be  a  good  supply  of  water, 
good  sewers,  ventilation,  a  proper  outfall,  and  means  of  disposing  of  the 
sewer  water.  If  these  conditions  cannot  be  united,  we  ought  not  to  'dis- 
guise the  fact  that  sewers,  improperly  arranged,  may  give  rise  to  no  incon- 
siderable dangers.  They  are  underground  tubes,  connecting  houses  and 
allowing  possibly,  not  merely  accumulation  of  excreta,  but  a  ready  trans- 
ference of  gases  and  organic  molecules  from  house  to  house,  and  occasion- 
ally also  causing,  by  bui'sting,  contamination  of  the  ground,  and  poisoning 
of  the  water  supply.  And  all  these  dangers  are  the  greater  from  being 
concealed.  It  is  probably  con-ect,  as  has  been  pointed  out,  that  in  deep- 
laid  sewers  the  pressm-e  inward  of  the  water  of  the  surrounding  soil  is  so 
great  as  frequently  to  cause  an  inflow  into  the  sewer,  and  so  prevent  the 
exit  of  the  contents  ;  but  in  other  cases,  the  damage  to  the  sewer  may  be 
too  great  to  be  neutralized  in  this  way,  and  in  the  instance  of  superficially 
laid  and  choked-up  pipes,  the  pressure  outward  of  the  contents  must  be 
considerable.  The  dangers  of  sewers  have  now  been  greatly  reduced,  by 
having  good  material,  better  construction,  good  ventilation,  sufficient 
water  supply,  and  means  of  disposal  of  the  sewage  water. 


Amount  of  Water  for  Sewers  intended  for  Excreta. 

Engineers  are  by  no  means  agreed  on  the  necessary  amount.  We 
Lave  ah-eady  named  25  gallons  per  head  per  diem,  on  the  authority  of 
Ml".  Bi-unel,  as  the  amount  required  to  keep  common  sewers  clear,  and  even 
with  this  amount  there  should  be  some  additional  quantity  for  flushing. 
But  in  some  cases,  a  good  fall  and  well-laid  sewers  may  require  less,  and 
in  other  cases,  bad  gradients  or  curves  or  workmanship  may  require  more. 
It  is  a  question  whether  rain  water  should  be  allowed  to  pass  into  sewei's  ; 
it  washes  the  sewers  thoroughly  sometimes,  but  it  also  carries  debris  and 
gravel  from  the  roads,  which  may  clog  ;  while  in  other  cases  storm  waters 
may  burst  the  sewers,  or  force  back  the  sewage.* 


Construction  of  Sewers. 

Sewers  are  differently  constructed  according  to  the  purposes  they  are 
to  sei-ve,  i.e.,  whether  simply  to  carry  off  house  and  trade  water,  or  the 
solid  excreta  in  addition,  or  one  or  both,  with  the   rainfall. 

In  following  out  the  subject,  it  will  be  convenient  to  trace  the  sewers 
from  the  houses  to  the  outfall. 

'  Storm  overflows  require  to  be  provided  ;  for  a  description  of  them  see  Bailey- 
Denton,  op.  cit.,  sections  Isii.  and  Ixxxv. 


22  PRACTICAL    HYGIENE. 


House  Pipes  and  Drains. 

It  will  be  convenient  to  call  the  conduits  inside  the  house,  which  run 
from  sinks  and  closets,  "house  pipes,"  and  to  give  the  term  "  drain  pipes  " 
to  the  conduits  which  receive  the  house  pipes,  and  carry  the  house  water 
into  tanks  or  main  sewers.  The  house  pipes  may  be  divided  into  sink  and 
water-closet  or  soil  pipes  ;  they  are  made  of  metal  (lead,  iron,  or  zinc,  or  two 
of  these)  or  of  earthenware.  The  drain  pipes  are  usually  made  of  well- 
burnt,  hard,  smooth,  glazed  earthenware.'  All  bricks,  jDorous  earthen- 
ware, or  substances  of  the  kind,  should  be  considered  inadmissible  for  drain 
pipes.  Iron  pipes  are  not  much  used  in  this  country,  but  are  common  and 
in  some  places  compulsory  in  America,  when  pipes  have  to  be  carried 
under  houses.  When  made  of  heavy  cast-iron,  jointed  and  well  caulked 
with  lead  or  Spence's  metal,  they  are  the  best  in  many  circumstances. 
Inside  they  may  be  enamelled,  or  coated  with  Dr.  Angus  Smith's  compo- 
sition, or  treated  by  Barff's  process.  The  pipes  and  drains  vary  in  size 
from  4  to  16  inches  diameter,'^  but  the  usual  size  of  stoneware  pij^es  is  4  to 
9  inches  ;  they  are  round  or  oval  in  shape.' 

Connection  of  House  Fij^es  with  the  Drains. — It  is  customary  to  com- 
mence the  drams  at  the  basement  of  the  house,  and  the  sink  and  closet 
pipes  pass  down  inside  the  house  and  join  on,  a  water-trap  being  placed 
at  the  junction.*  As  the  aspiratory  power  of  the  warm  house  is  then  con- 
stantly tending  to  draw  air  through  the  water-trap,  and  as  the  trap  is  liable 
to  get  out  of  order,  it  is  most  desii-able  to  alter  this  plan.  The  drains 
should  end  outside  the  house,  and  as  far  as  possible  every  house  pipe 
should  pass  outside  and  not  inside  or  between  walls  to  meet  the  drain. 
The  object  of  this  is  that  any  imperfection  in  the  pipe  should  not  allow  the 
pipe  air  to  pass  into  the  houses.  At  the  junction  of  the  house  pipe  and 
drain,  there  should  not  only  be  a  good  water-trap,  but  also  complete  ven- 
tilation and  connection  with  the  outside  air  at  the  point  of  junction.     The 

'  Mr.  Baldwin  Latham  cautions  us  to  see  that  the  socket  of  the  drain  pipe  is  made  with 
and  is  a  component  part  of  the  pipe,  and  not  merely  joined  on. 

^  Pipes  are  made  up  to  36  inclaes,  usually  roundup  to  16  or  18  inches,  and  oval 
ahove  that.  Engineers  are  now  desirous  of  restricting  the  term  "  drain"  to  a  pipe  that 
merely  draws  off  moisture  from  land,  using  the  term  "  sewer  "  for  a  pipe  carrying 
sewage  or  liquid  refuse  of  any  kind.  This  distinction,  however,  has  not  been  made  in 
the  Public  Health  Act  of  1875,  in  which  "  drain"  is  used  for  the  pipe  that  receives  the 
"house  pipes,"  and  "  sewer  "  for  the  main  pipe  of  a  system.  (See  Bailey  Denton's 
Sanitary  Engineering,  p.  16.) 

2  See  Mr.  William  Lassie's  Healthy  Houses  (2d  edition)  for  much  information  on  this 
and  kindred  subjects.  Some  of  the  drawings  given  here  have  been  copied  from  Mr. 
Eassie's  work,  by  his  permission  ;  reference  may  also  be  made  to  Sanitary  Arrangements 
for  Dwellings,  by  the  same  author. 

■*  Builders  are  always  anxious  to  conceal  tubes,  and  thus  carry  them  inside  the  walls, 
or  in  the  case  of  hollow  walls,  between  the  two.  The  consequence  is  that  any  escape 
of  air  must  be  into  the  house.  The  leakage  of  a  closet  pipe  carried  down  in  a  hollow 
wall  often  constantly  contaminates  the  air  of  the  house  It  would  be  infinitely  better 
to  run  the  pipes  at  once  through  the  wall  to  the  outside.  Few  persons  have  any  idea 
of  the  carelessness  of  plumbers' work — of  the  bad  junctions,  and  of  the  rapidity  with 
which  pipes  get  out  of  order  and  decay.  When  a  leaden  pipe  carrying  water  is  led 
into  a  water-closet  discharge  pipe,  it  is  frequently  simply  puttied  in,  and  very  soon  the 
dried  putty  breaks  away,  and  there  is  a  complete  leakage  of  gas  into  the  house.  Even 
if  well-joined,  the  lead  pipe  will,  it  is  said,  contract  and  expand,  and  thus  openings  are 
at  last  formed.  Dr.  Fergus,  of  Glasgow,  and  Dr.  N.  Carmichael,  have  directed  particu- 
lar attention  to  this,  in  the  case  of  lead  closet  pipes,  which  become  easily  perforated, 
and  which  have  only  a  limited  duration  of  wear. 


REMOVAL    OF    EXCRETA. 


23 


rule,  in  fact,  sliould  be,  that  the  xmion  of  any  house  pipe  whatever  with 
the  outside  drain  should  be  broken  both  by  water  and  by  ventilation.  In 
addition,  it  should  be  a  strict  rule,  that  no  drain  pipe  of  any  kind  should 
pass  under  a  house  ;  if  there  must  be  a  pipe  passing  from  front  to  back, 
or  the  reverse,  it  is  much  better  to  take  it  above  the  basement  floor  than 
underneath,  and  to  have  it  exposed  throughout  its  course.  In  such  a  case 
it  ought  to  be  of  cast-iron,  as  already  mentioned.  It  is  hardly  possible  to 
insist  too  much  on  the  importance  of  this  rule  of  disconnection  between 
house  pipes  and  outside  drains.  Late  events  have  shown  what  a  risk  the 
richer  classes  in  this  country  now  i-un,  who  not  only  bring  the  sewers  into 
the  houses,  but  multiply  water-closets,  and  often  put  them  close  to  bed- 
rooms.    The  simple  plan  of  disconnection,  if  properly  done,  would  insure 


Fig.  76. — Jennings'  Access-pipe. 


Fig.  77.— Stiffs  Access-pipe  and 
Junction. 


Fig.  78. — Doulton  &  Watt's  Access-pipe. 


them  against  the  otherwise  certain  danger  of  sewer  air  entering  the  house. 
Houses  which  have  for  years  been  a  nuisance  from  persistent  smells  have 
been  purified  and  become  healthy  by  this  means. 

Cleansing  of  Pipes  and  Drains. — Pipes  are  cleaned  by  flexible  bamboo  or 
jointed  rods  with  screws  and  rollers  to  loosen  sediment.  The  safest  plan 
of  cleaning  drains  is  from  man-holes,  the  drains  being  laid  in  straight  fines 
from  man-hole  to  man-hole.  By  this  means  obstructions  are  easily  detected 
and  removed.  The  use  of  movable  caps  runs  the  risk  of  leakage,  it 
being  difficult  to  make  the  drain  water-tight  again  after  removing  the  cap, 

but  with  care  such  caps  ( see  Figs.  75  to  77)  are 
useful  with  small  pipes,  where  man-holes  can- 
not be  employed.  Drain  pipes  should  also  be 
cleared  out  by  regular  flushing,  carried  out 
not  less  often  than  once  a  month.  This  is  best 
done  by  means  of  an  automatic  apparatus  such 
as  Field's  flush  tank  (Fig.  79).  By  regulating 
the  flow  of  water,  it  may  be  made  to  empty 
itself  as  often  as  necessary. 

■  Laying  of  Drains. —  They  should  be  laid 
very  carefully  on  concrete  in  all  soils.  Some- 
times, in  very  loose  soils,  even  piling  for  the 
Fig.  79.-Fieid'R  Pi^Bh  Tank.  j^^^j^  ^f  ^  f ^q^.  ^^^^  y^^  ^^^^  bcsides  the  Con- 
crete. When  pipes  are  not  laid  on  a  good  foundation,  leakage  is  sure  to 
occursooner  or  later,  and  the  final  expense  is  far  more  than  the  first  outlay 
would  have  been.  The  greatest  care  must  be  taken  in  laying  and  joining 
the  pipes,  and  in  testing  them  afterward  to  make  sure  they  are  water-tight. 
In  a  wet  soil,  a  good  plan  is  to  have  a  firm  basis,  or  invert  block,  which 


24  PRACTICAL    HYGIENE. 

is  itself  perforated  to  carry  off  subsoil  water,  and  to  put  the  drain  over 
this,  as  in  the  plan  of  Messi's.  Brooks  &  Son,  of  Huddersfield  (see  Fig.  92). 

The  "junction"  of  pipes  is  accomplished  by 
special  pipes,  known  by  the  names  of  single  and 
double  squares,  c^^rved  or  oblique  junctions,  ac- 
cording to  the  angle  at  which  one  pipe  runs  into 

Q         PI IP  the  other.     The   square   junctions  are   undesir- 

ff\  \S      Til       H  /^   able,  as   blockage   will    always   occvir,    and    the 
(fij^      J  U  L    SI  L/^   obHque  junctions  should  be  insisted  upon.    When 

Q  ^K  one  pipe  opens  into  another,  a  taper  pipe  is  often 

Av-^— J  (Jl!^-^~~1    ^sed  ;  the  calibre  being  contracted  before  it  en- 

ters the  receiving  pipe.     All  jointing  must  be  in 
Fig.  8  .—Junctions.  good  ccmcut,  uulcss  Special  patent  joints  (such 

as  Stanford's)  are  used.  Clay  jointing  is  wholly  inadmissible. 

Fall  of  Drain  Pipes. — 1  in  30  for  4-inch  drains,  and  one  in  40  for  6- 
inch  ;  or  roughly,  for  small  drains  1  inch  per  yard. 

House  Traps.— As  the  traps  are  usually  the  only  safeguard  against  the 
warm  house  drawing  sewer  air  into  it,  the  utmost  attention  is  necessary  to 
insure  their  efficiency.  There  is  almost  an  infinite  diversity,  but  they  can 
be  conveniently  divided  into  the  siphon,  the  midfeather,  the  Jiap)-tra]j,  and 
the  ball-trap. 

The  siphon  is  a  deeply  curved  tube,  the  whole  of  the  curve  being 
always  fuU  of  water.  It  is  a  useful  trap,  and  efficient  if  the  curve  is  deep 
enough,  so  that  there  is  a  certain  depth  of  water  (not  less  than  f  inch) 
standing  above  the  highest  level  of  the  water  in  the  curve,  and  if  the  water 
is  never  sucked  out  of  it,  and  if  the  pipe  is  not  too  small,  so  that  the  water 
is  earned  away,  when  it  runs  full,  by  the  siphon  action  of  the  pipe  beyond. 
If  two  siphons  succeed  each  other  in  the  same  pipe,  without  an  air  open- 
ing between,  the  one  wiU  suck  the  other  empty. 

The  midfeather  is  in  principle  a  siphon  ;  it  is  merely  a  round  or  square 
box,  with  the  enti-y  at  one  side  at  the  top,  and  the  discharge  pipe  at  a  cor- 
responding height  on  the  opposite  side,  and  between  them  a  partition 
reaching  below  the  lower  margin  of  both  pipes.  Water,  of  coiu'se,  stands 
in  the  box  or  receptacle  to  the  height  of  the  discharge,  and  therefore  the 
partition  is  always  to  some  extent  under  water.  Tlie  extent  should  not  be 
less  than  |  of  an  inch.  Heavy  substances  may  subside  and  coUect  in  the 
box,  from  which  they  can  be  removed  from  time  to  time  ;  but 
as  ordinarily  made,  it  is  not  a  good  kind  of  trap,  as  it  favors  the 
collection  of  deposit,  and  is  not  self-cleaning.  The  common 
ball-trap,  with  its  modifications,  is  a  variety  of  the  midfeather- 
trap,  but  it  is  so  inefficient  that  it  ought  to  be  given  up.  The 
best  kind  of  sink  trap  is  the  simple  siphon,  with  a  screw  cap  by 
which  to  clean  it  (Fig.  81). 

The  flap)  is  used  only  for  some  drains,  and  is  merely  a 
hinged  valve  which  allows  water  to  pass  in  one  direction,  but 
which  is  so  hung  as  to  close  afterward  by  its  own  weight.  It 
is  intended  to  prevent  the  reflux  of  water  into  the  secondary 
drains,  and  is  svipposed  to  prevent  the  passage  of  sewer  gas. 
But  it  is  probably  a  very  imperfect  block. 

The  hall-trap  is  used  in  some  special  cases  only  ;  a  ball  is 
lifted  up  as  the  water  rises,  until  it  impinges  on  and  closes  an  orifice, 
is  not  a  very  desirable  kind. 

However  varioiis  may  be  the  form  and  details  of  the  water-trap,  they 
can  be  referred  to  one  or  other  of  these  patterns. 


EEMOVAL    OF    EXCRETA. 


25 


Efficiency  of  Traps. — "Water  should  stand  in  a  trap  at  least  f  of  an  inch 
above  openings,  and  it  should  pass  thi'ough  sufficiently  often  and  with 
sufficient  force  to  clear  it.  An  essential  condition  of  the  efficiency  of 
all  traps  is  that  they  should  be  self-cleansing.  Many  traps  are  so  con- 
structed that  no  amount  of  velocity  of  water  can  clear  them.  Such 
traps  are   the    common  mason's  or  dip-trap  (Fig.   82),  and   the  notori- 


FlG.    82. — Common   Mason's    o 
Dip-trap.     Bad  form  of  Ti'ap. 


Pig.  83.— D  Trap.     Bad 
form  of  Trap. 


^ui'/;w)kA'-swww/'^fc.svs\\> 


ous  D  trap  (Fig.  83),  both  of  which  are  simply  cess-pools,  and  could 
never  be  cleaned  without  being  opened  up.  Such  traps  ought  to  be 
unhesitatingly  condemned.  Traps  are  often  ineffective, — 1st,  From  bad 
laying,  which  is  a  very  common  fault,  2d,  From  the  water  getting 
thoroughly  impregnated  with  sewer  effluvia,  so  that  there  is  escape  of 
effluvia  from  the  water  on  the  house  side.  3d, 
From  the  water  passing  too  seldom  along  the 
pipCj'so  that  the  trap  is  either  dry  or  clogged. 
4th,  From  the  pipe  being  too  small  (2  or  3 
inches  only),  and  "running  full,"  which  will 
sometimes  suck  the  water  out  of  the  trap ;  it 
usually  occurs  in  this  way,  as  frequently  seen 
in  sink  traps  :  the  pipe  beyond  the  trap  has 
perhaps  a  very  great  and  sudden  fall,  and  when 
it  is  full  of  water  it  acts  Hke  a  siphon,  and 
sucks  all  the  water  out  of  the  trap  ;  to  avoid 
this,  the  pipe  should  be  large  enough  to  pre- 
vent its  running  full,  or  the  trap  should  be  of 
larger  calibre  than  the  rest  of  the  pipe.  This, 
however,  will  not  always  prevent  it,  as  even 
6-inch  pipes  have  sometimes  sucked  a  siphon  vmmwi'm'miM 
dry.  The  question  has  lately  been  very  care- 
fully investigated  in  America,  by  Messrs.  Phil- 
brick  and  Bowditch,'  whose  report  has  shown 
the  dang'er  of  unsiphoning  which  small  pipes 
are  exposed  to.  The  remedy  appears  to  be 
to  introduce  an  air- vent  at  the  crown  of  the  trap 
(see  Fig.  84),  and  not  to  have  too  small  a  pipe, 
especially  when  several  pipes  unite  in  one  general 
waste.  The  experiments  also  showed  how  un- 
siphoning might  take  place  from  the  pressure  of 
descending  water  from  upper  floors,  so  that  air  might  be  forcibly  driven 

1  The  Sanitary  Engineer,  vol.  vi.,  p.  264,  1882  (New  York).  The  Siphonage  and 
Ventilation  of  Traps,  Report  to  the  National  Board  of  Health,  bv  E.  W.  Bowditch  and 
E.  S.  Philbrick,  C.E. 


^A 


Fig.  84. — Siphon  Closet  Basins  with 
ventilating  pipes.  A,  Soil  pipe  pass- 
ing up  above  the  eaves,  witli  open 
top.  B,  Subsidiary  Ventilating 
Pipe  (also  passing  up  above  eaves, 
with  open  top)  to  prevent  sucking 
of  the  si~phon. 


26 


PRACTICAL    HYGIENE. 


into  the  house  when  upper  closets  or  sinks  were  used.  5th,  Traps  may 
perhaps  be  inefficient  from  the  pressure  of  the  sewer  air,  combined  with 
the  aspirating  force  of  the  house  displacing  the  water,  and  allowing  the 
air  uninteri'upted  communication  between  the  sewer  and  the  house.  The 
extent  of  the  last  danger  cannot  be  precisely  stated.  From  a  long  series 
of  obsen'ations  on  the  pressure  of  the  air  in  the  London  sewers,  Dr.  Bur- 
don-Sanderson  ascertained  that  in  the  main  sewers,  at  any  rate,  the 
pressure  of  the  sewer  air,  though  greater  than  that  of  the  atmosjjhere, 
could  never  displace  the  water  in  a  good  trap.  In  a  long  house  drain 
which  got  clogged,  and  in  which  much  development  of  gaseous  efflvivia 
occurred,  there  might  possibly  be  for  a  time  a  much  greater  pressure,  but 
whether  it  would  be  enough  to  foi'ce  the  water  back,  with  or  without 
the  house  suction,  has  not  been  yet  experimentally  determined.  Dr.  NeiU 
Cai-michael  has  shown  that  water  siphon  traps  act  efficiently  so  long  as  they 


Fig.  85. — Pipes  open- 
ing above  Grating 
and  Trap. 


Fio.  86. — Disconnecting  and  Ventilat- 
ing Drain  Trap,  No.  2,  Buclian's 
Patent. 


Fig.  87. — Sim- 
ple GuUey 
Trap. 


are  not  emptied  by  any  siphon  action  beyond.  But  the  reasons  already 
given  show  that  we  ought  not  to  place  dependence  solely  on  traps, '  though 
they  are  useful  adjuncts.  In  arranging  the  house  pipes,  the  sink  and 
waste-water  pipes  must  not  be  carried  into  the  closet  soil  pipes,  but  must 
empty  in  the  open  air  over  a  grating.^  See  Fig.  85.  In  the  case  of  soil 
or  water-closet  pipes  there  must  be  also  a  complete  air-disconnection  be- 
tween the  jDipe  and  drain  by  means  of  one  of  the  contrivances  now  used 
by  engineers.  At  the  point  where  this  disconnection  is  made,  there  ought 
to  be  some  easy  means  of  getting  at  it  for  inspection. 

A  good  simple  form  is  Buchan's  trap  (Fig.  86).  A  good  form  of  man- 
hole is  Mr.  Rogers  Field's  (see  Figs.  88  to  90).'  Professor  Reynolds*  has 
suggested  an  arrangement  which  seems  fairly  good  and  simple. 

A  simple  trap  is  made  by  inserting  a  pipe  in  the  centre  of  a  siphon,  and 
carrying  this  pipe  to  the  surface,  or  higher  if  considered  desirable.  It  is, 
however,  apt  to  be  clogged  with  grease,  faeces,  and  other  light  matter  ris- 
ing into  the  pipe.  There  are  various  similar  aiTangements.  The  "  Som- 
erset Patent  Trap,"  designed  by  Mr.  Honeyman,  and  much  used  at  Glasgow, 


'  "Honestly  speaking,  traps  are  dangerous  articles  to  deal  witli  ;  tliey  should  be 
treated  merely  as  auxiliaries  to  a  good  drainage  system." — Eassie. 

'■*  For  the  sake  of  appearance  in  some  cases,  it  may  be  necessary  to  carry  the  pipe 
immediately  binder  the  grating,  but  care  must  be  taken  that  nothing  occurs  to  obstruct 
the  free  communication  with  the  open  air  through  the  grating. 

'  From  Mr.  Field's  By-Laws  for  Uppingham,  with  later  improvements.  I  am  in- 
debted to  Mr.  Field  for  several  valuable  suggestions. — [F.  de  C] 

''  Sewer  Gas,  by  Osborne  Reynolds,  M.A.,  Professor  of  Engineering  at  Owens  College, 
Manchester,  2d  edition,  1872. 


EEMOVAL    OF   EXCRETA. 


27 


Disconnecting-  Man-hole. 

Perforated  Iron  Door, 


From.  'House: 


Cleaning  Branch 
To  Sevxr. 


Fig.  88. — Longitudinal  Section. 


Fig.  89.— Plan. 


Fig.  90. — Cross  Section. 


on  one 


is  a  midfeather-trap  with  an  air-shaft  on  each  side  the  partition 
side  the  shaft  ventilates  the  pipe  leading  to  the 
sewer,  on  the  other  allows  fresh  air  to  pass  into 
the  house  pipe.     This  second  shaft  also  allows 
the  trap  to  be  cleaned. 

Eain-water  pipes  are  sometimes  used  to 
ventilate  drains,  but  independent  of  their  small 
size,  w*hich  often  leads  to  blockage,  they  are 
oft«n  full  of  rain,  and  cannot  act  at  the  time 
when  ventilation  is  most  required.  They  are 
also  apt  to  dehver  sewer  gas  into  garret  win- 
dows. The  plan  is  objectionable,  and  ought  to 
be  abandoned. 

A  good  form  of  disconnecting  trap  for  sink 
and  slop  waters  is  Dean's,  which  has  a  movable 
bucket  for  removing  deposit  (Fig.  91). 

In  yards,  gully  traps  of  different  kinds  are 
used,  the  action  of  which  will  be  at  once   understood 
ing  (Fig.  87). 

Examination  of  House  Pipes  and  Traps. 

Pipes  and  traps  are  generally  so  covered  in  that  they  cannot  be  in- 
spected ;  but  this  is  a  bad  arrangement.  If  possible,  all  cover  and  skii-ting 
boards  concealing  them  should  be  removed,  and  the  pipe  and  trap  under- 
ground laid  bare,  and  every  joint  and  bend  looked  to.  But  supposing  this 
cannot  be  done,  and  that  we  must  examine  as  well  as  we  can  in  the  dark, 
so  to  speak,  the  following  is  the  best  course  : — Let  water  run  down  the 
pipe,  and  see  if  there  is  any  smell ;  if  so,  the  pipe  is  full  of  foul  aii-  and 


Fig.  91.— Deans  GuUy  Trap.   A,  Han- 
dle of  movable  bucket. 


from  the   draw- 


28  PRACTICAL    HYGIENE. 

wants  ventilation,  or  the  trap  is  bad.  If  a  liglited  candle,  or  a  bit  of 
smouldeiing  brown  paper,  is  held  over  the  entrance  of  the  pipe  or  the 
gi'ating  over  a  ti-ap,  a  rellux  of  air  may  be  found  with  or  without  water 
being  poured  down.  It  should  be  noticed,  also,  whether  the  water  runs 
away  at  once,  or  if  there  is  any  check.  Tliis  is  all  that  can  be  done  inside 
the  house  ;  but  though  the  pipe  cannot  be  distui'bed  inside,  it  may  be  pos- 
sible to  open  the  earth  outside,  and  to  get  do^vn  to  and  open  a  drain  ;  in 
that  case,  pour  water  mixed  with  hme  down  the  house  pipe  ;  if  the  whitened 
water  is  long  in  appearance,  and  then  i-uns  in  a  dribble  merely,  the  drains 
want  flushing  ;  if  it  is  much  colored  and  mixed  with  dirt,  it  shows  the 
pipes  and  trap  ai-e  foul,  or  there  is  a  sinking  or  depression  in  some  part  of 
the  di'ain  where  the  water  is  lodging.  The  pipe  should  then  be  flushed 
by  pouiing  down  a  pailful  of  lime  and  water  till  the  Hme-water  flows  off 
nearly  clear.  The  di-ain  should  also  be  blocked,  and  water  poured  into  the 
house  pipe  to  see  if  it  be  water-tight  in  eveiy  part. 

Yard-traps  ai'e  often  very  foxil,  and  if  the  trap-water  be  stii'red,  gas 
bubbles  out,  which  is  a  sign  of  great  foulness,  or  that  the  traps  are  seldom 
used. 

Main  Sewers. 

The  outside  house  di-ain  ends  in  a  channel  which  is  common  to  several 
drains,  and  which  is  of  larger  size.  These  lai'ger  sewei's  ai'e  made  either 
of  round  glazed  earthenwai-e  pipes  from  15  to  24 
inches  diameter,  or  of  well-bui'nt  impersious  brick 
moulded  in  proper  curved  shape  and  set  in  Port- 
land cement,  or  stoneware  bricks  are  partly  used> 
The  shape  now  almost  universally  given,  except  in 
the  largest  outfall  pai't,  is  that  of  an  egg  with  the 
^Dr^nT^dTu^bsoU  kJ^''^^  ^^^  ^^^  downward.  Engineers  take  the  greatest 
cai-e  with  these  brick  sewers  ;  they  ai'e  most  solidly 
put  together  in  all  parts,  and  are  bedded  on  a  firm  un^delding  bed.  Much 
discussion  has  taken  place  as  to  theu'  size,  but  the  question  is  so  compH- 
cated  by  the  admission  of  rain  water,  that  it  is  difficult  to  lay  down  any 
fixed  inile,  at  least  as  regards  the  main  j^ipes.  All  other  sewers,  however, 
should  be  small,  and  M'ith  such  a  fall  as  to  be  self- cleansing. 

Sewers  should  be  laid  in  as  straight  lines  as  possible,  with  a  regukr  fall ; 
tributary  sewers  should  not  enter  at  right  angles,  but  obhquely  ;  and  if  the 
sewer  cui-ves,  the  radius  of  the  cuiwe  should  not  be  less  than  10  times  the 
cross  sectional  diameter  of  the  sewer.  Sometimes  there  is  an  arrangement 
for  subsoil  di-ainage  under  a  pipe  drain,  as  in  the  plan  proposed  by  ]\Ir. 
Brooks. 

The  fall  for  street  drains  is  usually  from  1  in  244  to  1  in  784,  according 
to  the  size  of  the  drain.  The  flow  through  a  sewer  should  in  no  case  be 
less  than  2  feet  per  second,  and  3  is  better.  As  in  the  house  drain,  the 
fall  should  be  equable  without  sudden  changes  of  level. ' 

'  In  some  cases  a  fall  is  almost  impossible  to  obtain,  as,  for  instance,  at  Soutbport, 
in  Lancashire,  where  the  ground  is  nearly  a  dead  level.  The  fall  there  is  about  1  in 
5,000,  and  never  exceeds  1  in  3,000.  In  such  a  case  the  drain  would  have  to  be  cleaned 
either  by  locks  or  valves  (flushing-gates)  to  retain  a  portion  of  the  contents  for  a  time, 
and  then  set  them  free  suddenly  in  order  to  flush  the  next  section,  or  by  special  arrange- 
ments, such  as  Field's  flush-tank. 


KEMOVAL    OF    EXCEETA. 


29 


Access  to  Sewers. 

It  is  of  importance  that  to  all  sewers  capable  of  being  entered  by  a  man, 
there  should  be  an  easy  mode  of  access.  Man-holes  opening  above,  or, 
what  is  better,  at  the  side,  should  be  provided  at  such  frequent  intervals, 
that  the  sewers  can  be  entered  easily  and  inspected  at  all  points.  The 
man-holes  are  sometimes  provided  with  an  iron  shutter  to  prevent  the 
sewer  air  passing  into  the  street,  or  by  the  side  of  the  man-hole  there  may 
be  a  ventilating  chamber. ' 

■  Calculation  of  Discharge  from  Sewers.^ 

Several  formulae  have  been  given,  of  which  the  following  is  the  most 
simple : — 

V  =  55  X  (y  D  X  2F). 

V  =  velocity  in  feet  per  minute. 
D  =  hydraulic  mean  depth. 

F  =  fall  in  feet  per  mile. 

Then,  if  A  =  section  area  of  current  of  fluid,  VA  =  discharge  in  cubic  feet 
per  minute. 

To  use  this  formula,  the  hydraulic  mean  depth  when  the  sewage  is 
flowing,  and  the  amount  of  fall  in  feet  per  mile,  must  be  first  ascertained. 
The  hydraulic  mean  depth  is  :^th  the  diameter  in  circular  pipes  ;  in  pipes 
other  than  circular,  it  is  the  section  area  of  current  of  fluid  divided  by  the 
wetted  perimeter.     The  wetted  perimeter  is  that  part  of  the  circumference 

*  Mr.  Baldwin  Latham  joins  the  sewers  in  man-holes,  so  that  if  one  is  blocked  an- 
other may  be  used ;  the  outlet  being  at  the  lower  level. 

^  The  following  table,  taken  from  Mr.  Wicksteed,  will  be  found  useful: — 

Sewers. 


Diameter. 


Velocity 

in  feet  per 

minute. 


Gradient 
required. 


inches 240 1  in 


9 
10 
15 


220. 
220. 
220. 
210. 
180. 


36 
65 

87 

98 

119 

244 


Velocity 
Diameter.  in  feet  per 

minute. 

18  inches 180 1 


180. 
180. 
180. 
180. 
180. 


Gr.idient 
required. 

in   294 
"    343 


392 
490 

588 
784 


Mr.  Latham  (Lectures  on  Sanitary  Engineering,  delivered  to  the  Royal  Engineers 
at  Chatham)  gives  a  table,  of  which  the  following  is  an  extract : — 


Diameter  in  inches. 

Rate  of  inclination  for  velocity  per  second. 

2  feet. 

3  feet. 

4  feet 

5  feet. 

6  feet. 

4 

1.194 

1.92 

1.53 

1.34 

1.24 

6 

292 

389 

137 
183 

80 
106 

51 
69 

36 

8 

48 

9 

437 

206 

119 

77 

54 

10 

486 

229 

133 

86 

60 

12 

583 

275 

159 

103 

72 

In  this  table  the  velocity  in  feet  multiplied  by  the  inclination  equals  the  length  of 
the  sewer  to  which  the  calculation  applies.  For  example,  if  the  velocity  is  6  feet  per 
second  in  a  pipe  whose  diameter  is  4  inches,  then  6  x  24  =  144  feet  is  the  length  of  the 
sewer, 


30  PRACTICAL    HYGIENE. 

of  the  pipe  wetted  by  the  fluid.  The  fall  in  feet  per  mile  is  easily  ob- 
tained, as  the  fall  in  50  or  100  or  200  feet  can  be  measui-ed,  and  the  fall 
per  mile  calculated  (5,280  feet  =  1  mile). 

Movement  of  Air  in  the  Sewers  and  Ventilation. 

It  seems  certain  that  no  brick  sewer  can  be  made  air-tight ;  for  on  ac- 
count of  the  numerous  openings  into  houses,  or  from  leakage  through 
brickwork,  or  exit  through  gratings,  man-holes,  and  ventilatmg  shafts,  the 
au-  of  the  tubes  is  in  constant  connection  with  the  external  air.  There  is 
generally,  it  is  beheved,  a  cuiTent  of  air  with  the  stream  of  water  if  it  be 
rapid.  The  tension  of  air  in  main  sewers  is  seldom  very  different  fi-om 
that  of  the  atmosphere,  or  if  there  be  much  difference  equihbrium  is 
quickly  restored.  In  twenty-three  obsei-vations  on  the  air  of  a  Liverpool 
sewer,  it  was  found  by  Drs."^Parkes  and  Burdon-Sanderson,'  that  in  fifteen 
"cases  the  tension  was  "less  in  the  sewer  than  in  the  atmosphere  outside 
(i.e.,  the  outside  air  had  a  tendency  to  pass  in),  and  in  eight  cases  the 
reverse  ;  but  on  the  average  of  the  whole  there  was  a  sHght  indraught  into 
the  sewer.  In  the  London  sewers,  on  the  other  hand,  Sanderson  noticed 
an  excess  of  pressure  in  the  sewers. 

If  at  any  time  there  is  a  very  rapid  flow  of  water  into  a  sewer,  as  in 
heavy  rains,  the  au-  in  the  sewer  must  be  displaced  ^^dth  great  force,  and 
possibly  may  force  weak  traps ;  but  the  pressui-e  of  aii'  in  the  sewers  is  not 
appreciably  affected  by  the  rise  of  the  tide  in  the  case  of  seaboard  towns.  ^ 
The  tide  rises  slowly,  and  the  au-  is  displaced  so  equably  and  gTadually 
through  the  numerous  apei-tures,  that  no  movement  can  be  detected.  It 
is  not  possible,  therefore,  that  it  can  force  water-traps  in  good  order,  when 
there  are  sufficient  ventilating  apertures. 

On  the  contrai-y,  the  blowing  off  of  steam,  or  the  discharge  of  au-  from 
an  au--pump  (as  in  some  trade  operations),  gi-eatly  heightens  the  pressure, 
and  might  drive  air  into  houses.  So  also  the  wind  blowing  on  the  mouth 
of  an  open  sewer  must  force  the  aii-  back  with  great  force. 

It  is,  therefore,  important  to  protect  the  outfall  mouth  of  the  sewer 
against  wind  by  means  of  a  flap,  and  to  prohibit  steam  or  aii-  being  forced 

into  sewers.  i  •  i    <! 

To  how  great  an  extent  it  is  the  openings  into  houses  which  thus  re- 
duce the  tension  of  the  aii-  in  main  sewers  is  difficult  to  say,  but  there  can 
be  httle  doubt  that  a  large  efiect  is  produced  by  houses  which  thus  act  as 
ventilating  shafts.  .       . 

When  a  sewer  ends  in  a  cul-de-sac  at  a  high  level,  sewer  gas  wiU  nse 
and  press  with  some  force  ;  at  least  in  one  or  two  cases,  the  openmg  of 
such  a  cul-de-sac  has  been  foUowed  by  so  strong  a  i-ush  of  au-  as  to  show 
that  there  had  been  considerable  tension.  It  is  also  highly  probable,  from 
the  way  in  which  houses  standing  at  the  more  elevated  pai-ts  of  sewers, 
and  communicating  -svith  them,  ai-e  annoyed  by  the  constant  entrance  of 
sewer  air,  while  houses  lower  down  escape,  that  some  of  the  gases  may  nse 
to  the  higher  levels. 

That  no  sewer  is  air-tight  is  certain,  but  the  openings  thi-ough  which 
the  air  escapes  are  often  those  we  should  least  desire.  It  is  therefore  ab- 
solutely necessai-y  to  proride  means  of  exit  of  foul  and  entrance  of  fi-esh 
air,  and  not  to  rely  on  accidental  openmgs.     The  air  of  the  sewer  should 

'  Report  on  the  Sanitary  Condition  of  Liverpool,  1870,  p.  27. 

2  Vide  same  Report,  p.  21,  for  the  case  of  Liverpool.  Dr.  Corfield's  observation  at 
Scarborough  was  coniirmatorj. 


REMOYAL    OF    EXCRETA.  31 

be  placed  in  the  most  constant  connection  with  the  external  aii',  by  making 
openings  at  every  point  where  they  can  be  put  with  safety.  In  London 
there  are  numerous  gratings  which  open  directly  into  the  streets,  and  this 
plan,  simple  and  apparently  rude  as  it  is,  can  be  adopted  with  advantage 
whenever  the  streets  are  not  too  narrow.  But  in  narrow  streets  the  sewer 
gratings  often  become  so  offensive  that  the  inhabitants  stop  them  up.  In 
such  cases  there  must  be  ventilating  shafts  of  as  large  a  diameter  as  can 
be  afforded,  and  running  up  sufficiently  high  to  safely  discharge  the  sewer 
air. '  In  some  of  these  cases  it  may  be  possible  to  connect  the  sewers  vdth 
factory  chimneys.^  The  sewer  should  never  be  connected  with  the  chim- 
neys of  dweUiag-houses. 

In  making  openings  in  sewers  it  seems  useless  to  follow  any  regular 
plan.  The  movement  of  the  sewer  aii-  is  too  iiTCgular  to  allow  us  to  sup- 
pose it  can  ever  be  got  to  move  in  a  single  direction,  though  probably  the 
most  usual  course  of  the  air  current  is  with  the  stream  of  water,  if  this  be 
rapid.  The  openings  should  be  placed  wherever  it  can  conveniently  be 
done  without  creating  a  nuisance.  Some  of  these  openings  will  be  inlets, 
others  outlets,  but  in  any  case  dilution  of  the  sewage  effluvia  is  sure  to  b© 
obtained.  jVIi*.  Kawlinson  considers  that  cverj'  main  sewer  should  have  one 
ventilator  every  100  yards,  or  18  to  a  mile,  and  this  should  be  a  large  effec- 
tive  opening.' 

But  there  may  be  cases  when  special  appliances  must  be  used.  For 
example,  in  what  are  called  "sewers  of  deposit,"  as  when  the  outflow  of 
the  sewer  water  is  checked  for  several  hours  daily  by  the  tide  or  other 
causes,  it  may  be  necessary  to  pro\ide  special  shafts,  and  the  indication 
for  this  will  be  the  evidence  of  constant  escape  of  sewer  air  at  particular 
points. 

The  use  of  charcoal  trays  has  not  answered  the  expectations  that  were 
formed  of  them. 

Inspection  of  Seivers. 

The  inspection  of  sewers  is  in  many  towns  a  matter  of  great  difficulty, 
on  account  of  the  means  of  access  being  insufficient,  and  also  because  the 
length  of  the  sewers  is  so  great.  Still  inspection  is  a  necessity,  especially 
in  the  old  flat  sewers,  and  should  be  systematically  carried  out,  and  a  record 
kept  of  the  depth  of  water,  the  amount  of  deposit,  and  of  sewer  shme  on 
the  side  or  roof. 

Choking  of  and  Deposits  in  Sewers — Causes. — Original  bad  construction  ; 
too  httle  fall  ;  sharp  cuiwes  ;  sinking  of  floor ;  want  of  water  ;  check  of 
flow  by  tides,  so  that  the  heavy  parts  subsidy 

Well-made  sewers  with  a  good  supply  of  water  are  sometimes  self- 
cleansing,  and  quite  free  from  deposit,  but  this  is,  unfortunately,  not  al- 
ways the  case. 

Even  in  so-called  self-cleansing  sewers,  it  has  been  noticed  by  ]Mr. 
Rawlinson  that  the  changing  level  of  the  water  in  the  sewers  leaves  a  de- 
posit on  the  sides,  which,  being  alternately  wet  and   dry,  soon  putrefies. 

'  In  Liverpool  there  were  small  shafts  with  Archimedean  screws  at  the  top.  From 
the  observations  of  Sanderson  and  Parkes,  it  appears  that  these  screws  did  act,  but  not 
to  such  an  extent  as  to  warrant  the  expense. 

^  It  seems  inadvisable  to  erect  chimneys  and  use  fires  with  an  idea  of  ventilating  the 
sewers  on  a  general  plan,  the  air  would  simply  be  drawn  with  great  force  through  the 
nearest  openings.  But  local  ventilation  by  a  factory  chimney,  when  gratings  cannot  be 
used,  is  a  different  thing. 

^  Others  have  recommended  1  in  50  yards. 


32  Pr.ACTICAL    HYGIENE. 

In  foul  sewers  a  quantity  of  slimy  matter  collects  on  the  crown  of  the 
sewers  ;  it  is  sometimes  2  to  4  inches  in  thickness,  and  is  highly  offensive. 
When  obtained  from  a  Livei-jiool  sewer  by  Drs.  Parkes  and  Burdon-Sander- 
son,  it  was  found  alkaline  from  ammonia  and  containing  nitrates.'  On 
microscopic  examination,  this  Liverpool  sewer  slime  contained  an  immense 
amount  of  fungoid  growth  and  Bacteria,  as  well  as  some  Conferixe.  There 
were  also  Acari  and  remains  of  other  animals  and  ova. 

When  deposits  occur,  they  ai-e  either  removed  by  the  sewer-men,  or 
they  are  carried  away  by  flushing  of  Avater. 

Flushing  of  Sewers. — This  is  sometimes  done  by  simply  carrying  a  hose 
from  the  nearest  hydrant  into  the  sewer,  or  reservoirs  are  provided  at  cer- 
tain points  which  are  suddenly  emptied.  The  sewer  water  itself  is  also 
used  for  flushing,  being  dammed  up  at  one  point  by  a  flushing  gate,  and 
when  a  sufficient  cjuantity  has  collected  the  gate  is  opened."  An  automatic 
system  is  however  preferable,  such  as  is  carried  out  by  Field's  annular 
siphon,  befoi-e  mentioned. 

Almost  all  engineers  attach  great  importance  to  regular  flushing,  and 
almost  the  only  advantage  of  allowing  the  rain  to  enter  the  sewers  is  the 
scouring  effect  of  a  heavy  rainfall  which  is  thus  obtained.  This,  however, 
is  so  irregular  that  it  is  but  a  doubtful  benefit. 

Disposal  of  the  Sewer  Water 

The  great  engineering  skill  now  available  in  all  civilized  countries  can 
insure  in  the  case  of  any  new  works  that  the  construction  of  sewers  shall 
be  perfect.  If  an  engineer  can  obtain  good  materials,  good  workmen,  and 
a  jDroper  supply  of  water,  there  is  no  doubt  that  sewers  can  be  so  solidly 
constructed  and  so  well  ventilated  that  the  danger  of  deposits  in  the 
sewers,  or  of  sewer  air  entering  and  carrying  disease  into  houses,  is  re- 
moved. 

But  the  difficulty  of  the  plan  of  removing  excreta  by  water  really  com- 
mences at  the  outfall.     How  is  the  sewer  water  to  be  disposed  of  ? 

This  difficulty  is  felt  in  the  case  of  the  foul  water  flowing  from  houses 
and  factories  without  admixture  of  excreta  almost  as  much  as  in  sewer 
water  with  excreta.  The  exclusion  of  excreta  from  sewers,  as  far  as  it  can 
be  done,  would  not  solve  the  problem — would,  indeed,  hardly  lessen  its 
difficulty.  In  seaboard  towns  the  water  may  flow  into  the  sea,  but  in  in- 
land towns  it  cannot  be  discharged  into  rivers,  being  now  px'ohibited  by 
law.  Independent  of  the  contamination  of  the  drinking  water,  the  sewer 
water  often  kills  fish,  creates«a  nuisance  which  is  actionable,  and  in  some 
cases  silts  up  the  bed  of  the  stream.  It  requires  in  some  way  to  be  puri- 
fied before  discharge.  At  the  present  moment  the  disposal  of  the  sewer 
water  is  the  sanitary  problem  of  the  day,  and  it  is  impossible  to  be  certain 
Avhich  of  the  many  pmns  may  be  finally  adopted.  It  Avill  be  convenient  to 
briefly  describe  these  jDlans. 

'  Report  on  the  Sanitary  State  of  Liverpool,  by  Drs.  Parkes  and  Burdon-Sanderson, 
1871.  The  amount  of  free  ammonia  was  .025  parts  per  cent.  ;  the  albuminoid  ammonia 
was  .004G2,  and  the  nitric  acid  .2035  parts  per  cent.  Photographs  are  given  of  the  mi- 
croscopic appearances  of  the  slime  in  this  report. 

'-'  Baldwin  Latham  points  out  that  there  is  a  point  of  flow  in  all  sewers  when  they 
discharge  more  than  when  running  full.  A  good  flushing  power  may  be  obtained  at 
considerably  less  than  the  full  discharge.    Tables  are  given  in  his  Sanitary  Engineering. 


EEMOVAL  OF  EXCEETA.  33 


1.  STORAGE  IN  TANK,  WITH  OVERFLOW. 

The  sewer  water  runs  into  a  cemented  tank  with  an  overflow-pipe,  which 
sometimes  leads  into  a  second  tank  similarly  arranged  ;  the  solids  subside, 
and  are  removed  from  time  to  time  ;  the  liquid  is  allowed  to  run  away. 
Instead  of  letting  the  liquid  run  into  a  ditch  or  stream,  it  has  been  sug- 
gested to  take  it  in  drain  pipes,  ^  to  1  foot  under  ground,  and  so  let  it  es- 
cape in  this  way  into  the  subsoil,  where  it  will  be  readily  absorbed  by  the 
roots  of  grasses.  The  fat,  grease,  and  coarser  solids  may  be  intercepted 
by  a  strainer,  and  daily  removed  and  mixed  with  earth.  The  liquid  por- 
tions may  be  discharged  periodically  by  means  of  the  automatic  flush-tank.' 
In  a  light  soil  this  could  no  doubt  be  readily  done  ;  <fand,  if  the  drain  pipes 
are  well  laid,  a  considerable  extent  of  grass  land  could  be  supplied  by  this 
subterranean  irrigation.  The  tank  plan  is,  however,  only  adapted  for  a 
small  scale,  such  as  a  single  house  or  small  village,  and  there  should  be 
ventilation  between  the  tank  and  the  house  m  all  cases.  This  plan  is  ap- 
plicable to  the  disposal  of  slop-waters  in  villages,  even  when  the  excreta 
are  dealt  with  by  dry  methods. 

2.    DISCHARGE    AT    ONCE   INTO    RUNNING   WATER. 

All  new  works  of  this  descrij)tion  are  now  prohibited,  and  the  plan  will 
probably  ultimately  cease  in  this  country.  ° 

3.    DISCHARGE   INTO    THE   SEA. 

The  outlet  pipe  must  be  carried  to  low  water,  and,  if  possible,  should 
be  always  under  water.  A  tide  flap  opening  outward  is  usually  provided. 
If  not  under  water  constantly,  special  care  must  be  taken  to  prevent  the 
wind  blowing  up  the  sewers.  The  tide  will  fill  the  outfall  sewers  (which 
are  generally  made  large)  to  the  level  of  high  water,  and  to  that  extent 
vdll  check  the  discharge,  and  in  the  sewers  filled  with  the  mixed  sea  water 
and  sewage  there  will  be  deposit.  To  remove  this  special  attention  is  ne- 
cessary. 

'  See  Mr.  Rogers  Field's  evidence,  Annual  Conference  on  the  Progress  of  Public 
Health  at  the  Society  of  Arts,  1880. 

^  When  the  sewer  water  passes  into  a  river  it  undergoes  considerable  purification  by 
subsidence,  by  the  influence  of  water  plants,  and  in  a  lesser  degree  by  oxidation.  Al- 
though some  oxidation  of  nitrogenous  organic  matters  into  nitrous  and  nitric  acids  and 
ammonia  must  take  place,  it  appears  from  Franklin's  experiments,"*  that  in  the  River 
Irwell,  which  receives  the  sewage  of  Manchester,  after  a  run  of  11  miles,  and  falling 
over  six  weirs,  there  is  no  formation  of  nitrites  and  nitrates,  and  there  is  even  an  in- 
crease in  the  organic  nitrogen  (V),  though  the  suspended  matters  are  less  (from  2.8  to 
1.44  parts  per  10,000)  than  at  first.  Average  London  sewage  diluted  with  9  parts  of 
water  and  siphoned  from  one  vessel  into  another  so  as  to  represent  a  flow  of  9G  and  192 
miles,  gave  a  percentage  reduction  in  the  organic  nitrogen  of  28.4  and  38.3  respectively. 
The  oxidation  of  sewage  appears,  then,  from  these  experiments,  to  take  place  slowly. 
Dr.  Letheby  considers,  however,  that  oxidation  takes  place  more  rapidly,  and  that  if 
sewage  is  mixed  with  20  times  its  bulk  of  water,  and  flows  for  9  miles,  it  will  be  per- 
fectly oxidized.*  Of  course,  it  is  clear  that  ova,  and  solid  parts  of  the  body,  like  epi- 
thelium, might  be  totally  unchanged  for  long  periods,^  and  we  may  conclude  that  oxi- 
dation of  sewage  in  running  water  cannot  be  depended  on  for  perfect  safety, 

3  Reports  of  the  Commissioners  appointed  to  inquire  into  the  Pollution  of  Rivers,  1870,  vols,  i.,  ii., 
and  iii. 

*  Reports,  of  Bast  London  Water  Bill  Committee  (1867),  p.  430,  questions  732-4. 

6  As  formerly  mentioned,  Dr.  Parkes  found  unchanged  epithelium  in  unfiRered  "Jhames  water  after  a 
transit  in  a  barrel  of  180  miles,  and  after  keeping  for  five  months.  It  was  transparent  and  worn,  but  quite 
recognizable. 

Vol.  II. -^^. 


34  PRACTICAL    HYGIENE. 

If  the  sewage  cannot  be  got  well  out  to  sea,  and  if  it  issues  in  naiTow 
channels,  it  may  cause  a  nuisance,  and  may  require  to  be  purified  before 
discharge.  In  the  Rivers  Pollutions  Act  (187(5)  power  is  given  to  prohibit 
dischai'ge  into  the  sea  or  tidal  waters  under  certain  cii'cumstances. ' 

4.    PRECIPITATION. 

Another  jalan  is  not  to  pour  the  whole  sewage  into  rivers,  but  to  pre- 
cipitate the  solid  part,  or  the  greater  portion  of  it,  and  then  to  allow  the 
liquid  to  pass  into  the  stream  or  over  the  land. 

This  is  sometimes  done  by  simple  subsidence,  the  sewage  being  received 
into  settling  reservoirs  or  trenches,  with  strainers  to  arrest  the  flow  to  some 
extent.  When  the  soKd  matter  has  collected  to  a  certain  amount,  the  sew- 
age is  turned  into  another  reservoir,  and  the  thick  j^art,  being  mixed  with 
coal  refuse  or  street  sweej)ings,  is  sold  as  manure. 

The  thin  water  which  runs  off  must  be  almost  as  dangerous  as  the  sew- 
age itself  when  poured  into  streams,  and  consequently  the  prohibition  to 
discharge  sewer  water  extends  to  it  also. 

In  order  to  produce  greater  purification,  the  sewage  in  the  subsiding 
tanks  is  now  usually  mixed  with  some  chemical  agents  which  may  precipi- 
tate the  suspended  matters. 

Numerous  substances  have  been  employed  as  precipitants.'' 

Lime  Salts. — Quicklime  (proportion  8  to  12  grains  per  gallon),  or  1  ft 
of  hme  for  600  gallons  of  sewage  (nearly) ;  chloride  of  lime,  which  is  added 
to  quicklime  in  the  proportion  of  about  ^V^li  part  of  chloride  to  1  of  hme  ; 
calcic  phosphate  dissolved  in  sulphuric  acid,  or  a  mixture  of  mono-  and  di- 
calcic  phosphate  with  a  Httle  liine  (Whitthread's  patent),'  are  said  to  be 
good  precipitants.     Chloride  of  calcium  has  also  been  recommended. 

Aluminous  /S'ti^sto^ices. 7— Aluminous  earth  mixed  with  sulphuric  acid 
(Bird's  process)  ;  impure  sulphate  of  aluminum  (Anderson's  and  Lenk's 
processes)  ;  refuse  of  alum  works,  either  alone  or  mixed  with  Kme  or  char- 
coal ;  clay  mixed  with  lime  (Scott's  cement  process) ;  natural  phosphate  of 
aluminum  dissolved  by  sulphuric  acid  and  mixed  with  lime.  In  all  these 
cases  the  amount  of  the  substance  added  is  from.  50  to  80  grains  per  gallon 
of  sewer  water, 

Magnesian  Salts  mixed  with  lime  in  the  form  of  superphosphates  (Blyth) ; 
impure  chloride  of  magnesium. 

Carbon  in  the  shape  of  vegetable  charcoal  ;  peat ;  sea-weed  charcoal ; 
carbonized  tan  ;  lignite  ;  Boghead  coke. 

'  The  word  "  stream  "  (into  which,  sewage  is  not  to  be  passed)  is  defined  by  section 
20  of  the  Act,  thus: — "  Stream  includes  the  sea  to  such  extent  and  tidal  waters  to  such 
point,  as  may,  after  local  inquiry  and  on  sanitary  grounds,  be  determined  by  the  Local 
Government  Board,  by  order  published  in  the  London  Gazette.  Save,  as  aforesaid,  it 
includes  rivers,  streams,  canals,  lakes,  watercourses,  other  than  watercourses,  at  the 
passing  of  this  Act,  mainly  used  as  sewers,  and  emptying  directly  into  the  sea  or  tidal 
waters,  which  have  not  been  determined  to  be  streams  within  the  meaning  of  this  Act 
by  such  order  as  aforesaid." 

■^  An  interesting  account  of  the  precipitating  process  is  given  in  a  book  called  The 
Sewage  Question,  the  author  of  which  has  had  the  advantage  of  Dr.  Letheby's  notes  and 
analyses.  A  list  of  no  less  than  57  processes  or  proposals  is  given  at  page  88,  from 
which  it  appears  that  the  first  precipitant  was  proposed  by  Deboissieu  so  long  ago  as 
1762,  and  was  a  mixture  of  acetate  of  lead  and  proto-sulphate  of  iron. 

■^  This  patent  was  found  to  give  good  results  in  removing  suspended  matters  and  or- 
ganic nitrogen,  a7id  the  Committee  of  the  British  Association  considered  the  process  de- 
served "further  investigation."  It  appears,  however,  to  have  come  at  present  to  a 
standstill. 


REMOVAL    OF    EXCKETA.  35 

Iron  in  fhe  shape   of    sulj^bate ;  percliloiide  (Ellerman's  and    Dale's 
liquid)  ;  the  sulphate  is  sometimes  mixed  vrith  lime  and  coal  dust. 
Manganese. — Coudy's  fluid. 
Zinc  suli^hate  and  chloride. 

The  deposit  obtained  from  any  of  these  processes  is  collected  and  dried. 
It  is  usually  dried  on  a  hot  floor,  a  stream  of  hot  air  being  allowed  also  to 
pass  over  it.  There  is  some  little  difficulty  in  dryiag  it,  but  this  is  now 
being  overcome.  Of  these  various  precipitants  the  best  appear  to  be  the 
aluminous  preparations  ;  the  crude  sulphate  of  aluminum  prepared  by  Dr. 
Anderson,  of  Coventry  ;  the  solution  patented  by  'Six.  Lenk  ;  the  ABC  pro- 
cess of  six.  Sillar,  which  consists  of  alum,  blood,  charcoal,  and  clay ;'  and 
Six.  Forbes's  sulphiiric  acid  solution  of  natiu'al  phosphate  of  aluminum. 
All  produce  rapid  subsidence  of  the  suspended  matters,  and  clarify  the 
liquid  to  a  very  great  extent.  The  sulphuric  acid  also  tends  to  prevent  de- 
composition of  the  deposit.  In  using  these  substances  the  sewage  water 
is  received  into  a  tank  or  well,  and  there,  or  on  its  way  thither,  receives 
the  jDrecipitating  agent,  which  is  generally  mixed  by  means  of  a  screw  or 
turbine.  After  thorough  mixing,  the  precipitate  is  allowed  to  subside,  and 
the  superabundant  water  is  run  off.  The  deposit  is  then  dug  out  and 
dried.  After  drying  the  deposit  apjDears  to  possess  some  agricultural 
value,'  and  to  be  saleable  at  a  price  which,  in  some  cases,  leaves  a  small 
profit.  The  profit  is  never  large,  and  in  some  instances  there  has  been 
even  a  loss.  The  clear  water  from  all  these  processes  contains  ammonia 
and  oxidizable  organic  matters,  as  well  as  j)hosphoric  acid  (in  most  cases) 
and  potash,  and  it  would  thus  appear  that  a  considerable  pai-t  of  the  sub- 
stances which  give  fertilizing  power  to  sewage  remain  in  the  effluent  water. 
The  caustic  hme  process,  when  properly  apjDhed,  appears  also  to  be  a 
powerful  precipitant,  but  the  deposit  has  no  agiicultiu'al  value. 

The  metalhc  precipitants  of  various  kinds  (iron,  zinc,  manganese)  are 
more  expensive  and  less  useful.  Blyth's  magnesian  process  was  unfavor- 
ably reported  on  by  ^Ir.  "Way. 

When  the  sewer  water  is  cleai-ed  by  any  of  these  plans,  is  it  fit  to  be 
discharged  into  streams  ?  In  the  opinion  of  some  authorities,  if  the  pre- 
ciiDitate  is  a  good  one  it  may  be  so,  and  it  appeal's  certain  that  in  many 
cases  it  is  chemically  a  tolerably  pure  water,  and  it  will  no  longer  silt  up 
the  bed  or  cause  a  nuisance.  But  it  still  contains  in  all  cases  some  organic 
matter,  as  weU  as  ammonia,  potash,  and  phosphoric  acid. ''  It  has,  there- 
fore, fertilizing  powers  certainly,  and  possibly  it  has  also  injurious  powers. 
No  proof  of  this  has  been  given,  but  also  no  disproof  at  jDresent,  and  when 
we  consider  how  small  the  agencies  of  the  sj^ecific  diseases  j^robably  are, 

^  The  proportions  are  stated  to  be,  6  grains  of  alum,  i  grain  of  blood,  20  grains  of 
clay,  and  (j  grains  of  charcoal,  to  10,000  grains  of  sewer  water.  Sometimes  a  little  lime 
is  added. 

-  Tills  never  exceeds  one-tbird  of  the  theoretical  or  chemical  value.  Thus  the  pro- 
duct by  Anderson's  process  at  Coventry  is  estimated  theoretically  at  i6s.  9-J^d.  per  ton ; 
the  practical  value  is  only  5s.  6d.  to  8s.  4d.  See  Dr.  Yoelcker's  Reports,  in  the  Report 
of  a  Committee  on  Town  Sewage  (1875),  p.  Ix   et  seq. 

^  Many  analyses  are  given  in  the  First  and  Second  Reports  of  the  Rivers  Pollution 
Commissioners,  from  which  it  appears  that  on  an  average  the  chemical  processes  re- 
move 89.8  per  cent,  of  the  suspended  matters,  but  only  36.6  per  cent,  of  the  organic 
nitrogen  dissolved  in  the  liquid,  ilr.  Crookes's  analyses  show  that  the  ABC  process, 
when  well  carried  out,  removes  all  the  phosphoric  acid.  Yoelcker's  analysis  of  the  ef- 
fluent water  treated  by  the  acid  phosphate  of  aluminum  shows  that  it  contains  more 
ammonia  than  the  original  sewer  water,  less  organic  nitrogen  by  one-half,  and  less 
phosphoric  acid  ;  it  is  pure  enough  to  be  discharged  into  streams. 


36  PRACTICAL    HYGIENE. 

and  how  likely  it  is  that  they  remain  suspended,  Ave  do  not  seem  to  be  in  a 
jDosition  to  expect  that  the  water,  after  the  subsidence  of  the  deposit,  will 
be  safe  to  di'ink.  We  must  adojjt  here  the  j^lan  which  is  the  safest  for  the 
community  ;  and  the  effluent  water  should  therefore  be  used  for  irrigation, 
or  be  filtei'ed  before  discharge.  The  clear  fluid  is  well  adapted  for  market 
gai'dens  ;  the  plants  gTown  as  vegetables  for  the  table  are  sometimes  in- 
jured by  iiTigation  with  unpuiified  sewer  water,  but  they  thiive  with  the 
purified  effluent  water. 

In  arranging  any  processes  for  precipitation  evei-jihing  must  be  as 
simple  as  possible  ;  there  is  no  margin  for  expenditui-e  or  comjDhcated  ar- 
rangements. 

Sewage  Cement. 

Instead  of  using  the  dried  dejDOsit  as  manvu'e.  General  Scott  has  pro- 
posed to  make  cement,  and  for  this  pui^iose  adds  Ume  and  clay  to  the 
sewer  water.  The  deposit  contains  so  much  combustible  matter  that  it 
requu-es  less  coal  to  burn  it  than  would  otherwise  be  the  case,  and  the 
saving  thus  effected  enables  (it  is  supposed)  cement  to  be  sold  at  a  remu- 
nerative rate.  If  this  should  iwro.  out  to  be  the  case,  the  sewage  cement 
process  has  the  advantage  of  destroying  by  fire  everything  which  might  be 
injurious  in  the  deposit,  while  the  efiluent  water,  which  contains  rather 
more  than  two-thirds  of  the  chlorine  and  thi-ee-fourths  of  the  dissolved 
nitrogen,  has  some  value  as  an  ii-rigator.  At  present  the  pecuniary  re- 
sults of  the  process  cannot  be  properly  determined.  General  Scott  also 
proposes  to  use  the  burnt  material  as  maniu-e  to  Ume  the  land  in  some 
cases. 

5.    FILTRATION    THKOUGH    EAETH,    CHAECOAL,    ETC. 

By  filtration  through  earth  is  meant  the  bringing  of  sewer  water  upon 
a  comparatively  small  area  of  porous  soil,  which  is  broken  up  and  com- 
minuted above,  and  is  deeply  underdrained,  so  that  the  sewer  water  may 
pass  through  the  soil  and  issue  by  the  drains.  IVIi*.  Dyke,  in  explaining 
the  system  employed  at  MerthjT-Tydvil '  by  Mr.  Bailey  Denton,  lays  down 
the  following  conditions  : — There  should  be — 1st,  a  jDorous  soil ;  2d,  an 
effluent  drain,  not  less  than  6  feet  from  the  surface  ;  3d,  proj^er  fall  of  land 
to  allow  the  sewage  to  spread  over  the  whole  land  ;  and  4th,  division  of 
filtering  area  into  four  parts,  each  part  to  receive  sewage  for  six  hours, 
and  to  have  an  intei-A^al  of  eighteen  hours.  He  considers  that  an  acre  of 
land  would  take  100,000  gallons  per  day,  though  this  seems  a  rather  large 
amount.  At  MerthjT-TydvU  20  acres  of  land  were  divided  into  beds, 
which  sloped  toward  the  effluent  di-ain  b}'  a  fall  of  1  in  150.  The  surface 
was  j^loughed  in  ridges,  on  which  vegetables  were  sown ;  the  sewage 
(strained)  passed  from  a  earner  along  the  raised  margin  of  each  bed  into 
the  fuiTows.  The  effluent  water  was  stated  to  be  pure  enough  to  be  used 
for  di'ink.  Since  1872  these  filter-beds,  as  weU  as  230  acres  of  other  por- 
tions of  the  land,  have  been  used  as  ordinary  irrigation  ground.  The 
effluent  water  remains  bright  and  pure.^  Another  case  of  marked  success 
with  intermittent  filtration  is  that  of  Kendal.  The  best  soil  for  filtration 
appears  to  be  a  loose  marl,  containing  hydrated  ii'on  oxide  and  alumina, 
but  sand  and  even  chalk  produce  excellent  results.     But  in  order  that  fil- 

'  On  the  Downward  Intermittent  Filtration  of  Sewage  at  Mertliyr-Tydvil,  bv  T.  J. 
Dyke,  F.R.C.S.  Eng. 

'  Report  on  Town  Sewage. 


REMOVAL    OF    EXCRETA.  37 

tration  shall  bs  successful  it  is  necessary  that  the  amount  of  filtering  mate- 
rial shall  be  large  ;  it  must  not  be  less  than  1  cubic  yard  for  8  gallons  of 
sewage  in  twenty-four  houx'S,'  and  in  the  case  of  some  soils  must  be  more. 
If  the  drains  are  6  feet  below  the  sui-face,  then  an  acre  will  contain  9,680 
cubic  yards  of  filtering  material,  and  at  8  gallons  per  yard  an  acre  woiild 
suffice  for  77,440  gallons.  Crops  may  be  grown  on  the  land,  and  indeed 
it  is  desirable  that  they  should  be. 

When  the  filters  are  too  small,  they  fail  to  do  much  good  ;  and  Letheby 
has  given  analyses  which  prove  that  small  filters  may  be  nearly  useless.  It 
apj)ears  undesu-able  to  use  charcoal  filters  on  this  account,  and  all  filtration 
through  chai'coal  has  been  a  failui-e.  Spongy  iron  has  been  lately  veiy 
strongly  recommended.     Garferal  has  also  been  suggested. 

Filtration  may  be  downward  or  upward,  but  the  former  kind  is  much 
more  efficacious.     UiDward  filtration  may  be  said  to  be  now  abandoned. 

Condition  of  the  Effluent  Water. — When  5.6  gallons  of  sewage  were  fil- 
tered in  twenty-foui'  hoxu's  through  a  cubic  yard  of  earth,  it  was  found  by 
the  Eivers  Pollution  Commissioners  that  the  organic  carbon  was  reduced 
from  4.386  parts  to  .734,  and  the  organic  nitrogen  from  2.484  parts  to 
.108  parts  in  100,000.  The  whole  of  the  sediment  was  removed.  Nitrates 
and  nitrites,  which  did  not  exist  before  filtration,  were  found  afterward, 
showing  oxidation. 

6.    IKRIGATION.'^ 

By  irrigation  is  meant  the  passage  of  sewer  water  over  and  through  the 
soil,  with  the  view  of  bringing  it  as  speedily  as  possible  under  the  influ- 
ence of  gTOwing  plants.  For  this  piupose  it  is  desirable  that  the  sewer 
water  should  be  brought  to  the  land  in  as  fresh  a  state  as  possible.  In 
some  cases,  as  at  Carlisle,  carbolic  acid  in  small  quantities  has  been  added 
to  the  sewage  in  its  flow  for  the  purpose  of  preventing  decomposition,  and 
the  plan  appears  to  be  effectual.  The  sewer  water  is  usually  warmer  than 
the  ah'  at  all  times,  and  will  often  cause  growth  even  in  winter. 

The  effect  on  growing  plants,  but  especially  on  Italian  rye-grass,  is  very' 
great  ;  immense  crops  are  obtained,  although  occasionally  the  grass  is  rank 
and  rather  watery.  For  cereals  and  roots  it  is  also  well  adapted  at  certain 
periods  of  growth,  as  well  as  for  market  vegetables  when  the  viscid  parts 
are  separated.  When  the  sewer  water  permeates  through  the  soil  there 
occur — 1st,  a  mechanical  aiTest  of  suspended  matters  ;  2d,  an  oxidation  pro- 
ducing nitrification,  both  of  which  results  depend  on  the  porosity  and 
physical  attraction  of  the  soil ;  and,  3d,  chemical  interchanges.  The  last 
action  is  important  in  agriculture,  and  has  been  examined  by  Bischof, 
Liebig,  Way,'  Henneberg,  Warrington,'  and  others.     Hydrated  ferric  oxide 

'The  Rivers  Pollution  Commissioners  give  a  smaller  amount,  viz.,  5^  gallons  per 
cubic  yard ;  but  some  of  their  experiments  seem  to  show  that  we  must  increase  the 
amount.  For  example,  the  soil  at  Beddington  was  found  bj  them  to  have  a  remark- 
able power  of  nitrification  up  to  the  extent  of  7. 6  gallons  per  cubic  yard  in  twenty-four 
hours.  But  when  this  rate  was  doubled  nitrification  ceased,  and  the  soil  became 
clogged.  The  best  soil  experimented  on  (Dursley  soil),  containing  43  of  silica  and  18 
of  oxide  of  iron,  purified  9.9  gallons  in  twenty-four  hours  per  cubic  yard.  But  as  few 
soils  would  be  so  good,  the  limit  of  8  gallons  is  selected  in  the  text. 

■^  On  the  application  of  sewage  to  land  many  works  have  been  published.  Dr.  Cor- 
field's  work  on  the  Treatment  and  Utilization  of  Sewage,  2d  edition,  and  the  Report  of 
the  Committee  of  the  British  Association,  1872,  give  the  best  summary  of  the  subject 
up  to  date  of  publication.     Also  the  Report  of  the  Committee  on  Town  Sewage,  1876. 

^  Journal  of  Royal  Agricultural  Society,  vol.  xi. 

■*  Chemical  News,  May,  1870.  Warrington's  paper  gives  a  good  r'sume  of  the  sub- 
ject, and  many  original  experiments,  and  can  be  consulted  for  full  details. 


38  PRACTICAL    IIYGIE^-E. 

and  alumina  absorb  phosphoric  acid  from  its  salts,  and  a  highly  basic  com- 
pound of  the  acid  and  metallic  oxide  is  formed.  They  act  more  powerfully 
than  the  sihcates  in  this  v^aj.  The  hydrated  double  silicates  absorb  bases. 
Silicates  of  aluminum  and  calcium  absorb  ammonia  and  potassium  from 
all  the  salts  of  those  bases,  and  a  new  hydrated  double  silicate  is  formed,  in 
which  calcium  is  more  or  less  perfectly  replaced  by  potassium  or  ammonium. 
Humus  also  forms  insoluble  compounds  with  these  bases.  Absoi'ption  of 
potash  or  ammonia  is  usually  attended  with  separation  of  lime,  winch  then 
takes  carbonic  acid. 

The  soil  must  be  properly  prepared  for  sewage  ii-rigation  ;  either  a 
gentle  slope,  or  a  ridge  with  a  gentle  slope  on  each  side  of  about  30  feet 
wide,'  with  a  conduit  at  the  summit,  or  flat  basins  suiTounded  by  ridges, 
are  the  usual  plans.  The  sewer  water  is  allowed  to  trickle  down  the  slope 
at  the  rate  of  about  8  feet  per  hoiu',  or  is  let  at  once  into  the  flat  basin. 
The  water  passes  through  the  soil,  and  should  be  carried  off  by  drains  from 
5  to  6  feet  deep,  and  thence  into  the  nearest  water-course. 

The  sewer  water  should  reach  the  ground  in  as  fresh  a  state  as  possible  ; 
it  is  usually  run  through  coarse  strainers  to  arrest  any  large  substances 
which  find  their  way  into  the  sewers,  and  to  keep  back  the  grosser  parts 
which  form  a  scum  over  the  land  ;  it  is  then  received  into  tanks,  whence  it 
is  carried  to  the  land  by  gi-avitation,  or  is  pumped  up.  The  "  carriers  "  of 
the  sewer  water  are  either  simj^le  trenches  in  the  ground,  or  brick  culverts, 
or  concreted  channels,  and  by  means  of  simple  dams  and  gates  the  water 
is  directed  into  one  or  other  channel  as  may  be  required.  Everything  is 
now  made  as  simple  and  inexpensive  as  possible — underground  channels 
and  jets,  hydrants,  hose  and  jets,  are  too  expensive,  and  overweight  the 
plan  with  unnecessary  outlay. 

The  amount  of  land  required  is,  on  an  average,  1  acre  to  100  persons  ; 
this  is  equal  to  a  square  of  70  yards  to  the  side,  and  will  take  2,000  gallons 
in  twenty-four  hours. 

The  sewer  water  is  apphed  intermittently  when  the  plants  are  growing  ; 
but  in  winter  it  is  sometimes  used  constantly,  so  as  to  store  up  noui'ish- 
ment  in  the  soil  for  the  plant-growth  in  the  spring.^ 

The  amount  of  sewer  water  which  can  be  applied  will  yary  with  the 
kind  of  ground,  the  amount  of  rain,  and  the  season  of  the  year.  In  the 
year  ending  1871,  it  appeal's  that,  on  the  Lodge  fai'm  at  Barking,  622,324 
tons  of  sewage  were  applied  to  163  acres  (nearly),  or  about  3,800  tons  per 
acre.     In  the  six:teen  months  ending  December,  1872,  the  average  quantity 

^  This  was  the  arrangement  of  Mr.  Hope's  farm  at  Romford. 

'  See  an  interesting  paper  on  the  "  Utilization  of  the  Sewage  of  Paris,"  by  Sandford 
Moore,  B.A.,  Assist.-Surgeon,  4th  Dragoon  Guards  (Medical  Times  and  Gazette,  June, 
1870).  In  the  summer  "  arrosage  "  is  practised  ;  the  land  is  ploughed  in  furrows  and 
ridges,  and  the  water  is  allowed  to  flow  into  the  furrows,  and  not  allowed  to  wet  the 
vegetables  which  are  planted  on  the  ridges.  In  winter  "  colmatage  "  is  had  recourse  to ; 
the  ridges  are  levelled  and  the  entire  surface  is  submerged  under  sewage  water.  The 
sewers  of  Paris  receive  only  a  small  part  of  the  solid  excreta  (though  most  of  the  urine), 
but  the  fluid  is  highly  fertilizing.  Precipitation  with  alum  was  also  formerly  had 
recourse  to  in  Paris,  but  has  now  been  abandoned. 

For  detailed  information  see  tlie  Report  of  the  Prefecture  of  the  Seine,  Sur  I'Assai- 
nissement  de  la  Seine.  An  abstract  is  given  in  the  Annales  des  Ponts  et  Chaussees, 
and  is  translated  by  R.  Manning,  M.T.C.E.  (E.  &  F.  N.  Spon).  1870.  Similar  works 
are  in  process  at  Berlin,  and  are  described  in  the  same  paper.  At  Brussels,  the  Senne, 
during  its  passage  tlirougli  the  cit}-,  is  no  longer  used  as  the  main  sewer,  and  although 
the  sewage  is  still  poured  into  it  at  a  lower  point,  it  will  ultimately  be  disposed  of  by 
irrigation. 


EEMOVAL    OF    EXCKETA. 


39 


was  3,342  tons  per  acre  annually,     On  the  most  porous  part  of  the  farm  as 
much  as  960  tons  have  been  applied  in  twelve  hours/ 

Condition  of  the  Effluent  Water  after  Irrigation. 

When  the  sewer  water  passes  over  and  not  thi'ough  the  soil,  it  is  often 
impure,  and  even  suspended  matters  of  comparatively  large  size  (such  as 
epithelium)  have  been  found  in  the  water  of  the  stream  into  which  it  flows. 
It  requires,  therefore,  that  care  shall  be  taken  in  every  sewage  fai-m  that  the 
water  shall  not  escape  too  soon.  Dr.  Letheby,^  whose  authority  on  such  a 
question  no  one  can  doubt,  rated  the  cleansing  power  of  soil  much  lower 
than  the  Kivers  Pollution  Commissioners  or  the  Committee  of  the  British 
Association,  and  his  analyses  make  it  at  any  rate  quite  certain  that  the 
proper  purification  of  the  sewer  water  demands  very  careful  preparation  of 
the  ground  in  the  first  instance,  and  constant  care  afterward.  But  the 
chemical  evidence  of  the  good  effect  of  irrigation  is  too  strong  to  admit  a 
doubt  to  exist,  as  may  be  seen  from  the  table  given  by  the  Rivers  Pollution 
Commissioners.  ^ 

The  results  are  much  better  than  those  of  any  chemical  precipitant, 
although  they  are  not  quite  so  good  as  the  downward  filtration  plan. 


'  Mr.  Morgan's  Report,  quoted  in  Food,  Air,  and  Water,  December,  1871. 

'^  The  Sewage  Question,  1^72,  pp.  3-27. 

^  The  standard  of  purity  whicli  effluent  water  should  have  has  not  yet  been  fixed. 
That  proposed  by  tlie  Rivers  Pollution  Commissioners,  which  is  based  on  the  method 
of  analysis  proposed  by  Dr.  Fraukland,  and  which  is  not  yet  universally  admitted,  was 
as  follows : — 

Standard  of  Biners  Pollution   Commissioners.     Maximum  of  Impurity  permissible  in 
100,000  parts  by  weight  of  the  liquid. 


Dry  organic 

matter     in 
suspension. 

Color. 

In  Solution. 

Dry  mineral 
matter     in 
suspension. 

Organic 
carbon. 

Organic 
nitrogen. 

Any  metal  ex- 
cept Calcium, 
Magnesium, 
Potassium,  or 
Sodium. 

Arsenic. 

Chlorine. 

Sulphur  as 
SH2,     or 
sulphate. 

3 

1 

Shown  in  a 
stratum  of 
1   inch  in 
a   white 
plate. 

2 

.3 

3 

.05 

1 

1 

A  certain  degree  of  acidity  or  alkalinity  is  also  ordered  not  to  be  surpassed.  In  the 
discussions  on  the  Public  Health  Bill  in  the  House  of  Commons,  this  standard,  which 
had  been  embodied  in  the  Bill,  was  struck  out,  and  the  standard  is  left  to  be  hereafter 
determined.  (No  standard  is  given  in  the  Rivers  Pollution  Act  of  1876.)  The  objec- 
tion to  the  plan  is  not  merely  the  doubt  about  the  substances  represented  by  organic 
carbon  or  nitrogen,  but  also  because  the  standard  does  not  take  into  consideration  the 
volume  of  water  into  which  the  foul  water  flows.  The  Thames .  Conservancy  Commis- 
sioners adopt  a  standard  for  effluent  sewage  as  follows  :  — 

Must  not  exceed  in  70,000  parts, 

Suspended  matters 3     parts. 

Total  solids 70        " 

Organic  carbon 2         '* 

Organic  nitrogen 0.75    " 


40  PRACTICAL    HYGIENE. 


Do  Sewage  Irrigation  Farms  affect  the  Public  Health  or  Public  Comfort  ? 

That  sewage  farms,  if  too  near'  to  houses  and  if  not  carefully  conducted, 
may  give  oflf  disagreeable  eftiuvia,  is  certain  ;  but  it  is  also  clear  that  in 
some  farms  this  is  very  trifling,  and  that  when  the  sewer  water  gets  on  the 
land  it  soon  ceases.  It  is  denied  by  some  persons  that  more  nuisance  is 
excited  than  by  any  other  mode  of  using  manure.  As  regards  health,  it 
has  been  alleged  that  these  farms  may — 1st,  give  off  efflu\-ia  which  may 
l^roduce  enteric  fever,  or  dysentery,  or  some  allied  affection  ;  or,  2d,  aid  in 
the  spread  of  entozoic  diseases  ;  or,  3d,  make  ground  swampy  and  marshy, 
and  may  also  poison  wells,  and  thus  affect  health. 

The  evidence  of  Edinburgh,  Croydon,'  Aldershot,  Rugby,  Worthing, 
Romford,  the  Sussex  Lunatic  Asylum,"  is  very  strong  against  any  influence 
in  the  production  of  typhoid  by  sewage  farms'  efflu\'ia.  On  the  other 
hand,  Dr.  Clouston's  record  of  the  outbreak  of  dysenteiy  in  the  Cumber- 
land Asylum  is  counter-evidence  of  weight,  and  so  is  one  of  the  cases 
noted  by  Letheby,^  of  tyj)hoid  fever  outbreak  at  Copley,  when  a  meadow 
was  irrigated  with  the  brook  water  containing  the  sewage  of  Halifax. 

The  negative  evidence  is,  however,  so  stx*ong  as  to  justify  the  view  that 
the  effluvia  from  a  well-managed  sewage  farm  do  not  produce  tj^jhoid 
fever  or  dysenteiy,  or  any  affection  of  the  kind.  In  a  case  at  Eton,  in 
which  some  cases  of  enteric  fever  were  attributed  to  the  effluria.  Dr. 
Buchanan  disco vei'ed  that  the  sewer  water  had  been  drunk  ;  this  was  more 
likely  to  have  been  the  cause. 

With  regard  to  the  second  point,  the  spread  of  entozoic  diseases  by  the 
carriage  of  the  sewer  water  to  the  land  was  at  one  time  thought  probable, 
though  as  solid  excreta  from  towns  have  been  for  some  years  largely  em- 
ployed as  manure,  it  is  doubtful  whether  the  Uquid  j)lans  would  be  more 
dangerous.  The  special  entozoic  diseases  w'hich,  it  is  feared,  might  thus 
arise,  are  Tape-ivorms,  Bound  ivorms.  Trichina,  Bilharzia  and  Distoma 
hepaticum  in  sheep.  Cobbold's  latest  observations  show  that  the  embrj'os 
of  Bilharzia  die  so  rapidlj^  that,  even  were  it  introduced  into  England, 
there  would  be  little  danger.  The  Trichina  disease  is  only  known  at 
present  to  be  produced  in  men  by  the  worms  in  the  flesh  of  pigs  which  is 
eaten,  and  it  is  at  least  doubtful  whether  pigs  receive  them  from  the 
land.  There  remain,  then,  only  Tajje-icorms  and  Bound  ivorms  for  men  and 
Distoma  hepaticum  for  sheep  to  be  dreaded.  But  with  regard  to  these, 
the  evidence  at  present  is  entirely  negative  ;  and  until  positive  evidence  is 
jDroduced,  this  argument  against  sewage  iiTigation  may  be  considered  to 
be  unsupported. 

The  third  criticism  appears  to  be  true.  The  land  may  become  swampy, 
and  the  adjacent  wells  poisoned,  and  disease  (ague  *  and  perhaps  diarrhoea 
and  dj'senteiy)  be  thus  produced.  But  this  is  owing  to  mismanage- 
ment, and  when  a  sewage  farm  is  properly  arranged  it  is  not  damp,  and 
the  weUs  do  not  suffer. 

'  Carpenter,  various  papers  and  essays  on  this  subject  drawn  from  the  experience  of 
Croydon  Sewage  Farm 

■'  Dr.  J.  W.  Williams,  Brit.  Med.  Journal,  May  11,  1872. 

^  The  Sewage  Question,  p.  190. 

*  Tliere  is  no  ague  or  any  other  disease  traceable  to  the  sewage  irrigation  at 
Craigentinny,  near  Edinburgh. 


REMOVAL    OF    EXCRETA.  41 


Objections  to  Sewers. 

The  main  objections  are  as  follows  : — 

1.  That  as  underground  channels,  connecting  houses,  they  allow  transfer- 
ence of  ejfluvia  from  place  to  place. — The  objection  is  based  on  good  evi- 
dence, but  it  must  be  said  in  reply  that,  if  proper  traps  are  put  down,  and 
if  air-disconnection,  in  addition,  is  made  between  the  outside  drains  and 
the  house  pipe,  such  transference  is  impossible.  The  objection  is  really 
against  an  error  of  construction,  and  not  against  the  plan  as  properly  car- 
ried out.  Besides,  the  objection  is  equally  good  against  any  kind  of 
sewer,  and  yet  such  underground  conduits  are  indispensable. 

2.  That  the  2^ipes  break  and  contaminate  the  ground. — This  is  a  great 
evil,  and  it  requires  care  to  avoid  it.  But  such  strong  pipes  are  now  made, 
that  if  builders  would  be  more  careful  to  make  a  good  bed,  and  to  con- 
nect the  joints  firmly,  there  would  be  little  danger  of  leakage,  as  far  as 
the  j)ipe  drains  are  concerned,  and  not  much  damage  of  the  main  brick 
sewers.  All  pipes,  however,  ought  to  be  actually  and  carefully  tested  after 
being  laid  and  before  being  covered  in,  otherwise  it  is  impossible  to 
ensure  their  being  water-tight,  even  when  everything  is  sound  to  all 
appearance. 

3.  That  the  water  supply  is  constantly  in  danger  of  contamination. — This 
also  is  ti'ue,  and  as  long  as  overflow  pipes  from  cisterns  are  carried  into 
sewers,  and  builders  will  not  take  care  to  make  a  complete  separation  be- 
tween water  pipes  and  refuse  pipes,  there  is  a  source  of  danger.  But  this 
is  again  clearly  an  error  in  constructive  detail,  and  is  no  argument  against 
a  proper  arrangement. 

On    the  iNFIiUENCE  THE    CoNSTEUCTION  OF    SeWEKS  HAS  HAD  ON  THE  DeATH    EatE 

OP  Towns. 

Keference  has  already  been  made  to  the  possibility  of  sewers  being  the 
channels  by  which  enteric  fevers  and  cholera  have  been  propagated  from 
house  to  house,  and  from  which  emanations,  causing  diarrhcea  and  other 
complaints,  may  arise.  Admitting  the  occasional  occurrence  of  such  cases, 
it  Temains  to  be  seen  whether  the  sanitary  advantages  of  sewers  may  not 
greatly  counterbalance  their  defects.  The  difficulty  of  proving  this  point 
statistically  consists  in  the  number  of  other  conditions  affecting  the  health 
of  a  town  in  addition  to  those  of  sewerage.  Dr.  Buchanan  '  has,  however, 
given  some  valuable  evidence  on  this  point,  which  has  been  well 
commented  on  by  Mr.  Simon.  He  inquired  into  the  total  death  rate  fi'om 
all  causes,  and  the  death  rate  from  some  particular  diseases,  in  twenty- 
five  towns  before  and  after  sanitary  improvements,  which  consisted  princi- 
pally of  better  water  supply,  sewerage,  and  town  conservancy.  The  gen- 
eral result  is  to  show  that  these  sanitary  improvements  have  resulted  in  a 
lowering  of  the  death  rate  in  nineteen  out  of  twenty-five  towns,  the 
average  reduction  in  these  nineteen  cases  being  10.5  per  cent.  The  reduc- 
tion in  typhoid  (enteric)  fever  was  extremely  marked,  and  occurred  in 
twenty-one  towns  out  of  twenty-four,  the  average  reduction  being  45.4  per 
cent,  in  the  deaths  from  typhoid.  In  three  cases  there  was  an  augmentation 
of  tj^phoid  fever,  but  this  was  manifestly  owing  to  imperfection  in  the 
sewerage  arrangements  ;  and  these  cases  afford  excellent  instances  of  the 

'  Ninth  Report  of  the  Medical  Of&cer  to  the  Privy  Council,  p.  12  et  seq.  and  p.  40. 


42  PRACTICAL    HYGIENE. 

unfavorable  part  badly  arranged  sewers  may  i^lay  in  this  direction.' 
Soyka  ^  has  given  some  interesting  statistics  of  German  towns  with  regard 
to  this  point.  In  Hamburg  the  typhoid  deaths  per  1,000  total  deaths  has 
fallen  from  48.5  to  10.5  ;  in  Dautzig,  from  26.6  to  2.3.  In  Frankfort  the 
typhoid  deaths  per  10,000  living  have  fallen  fi'om  9  to  2  ;  in  Munich,  from 
24.2  to  8.9 

Diarrhoea  has  also  been  reduced,  but  not  to  svich  an  extent ;  and  in 
some  towns  it  has  increased,  while  typhoid  fever  has  simultaneously  di- 
minished.^ But  the  term  diarrhcea  is  so  loosely  ixsed  in  the  retm-ns  as  to 
make  any  deduction  uncertain.  Cholera  epidemics  Dr.  Buchanan  consid- 
ers to  have  been  rendered  "  practically  harmless. "  The  immense  signifi- 
cance of  this  statement  will  be  at  once  aj)preciated.  Whether  the  result 
is  owing  solely  to  the  sewerage  or  to  the  improved  water  supply,  which  is 
generally  obtained  at  the  same  time,  is  not  certain.  Phthisis,  which  Dr. 
Buchanan  and  Dr.  Bowditch  *  find  to  be  so  much  influenced  by  dampness 
of  soil,  does  not  appear  to  have  been  affected  by  the  removal  of  excreta 
per  se,  at  least  towns  such  as  Alnwick  and  Beynmawr,  which  are  thor- 
oughly drained,  show  no  lowering  in  the  phthisical  mortahty.  Nor  could 
Dr.  Buchanan  trace  any  effect  on  the  other  diseases  of  the  lungs. 

As  far  as  can  be  seen,  the  effect  of  good  sewerage  has  therefore  been  to 
reduce  the  general  death  rate,  especially  by  the  reduction  of  deaths  from 
t\'phoid  and  from  cholera  (and  in  some  towns  from  diarrhoea),  but  partly, 
in  all  probability,  by  general  improvement  of  the  health.  The  action  has 
been,  in  fact,  very  much  in  the  direction  we  might  have  anticipated. 

It  may  be  observed,  that  this  inquiry  by  Dr.  Buchanan  does  not  deal 
with  the  question  as  between  sewers  and  efficient  dry  methods  of  removing 
excreta  (on  which  point  we  possess  at  present  no  evidence),  but  between 
sewerage  and  the  old  system  of  cesspools. 

Modifications  of  the  "Wet  Method  op  Removing  Excreta. 

The  Separate  System. 

By  this  term  is  meant  the  arrangement  which  carries  the  rain  water  in 
separate  channels  into  the  most  convenient  water-course.^  IVIi-.  Ward's 
celebrated  phrase  "the  rain  to  the  river,  the  sewage  to  the  soil,"  is  the 
princiiDle  of  this  plan.  Its  advantages  are  that  the  sewers  can  be  smaller ; 
that  the  amount  of  sewer  water  to  be  dealt  with  at  the  outflow  is  much 
less  in  quantity,  more  regular  in  flow,  and  richer  in  fertilizing  ingredients, 
and  is,  therefore,  more  easily  and  cheaply  disposed  of.  The  grit  and 
debris  of  the  roads  also  are  not  carried  into  the  sewers  ;  and  the  stoi'm 
waters  never  flood  the  houses  in  the  low  parts  of  the  towTi. 

The  disadvantages  are,  that  separate  channels  and  pipes  have  to  be 
provided  for  the  rain  ;  that  the  rain  from  all  large  cities  can-ies  from  roofs 
and  fi'om  streets  much  organic  debris  which  pollutes  streams,  and  that  the 


■  See  the  case  of  Worthing  (p.  45,  Ninth  Report,  etc.,  op.  cit.),  for  a  striking  in- 
stance of  the  spread  of  typhoid  through  sewers. 

''  Deutsche  Viertelj.  fiir  Offl.  Ges.,  Band  xiv.,  Heftl,  1882,  p.  33. 

3  Vircliow  has  called  attention  to  the  lessening  of  typhoid. 

*  Ninth  and  Tenth  Reports  of  the  Medical  Officers  to  the  Privy  Council.  See  es- 
pecially Dr.  Buchanan's  Report  in  the  last-named  work,  p.  57. 

'"  On  this  subject  the  works  of  Mr.  Menzies,  who  first  described  this  plan,  and  of 
Colonel  Ewart,  R.E.  (Report  on  the  Drainage  of  Oxford,  Eton,  Windsor,  and  Abingdon, 
1868),  will  be  found  very  useful. 


REMOVAL    OF    EXCRETA.  43 

scouring  effect  of  the  rain  on  sewers  is  lost,  though  this  last  is  a  very  ques- 
tionable objection. 

The  adoption  of  one  or  other  system  will  probably  depend  on  local 
conditions.  If  a  town  in  Eui-ope  Hes  low,  and  it  is  expensive  to  lift  sew- 
age ;  if  land  cannot  be  obtained  ;  or  if  the  natui'al  contour*  of  the  gi-ound 
is  very  favorable  for  the  flow  of  rain  in  one  direction,  while  it  is  convenient 
to  carry  the  sewage  in  another,  the  separate  system  would  be  the  best.  So 
also  in  the  tropics,  with  a  heavy  rainfall  and  a  long  drj^  season,  the  pro- 
viding of  sewers  large  enough  to  carry  off  the  rain  would  be  too  expensive 
for  all  except  the  richest  cities,  and  the  disposal  of  the  storm  water  would 
be  difficult. 

In  all  cases  in  which  rain  enters  the  sewers,  some  plan  ought  to  be 
adopted  for  storm  waters.'  If  irrigation  is  the  plan  carried  out,  the  sewer 
water  becomes  so  dilute  and  so  large  in  quantity  in  storms,  that  the  ap- 
phcation  to  land  is  usually  suspended,  and  the  sewer  water  is  allowed  to 
pass  at  once  into  streams. 

In  this  way  the  e^il  which  irrigation  is  intended  to  prevent  is  pro- 
duced, though,  doubtless,  the  sewer  water  is  highly  dilute.  In  London, 
the  storm  waters  mingled  with  sewage  are  allowed  to  flow  into  the  Thames, 
special  openings  being  provided. 

The  Interception  System. 

In  many  of  the  continental  cities  the  fluid  and  solid  excreta  fall  into  a 
receptacle  with  perforated  sides  or  bottom,  so  that  the  fluid  pai-t  drains 
away  and  the  solid  is  retained,  and  is  removed  from  time  to  time.  Such  a 
plan  may  keep  the  sewers  free  from  deposit,  but  has  the  great  disadvan- 
tage of  retaining  large  collections  of  excreta  close  to  and  in  many  cases 
immediately  under  or  in  the  cellars  of  houses,  and  no  ventilation  can  en- 
tirely remove  all  effluvia. 

An  improvement  on  this  plan  is  a  method  proposed  by  Mr.  Chesshire, 
of  Birmingham.  He  places  outside  the  house,  in  any  place  where  access 
is  easy,  a  comparatively  small  box,  connected  by  trapped  pipes  with  the 
water-closet  at  one  end,  and  the  sewer  at  the  other.  The  lid  of  the  box 
is  fixed  down  with  concrete  or  putty,  so  that  the  access  of  au'  is  stoj)ped. 
Across  one  end  of  the  box  is  a  single  or  double  strainer,  which  allows  the 
urine  and  water  to  pass,  but  retains  the  solids.  From  time  to  time  the 
box  is  lifted  out,  carted  away,  and  another  is  inserted.  The  solid  matter 
is  almost  free  from  odor,  as  the  limited  access  of  air  hinders  putrefaction. 

The  difficulty  about  this  plan  is  the  occasional  blockage  of  the  strainer, 
so  that  the  solid  matters  remain  wet,  and  may  soon  fill  the  box,  so  that  the 
lid  may  be  forced  off.  The  hquid  which  flows  from  the  box  is  of  course 
highly  impure  with  excreta,  but  the  retention  of  the  solids  prevents  block- 
age of  the  sewers.  At  jDresent  it  can  only  be  said  that  this  plan  has  not 
been  yet  practically  estabhshed  on  the  large  scale,  but  is  well  worthy  of 
extended  trial,  particularly  in  cases  where  the  difficulties  of  irrigation  are 
great. 

Water- Closets  and  Water-Troughs. 

Watey^- Closets. — The  pan  of  the  closet  is  usually  a  cone  in  earthenware 
(which  is  better  than  metal),  and  a  siphon  or  flap  valve  below.  In  addi- 
tion, there  are  numerous  contrivances  for  flushing  the  pan  and  siphon, 

'  Plans  for  this  purpose  are  figured  and  described  in  the  works  on  Sanitary  En- 
gineering, by  Baldwin  Latham  and  Bailey  Denton. 


4-i  PRACTICAL   HYGIENE. 

and  for  preventing  the  escape  of  the  air  from  the  soil  pipe  into  the  house.' 
The  soil  pipe  is  usually  of  cast  lead  ;  but  both  lead  and  iron  are  easily- 
eaten  through,  as  shown  by  Drs.  Fergus  and  N.  Carmichael,  and  earthen- 
wai-e  pipes,  if  strong  and  well  joined,  would  be  preferable.'' 

The  points  to  be  looked  to  in  examining  closets  are — 1st,  that  the  pan 
is  nearly  a  cone,  and  not  a  half  circle  with  a  flat  bottom  ;  2d,  that  the 
amount  and  force  of  water  is  sufficient  to  sweep  everything  out  of  the 
siphon  ;  3d,  that  the  soil  pipe  is  ventilated  beyond  the  siphon,  by  being 
earned  up  full -bore  to  the  top  of  the  house  ;  4th,  that  the  junction  of  siphon 
and  soil  pipe  and  the  lengths  of  the  soil  pipe  are  perfect. 

"With  respect  to  water,  a  pipe  from  the  house  cistern  frequently  leads 
to  the  closet ;  but  if  so,  there  is  danger  of  gas  rising  through  the  pipe. 
There  should  be  a  special  small  cistern  for  the  use  of  the  closet.  "What 
ai'e  termed  water-waste  preventers  are  now  commonly  used,  fed  either  by 
a  cistern  or  by  constant  supply.  They  are  boxes  which  are  emptied  by  a 
valve  into  the  pan,  and  are  then  refilled.  There  are  many  kinds,  but  per- 
haps the  best  are  those  that  work  by  siphon  action,  brought  into  play  by 
pulling  a  wire.  The  amount  of  water  should  not  be  less  than  two  gallons, 
and  the  fall  should  not  be  less  than  3  or  4  feet,  so  as  to  insure  thorough 
scouring  of  the  soil  jDipe.' 

The  ventilation  of  the  soil  pipe  is  a  matter  of  importance,  as  the  water 
from  the  pan  suddenly  displaces  a  large  body  of  foul  air,  which  rises 
through  the  giphon  as  the  water  flows.  The  best  plan  is  to  caiTy  up  the 
soil  pipe  full-bore  to  the  roof,  far  from  any  windows.  It  is  well  also  to 
have  a  second  pipe  from  the  cro\\Ti  of  the  siphon  to  the  ventilating  pipe,  in 
order  to  prevent  the  unsiphoning  of  the  trap  (see  Fig.  84).  Air  is  suppHed 
by  a  grating  below,  as  in  Buchan's  and  other  disconnecting  traps,  or  (as  in 
Banner's  plan)  by  dra-^\dng  aii'  from  another  shaft  earned  up  the  house. 
The  ciuTcnts  in  the  two  shafts  are  determined  by  reversed  cowls.  In  some 
cases  it  is  proposed  to  draw  the  air  doicyi  the  soil  pipe  and  vp  another  pipe. 

The  simple  hopper  closet,  or  some  form  of  "wash-out"  closet,  with  a 
siphon  trap  below,  is  the  safest ;  but  there  are  some  good  fonns  of  valve 
closet  in  the  market.  They  are,  however,  too  frequently  made  with  over- 
flow pipes  passing  into  the  soil  pipe.  These,  although  siphon  trapped,  are 
apt  to  be  sucked  dry.  They  are  thus  dangerous,  and  they  ai-e  really 
unnecessaiy,  for  a  well-made  siphon  pan  rarely  overflows.  If  it  does,  it  is 
better  to  receive  the  overflow  on  to  a  safe  under  the  closet,  from  which  the 
water  flows  out  through  a  pipe  to  the  open  air,  such  pipe  acting  as  a  warn- 
ing pijDe.  The  old  pan-closet,  with  its  filthy  container  and  D  trap,  ought  to 
be  absolutely  discarded. 

The  jDosition  of  the  closet  is  a  matter  of  great  moment.  If  possible,  it 
should  always  be  in  an  outbuilding,  or  a  pi'ojection,  with  thorough  ventila- 
tion between  it  and  the  house.  In  two-storied  buildings  it  might  be  put  in 
a  small  third  stors'  in  the  roof,  and  well  ventilated  alDOve,  The  windows 
in  a  closet  ought  alwaj's  to  op^  quite  to  the  ceiling. 

'  Mr.  Eassie's  work,  Healthy  Houses,  gives  a  good  account  of  the  various  kinds  of 
closets. 

"  In  his  work  on  Sanitary  Arrangements  for  Dwellings,  Mr.  Eassie  does  not  approve 
of  earthenware  pipes,  preferring  the  strongest  cast  lead  to  any  other. 

'  The  Army  Sanitary  Committee  (On  Sanitary  Appliances,  Blue  Book,  1871,  p.  IT) 
state  that  the  amount  of  water  used  in  the  water-closets  in  the  army  is,  for  Green's 
closet,  between  ^  gallon  and  1  gallon  for  each  time  of  use ;  Underhay's,  Lambert's,  and 
the  pan-clos«t,  from  1  to  1-^  gallon ;  and  for  Jeuuiug's  closet,  usually  the  same,  or  in 
some  stations  3  gallons. 


REMOVAL    OF    EXCRETA.  45 

In  all  cases,  a  tube  should  pass  from  the  top  of  the  closet  to  the  outer 
air,  and,  if  the  closet  is  in  a  bad  situation,  the  tube  should  be  heated  by  a 
gas-jet. 

It  is  a  bad  plan  to  have  the  pull-up  handle  covered  by  the  lid  ;  ^  it 
should  be  able  to  be  pulled  up  when  the  lid  is  shut,  or  the  shutting  of  the 
lid  should  open  the  water-waste  preventer  cistern.  In  wash-out  closets  the 
flush  is  often  obtained  by  pulling  a  wn-e  hke  a  beU-puU,  as  mentioned 
above. 

The  plan  of  placing  closets  in  the  basement  should  be  entirely  given  up ; 
closet  air  is  certain  to  be  drawn  into  the  house. 

Water-Troughs  or  Latrines. — These  are  very  strong  earthenware  or  cast- 
iron  receptacles,  which  are  about  half  f  uU  of  water.  The  excreta  drop  into 
the  water,  and  once  or  twice  a  day  a  valve  is  raised,  and  th*e  water  and 
excreta  pass  into  a  drain.  There  is  usually  a  receptacle  into  which  fall 
bits  of  bricks,  towels,  or  other  things  which  are  thrown  in,  so  that  they  are 
stopped  and  fished  out  when  the  trough  is  emptied,  and  do  not  pass  into 
the  drain.  The  amount  of  water  in  the  water-latrines  used  in  some  barracks 
is  about  5  gallons  per  head  daily,  so  that  the  plan  is  not  economical  of 
water,  but,  as  it  avoids  all  loss  by  the  dripping  in  closets,  there  is  probably 
no  great  excess  of  expenditure.  It  is  a  good  plan  to  have  a  flexible  hose 
attached  to  the  water  pipe,  so  as  to  wash  thoroughly  the  seats  and  partitions 
every  day. 

The  chief  objection  to  this  plan  has  been  the  labor  which  is  necessaiy  to 
empty  the  trough  ;  but  this  may  be  obviated  by  the  use  of  automatic  flush 
tanks,  discharging  periodically.  On  the  other  hand,  there  is  saving  of  ex- 
penditure in  repairs  to  water-closets.^ 

In  judging  of  the  value  of  a  water-trough,  the  amount  of  water,  the 
surface  exposed  to  evaporation,  and  the  completeness  of  the  flushing,  are 
the  points  to  look  to. 

Dry  Methods.^ 

The  use  of  sewers  and  removal  by  water  are  in  many  cases  impracticable. 
A  fall  cannot  be  obtained  ;  or  there  is  insufiicient  water  ;  or  the  severity  of 
the  chmate  freezes  the  water  for  months  in  the  year,  and  removal  by  its 
means  cannot  be  attempted.  Then  either  the  excreta  will  accumulate 
about  houses,  or  must  be  removed  in  substance  daily  or  periodically. 
Even  when  water  is  abundant,  and  sewers  can  be  made,  many  agriculturists 
are  in  favor  of  the  dry  system,  as  giving  a  more  valuable  fertilizing  product ; 
and  various  plans  ai'e  in  use. 

It  is  not  necessary  to  consider  here  the  employment  of  cesspools,  dead- 

'  In  Dr.  Aldridge's  patent  the  handle  cannot  be  pnlled  up  until  the  lid  is  shut  down  ; 
there  is  also  arrangement  for  carrying  off  foul  gas  by  means  of  a  pipe  communicating 
with  the  outer  air,  the  lid  itself  being  air-tight  "round  the  rim  of  the  seat. 

^  In  the  army  two  kinds  of  latrines  (Macfarlane's,  of  cast-iron,  and  Jenning's,  of 
earthenware)  have  been  in  use  for  about  twenty  years.  The  Army  Sanitary  Committee 
(On  Sanitary  Appliances  introduced  into  Barracks,  Blue  Book,  1871,  p.  14)  state  that  out 
of  183  barracks  only  53  have  been  charged  with  repairs,  and  the  average  expenditure 
on  these  53  has  been  12s.  per  barrack  annually  for  Macfarlane's,  and  18s.  9d.  per 
barrack  for  Jenning's  latrine,  and  nearly  the  whole  of  these  expenses  have  been  caused 
by  articles  thrown  carelessly  into  the  latrines. 

^  On  the  dry  methods  of  removal  a  very  good  paper  has  been  published  by  Dr. 
Buchanan  and  Mr.  Radcliffe  (Twelfth  Report  of  the  Medical  Officer  to  the  Privy 
Council,  1870,  pp.  80  and  111) ;  also  another  by  Mr.  Netten  Radcliffe  (Report  on  certain 
Means  of  preventing  Excrement  Nuisances  in  Towns  and  Villages,  New  Series,  No.  2, 
1874). 


46  PRACTICAL    HYGIENE. 

wells,  etc.,  as  such  plans  must  be  considered  quite  unsanitary,  and  should 
he  invariably  discontinued.  If  excreta  are  ever  allowed  to  accumulate,  it 
should  be  in  properly  prepared  receptacles,  and  after  admixture  with 
deodorants. 

Removal  vnthout  Admixture. 

In  some  cases  the  solid  and  liquid  excreta  pass  into  boxes  or  tanks, 
which  are  emptied  daily,  or  from  time  to  time,  and  the  sewage  is  at  once 
applied  to  land  without  further  treatment.  In  Glasgow  the  excreta  from 
one  part  of  the  town,  containing  80,000  people,  are  now  removed  eveiy  day 
without  admixture,  except  ^\-ith  the  garbage  from  the  houses,  and  are  sent 
long  distances  at  a  profit.'  If  the  removal  can  be  made  daily,  the  plan  is  a 
good  one  ;  the  manure  should  not  be  applied  in  the  immediate  neighbor- 
hood of  dwellings,  and  the  Ban-ack  Commissioners  have  ordered  that  it 
shall  not  be  put  on  land  nearer  barracks  than  500  yards. 

In  some  towns  in  the  north  of  England  (Salford,  Halifax,  Nottingham), 
the  receptacles  are  lined  with  some  absorbent  material  (refuse  of  cloth 
manufactures),  and  at  Aldershot  with  stable  litter,  intended  to  absorb  the 
urine  (Goux  system)  ;  in  other  cases  the  urine  is  carried  off  by  a  pij)e  into 
a  drain  ;  the  intention  being,  in  both  cases,  to  make  the  fecal  matter  drier, 
and  to  delay  decomposition. 

In  others,  the  soil  being  removed  daily,  or  at  short  intervals,  is  taken  to  a 
manufactory,  and  there  subjected  to  manipulations  which  convert  it  into  a 
manure. 

Under  the  term  "  Poudrette,"  manufactories  of  this  kind  have  been  long 
carried  on  in  France,  though  they  are  said  not  to  be  very  profitable.^  At 
present,  however,  a  portion  of  the  nitrogen  of  the  urea  is  converted  into 
ammonia,  and  is  united  with  sulphuric  acid,  and  comes  into  the  market  as 
sulphate.     In  England,  also,  there  have  been  several  manufactories. 

Thei'e  have  been  great  discussions  as  to  the  salubrity  of  the  French 
poudrette  manufactories,  and  the  evidence  is  that  they  are  not  injurious  to 
the  Avorkmen  or  to  the  neighborhood,  although  often  disagreeable.  But 
the  poudrette  can  take  on  a  kind  of  fermentation  which  renders  it  dangerous, 
and  Parent-Duchutelet  has  recorded  two  cases  of  outbreaks  of  a  fatal  fever 
(typhoid  ?)  on  board  ships  loaded  with  poudrette.  In  the  case  of  the  Eu- 
reka Company  in  England  no  bad  effect  was  produced  on  the  health  of  the 
men. 

Admixture  with  Deodorizing  and  Anti-putrescent  Substances. 

Usually,  however,  some  deodorizing  substance  is  mixed  with  the  excreta 
before  they  are  removed  from  the  house,  and  they  are  then  at  once  applied 
to  land  without  further  preparation.  Mr.  Moule's  advocacy  of  the  use  of 
dried  earth  has  brought  into  prominent  notice  the  great  deodorizing  pow- 
ers of  this  substance,  and  perhaps  no  suggestion  of  late  years  has  had  more 
important  consequences.  The  various  substances  employed  to  prevent 
odor  and  decomposition  are  as  follows  : — 

'  At  Carlsruhe,  Mannheim,  Eastadt,  and  Bruchsal  the  excreta  are  removed  in  boxes 
holding  about  116  cubic  feet  (Prussian)  every  evening.  From  an  experience  of  eight- 
een years  (1851-1868),  the  excreta  of  6,::5ol  men  (mean  strength)  returned  7,628  florins 
per  annum,  of  about  Is.  lid.  English  money  per  head.  In  Bruchsal  it  was  Is.  Id., 
and  in  Mannheim  2s.  6d.  per  head.  This  rich  manure  has  converted  the  sandy  wastes 
into  fertile  corn-fields. 

•  Nearly  all  the  solid  excreta  of  Paris  are  dealt  with  in  the  same  way,  at  the  great 
depot  of  Clichy-la-Garenne. 


KEMOVAL    OF   EXCEETA.  47 

1.  Coal  and  Wood  Allies. — This  is  a  common  practice  in  the  north  of 
England,  and  closets  are  made  ^ith  hinged  flaps  or  seats,  so  that  the  coal 
ashes  may  be  thrown  on  the  sewage.  Sometimes  screens  are  used,  so  that 
the  large  cinders  are  held  back,  and  can  again  be  used  for  firing.  In  some 
towns  there  are  receptacles  (middens)  intended  both  for  excreta  and  ashes  ; 
sometimes  these  ai'e  cemented,  but  ai-e  usually  poi'ous,  and  there  may  be  a 
pipe  leading  into  a  sewer  so  as  to  dry  them.  The  midden  system  is  a  bad 
one  ;  even  -nith  every  care,  the  vast  heaps  of  putrefjdng  material  which  ac- 
cumulate in  some  of  our  towns  must  have  a  very  deleterious  influence  on 
the  health,  and  the  sooner  all  middens  ai-e  abolished  the  better.  The  de- 
odorizing effect  of  coal  ashes  is  very  shght.  The  mixtui-e  of  coal  ashes  and 
excreta  usually  finds  a  sale,  but  the  profit  is  much  greater  if  no  ashes  are 
mixed  "udth  it.  Wood  ashes  are  far  more  powerful  as  deodoi'izers,  but  it  is 
not  easy  in  this  country  to  have  a  proper  supjDly. 

2.  Charcoal.— There  is  no  better  deodorizer  than  charcoal.'  Animal 
charcoal  is  too  exj)ensive,  and  peat  charcoal  is  cheaper  ;  according  to  Dan- 
chell,  3  ounces  of  peat  charcoal  are  equal  to  1^  lb  of  earth  ;  and  this  author 
states  that  the  cost  of  charcoal  for  a  family  of  six  persons  would  only  be  Is. 
6d.  per  month.  A  plan  has  been  proposed  by  Mr.  Stanford,  ^  and  is  in  use 
at  Glasgow,  which  may  obviate  the  difficulty  of  price.  ]Mr.  Stanford  pro- 
poses to  obtain  charcoal  from  sea-weed  ;  the  charcoal  is  cheap,  and  remark- 
ably useful  as  a  deodorizer.  After  it  has  become  thoroughly  impregnated 
with  fi\?ces  and  urine,  the  mixture  is  re-carbonized  in  a  retort,  and  the  car- 
bon can  be  again  used  ;  the  distilled  j)roducts  (ammoniacal  liquor,  contain- 
ing acetate  of  Hme,  tar,  gas)  are  sufficient  to  pay  the  cost,  and  it  is  said 
even  to  give  a  profit. 

The  closet  used  with  this  carbon  is,  in  principle,  similar  to  Moule's 
earth  closet,  with  various  improvements  for  more  thoroughly  mixing  the 
charcoal  and  sewage. 

The  advantages  claimed  by  INIr.  Stanford's  process  are  the  complete  de- 
odorizing effect ;  the  small  amount  of  charcoal  requu-ed  as  compared  with 
dr}-  earth  (three-fourths  less  required) ;  the  value  of  the  diy  manure,  or  of 
the  distilled  j)ro  ducts,  if  the  mixture  is  rebunit  ;  and,  in  the  last  case 
(burning),  the  complete  destruction  of  all  noxious  agencies.  In  using  it 
the  mixed  charcoal  and  sewage  may  be  stored  for  some  months  without 
odor  in  some  convenient  receptacle  outside,  but  not  under  the  house  ;  and 
Mr.  Stanford  states  that  all  the  house  urine  can  be  also  allowed  to  flow 
into  this  receptacle.  The  rebuming  of  the  mixture  can  be  done  in  a  gas 
retort,  or  a  special  retort  is  built  for  the  purpose  ;  the  charcoal  left  in 
the  retort  is  returned  to  the  house. 

3.  Earth. — Since  the  Eev.  Mr.  Moule  pointed  out  the  powerful  deodor- 
izing properties  of  dried  earth,  many  different  closets  have  been  proposed. 

jVIr.  Moule's  earth  closet  consists  of  a  wooden  box,  with  a  receptacle 
below,  and  a  hopper  above,  from  which  dried  earth  falls  on  the  sewage 
when  the  plug  is  pulled  up.  The  earth  is  previously  dried,  and  about  1^ 
to  1^  ft)  of  the  dried  earth  per  head  daily  is  the  usual  allowance.  For  a 
single  house,  the  earth  can  be  dried  over  the  kitchen  fire  ;  but  if  a 
village  is  to  be  suppHed,  a  smaU  shed,  fitted  with  tiles,  below  which  smoke 
pipes  from  a  small  furnace  pass,  is  requii'ed.  The  earth  used  in  the  closet 
is  sufficient  to  deodorize  the  solid  excreta,  and  the  portion  of  the  urine 

'  At  Kreilingen,  in  Holland,  a  pail  system  is  in  use,  where  charcoal  is  employed 
made  from  burning  town  refuse.  It  appears  to  yield  a  product  of  sufficient  value  to 
pay  for  itself. 

-  Chemical  News,  June  and  October,  1869,  and  February,  1872. 


48  PRACTICAL    HYGIENE. 

passed  with  them ;  but  the  rest  of  the  urine  and  house  water  has  to  be 
carried  off  in  pipes,  and  disjiosed  of  in  some  other  way.  The  receptacle  is 
emptied  from  time  to  time,  and  the  mixture  is  stored  until  it  can  be  ap- 
pUed  to  land. 

The  advantages  of  this  plan  are  obvious ;  its  disadvantages  are  the  ne- 
cessity of  collecting,  and  dicing,  and  storing  the  earth,  which  for  cottagers 
who  have  little  space,  and  possibly  no  means  of  getting  earth,  is  a  serious 
matter.  The  supply  of  dried  earth  to  large  towns  is  almost  a  matter  of 
impossibility,  so  large  is  the  amount  required.'  Again,  the  attention  ne- 
cessary to  prevent  the  house  water  being  thrown  in,  and  to  remove  the  soil 
at  sufficiently  short  periods,  sometimes  militates  against  the  success.  To 
obviate  these  disadvantages,  some  modifications  have  been  introduced  into 
Moule's  closet  ;  one  side  of  the  receptacle  may  be  covered  with  a  grating, 
leading  to  a  pipe,  so  that  aU  fluids  drain  aAvay,  and  the  house  water  can  be 
thrown  in.  In  another  plan,  as  in  Taylor's  improved  closet,  the  urine  is 
carried  away  without  mixing  at  all  with  the  solid  excreta.  Sometimes  the 
urine  thus  separated  is  led  into  another  box  of  earth,  and  is  thus  more 
easily  disposed  of,  if  there  are  no  means  of  taking  it  entirely  away  ;  or  it  is 
passed  into  a  tank,  and  then  used  as  hquid  manure.  In  another  modifica- 
tion (Moser's  original  form),  a  partition  along  the  front  holds  some  absorb- 
ent substance  (sawdust,  straw),  into  which  the  urine  passes,  and  the  solids 
are  thus  kept  diy.  This  separation  of  the  uriwe  and  solids  certainly  appears 
to  be  an  improvement.  Dr.  Carpenter,  of  Croydon,  reports  well  of  these 
closets." 

The  best  kind  of  earth  is  clay,  marl,  and  vegetable  humus ;  when  dried, 
the  clay  is  easily  powdered.     Chalk  and  pure  sand  are  of  little  use. 

The  earth  system  is  coming  into  gi*eat  use  in  India,  and  is  carried  out 
with  great  attention  to  detail.  In  those  European  stations  where  water  is 
not  procui-able,  Mr.  Moule's  invention  has  been  a  boon  of  great  value,  and 
medical  officers  have  stated  that  nothing  has  been  done  in  India  of  late 
years  which  has  contributed  so  much  to  the  health  and  comfort  of  the 
men.^  The  plan  of  sepai-ating  the  urine  from  the  faeces  has  been  strongly 
advocated  hj  Dr.  Cornish,  of  Madras,  and  would  no  doubt  be  attended 
with  great  advantages  in  India  if  there  ai'e  means  of  disposal  of  the  urine. 
The  chief  difficulty  in  the  European  ban-acks  in  India  is  felt  during  the  rainy 
seasons,  when  the  mixed  excreta  and  earth  cannot  be  kept  sufficiently  dry. 

In  the  case  of  natives  of  India,  however,  a  serious  difficulty  arises  in 
the  use  of  the  earth  system,  in  consequence  of  the  universal  use  of  water 
for  ablution  after  using  the  closet.  Every  native  takes  with  him  a  small 
vessel  holding  10  to  20  ounces  of  water,  so  that  a  large  amount  of  fluid  has 
to  be  disposed  of.  The  usual  earth  closet  does  not  suffice  for  this.  ]\Ir. 
Charles  Turner,  C.E.,  of  Southampton,  contrived  a  closet  suitable  for  the 
native  family ;  Mt  is  unfortunately  too  costly,  and  possibly  a  simple  iron 

'  For  workhouses,  prisons,  barracks  in  country  places,  where  there  is  plenty  of  la- 
bor, and  no  difficulty  in  obtaining  and  afterward  disposing  of  the  earth,  the  plan  is 
most  perfect.  So  also  for  small  villages,  if  some  central  authority  arranges  for  the  sup- 
ply of  earth,  and  for  the  removal  of  the  used  soil.  For  a  good  statement  of  the  advan- 
tages of  the  earth  system,  see  Dr.  Hawksley's  paper  in  the  Report  of  the  Leamington 
Congress  on  the  Sewage  of  Towns. 

■  Bailey  Denton,  op.  cit.,  p.  102. 

^An  account  of  the  Bengal  arrangements  will  be  found  in  the  2d  edition  of  this 
work,  p.  329,  but  the  plans  have  been  much  altered. 

*  This  was  done  at  the  suggestion  of  Dr.  Niven,  of  Bombay.  Mr.  Turner's  closet  is 
described  and  figured  in  Dr.  Parke's  Report  on  Hygiene  for  1867,  Army  Medical  Re- 
port for  1866,  published  1868,  vol.  iii.,  p.  307. 


REMOVAL    OF    EXCRETA.  49 

bos,  with  a  pipe  to  carry  off  the  urine  and  ablution  water,  would  be  bet- 
ter suited  for  the  poorer  classes. 

It  appears  from  the  observations  of  Mr.  Fawcus,  at  the  jail  of  Alipore, 
that  more  earth  must  be  used  for  vegetable  than  for  animal  feeders  ;  the 
experiment  gave  5.1  lb  avoir.  (2|-  seers)  of  undried  earth  for  the  daily 
evacuation  of  a  vegetable-feeding  Hindoo.  The  urine  discharge  (2  lb)  re- 
quired 8.2  ft)  of  earth.  The  eai'th  was  ef&cacious  in  proportion  to  the 
vegetable  organic  matter  or  humus.  In  the  experiments  in  this  country 
the  clayey  matters  (silicates  of  alumina)  have  seemed  to  be  chiefly  usefuL 
In  Indian  jails  and  some  cantonments  the  trench  system  is  used  ;  shallow 
(1  to  1^  foot  deep)  trenches  are  dug  in  a  field,  and  earth  is  thrown  over  the 
excreta  ;  when  the  trenches  are  fuU,  the  whole  is  ploughed  up,  and  vege- 
tables are  at  once  planted,  trenches  being  dug  elsewhere  ;  after  two  or 
three  crops  this  portion  of  the  field  may  be  used  again.  Great  import- 
ance is  attached  to  the  early  and  repeated  cropping  of  the  ground.' 

4.  Deodorizing  Powders. — Instead  of  charcoal  or  earth,  M'Dougall's  or 
Calvert's  carbolic  acid  powders  may  be  used,  and  this  plan  has  been  largely 
adopted  in  some  Indian  stations.  A  comparatively  small  quantity  is  re- 
quired, but  the  smell  of  the  carbolic  acid  and  the  cost  are  somewhat 
against  the  plan.  Dr.  Bond's  preparations  of  Terebene,  viz.,  the  Terebene 
powder,  Cupralum,  etc.,  are  very  efficacious,  and  have  a  pleasant  odor. 
Langton -Jones'  Universal  Disinfecting  Powder  is  inodorous,  but  not  very 
powerful. 

5.  Sawdust  mixed  with  sulphuric  or  carbolic  acid. — The  mixture  of 
sulphuric  acid  and  sawdust  has  been  found  to  have  little  efficacy ;  the  car- 
bolic acid  has  the  disadvantage  of  the  odor  which  adheres  to  the  clothes. 
Chloralum  powder  is  also  mixed  with  sawdust,  and  is  moderately  effica- 
cious. 

6.  In  Germany,  Silvern' s  deodorizer  (a  mixture  of  hme,  magnesium 
chloride,  and  coal-tar)  is  much  used.  The  Midler-Schilr  deodorizer  is  com- 
posed of  100  lb  of  lime,  20  lb  of  powdered  wood  charcoal,  10  ft)  of  peat 
powder  or  sawdust,  and  1  lb  of  carboHc  acid  containing  60  to  70  per  cent 
of  real  acid.  After  mixing,  the  mass  is  put  under  cover  for  a  night  to 
avoid  any  chance  of  self- combustion,  and  when  it  is  dry  it  is  packed  in 
barrels.  Lueder  and  Leidloff's  powder,  consisting  of  fenic  sulphate,  fer- 
rous sulphate,  calcium  sulphate,  and  a  little  free  sulphuric  acid,  is  also  much 
used.     It  is  moderately  successful. 

Arrangement  of  Closets  on  the  Dry  Plan. 

As  the  excreta  after  being  mixed  with  the  deodorizer  are  in  most  cases 
kept  for  some  days  or  even  weeks  close  to  the  house,  the  same  rules  as  to 
position  and  construction  of  closets  should  be  employed  as  in  the  case  of 
water-closets.  The  closet  should  never  be  in  the  basement,  but  in  the 
roof,  or,  better  still,  in  a  detached  building  or  semi-detached,  and  with 
thorough  ventilation  between  it  and  the  house  ;  there  should  be  a  pipe 
leading  at  once  to  the  outer  air  from  the  closet,  and  one  from  the  re- 
ceptacle. 

'  Two  objections  liave  been  made  to  tbe  dry  eartb  system  : — 1.  It  is  almost  impos- 
sible to  get  rid  of  a  certain  amount  of  smell,  even  with  deodorants.  2.  The  product  is 
not  very  valuable,  according  to  Dr.  Gilbert's  analysis,  not  so  valuable  as  good  garden 
mould,  even  after  the  earth  has  been  twice  used.  The  chief  value  is  therefore  a  sani- 
tary one. 

Vol.  n.-4 


50  PKACTICAL    HYGIENE. 

The  receptacle  itself  is  usually  movable  ;  but  if  not,  it  should  be  most 
carefully  cemented,  so  that  no  leakage  may  occur. 

With  these  precautions  no  odor  will  be  perceived  ;  but  it  is  still  very 
desirable  that  the  removal  of  the  soil  should  be  as  fi'equent  as  possible. 
In  country  houses  there  is  no  diiiiculty,  but  in  towns  the  removal  can 
seldom  be  more  frequent  than  once  a  week,  and  often  is  only  once  a 
month. 

The  forms  of  the  closet  itself  are  numerous.  Those  applicable  k»  the 
earth  plan  have  been  ah-eady  noticed.  Colonel  Synge,  E.E.,  has  patented 
a  closet  for  'Mr.  Stanford's  charcoal  process  (the  Alver  appliance  for  diy 
deodorants).  In  Germany  and  the  north  of  Europe,  where  the  dry-  re- 
moval, but  without  admixtui'e  with  deodorant  powders,  is  in  much  use, 
there  are  various  closets  in  which  the  mine  and  fteces  are  separated.' 
The  "  air-closet"  of  Mehlhouse  is  said  to  be  a  good  arrangement  fo? houses. 
The  urine  runs  into  a  porcelain  funnel  fixed  on  the  front  wall  of  the  pan, 
and  then  into  an  iron  vessel,  fi'om  which  it  can  readily  be  removed  through 
a  valve  ;  the  solids  fall  into  an  ii-on  receptacle  at  the  back  part  of  the  pan. 
A  discharge  tube  passes  fi-om  the  back  and  top  part  of  this  receptacle  into 
a  chimney.  Two  openings  in  the  front  wall,  which  can  be  closed  by 
valves,  can  be  used  as  inlets  for  the  air.  If  a  hopper  with  charcoal  or 
dried  earth  were  attached  to  this  closet,  it  would  be  almost  identical  with 
Taylor's  improved  closet.'' 

Carbonization. 

In  1869,  ]Mr.  Hickey,'  of  Darjeeling  (Bengal  Presidency),  proposed  to 
cai'bonize  the  sewage  in  retorts,  either  mth  or  without  previous  admixture 
with  charcoal.  Almost  at  the  same  time  'Mx.  Stanford '  proposed  the  plan 
ah'eady  referred  to,  of  the  addition  of  sea-weed  charcoal,  and  subsequent 
distillation. 

In  India  the  difficulty  of  obtaining  a  remunerative  price  for  the  am- 
moniacal  products,  and  the  large  cost  of  the  apparatus  necessary  for  work- 
ing the  plan,  have  been  unfavorable  to  its  success.  Carbonization  is  now 
being  tried  in  this  countiy,  and  may  possibly  be  commercially  successful. 
Experience  only  can  show  if  it  is  so  ;  but  if  it  will  return  a  profit,  there 
can  be  no  question  that  it  is  an  excellent  plan  in  a  piu-ely  sanitary  point  of 
view.  The  chief  money  difficulty  in  the  process  is  the  large  amount  of 
water  which  has  to  be  driven  oflt^  which  gi-eatly  increases  the  expense. 

In  Manchester  Frs'er's  patent  method  is  in  operation,  and  it  is  also 
being  applied,  ui  whole  or  in  part,  at  Birmingham  and  at  Leeds.  It  consists 
of  a  Destmctor,  which  reduces  to  slag  all  the  more  bulky  town  refuse,  such 
as  cinders  and  ashes,  broken  earthenware  and  glass,  which  cannot  be  dealt 
with  except  by  being  accumulated  in  a  i-ubbish  heap.  This  slag  is  ground, 
mixed  with  hme,  and  sold  as  mortar.  The  appai-atus  is  so  arranged  that 
none  of  the  heat  is  lost,  while  the  heated  products  of  combustion  pass  over 

'  Roth  and  Lex  (op.  cit. ,  p.  454  )  give  a  good  description  of  these.  See  also  for 
some  good  remarks,  Pettenkofer's  paper  on  the  "Sewerage  of  Bale"  (Zeitsch.  fiir 
Biologie,  Band  iii.,  p.  27:^). 

'  Dr.  Bond  has  also  invented  a  good  form  of  self-acting  closet,  which  separates  the 
urine  and  fjBces.  At  Manchester  and  Salford  the  cinder-sifting  closet  of  Mr.  Morrell 
is  in  use- 

"  The  Carbonization  or  Dry  Distillation  System  of  Conservancy,  by  W.  R.  S.  Hickey, 
C.E.  ;  with  a  note  on  Dry  Sewage,  by  F.  J  Monat,  M.D.    Darjeeling,  1869. 

••  A  Chemist's  View  of  the  Sewage  Question,  Chemical  News,  June  to  October, 
1869. 


EEMOVAL    OF    EXCRETA.  51 

fresh  portions  of  material  and  prepare  it  for  combustion.  The  mass  is  re- 
duced in  bulk  to  one-third.  Other  refuse,  such  as  condemned  food,  vege- 
table garbage,  street  sweepings,  and  the  hke,  are  reduced  to  charcoal  in 
another  apparatus  called  the  Carbonizer.  The  cai-bon  thus  produced  is 
used  for  disinfecting  purposes,  for  decolorizing  the  waste  water  from  fac- 
tories, etc.  The  excreta  proper  it  is  proposed  to  coUect  in  pails  and  re- 
duce to  small  bulk,  by  drying  in  a  closed  apparatus,  called  the  Concretor  ; 
the  ammonia  being  fixed  by  the  sulphuric  acid  fumes  produced  by  the 
other  processes.  By  this  means  the  contents  of  the  pails  are  reduced  to 
one-twelfth,  and  a  valuable  manure  obtained,  which  may  be  either  in  the 
form  of  poudrette  or  mixed  with  a  little  charcoal. 

The  Pneumatic  Air  Plan  '  (Aspiration  Plan). 

A  Dutch  engineer.  Captain  Liernur,  proposed  some  years  since  an 
entirely  novel  plan.  No  water  or  deodorizing  powders  are  used  ;  the  ex- 
creta faU  into  a  straight  earthenware  pipe,^  leading  to  a  smaller  iron  siphon 
pipe,  from  which  they  are  extracted  periodically  by  exhaustion  of  the  air. 
The  extracting  force  which  can  be  used  (by  an  air-pump  worked  by  a 
steam  engine),  is  said  to  be  equal  to  a  pressure  of  1,500  lb  per  square  foot, 
which  is  sufficient  to  draw  the  excreta  through  the  tubes  with  great 
rapidity.  The  plan  has  been  tried  on  the  small  scale  at  Prague,  Eotter- 
dam,  Amsterdam,  Ley  den,  and  Hanau,  also  at  Briinn,  Olmutz,  and  St. 
Petersburg,  and  the  opinions  concerning  it  are  very  various.  It  does  not 
render  sewers  unnecessary  ;  indeed,  the  system  contemplates  an  arrange- 
ment of  sewers  for  slop  and  other  waters. 

Shane's  Ejector  System. — This  is  an  opposite  plan  to  Liernur's,  the  agent 

^  The  Sewage  Question,  by  F,  C.  Krepp,  London,  1867.  This  book  was  written 
for  the  purpose  of  bringing  the  Liernur  plan  before  the  public,  and  some  parts  of  it 
must  be  taken  with  limitation. 

Reports  in  Deutsche  Vierteljahrs.  fiir  offentl.  Gesundsheitspii. ,  Band  iii. ,  p.  3l3 
(1871). 

Ibid.,  Band  iii.,  p.  312. 

Report  of  Kauff  and  Esser,  in  Deutsche  Viertelj.  fiir  off.  Gesundsheitspii.,  Band  iv., 
p.  316.  These  gentlemen  were  sent  from  Heidelberg  to  investigate  the  plan.  Reports 
of  Messrs.  Schroder  and  Lorent  (Ibid.,  Band  iv.,  p.  486).  In  this  Report  is  a  good 
technical  and  financial  account. 

Ballot  (Medical  Times  and  Gazette,  February  15,  1873)  spoke  favorably  of  it,  and 
considered  it  to  have  been  a  decided  success  in  Amsterdam  and  Leyden.  Gori,  on  the 
other  hand  (Med.  Times  and  Gazeirte,  March  8,  1873),  replied  to  Ballot,  denied  that 
this  is  the  case,  and  declared  that  in  Amsterdam  all  with  one  consent  say,  "It  is  im- 
practicable."    Ballot  adheres,  however,  to  his  statement. 

I  saw  the  system  at  work  in  Leyden  in  September,  1876,  when  much  of  its  results 
and  details  was  explained  to  me  by  the  late  Professor  Boogaard,  and  again  in  Amster- 
dam in  1879,  with  Captain  Liernur  himself.  It  seemed  very  effectual,  and  there  was  a 
total  absence  of  odor,  although  I  was  present  in  some  of  the  closets  at  the  moment  that 
the  contents  were  sucked  away  by  the  apparatus.  In  Leyden  the  material  is  sold  in  bar- 
rels in  the  liquid  form  ;  but  at  Dordrecht,  where  the  newest  and  most  complete  works 
are,  it  is  made  into  poudrette,  which  is  said  to  pay.  In  this  country,  Mr.  Adam  Scott 
has  done  his  best  to  bring  it  to  public  notice  (see  his  papers  in  the  Builder,  Sanitary 
Record,  Public  Health,  etc.).  He  considers  that  it  has  been  shown  by  five  years'  ex- 
perience in  Holland,  that  the  pneumatic  system,  by  removing  excrement  without  any 
possible  pollution  of  air,  soil,  or  water,  has  banished  typhoid  and  diphtheria,  as  well  as 
cholera  and  any  diseases  that  are  conveyed  by  the  discharge  from  the  intestines.  The 
Committee  on  Town  Sewage  (Mr.  Rawlinson  and  Mr.  C.  S.  Reade)  speak  most  dis- 
paragingly of  it,  more  so,  indeed,  than  seems  warranted  by  all  the  evidence.  On  the 
other  hand,  the  patent  for  Austria  and  Hungary  has  been  purchased  by  the  Vienna 
Joint-Stock  Agricultural  Society,  who  consider  it  a  success,  both  hygienically  and 
firiaucially. — (F.  de  C). 


52  PRACTICAL    HYGIENE. 

being  compressed  air  instead  of  exhaustion.     It  lias  been  applied  at  Wrex- 
ham and  at  Eastbourne,  and  is  well  spoken  of. 

Comparison  of  the  Different  Methods. 

Much  controversy  has  arisen  on  this  point,  though  it  does  not  appear 
that  the  question  of  the  best  mode  of  removing  excreta  is  really  a  very  dif- 
ficult one.  It  is  simply  one  which  cannot  be  always  answered  in  the  same 
way. 

It  will  probably  be  agreed  by  all  that  no  large  town  can  exist  without 
sewers  to  carry  off  the  foul  house  water,  some  ui'ine  and  trade  products, 
and  that  this  sewer  water  must  be  purified  before  discharge  into  streams. 
The  onl}'  question  is,  whether  fecal  excreta  should  also  pass  into  the  sewei-s. 

It  will  also  be,  no  doubt,  admitted  that  no  argument  ought  to  be  drawn 
against  sewers  from  imperfection  in  their  construction.  The  advocate 
of  water  removal  of  solid  excreta  can  fahly  claim  that  his  argument  pre- 
supposes that  the  sewers  are  laid  with  aU  the  precision  and  precaution  of 
modern  science  ;  that  the  houses  are  thoroughly  secured  from  reflux  of 
sewer  air  ;  that  the  water-closets  or  water-troughs  are  properly  used  ;  and 
that  the  other  conditions  of  sufficient  water  supply  and  power  of  disposal 
of  the  sewer  water  are  also  present.  If  these  conditions  are  fulfilled, 
what  reason  is  there  for  keeping  out  of  the  sewer  water  (which  must,  under 
any  circumstance  of  urban  life,  be  foul)  the  solid  excreta,  which,  after  all, 
cannot  add  very  greatly  to  its  impui-ity,  and  do  add  something  to  its  agii- 
cultural  value  ? 

That  it  is  not  the  solid  excreta  alone  which  cause  the  difficulty  of  the 
disposal  of  sewer  water  is  seen  from  the  case  of  Birmingham.  That  town 
is  sewered  ;  it  contains  nearly  400,000  inhabitants,  and  is  in  the  greatest 
difficulty  how  to  dispose  of  its  sewer  water  ;  yet  the  sohd  excreta  of  only  6 
per  cent,  of  the  inhabitants  pass  into  the  sewers,  while  the  sohd  excreta  of 
the  remainder  are  received  into  middens.'  The  problem  of  disposal  is  as 
serious  for  Birmingham  as  if  all  the  excreta  passed  in. 

Tliat  great  difficult}^,  in  fact,  consists  not  so  much  in  the  entrance  of 
the  solid  excreta  into  sewers,  as  in  the  immense  quantity  of  water  Avhich 
has  to  be  disposed  of  in  the  case  of  vei-y  large  inland  towTis  with  water- 
closets.  If  water-closets  are  not  used,  the  amount  of  water  supphed  to 
towns,  and  that  of  sewer  water,  are  considerably  lessened. 

Looking  to  all  the  conditions  of  the  problem,  it  appears  impossible  for 
all  towns  to  have  the  same  plan,  and  the  circumstances  of  each  town  or 
village  must  be  considered  in  determining  the  best  method  for  the  re- 
moval of  excreta.  London  is  particularly  well  adapted  for  water  sewer- 
age, on  account  of  the  confoiTaation  of  the  ground  north  of  the  Thames,  of 
the  number  of  streams  (which  have  all  been  converted  into  sewers),  and  of 
the  comparative  facility  of  getting  rid  of  its  sewer  water.  The  same  may 
be  said  of  Livei-pool  and  many  other  towns.  In  Birmingham,  on  the  other 
hand,  the  inland  position,  the  price  of  land,  and  the  comparative  difficulty 
of  getting  water,  seem  to  render  other  plans  more  desirable.  If  it  had 
been  possible,  years  ago,  to  act  with  om*  pi'esent  knowledge,  and  to  devise 
a  scheme  for  Birmingham,  it  would  have  been  best  to  have  taken  the  rain- 

'  Report  of  the  Birmingham  Sewage  Inquiry  Committee  (1871),  Summary,  p.  11.  It 
should,  liowever.  be  added  that  two-thirds  of  the  middens  drain  into  the  sewers,  i.e., 
allow  urine  and  some  diffluent  fecal  matter  to  pass  in.  In  187.5,  128. .512  tons  of  mid- 
den refuse  were  removed  and  sent  to  country  depots,  to  be  afterward  disposed  of  to 
farmers. 


REMOVAL    OF    EXCRETA.  53 

fall  into  the  Kea  ;  to -have  had  the  sewers  merely  for  house  and  trade  water 
(which  would  have  given  a  manageable  amount  for  filtration  throu.gh  land) ; 
and  to  have  introduced  some  deodorizing  dry  plan  for  the  soUd  excreta, 
and  for  a  part  of  the  urine,  with  short  periods  of  removal. 

In  many  towns  where  land  is  more  available,  the  immediate  application 
to  land,  either  by  filtration  or  irrigation,  may  be  evidently  indicated  by  the 
conditions  of  the  case,  while  in  others  precipitation  may  have  to  be  re- 
sorted to  before  application  to  land.  It  does  not  appear  that  precipitation 
should  in  all  cases  precede  irrigation  or  filtration,  though  mechanical 
arrest  of  the  large  suspended  matters  is  necessary.  There  may  be  some 
towns,  again,  in  which  the  impossibility  of  getting  water  or  land  may 
necessitate  the  employment  of  dry  removal ;  and  this  is  especially  the  case 
with  small  towns  and  \dllages,  where  the  expense  of  good  sewers  and  of  a 
good  supply  of  water  is  so  great  as  to  render  it  impossible  to  adopt  re- 
moval by  water.  It  may,  indeed,  be  said  that,  in  small  towns  in  agricul- 
tural districts,  the  dry  removal,  if  properly  carried  out,  will  be  the  best 
both  for  the  inhabitants  and  for  the  land. 

The  view  here  taken  that  no  single  system  can  meet  all  cases,  and  that 
the  circumstances  of  every  locality  must  guide  the  decision,  is  not  a  com- 
promise between  opposing  plans,  but  is  simply  the  conclusion  which  seems 
forced  on  us  by  the  facts  of  the  case.  It  does  not  invalidate  the  conclusion 
already  come  to,  that,  where  circumstances  are  favorable  for  its  efficient 
execution,  the  water  sewage  plan  (with  or  without  interception  of  rainfall) 
is  the  best  for  large  communities. 


CHAPTER  XL 

WARMING   OF   HOUSES. 

The  heat  of  the  human  body  can  be  preserved  in  two  ways  : — 

1.  The  heat  generated  in  the  body,  which  is  continually  radiating  and 
being  carried  away  by  moving  air,  can  be  retained  and  economized  by 
clothes.  If  the  food  be  suflflcient,  and  the  skin  can  thus  be  kejjt  warm, 
there  is  no  doubt  that  the  body  can  develop  and  retain  its  vigor  with 
little  external  warmth.  In  fact,  provided  the  degree  of  external  cold  be 
not  too  gTeat  (when,  however,  it  may  act  in  part  by  rendering  the  procuring 
of  food  difficult  and  precarious),  it  would  seem  that  cold  does  not  imply 
deficiency  of  bodily  health,  for  some  of  the  most  vigorous  races  inhabit  the 
cold  countries.  In  temperate  climates  there  is  also  a  general  impression 
that  for  healthy  adults  external  cold  is  invigorating,  provided  food  be  suf- 
ficient, and  if  the  internal  warmth  of  the  body  is  retained  by  clothing. 

2.  Extei'nal  heat  can  be  applied  to  the  body  either  by  the  heat  of  the 
sun  (the  great  fountain  of  all  physical  force,  and  vivifier  of  life),  or  by 
artificial  means,  and  in  all  cold  coimtries  artificial  warming  of  habitations 
is  used. 

The  points  to  determine  in  respect  of  habitations  are — 
1st.  What  degree  of  artificial  warmth  should  be  given  ? 
2d.  What  are  the  different  kinds  of  warmth,  and  how  are  they  to  be 
given? 


SECTION  I. 

DEGREE  OF  WARMTH. 

For  Healthy  Persons. — There  appears  no  doubt  that  both  infants  and 
old  persons  require  much  artificial  warmth,  in  addition  even  to  abundant 
clothes  and  food.  The  lowering  of  the  external  temperature,  especially 
when  rapid,  acts  very  depressingiy  on  the  very  young  and  old  ;  and  when 
we  remember  the  extraordinary  vivifying  effect  of  warmth,  we  cannot  be 
surprised  at  this. 

For  adult  men  of  the  soldier's  age,  who  are  properly  fed  and  clothed, 
it  is  probable  that  the  degree  of  temperature  of  the  house  is  not  very 
material,  and  that  it  is  chiefly  to  be  regulated  by  what  is  comfortable.  Any 
temperature  over  48°  up  to  60°  is  felt  as  comfortable,  though  this  is  de- 
pendent in  part  on  the  temperature  of  the  external  air.  It  seems  certain 
that  for  healthy,  well-clothed,  and  well-fed  men  we  need  not  give  our- 
selves any  gi-eat  concern  about  the  precise  degree  of  warmth. 

For  cliik.ren  and  aged  persons  we  are  not  in  a  position  at  j^resent  to 
fix  any  exact  temperature  ;  for  new-bom  children  a  temperatvire  of  65°  to 


WARMING    OF    HOUSES.  OD 

70°,  or  even  more,  may  be  necessary,  and  old  people  bear  with  benefit  a 
still  higher  warmth.' 

For  Sick  Persons. — The  degree  of  temperature  for  sick  persons  is  a 
matter  of  great  importance,  which  requires  more  investigation  than  it  has 
received.  There  seems  a  sort  of  general  rule  that  the  air  of  a  sick-room 
or  hospital  should  be  about  60°  Fahr.,  and  in  most  Continental  hospitals, 
warmed  artificially,  this  is  the  contract  temperature ;  but  the  propriety  of 
this  may  be  questioned,^ 

There  are  many  diseases  greatly  benefited  by  a  low  temperature,  es- 
pecially all  those  with  preternatural  heat.  It  appHes,  almost  without  ex- 
ception (scarlet  fever?),  to  the  febrile  cases  in  the  acute  stage,  that  it  is 
desirable  to  have  the  temperature  of  the  air  as  low  as  50°,  or  even  45°  or 
40°.  Cold  air  moving  over  the  body  is  a  cooling  agent  of  great  power, 
second  only,  if  second,  to  cold  effusion  ;  nor  is  there  danger  of  bad  results 
if  the  movement  is  not  too  great.  The  Austrian  experiments  on  tent 
hospitals^  show  conclusively  that  even  considerable  cold  is  well  borne. 
Even  in  the  acute  lung  affections  this  is  the  case.  Pneumonia  cases 
do  best  in  cold  wards,  provided  there  is  no  great  current  of  air  over  them. 
Many  cases  of  phthisis  bear  cool  air,  and  even  transitions  of  temperature, 
well,  provided  there  be  no  great  movement  of  air.  On  the  other  hand,  it 
would  appear  that  chronic  heart  diseases  with  lung  congestion,  emphysema 
of  the  lungs,  and  diseases  of  the  same  class,  require  a  warm  air,  and  per- 
haps a  moist  one.  With  respect  to  the  inflammatory  affections  of  the  throat, 
larynx,  and  trachea,  no  decided  evidence  exists  ;  but  the  spasmodic  affec- 
tions of  both  larynx  and  bronchial  tubes  seem  benefited  by  warmth. 

In  the  convalescence,  also,  from  acute  disease,  cold  is  very  badly  borne  ; 
no  doubt,  the  body,  after  the  previous  rapid  metamorphosis,  is  in  a  state 
very  susceptible  to  cold,  and,  like  the  body  of  the  infant,  resists  external 
influences  badly.  Convalescents  from  fever  must  therefore  be  always  kept 
warm.  This  is  probably  the  reason  why  it  is  found  inadvisable  to  trans- 
fer febrile  patients  treated  in  a  permanent  hospital  to  convalescemt  tents, 
although  patients  treated  from  the  first  in  tents  have  a  good  convalescence 
in  them,  as  if  there  were  something  in  habit. 


SECTION  n. 

DIFFERENT   KINDS  OF   WARMTH. 

Heat  is  communicated  by  radiation,  conduction,  and  convection.  The 
latter  term  is  applied  to  the  conveyance  from  one  place  to  another  of  heat 
by  means  of  masses  of  air,  while  conduction  is  the  passage  of  heat  from 
one  particle  to  another — a  very  slow  process.  Practically,  conduction  and 
convection  may  be  both  considered  under  the  head  of  convection. 

'  It  is  singular,  however,  tliat  in  some  old  people  the  temperature  of  the  body  is 
higher  than  normal  (John  Davy).  Is  there,  then,  a  difference  in  th«  amount  of  ex- 
ternal heat  required  in  different  persons  ? 

^  It  is  owing  to  this  rule  that  in  French  hospitals,  artificially  ventilated  and  warmed 
by  hot  air,  the  amount  of  air  is  lessened  and  its  temperature  heightened  in  order  to 
keep  up  the  contract  temperature  of  15^  C.  (=  59^  F. )  The  air  is  often  then  close  and 
disagreeable.  A  safe  general  rule  is  never  to  sacrifice  fresh  air  to  temperature,  except 
in  the  most  extreme  cases.  Of  course,  cold  currents  of  air  are  to  be  avoided  if  possible, 
but  it  is  safer,  as  a  rule,  to  let  the  general  temperature  go  down,  rather  than  diminish, 
the  change  of  air.     In  most  cases  it  can  be  compensated  for  by  additional  covering. 

2  See  Report  on  Hygiene  in  the  Army  Medical  Reports,  vol.  iv.,  by  Dr.  Parkes.  The 
Prussians  have  also  lately  made  great  use  of  tents  in  the  summer. 


56  PRACTICAL    HYGIENE. 

Radiant  heat  has  been  considered  by  most  writers  the  best  means  of 
warming  ;  it  heats  the  body  without  heating  the  air,'  and  of  course  there 
is  no  possibihty  of  impurity  being  added  to  the  air. 

The  disadvantages  of  radiant  heat  are  its  cost,  and  its  feebleness  at  any 
distance.  The  cost  can  be  lessened  by  proper  arrangement,  but  the  loss  of 
heat  by  distance  is  irremediable.  The  effect  lessens  as  the  square  of  the 
distance — i.e.,  if,  at  1  foot  distance  from  the  fire,  the  warming  effect  is  said 
to  be  equal  to  1,  at  4  feet  distance  it  will  be  sixteen  times  less.  A  long 
room,  therefore,  can  never  be  wai'med  properly  by  radiation  from  one 
centre  of  heat  only. 

It  has  been  attempted  to  calculate  the  amount  of  air  warmed  by  a  cer- 
tain space  of  incandescent  fire,  and  1  square  inch  has  been  supjDosed  suffi- 
cient to  warm  8.4  cubic  feet  of  air.  But  much  depends  on  the  walls,  and 
whether  the  rays  fall  on  them  and  wai-m  them,  and  the  air  passing  over 
them. 

Radiating  grates  should  be  so  disposed  as  that  every  ray  is  thi'own  out 
into  the  room.  The  rules  indicated  by  Desagidiers  were  applied  by  Rum- 
ford.  Count  Rumford  made  the  width  of  the  back  of  the  grate  one-third 
the  width  of  the  hearth  recess  ;  the  sides  then  sloped  out  to  the  front  of 
the  recess  ;  the  depth  of  the  gi'ate  from  before  backAvard  was  made  equal 
to  the  width  of  the  back.  The  sides  and  back  were  to  be  made  of  non- 
conducting material ;  the  chimney  throat  was  contracted  so  as  to  lessen 
the  draught,  and  insure  more  complete  combustion.  The  grate  was 
brought  as  far  forward  as  possible,  but  still  under  the  throat. 

The  open  chimney,  which  is  a  necessity  of  the  use  of  radiant  grates,  is 
so  great  an  advantage  that  this  is  per  se  a  strong  argument  for  the  use  of 
this  kind  of  warming,  but,  in  addition,  there  can  be  httle  doubt  that  radi- 
ant heat  is  reall}^  the  healthiest. 

Still  the  immense  loss  of  heat  in  our  common  EngHsh  fire-places  must 
lead  to  a  modification,  and  radiant  heat  must  be  supplemented  by 

Convection  and  Conduction. 

The  air  is  heated  in  this  case  by  passing  over  hot  stones,  earthenware, 
iron  or  copper  plates,  hot  water,  steam,  or  gas  pipes.  The  aii-  in  the  room 
is  thus  heated,  or  the  air  taken  from  outside  is  warmed,  and  is  then  allowed 
to  pass  into  the  room,  if  jiospible  at  or  near  the  floor,  so  that  it  may  prop- 
erly mingle  with  the  air  already  there.  The  heat  of  the  warming  surface 
sbould  not  be  gx'eat,  probably  not  moi*e  than  120^  to  140°  Fahr.  ;  there 
should  be  a  large  surface  feebly  heated.  The  air  should  not  be  heated 
above  75°  or  80°  Fahr.,  and  a  large  body  of  aii-  gently  heated  should  be 
preferred  to  a  smaller  body  heated  to  a  greater  extent,  as  more  likely  to 
mix  thoroughly  with  the  air  of  the  room. 

It  does  not  matter  what  the  kind  of  surface  may  be,  provided  it  is  not 
too  hot.  If  it  is,  the  air  acquii'es  a  peculiar  smell,  and  is  said  to  be  burnt ; 
this  has  been  conjectured  to  be  from  the  charring  of  the  organic  matter. 
Some  have  suj)posed  the  smell  to  be  caused  by  the  effect  of  the  hot  air  on 
the  mucous  membrane  of  the  nose,  but  it  is  not  perceived  in  air  heated  by 
the  sun.  Such  air  is  also  relatively  very  dry,  and  absorbs  water  eagerly 
from  all  substances  which  can  yield  it. 

'  Dr.  Sankey  has  made  experiments  whicli  show  that  the  temperature  of  the  air  of 
a  room  heated  by  radiant  heat  is  really  lower  than  the  temperature  indicated  by  the 
thermometer,  because  the  bulb  is  warmed  by  radiation.  When  this  is  prevented  by 
enclosing  the  bulb  in  a  bright  tin  case  the  thermometer  falls. 


WARJIIN'G    or    HOUSES.  57 

If  the  air  is  less  heated  (not  more  than  To"")  it  has  no  smell,  and  the 
relative  humidity  is  not  lessened  to  an  appreciable  extent.  Haller's  ex- 
periments, carried  on  over  six  years  "with  the  Meissner  stove  common  in 
Germany,  shovr  that  there  the  relative  moisture  is  not  lessened  with  mod- 
erate warming,'  and  the  same  result  has  been  found  with  the  Galton  stoves. 
On  the  other  hand,  when  the  plates  are  too  hot,  the  air  may  be  really  too 
much  dried,  and  Dr.  Sankey  states  that  while  he  never  found  the  difference 
between  the  diw  and  wet  bulbs  in  a  room  warmed  by  radiant  heat  to  be 
more  than  8^  Fahi'.,  he  has  noticed  in  rooms  wanned  by  hot  air  a  differ- 
ence of  15^  to  11"  Fahr.,  which  implies  a  relative  humidity,  if  the  tempera- 
ture be  60",  of  only  34  per  cent,  of  saturation,  which  is  much  too  diw  for 
health.  In  this  case  the  air  is  always  unpleasant,  and  mast  be  moistened 
by  passing"  over  water  before  it  enters  the  room,  if  possible  ;  some  heat  is 
thus  lost,  but  not  much.  Of  the  various  means  of  heating,  water  is  the  best, 
as  it  is  more  under  control,  and  the  heat  can  be  carried  everywhere.  Steam  is 
equally  good,  if  waste  steam  can  be  utilized,  but  if  not,  it  is  more  expensive. 
Hot  water  pipes  are  of  two  kinds  :  pipes  in  which  the  water  is  not  heated 
above  200"  Fahr.,  and  which,  therefore,  are  not  subjected  to  great  pressure  ; 
and  pipes  in  which  the  water  is  heated  to  300°  or  350^  Fahi'.,  and  which 
are  therefore  subjected  to  great  pressui-e.  These  pipes  (Perkin's  patent) 
are  of  small  internal  calibre  (about  ^  inchj,  with  thick  walls  made  of  two 
pieces  of  welded  ii'on  ;  the  ends  of  the  pipes  are  joined  by  an  ingeniously 
contrived  screw.  In  the  low-pressure  pipes  there  is  a  boiler  from  which 
the  water  cu'culates  through  the  pipes  and  returns  again,  outlets  being 
provided  at  the  highest  points  for  the  exit  of  the  air.  In  Perkin's  system 
there  is  no  boiler  ;  one  portion  of  the  tube  passes  through  the  fire. 

]Mi-.  Hood  states  that  5  feet  of  a  4-inch  pipe  wih  Avarm  1,000  cubic  feet 
in  a  public  room  to  55 ^  In  dwelling-houses  for  every  1,000  cubic  feet  12 
feet  of  4-inch  pipe  should  be  given,  and  will  warm  to  65'.  In  shops,  10 
feet,  and  in  workrooms  6  feet  per  1,000  cubic  feet  are  sufficient.  If  Per- 
kin's pipes  are  used,  as  the  heating  power  is  greater,  a  less  amount  does, 
probably  about  two-thirds,  or  a  little  more. 

Steam  piping  is  now  also  much  used,  and  in  some  cases  is  more  con- 
venient even  than  water.  The  Houses  of  Parhament  are  warmed  by  steam 
pipes  in  a  chamber  under  the  floor  ;  the  radiating  suiiace  of  the  pipes  is 
increased  by  soldering  on  to  them  at  inteiwals  a  number  of  zinc  or  (prefer- 
ably) smaU  copper  plates.  If  it  is  wished  to  lessen  the  amount  of  heat, 
the  pipes,  where  pro%ided  with  thin  plates,  ai'e  simply  covered  vvith  a 
woollen  cloth. 

The  easy  storing  up  and  conveyance  of  heat  to  any  part  of  the  room  or 
house  by  means  of  water  pipes,  the  moderate  temperature,  and  the  facihty  of 
admission  of  external  air  at  any  point  by  2:)assing  the  fresh  air  over  coils,  or 
water  leaves,  make  it  certain  that  the  plan  of  wai'ming  by  hot  water  will  be 
greatly  used  in  time  to  come,  although  the  open  fire-place  may  be  retained 
for  comfort. 

^h\  George  has  devised  a  gas  stove  (called  the  Calorigen),  which  ap- 
pears to  be  a  decided  improvement  on  the  common  gas  stove.  Gas  is 
burnt  in  a  small  iron  box,  and  the  jDroducts  of  combustion  ai-e  carried  to 
the  open  air  by  a  tube.  Another  coiled  tube  runs  up  through  the  box  ; 
this  communicates  below  with  the  outer  aii',  and  above  opens  into  the  rooms. 
As  the  fresh  ah-  passes  through  this  tube  it  is  waiTaed  by  the  heat  of  the 

'  Die  Luftuns  und  Erwarmung  der  Kinderstube  und  des  Krankenzimmers,  vou 
D.  C.  Haller,  1860,  pp.  29-38, 


58  PRACTICAL    HYGIENE. 

gas  stove.  Mr.  Eassie  speaks  very  well  of  this  stove,  which  he  has  put  up 
in  several  places.  He  says  he  has  known  one  to  be  persistently  capable  of 
registering  fifteen  degrees  above  the  external  temperature  dtuing  a  very 
severe  winter,  and  that  too  in  a  room  of  over  1,7U0  cubic  feet,  with  the 
roof  and  three  sides  constnicted  of  glass.'  A  coal  calorigen  is  also  made 
which  seems  to  answer  welL  Dr.  F.  T.  Bond's  Euthermic  stove  is  also  a 
very  good  contrivance. 

A  plan  which  was  proposed  130  years  ago  by  Desagnaliers  is  now  coming 
into  genei'al  use,  viz.,  to  have  an  air-chamber  round  the  back  and  sides  of 
a  radiating  grate,  and  to  pass  the  external  air  through  it  into  the  room. 
Thus  a  great  economy  of  heat,  and  a  considerable  quantity  of  gently 
warmed  aii',  passes  into  the  room.  In  Captain  Galton's  grate,  and  in  the 
plan  projjosed  by  IVIr.  Chadwick  for  cottages,  the  lower  part  of  the  chimney 
is  also  made  use  of.  The  advantages  of  these  grates  are  that  they  com- 
bine a  good  amount  of  cheerful  open  fire,  radiant  heat,  and  chimney  ven- 
tilation, with  supplementary  wanning  by  hot  air,  so  that  more  value  is 
obtained  from  the  fuel,  and  larger  spaces  can  be  more  efl'ectually  wai'med. 
A  great  number  of  patents  have  been  taken  out  for  grates  of  this  kind. 
The  air-chamber  should  not  be  too  small,  or  the  air  is  unduly  heated  ;  the 
heated  surface  should  be  very  large  ;  fire-clay  sometimes  gives  a  peculiar 
odor  to  the  air,  which  iron  does  not  do  if  the  sui-face  of  iron  be  veiy  large 
and  disj)osed  in  gills  ;  a  combination  also  of  iron  and  fire-clay  is  said  to  be 
good,  and  to  give  no  odor.  The  conduit  leading  to  the  air-chamber  should 
be  short,  and  both  it  and  the  chamber  should  be  able  to  be  opened  and 
cleaned,  as  much  dust  gets  in.  The  room  opening  of  the  air-chamber 
should  be  so  far  up  that  the  hot  aii'  may  not  be  at  once  breathed,  and  there 
should  be  no  chance  of  its  being  at  once  drawn  up  the  chimney.  The 
action  of  all  stoves  of  the  kind  is  liable  to  considerable  variation  from  the 
action  of  the  wind  ;  and  sometimes  the  current  is  even  reversed  and  hot 
air  is  driven  out. 

Attention  has  been  lately  directed,  both  in  France  and  America,  to  the 
fact  of  the  comparative  ease  with  which  gases  pass  through  red  hot  cast- 
iron.  Mr.  Graham  showed  that  iron  heated  to  redness  will  absorb  4.15 
times  its  volume  of  carbon  monoxide  ;  and  the  experiments  by  MM.  DeriUe 
and  Troost,  made  at  the  request  of  General  Morin,  proved  that  in  a  cast- 
iron  stove  heated  \rith  common  coal  there  passed  through  the  metal  in  92 
hours  589  C.C.  of  carbon  monoxide,^  or  from  .0141  to  .132  per  cent,  of  the 
ail'  which  was  slowly  passed  over  the  hot  surface.  In  America  Dr.  Derby' 
has  directed  particular  attention  to  this  point,  and  has  adduced  very  strong 
reasons  for  believing  that  the  decidedly  injurious  efi'ects  produced  by 
some  of  the  plans  of  warming  houses,  especially  by  air  passing  over  a  cast- 
iron  furnace  heated  with  anthracite  is  due  to  an  admixture  of  carbon  mon- 
oxide. Professor  Coulier,  of  the  Val  de  Grace,*  has  contended  that  the 
amount  of  carbon  monoxide  passing  through  in  the  experiments  of  Deville 
and  Ti'oost  is  reaUy  so  small,  that  if  mixed  with  the  air  of  a  room  which  is 
f aii'ly  ventilated,  it  would  be  quite  innocuous  ;  and  he  believes  (from  direct 

'  Sanitary  Arrangements  for  Dwellings,  1874,  p.  140. 

'  Comptes  Renclus  de  I'Acad.,  Jan.,  18(58.  These  experiments  were  first  undertaken 
in  consequence  of  a  statement  by  Dr.  Carret,  that  in  tlie  department  of  Haute-Savoie 
an  epidemic  occurred  which  affected  persons  only  in  the  houses  where  iron  stoves  were, 
and  not  porcelain. 

^  Anthracite  and  Health,  by  G.  Derby,  M.D.,  Professor  of  Hygiene  in  Harvard  Uni- 
versity. 

*  Mem.  de  Med.  Mil.,  Sept.,  1868,  p.  250. 


WARMING    OF    HOUSES.  59 

experiment)  that  the  headache  and  oppressive  feeling?  produced  by  these 
iron  stoves  are  really  owing,  as  was  formerly  believed,  to  the  relative  dry- 
ness of  the  air.  But  evidence  is  adverse  to  this  now.  The  gas  passes 
with  much  greater  difficulty  through  wrought-iron,  or  through  stoves  lined 
with  fireclay.' 

A  great  number  of  grates  and  stoves  have  been  proposed,  which  it  is 
impossible  here  to  notice.  In  Germany  many  excellent  stoves  are  now 
used,  which  not  only  economize  fuel  but  warm  the  outside  air,  which  is 
admitted  round  or  under  them.^  The  medical  officer's  advice  will  be 
sought,  first,  as  to  the  kind  ;  and  second,  as  to  the  amount  of  heat.  He 
will  find  no  difficulty  in  coming  to  the  conclusion  that  in  most  cases  both 
methods  (radiation-  and  convection)  should  be  employed  ;  the  air  warmed 
by  plates  or  coils  of  water-pipes  being  taken  fresh  from  the  external  air 
and  thereby  conducing  to  ventilation.  He  will  be  also  called  on  to  state 
the  relative  amount  of  radiant  and  convected  heat,  and  to  determine  the 
heat  of  the  plates,  and  of  the  air  coming  off  them,  and  the  degree  of  hu- 
midity of  the  air.  The  thermometer,  and  the  dry  and  wet  bulbs,  wiU  give 
him  £dl  the  information  he  wants  on  these  points.^ 

'  Dr.  Bond  has  recommended  a  coating  of  silicate  as  a  preventive  against  the  passage 
of  deleterious  products  tlirough  an  iron  stove. 

^  See  a  good  account  in  Roth  and  Lex's  work  (op.  cit.,  p.  365). 

^  Mr.  Chadwick  has  lately  called  attention  to  the  old  Roman  plan  of  the  Hypocausu, 
where  the  floor  of  the  room  Is  warmed  by  pipes,  or  by  carrying  smoke-flues  under  it, 
and  lie  has  contrived  some  ingenious  plans  to  carry  out  the  idea.  There  can  be  no 
doubt  of  the  great  comfort  of  this  plan,  although  it  appears  to  be  expensive.  Attention 
has  been  called,  of  late;  years,  to  heating  on  the  whole  house  system,  and  there  can  be 
no  doubt  that  this  is  an  excellent  plan,  if  properly  carried  out  and  carefully  supervised. 
Drs.  Drysdale  and  Hayward  in  this  country  (Health  and  Comfort  in  House  Building, 
London,  1872),  and  Dr.  Griscom,  of  New  York,  have  devised  ingenious  plans  for  the 
purpose.  In  colder  countries,  such  as  Russia,  the  plan  is  in  general  use,  but  apparently 
with  little  or  no  regard  to  proper  supply  of  fresh  air,  or  carrying  away  of  foul  air. 


CHAPTER  XII. 

EXERCISE. 

A  PERFECT  state  of  health  implies  that  every  organ  has  its  due  share  of 
exercise.  If  this  is  deficient,  nutrition  suffers,  the  organ  lessens  in  size, 
and  eventually  more  or  less  degenerates.  If  it  be  excessive,  nutrition,  at 
first  apparently  vigorous,  becomes  at  last  abnormal,  and  in  many  cases,  a 
degeneration  occurs  which  is  as  complete  as  that  which  follows  tlie  disuse 
of  an  organ.  Every  organ  has  its  special  stimulus  which  excites  its  action, 
and  if  this  stimulus  is  perfectly  normal  as  to  quality  and  quantity,  perfect 
health  is  necessarily  the  result. 

But  the  term  exercise  is  usually  employed  in  a  narrower  sense,  and  ex- 
presses merely  the  action  of  the  voluntary  muscles.  This  action,  though 
not  absolutely  essential  to  the  exercise  of  other  organs,  is  yet  highly  im- 
portant, and  indeed,  in  the  long  run,  is  reaUy  necessary  ;  the  heart  espe- 
cially is  evidently  affected  by  the  action  of  the  voluntary  muscles,  and  this 
may  be  said  of  all  organs,  with  the  exception  perhaps  of  the  brain.  Not 
only  the  circulation  of  the  blood,  but  its  formation  and  its  destruction,  are 
profoundly  influenced  by  the  movement  of  the  voluntary  muscles.  With- 
out this  muscular  movement  health  must  inevitably  be  lost,  and  it  becomes 
therefore  important  to  determine  the  effects  of  exercise,  and  the  amount 
which  should  be  taken. 

SECTION  I. 

THE  EFFECTS  OF  EXERCISE. 

(a)  On  the  Lungs — Elimination  of  Garhon.—T\\e  most  important  effect 
of  muscular  exercise  is  produced  on  the  lungs.  The  ptilmonary  ckcula- 
tion  is  greatly  hurried,  and  the  quantity  of  air  inspired,  and  of  carbon 
dioxide  expired,  is  marvellously  increased.  Dr.  Edward  Smith  investigated 
the  first  point  carefully,  and  the  following  table  shows  his  main  results. 
Taking  the  lying  position  as  unity,  the  quantity  of  air  inspired  was  found 
to  be  as  follows  : — 


Lying  position 1.0 

sitting 1.18 

Standing 1.33 

Singing 1.26 

Walking  1  mile  per  hour,    1.9 

2  miles       "  2.76 

3  "  "  3.23 
"        and  carrying  34  lb,  3.5 

The  great  increase  of  air  inspired  is  more  clearly  seen  when  it  is  put  in 
this  way  :  under  ordinary  cirexunstances,  a  man  draws  in  480  cubic  inches 


Walking  and  carrying  63  ft,  3.84 
118  ft,  4.75 
"        4  miles  per  hour.  .5.0 
6      "  "        7.0 

Riding  and  trotting 4.05 

Swimming 4.33 

Treadmill 5.5 


EXERCISE. 


61 


per  minute  ;  if  he  walks  four  miles  an  hour  he  draws  in  (480  x  5  = )  2,400 
cubic  inches  ;  if  six  miles  an  hoiu-  (480  x  7  =^  )  3,260  cubic  inches.  Sim- 
ultaneously, the  amount  of  carbon  dioxide  in  the  expired  air  is  increased 
(Scharling  and  many  others). 

The  most  reliable  observations  in  this  direction  are  those  made  by  E. 
Smith,  Hu-n,^  Speck,^  and  Pettenkofer  and  Yoit.'  As  there  is  no  doubt 
that  the  peculiar  means  of  investigation  render  the  experiments  of  the  last- 
named  authors  as  accurate  as  possible  in  the  present  state  of  science,  they 
are  given  briefly  in  the  following  table.  ^ 

Absorption  and  Eliinination  in  Rest  and  Exercise. 


Rest-day 

Work-day 

Excess  on  work-day  (with  exception  of  ) 
urea) j 


Elimination  in  Grams  of — 


Absorption   

of  Oxygen  in    p     , 
Grammes.   ^Car^o-^  I  Water. 


708.9 
954.5 


245.6 


911.51    828.0 
1284.2  2042.1 


372.7 


1214.1 


Urea. 


37.2 
37 


-0.2 


In  other  words,  during  the  work-day,  3,804  grains  or  8.69  ovmces  of 
oxygen  were  absorbed  in  excess  of  the  rest-day,  and  5,750  grains  or  13 
ounces  in  excess  of  carbon  dioxide  were  evolved.  Expressing  this  as  car- 
bon, an  excess  of  1,568  gTains  or  3.58  ounces  were  eliminated  in  the  work- 
day. There  was  an  excess  of  oxidation  of  carbon  equal  to  34.6  per  cent., 
and  it  must  be  remembered  that  the  so-called  "  work-day  "  included  a 
period  of  rest  ;  the  work  was  done  only  duiing  the  working  hours,  and 
was  not  excessive. 

It  will  be  observed  from  these  experiments  that  a  large  amount  of  water 
was  ehminated  during  exercise,  while  the  ui-ea  was  slightly  lessened. 

It  seems  certain  that  the  great  formation  of  carbon  dioxide  takes  place 
in  the  muscles  ;  °  it  is  rapidly  carried  off  from  them,  and  if  it  is  not  so,  it 
would  seem  highly  probable  that  their  strong  action  becomes  impossible. 
At  any  rate,  if  the  pulmonary  circulation  and  the  elimination  of  carbon 
dioxide  are  in  any  way  impeded,  the  power  of  continuing  the  exertion 
rapidly  lessens.  The  watery  vapor  exhaled  from  the  lungs  is  also  largely 
increased  during  exertion. 

Muscular  exercise  is  then  clearly  necessary  for  a  sufficient  elimination 
of  carbon  from  the  body,  and  it  is  plain  that,  in  a  state  of  prolonged  rest, 
either  the  carboniferous  food  must  be  lessened  or  carbon  will  accumulate. 

Excessive  and  badly  arranged  exertion  may  lead  to  congestion  of  the 
lungs  and  even  hsemoi^tysis.     Deficient  exercise,  on  the  other  hand,  is  one 


'  Lud wig's  Phys.,  2d  edit,  Band  i.,  p.  743. 

'  Archiv  des  Vereins  fiir  wiss.  Heilk.,  Band  vi.,  pp.  28o  and  289. 

^  Zeitsch.  fiir  Biologie,  Bands  ii.  and  iii.,  and  Raake's  Phys.  des  Menschen,  p.  551. 

•*  The  numbers  given  by  Hirn  and  Speck  are  very  accordant ;  they  ■will  be  found 
quoted  in  the  2d  edition  of  this  -n-ork,  if  it  is  wished  to  refer  to  them. 

'  See  the  observations  of  Valentin  and  others,  and  especially  the  experiments  of 
Sczelkow  (Henle's  Zeitschrift,  1863,  Band  xvii. ,  p.  106).  The  amount  of  CO-,  passing 
o£E  from  contracting  muscles  was  indeed  so  great,  and  so  much  in  excess  of  tlie  O  pass- 
ing to  them,  that  it  was  conjectured  that  carbonic  acid  must  have  been  formed  during 
contraction  from  substances  rich  in  oxygen  (such  as  formic  acidj,  or  that  oxygen  must 
have  been  obtained  otherwise  than  from  inspiration. 


62  PKACTICAL    HYGIENE. 

of  the  causes  which  produce  those  nutritional  alterations  in  the  lung  which 
we  class  as  tuberculous. 

Certain  miles  flow  from  these  facts.  During  exercise  the  action  of  the 
.ungs  must  be  perfectly  free  ;  not  the  least  impediment  must  be  offered  to 
the  fi-eest  play  of  the  chest  and  the  action  of  the  respiratory  muscles.  The 
dress  and  accoutrements  of  the  soldier  should  be  planned  in  reference  to 
this  fact,  as  there  is  no  man  who  is  called  on  to  make,  at  certain  times, 
gi-eater  exertion.  And  yet,  tUl  a  very  recent  date,  the  modern  armies  of 
Euroj^e  were  dressed  and  accoutred  in  a  fashion  which  took  from  the  sol- 
dier, in  a  great  degi-ee,  that  power  of  exertion  for  which,  and  for  which 
alone,  he  is  selected  and  trained. 

The  action  of  the  lungs  should  be  watched  when  men  are  being  trained 
for  exertion  ;  as  soon  as  the  resiDirations  become  laborious,  and  especially 
if  there  be  sighing,  the  lungs  are  becoming  too  congested,  and  rest  is 
necessary. 

A  second  point  is,  that  the  great  increase  of  carbon  excreted  demands 
an  increase  of  carbon  to  be  given  in  the  food.  There  seems  a  general  ac- 
cordance, among  physiologists,  that  this  is  best  given  in  the  form  of  fat, 
and  not  of  starch,  and  this  is  confirmed  by  the  instinctive  apj)etite  of  a  man 
taking  exertion,  and  not  restrained  in  the  choice  of  food. 

A  third  rule  is,  that  as  spirits  lessen  the  excretion  of  pulmonary  cai'bon 
dioxide,  they  are  hiirtful  diu-ing  exercise  ;  and  it  is  perhaps  for  this  reason, 
as  well  as  from  their  deadening  action  on  the  nei-\'es  of  volition,  that  those 
who  take  spirits  are  incapable  of  gi-eat  exertion.  This  is  now  well  under- 
stood by  trainers,  who  allow  no  spii'its,  and  but  little  wine  or  beer.  It  is 
a  curious  fact,  stated  by  Ai'tmann,  that  if  men  undergoing  exertion  take 
spirits,  they  take  less  fat.  Possibly  in  reality  they  lessen  the  amount  of 
exertion,  and  therefore  requii-e  less  fat.  Water  alone  is  the  best  fluid  to 
train  on. 

A  fourth  rvile  is,  that  as  the  excretion  of  carbon  dioxide  (and  perhaps 
of  pulmonary  organic  matter)  is  so  much  increased,  a  much  larger  amount 
of  pure  air  is  necessaiy  ;  and  in  every  covered  building  (as  gymnasia,  riding- 
schools,  etc.)  where  exercise  is  taken,  the  ventilation  must  be  cdrried  to 
the  greatest  possible  extent,  so  soon  does  the  air  become  vitiated. 

(6)  On  the  Heart  and  Vesf^els. — The  action  of  the  heart  rapidly  increases 
in  force  and  frequency,  and  the  flow  of  blood  through  all  parts  of  the  body, 
including  the  heai-t  itself,  is  augmented.  The  amount  of  increase  is  usu- 
ally from  ten  to  thirty  beats,  but  occasionally  much  more.  After  exercise, 
the  heart's  action  faUs  below  its  noi-mal  amount ;  and  if  the  exercise  has 
been  exceedingly  prolonged  and  severe,  may  fall  as  low  as  fifty  or  forty  per 
minute,  and  become  intermittent.  Dm'ing  exertion,  when  the  heart  is  not 
oppressed,  its  beats,  though  rapid  and  forcible,  are  regular  and  equable  ; 
but  when  it  becomes  embaiTassed,  the  pulse  becomes  very  quick,  small, 
and  then  unequal,  and  even  at  last  in-egular.  "When  men  have  gone 
through  a  good  deal  of  exertion,  and  then  are  called  upon  to  make  a  sud- 
den effort,  the  pulse  may  become  very  small  and  quick  (160-170),  but  stiU 
retain  its  equabihty.  There  seems  no  hai'm  in  this,  but  such  exertion  can- 
not be  long  continued. 

The  ascension  of  heights  gi-eatly  tries  a  fatigued  heai-t.  The  accommo- 
dation of  the  heai't  to  gi-eat  exertion  is  probably  connected  with  the  easy 
flow  of  blood  thi'ough  its  own  structure. 

Excessive  exercise  leads  to  affection  of  the  heart ;  iiiptui'e  (in  some  few 
cases),  palpitation,  hypertrophy  in  a  good  many  cases,  and  more  rarely 
valvular  disease.     These  may  be  avoided  by  cai-eful  training,  and  a  due 


EXERCISE.  63 

proportion  of  rest.  Injuries  to  vessels  may  also  result  from  too  sudden 
or  prolonged  exertion.  The  sphygmographic  observations  of  Dr.  Eraser  ' 
on  the  pulses  of  men  after  rowing,  show  how  much  the  pressure  is  in- 
creased. 

Deficient  exercise  leads  to  weakening  of  the  heart's  action,  and  prob- 
ably to  dilatation  and  fatty  degeneration. 

In  commencing  an  unaccustomed  exercise,  the  heart  must  be  closely 
watched  ;  excessive  rapidity  (120-140),  inequality,  and  then  irregularity, 
will  point  out  that  rest,  and  then  more  gi-adual  exercise,  are  necessary,  in 
order  that  the  heart  may  be  accustomed  to  the  work. 

(c)  On  the  Skin. — The  skin  becomes  red  from  turgescence  of  the  vessels, 
and  perspiration  is  increased  ;  water,  chloride  of  sodium,  and  acids  (prob- 
ably in  part  fatty)  pass  off  in  great  abundance.  Some  nitrogen  passes  off 
in  a  soluble  form  (urea?),  but  the  amount  is  extremely  small. ^  No  gaseous 
nitrogen  is  given  off  in  healthy  men  from  the  skin. 

The  amount  of  fluid  passing  off  is  not  certain,  but  is  very  great. 
Speck's  experiments  show  that  it  is  at  least  doubled  under  ordinary  con- 
ditions. Pettenkofer  and  Voit's  experiments  show  even  a  larger  increase. 
The  usual  ratio  of  the  urine  to  the  lung  and  skin  excreta  is  reversed. 
Instead  of  being  1  to  0.5  or  0.8,  it  becomes  1  to  1.7,  or  2,  or  even  2.5.  This 
evaporation  reduces  and  regulates  the  heat  of  the  body,  which  would 
otherwise  soon  become  excessive  ;  so  that,  as  long  ago  pointed  out  by  Dr. 
John  Dav}',  the  body  temperature  rises  little  above  the  ordinary  tempera- 
ture. No  amount  of  external  cold  seems  to  be  able  to  hinder  the  passage 
of  fluid,  though  it  may  partly  check  the  rapidity  of  evaporation.  If  any- 
thing check  evaporation,  the  body  heat  increases,  and  soon  languor  comes 
on  and  exertion  becomes  difiicult. 

During  exertion  there  is  little  danger  of  chill  under  almost  any  circum- 
stances ;  but  when  exertion  is  over,  there  is  then  great  danger,  because  the 
heat  of  the  body  rapidly  declines,  and  falls  below  the  natural  amount, 
and  yet  evaporation  from  the  skin,  which  still  more  reduces  the  heat,  con- 
tinues. • 

The  rules  to  be  drawn  from  these  facts  are — that  the  skin  should  be 
kept  extremely  clean  ;  during  the  period  of  exertion,  it  may  be  thinly 
clothed,  but  immediately  afterward,  or  in  the  intervals  of  exertion,  it 
should  be  covered  sufficiently  weU  to  prevent  the  least  feeling  of  coolness 
of  the  surface.     Flannel  is  best  for  this  purpose. 

{d)  On  the  Voluntary  Muscles. — The  muscles  grow,  become  harder,  and 
respond  more  readUy  to  volition.  Their  growth,  however,  has  a  limit ; 
and  a  single  muscle,  or  group  of  muscles,  if  exercised  to  too  great  an  ex- 
tent, will,  after  growing  to  a  great  size,  commence  to  waste.  But  this 
seems  not  to  be  the  case  when  all  the  muscles  of  the  body  are  exercised, 
probably  because  no  muscle  can  then  be  over-exercised.  It  seems  to  be  a 
fact,  however,  that  prolonged  exertion,  without  sufiicient  rest,  damages  to 
a  certain  extent  the  nutrition  of  the  muscles,  and  they  become  soft. 

The  rules  to  be  drawn  from  these  facts  are,  that  all  muscles,  and  not 
single  groups,  should  be  brought  into  play,  and  that  periods  of  exercise 
must  be  alternated,  especially  in  early  training,  with  long  intervals  of  rest. 

(e)  On  the  Nervous  System. — The  effect  of  exercise  on  the  mind  is  not 
clear.  It  has  been  supposed  that  intellect  is  less  active  in  men  who  take 
excessive  exercise,  owing  to  the  greater  expenditure  of  nervous  force  in 

'  Journal  of  Physiology,  November,  1868. 

^  See  On  the  Excretion  of  Nitrogen  by  the  Skin,  by  J.  Byrne  Power,  L.C.P.I., 
Proceedings  of  the  Royal  Society,  1882,  vol.  xxxiii.,  p.  354. 


64  PRACTICAL   HYGIENE. 

that  direction.  But  there  is  no  doubt  that  great  bodily  is  quite  consistent 
Avith  extreme  mental  activity ;  and,  indeed,  considering  that  perfect  nutri- 
tion is  not  possible  except  with  bodily  activity,  we  should  infer  that  suf- 
ficient exercise  would  be  necessary  for  the  perfect  performance  of  mental 
work.  Doubtless,  exercise  may  be  pushed  to  such  an  extreme  as  to  leave 
no  time  for  mental  cultivation  ;  and  this  is  perhaps  the  explanation  of  the 
proverbial  stupidity  of  the  athletae.  Deficient  exercise  causes  a  heightened 
sensitiveness  of  the  nervous  system,  a  sort  of  morbid  excitabihty,  and  a 
greater  susceptibihty  to  the  action  of  external  agencies. 

(/)  On  the  Digestive  System. — The  appetite  largely  increases  with  exer- 
cise, especially  for  meat  and  fat,  but  in  a  less  degree,  it  would  appear,  for 
the  carbohydrates.  Digestion  is  more  perfect,  and  absorption  is  more 
rapid.  The  cii-culation  through  the  hver  increases,  and  the  abdominal 
circulation  is  carried  on  with  more  vigor.  Food  must  be  increased,  espe- 
cially nitrogenous  substances,  fats,  and  salts,  and  of  these  especially  the 
phosphates  and  the  chlorides.'  The  effects  of  exercise  on  digestion  are 
greatly  increased  if  it  be  taken  in  the  free  air,  and  it  is  then  a  most  valu- 
able remedy  for  some  fomis  of  dyspepsia.^  Conversely,  deficient  exercise 
lessens  both  appetite  and  digestive  power. 

(g)  On  the  Generative  Organs. — It  has  been  supposed  that  puberty  is 
delayed  by  physical  exertion,  but  perhaps  the  other  circumstances  have 
not  been  allowed  full  weight.  Yet,  it  would  apjiear  that  very  strong  exer- 
cise lessens  sexual  desii-e,  possibly  because  nervous  energy  is  turned  in  a 
special  direction. 

(h)  On  the  Kidneys. — The  water  of  the  urine  and  the  chloride  of 
sodium  often  lessen  in  consequence  of  the  increased  passage  from  the  skin. 
The  urea  is  not  much  changed.  The  uric  acid  increases  after  great  exer- 
tion ;  so  also  apparently  the  pigment  ;  the  phosphoric  acid  is  not  aug- 
mented ;  ^  the  sulphuric  acid  is  moderately  increased  ;  the  free  carbonic 
acid  of  the  lu'ine  is  increased  ;  the  chlorides  are  lessened  on  account  of  the 
outflow  by  the  skin  ;  the  exact  amount  of  the  bases  has  not  been  deter- 
mined, but  a  greater  excess  of  soda  and  potash  is  eliminated  than  of  Hme 
or  magnesia  ;  nothing  certain  is  known  as  to  hippuiic  acid,  sugar,  or  other 
substances.* 

'  It  is  yet  uncertain  what  kind  of  diet  should  be  allowed  during  long  marches  in 
the  tropics.  Dr.  Kirk  states  that  in  South  Africa  (10"  to  17  S.L.),  during  Dr.  Living- 
stone's second  expedition,  a  large  quantity  (2  Iti)  of  animal  food  was  found  to  be  essen- 
tial; this  was  preferred,  though  any  quantity  of  millets  and  leguminosae  could  have 
been  procured.  Fat  was  taken  in  large  quantities.  It  was  found,  also,  that  boiled 
was  better  than  roast  meat,  because  the  men  covild  eat  more  of  it.  No  bad  effect  what- 
ever was  traceable  to  the  use  of  this  great  amount  of  meat,  even  to  the  intensest  heat. 
■^  James  Blake,  Pacific  Medical  and  Surgical  Journal,  1860. 
^  Dr.  Parkes'  experiments. 

*  In  the  careful  observations  made  by  Dr.  Pavy  on  Weston,  the  pedestrian  (Lancet, 
December,  1876),  the  following  changes  were  found  ;  taking  the  amount  excreted 
during  rest  as  1  : — 

Constituents,  Best.  Walking. 

Urea 1     1.743 

Uric  acid 1     1.287 

Chlorine 1     478 

Siilphuric  acid 1     1.520 

Phosphoric  acid 1     1.985 

Soda 1     822 

Potash 1     1.424 

Lime 1 1.559 

Magnesia 1     989 

All  the  constituents  thus  appear  to  be  increased,  except  the  chlorine  and  the  soda, 


EXEECISE.  65 

(i)  On  the  Boicels. — The  effect  of  exercise  is  to  lessen  tlie  amount, 
partly,  probably  from  lessened  passage  of  water  into  the  intestines.  The 
nitrogen  does  not  appear  to  be  much  altered/ 

[k]  On  the  Elimination  of  Nitrogen. — A  great  number  of  experiments 
have  been  made  in  the  amount  of  nitrogen  passing  off  by  the  kidneys  dur- 
ing exercise.''  The  amount  of  urea  has  been  usually  determined,  and  the. 
nitrogen  has  been  calculated  from  this ;  Meissner  has  determined  the 
amount  of  the  creatin,  and  the  creatinine  ;^  while  Fick  and  Wislicenus 
have  comjDared  the  total  nitrogen  (by  soda  hme  in  the  manner  of  Yoit)  as 
well  as  the  ureal  nitrogen,  and  Dr.  Parkes  repeated  their  experiments.* 
The  experiments  have  been  usually  cai-ried  on  by  determining  the  nitro- 
genous excretion  irt  twenty-four  hoiu's  with  and  without  exercise  ;  but  in 
some,  the  period  during  which  work  was  actually  performed  was  compared 
with  previous  and  subsequent  ec[ual  rest  j^eriods.  Some  experiments  were 
performed  on  men  who  took  no  niti'ogen  as  food  ;  others  were  on  men  on 
a  constant  diet,  so  that  the  variation  produced  by  the  altering  ingress  of 
nitrogen  was  avoided  as  far  as  possible. 

In  this  jDlace  it  is  impossible  to  give  an  account  of  these  long  researches, 
and  therefore  only  a  shoi't  summary  can  be  given.  (1)  "When  a  period  of 
exercise  is  comj^ared  after  an  interval  with  one  of  rest  (the  diet  being  with- 
out nitrogen  or  with  uniform  nitrogen),  the  ehmination  of  nitrogen  by  the 
kidneys  is  decidedly  not  increased  in  the  esei'cise  period.  The  experi- 
ments on  this  point  are  now  so  numerous  that  it  may  be  stated  without 
doubt.  It  is  possible  that  the  ehmination  may  even  be  less  during  the  ex- 
ercise than  during  the  work  period.  This  would  appear  in  part  from  some 
of  Ranke's,  and  Fick  and  WisHcenus'  experiments  ;  fi'om  Noyes',  as  far  as 
regards  the  ui'ea  ;  and  from  Meissner's,  as  far  as  the  creatin  (or  creatinine) 
is  concerned ;  while  Dr.  Parkes  found  a  decrease,  which  was  not  inconsid- 
erable, both  in  the  total  nitrogen  and  in  the,  ui-ea.  Additional  observations 
are,  however,  much  wanted  on  this  point. 

(2)  When  a  day  of  rest  is  compared  with  a  day  of  work  {i.e.,  a  day  with 
some  hoiu's  of  work  and  some  hours  of  rest),  the  amount  of  nitrogen  is  al- 
most or  quite  the  same  on  the  two  days ;  if  anything  there  is  a  shght  in- 
crease in  the  nitrogen  on  the  rest  day.  In  a  day  of  pari  exercise  and  part 
rest,  it  is  quite  possible  that  there  may  be  compensatory  action,  one  part 
balancing  the  other,  so  as  to  leave  the  total  excretion  httle  changed. 

(3)  "WTien  a  period  of  great  exercise  is  immediately  followed  by  an 
equal  period  of  rest,  the  nitrogenous  elimination  is  increased  in  the  latter. 
Meissner's  observations  show  that  this  is  in  pari  owing  to  increased  dis- 
charge of  creatin  and  creatinine  ;  Parkes'  observations  also  show  an  in- 
crease of  non-ureal  nitrogen.  But  the  urea  is  also  sHghtly  increased  in 
this  period. 

(4)  When  two  days  of  complete  rest  are  immediately  followed  by  days 


which,  are  notably  diminislied,  especially  the  chlorine ;  the  magnesia  is  also  dimin- 
i.shed,  but  in  a  much  less  degree.  In  these  experiments,  however,  the  diet  was  not 
uniform,  and  the  exercise  was  excessive. 

>  Proceedings  of  the  Royal  Society,  Xo.  94,  1867,  p.  52. 

-  For  a  statement  of  these  experiments  iip  to  1860,  see  Dr.  Parkes'  work  On  the 
Composition  of  the  Urine,  1860,  p.  85.  Since  this  time  the  chief  experiments  have 
been  by  Voit,  Pettenkofer,  J.  Ranke,  E.  Smith,  Haughton,  Fick  and  Wislicenus,  Byas- 
son,  Xoyes,  Meissner,  Pavy,  Parkes,  and  others.  At  present  the  subject  is  being  in- 
vestigated by  a  Committee  of  the  British  Association. 

2  Henle's  Zeitschrift  at.  Med.,  Band  xxxii.,  p.  283. 

*  Proceedings  of  the  Royal  Society,  Xo.  89  (1867),  and  Xo.  94  (1867). 
Vol.  n.— o 


66  PRACTICAL    HYGIENE. 

of  common  exercise,  the  nitrogenous  elimination  diminishes  during  the 
first  day  of  exercise  (Parkes). 

On  tlie  whole,  if  the  facts  have  been  stated  correctly,  the  effect  of  exer- 
cise is  certainly  to  influence  the  elimination  of  nitrogen  by  the  kidneys, 
but  within  narrow  limits,  and  the  time  of  increase  is  in  the  period  of  rest 
succeeding  the  exercise  ;  while  during  the  exercise  period  the  evidence, 
though  not  certain,  points  rather  to  a  lessening  of  the  elimination  of  nitrogen. 

It  would  appear  from  these  facts  that  well-fed  persons  taking  exercise 
would  require  a  little  more  nitrogen  in  the  food,  and  it  is  certain,  as  a 
matter  of  experience,  that  persons  undergoing  laborious  work  do  take  more 
nitrogenous  food.  This  is  the  case  also  with  animals.  The  possible  rea- 
son of  this  will  appear  presently. 

(Z)  On  the  Tenvperature  of  the  Body. — As  already  stated,  the  temperature 
of  the  body,  as  long  as  the  skin  acts,  rises  little.  Dr.  Clifford- AUbutt, ' 
from  observations  made  on  himself  when  climbing  the  Alps,^  found  his 
temperature  fairly  uniform  ;  the  most  usual  effect  was  a  slight  rise,  com- 
pensated by  an  earher  setting  in  of  the  evening  fall.  On  two  occasions  he 
noticed  two  curious  depressions,  amounting  to  no  less  than  4.5°  Fahi'.  ; 
he  believes  these  were  due  to  want  of  food,  and  not  to  exercise  per  se.  In 
experiments  on  soldiers  when  marching,  Dr.  Parkes  found  no  difference  in 
temperature  ;  or  if  there  was  a  very  slight  rise,  it  was  subsequently  com- 
pensated for  by  an  equal  fall,  so  that  the  mean  daily  temperature  remained 
the  same.'  A  decided  rise  in  temperature  during  marching  would  then 
show  lessening  of  skin  evaporation,  and  may  possibly  be  an  important  in- 
dication of  impending  sunstroke. 

Changes  in  the  3Iuscles. — The  discussion  on  this  head  involves  so  many 
obscure  physiological  points,  that  it  would  be  out  of  place  to  pursue  it  here 
to  any  length.  The  chief  changes  during  action  appear  to  be  these  :  — 
There  is  a  considerable  increase  in  temperature  (Helmholtz)  which,  up  to 
a  certain  point,  is  proportioned  to  the  amount  of  work.  It  is  also  propor- 
tioned to  the  kind,  being  less  when  the  muscle  is  allowed  to  shorten  than  if 
prevented  from  shortening  (Heidenhain)  ;  the  neutral  or  alkaline  reaction 
of  the  ti'anquil  muscle  becomes  acid  from  para-lactic  acid  and  acid  potas- 
sium phosphate  ;  the  venous  blood  passing  from  the  muscles  becomes  much 
darker  in  color,  is  much  less  rich  in  oxygen,  and  contains  much  more 
carbonic  acid  (Sczelkow)  ;  the  extractive  matters  soluble  in  water  lessen, 
those  soluble  in  alcohol  increase  (Helmholtz,  in  frogs)  ;  the  amount  of 
water  increases  (in  tetanus,  J.  Ranke),  and  the  blood  is  consequently 
poorer  in  water;  the  amount  of  albumen  in  tetanus  is  less  according  to 
Kanke,  but  Kiihne  has  pointed  out  that  the  numbers  do  not  justify  this  in- 
ference." Baron  J.  von  Liebig  stated  that  the  creatin  is  increased  (but  this 
was  an  inference  from  old  observations  on  the  extractum  carnis  of  hunted 
animals,  and  required  confirmation).  Sarokin  has  stated  the  same  fact  in 
respect  of  the  frog.  The  electro-motor  currents  show  a  decided  diminu- 
tion during  contraction. 

'  Alpine  Journal,  May,  1871 . 

'  In  the  experiments  made  by  Dr.  Calberla  (Arcliiv  der  Heilkunde,  1875,  p.  376') 
and  liis  two  guides,  during  their  ascents  of  Monte  Rosa  and  the  Matterliorn,  in  August, 
1874,  no  depressions  were  found  as  have  been  recorded  by  other  observers.  In  none  of 
the  three  persons  did  the  temperature  ever  fall  below  36.4'  C.  (=97.5°  F.),  or  rise  above 
37.8^  C.  (  =  100°  F.).  Dr.  Thomas,  of  Leipsic,  in  ascents  in  Savoy  and  Dauphine  (3,500 
and  3, 750  metres),  could  also  find  no  lowering  of  temperature. 

3  Proceedings  of  the  Royal  Society,  No.  127  and  No.  136. 

^Lehrb.  der  Phys.  Chem.,  1868,  p.  323. 


EXEECISE.  67 

That  great  molecular  changes  go  on  in  the  contracting  muscles  is  cer- 
tain, but  their  exact  nature  is  not  clear  ;  according  to  Ludimar  Hermann. ' 
there  is  a  jelly-like  separation  and  coagulation  of  the  myosin,  and  then  a 
resumption  of  its  prior  form,  so  that  there  is  a  continual  splitting  of  the 
muscular  structure  into  a  myosin  coagulura,  carbon  dioxide,  and  a  free  acid, 
and  this  constitutes  the  main  molecular  movement.  But  no  direct  evidence 
has  been  given  of  this. 

The  increased  heat,  the  great  amount  of  carbon  dioxide,  and  the  dis- 
appearance of  oxygen,  combined  with  the  respiratory  phenomena  akeady 
noted,  aU  seem  to  show  that  an  active  oxidation  goes  on,  and  it  is  very 
probable  that  this  is  the  source  of  the  muscular  action.  The  oxidation 
may  be  conceived  to  take  place  in  two  ways — either  during  rest  oxygen  is 
absorbed  and  stored  up  in  the  muscles  and  gradually  acts  there,  produc- 
ing a  substance  which,  when  the  muscle  contracts,  sphts  up  into  lactic 
acid,  carbon  dioxide,  etc.  ;  or,  on  the  other  hand,  during  the  contraction  an 
increased  absorption  of  oxygen  goes  on  in  the  blood  and  acts  upon  the 
muscles,  or  on  the  substances  in  the  blood  circulating  thi'ough  the  muscles.* 
The  first  view  is  strengthened  by  some  of  Pettenkofer  and  Voit's  experi- 
ments, which  show  that  during  rest  a  certain  amount  of  storage  of  oxygen 
goes  on,  which  no  doubt  in  part  occurs  in  the  muscles  themselves.  Indeed, 
it  has  been  inferred  that  it  is  this  stored  up  oxygen,  and  not  that  breathed 
in  at  the  time,  which  is  used  in  muscular  action.  The  increased  oxidation 
gives  us  a  reason  why  the  nitrogenous  food  must  be  increased  during 
periods  of  great  exertion.  An  increase  in  the  supply  of  oxygen  is  a  neces- 
sity for  increased  muscular  action  ;  but  Pettenkofer  and  Voit's  observations 
have  shown  that  the  absoi-ption  of  oxygen  is  dependent  on  the  amount  and 
action  of  the  nitrogenous  structures  of  the  body,  so  that,  as  a  matter  of 
course,  if  more  oxygen  is  required  for  increased  muscular  work,  more 
nitrogenous  food  is  necessary.  But  apart  from  this,  although  experiments 
on  the  amount  of  nitrogenous  elimination  show  no  very  great  change  on 
the  whole,  there  is  no  doubt  that,  with  constant  regular  exercise,  a 
muscle  enlarges,  becomes  thicker,  heavier,  contains  more  soUd  matter,  and 
in  fact  has  gained  in  nitrogen.  This  process  may  be  slow,  but  it  is  certain  ; 
and  the  nitrogen  must  either  be  supplied  by  increased  food,  or  be  taken 
from  other  parts.  ^ 

So  that,  although  we  do  not  know  the  exact  changes  going  on  in  the 
muscles,  it  is  certain  that  regular  exercise  produces  in  them  an  addition  of 
nitrogenous  tissue. 

Whether  this  addition  occurs,  as  usually  believed,  in  the  period  of  rest 
succeeding  action,  when  ia  some  unexplained  way  the  destruction,  which  it 
is  presumed  has  taken  place,  is  not  only  repaii-ed,  but  is  exceeded  (a  process 
difficult  to  understand),  or  whether  the  addition  of  nitrogen  is  actually  made 
during  the  action  of  the  muscle,*  must  be  left  undecided  for  'the  present. 

^  Unters.  iiber  den  StofEwechsel  der  Muskeln,  von  Dr.  L.  Hermann  ;  Weitere  Unter- 
such.  zur  phys.  der  JVIuskeln,  von  Dr.  L.  Hermann,  1867. 

-  Heaton  (Quarterly  Journal  of  Science,  1868)  has  given  strong  reasons  for  believing 
that  the  oxidation  goes  on  in  the  blood. 

^  The  way  in  which  a  vigorously  acting  part  will  rob  the  body  of  nitrogen,  and  thus 
in  some  cases  cause  death,  is  seen  in  many  cases  of  disease.  A  rapidly  growing  cancer 
of  the  liver,  for  example,  takes  so  much  nitrogen  as  well  as  fat  that  it  actually  starves 
the  rest  of  the  body,  and  both  voluiitary  muscles  and  heart  waste.  This  is  the  case, 
though  it  is  less  marked,  with  growing  tumors  of  other  parts,  and  with  great  discharges. 
Powerful  muscular  action,  if  the  food  is  not  increased,  evidently  acts  in  something  the 
same  way ;  the  health  is  greatly  affected,  and  the  heart  especially  fails. 

*  Proceedings  of  the  Royal  Society,  No.  94,  1867. 


68  PRACTICAL    HYGIENE. 

The  substances  Tvhieli  are  thus  oxidized  in  the  muscle,  or  in  the  blood 
circulating  through  it,  and  from  which  the  energy  manifested,  as  heat  or 
muscular  movement,  is  believed  to  be  derived,  may  prbably  be  of  differ- 
ent kinds.  Under  ordinary  cii'cumstances,  the  experiments  and  calcula- 
tions of  Fick  and  Wislicenus,  and  <;thers,  and  the  arguments  of  Traube, 
seem  sufficient  to  show  that  the  non-nitrogenous  substances,  and  perhaps 
especially  the  fats,  furnish  the  chief  substances  r.cted  upon.  But  it  is 
probable  that  the  nitrogenous  substances  also  furnish  a  contingent  of 
energy. '  The  exact  mode  in  which  the  energy'  thus  1  'berated  oy  oxidation 
is  made  to  assume  the  form  of  mechanical  motion  is  quite  obsciu'e. 

The  Exhaustion  of  Muscles. 

There  seems  Httle  doubt  that  the  exhaustion  of  muscles  is  chiefly  o^ing 
to  two  causes — first,  and  principally,  to  the  accumulation  in  them  of  the 
products  of  their  own  action  (especially  para-lactic  acid)  ;  and,  secondly, 
from  the  exhaustion  of  the  supply  of  oxygen.  Hence  rest  is  necessary,  in 
order  that  the  blood  may  neutralize  and  can-y  away  the  products  of  action, 
so  that  the  muscle  may  recover  its  neutrality  and  its  normal  electrical  cur- 
rents, and  may  again  acquire  oxygen  in  sufficient  quantity  for  the  next 
contraction.  In  the  case  of  all  muscles  these  intervals  of  action  and  of  ex- 
haustion take  place,  in  part  even  in  the  period  which  is  called  exercise,  but 
the  rest  is  not  sufficient  entii'ely  to  restore  it.  In  the  case  of  the  heart, 
the  rest  between  the  contractions  (about  two-thfrds  of  the  time),  is 
sufficient  to  allow  the  muscle  to  recover  itself  perfectly. 

The  body  after  exertion  absorbs  and  retains  water  eagerly ;  the  water, 
though  taken  in  large  quantities,  does  not  pass  off'  as  rapidly  as  usual  by 
the  kidneys  or  the  skin,  and  instead  of  causing  an  augmented  metamor- 
phosis, as  it  does  in  a  state  of  rest,  it  produces  no  effect  whatever.  So 
completely  is  it  retained,  that  although  the  skin  has  ceased  to  perspire, 
the  uiiue.does  not  increase  in  quantity  for  several  hours.  The  quantity  of 
W'ater  taken  is  sometimes  so  gi-eat  as  not  only  to  cover  the  loss  of  weight 
caused  by  the  exercise,  but  even  to  increase  the  weight  of  the  body. 

We  can  be  certain,  then,  of  the  absolute  necessity  of  water  diu-ing  and 
after  exercise,  and  the  old  mle  of  the  trainer,  who  lessened  the  quantity 
of  water  to  the  lowest  point  which  could  be  borne,  must  be  wrong.  In 
fact,  it  is  now  being  abandoned  by  the  best  trainers,  who  allow  a  liberal 
allowance  of  fluid.  The  error  probabl}'  arose  in  this  way  :  if,  during  great 
exertion,  water  is  denied,  at  the  end  of  the  time  an  enormous  quantity  is 
often  di'urik,  more,  in  fact,  than  is  necessary,  in  order  to  still  the  ovei-jjow- 
ering  thirst.  The  sweating  which  the  trainer  had  so  sedulously  encour- 
aged is  thus  at  once  compensated,  and,  in  his  view,  all  has  to  be  done  over 
again.  All  this  seems  to  be  a  misapprehension  of  the  facts.  The  body 
must  have  water,  and  the  proper  plan  is  to  let  it  j^ass  in  in  small  quantities 

'  Pavy  shows,  in  his  observations  on  Weston  and  Perkins,  that  the  excess  of  nitro- 
gen eliminated  dnring  the  walking  period,  over  the  period  of  rest,  was  equivalent  to 
about  542  foot-tons  per  man  per  diem.  The  total  average  daily  work  done,  he  states 
at  1,264  foot-tons,  but  this  is  an  under-estimate,  as  the  velocity  was  apparently  greater 
than  that  of  average  walking,  the  co-efficient  of  which  (-/,r)  he  assumes  as  the  proportion 
of  resistance.  N.B. — One  grain  of  nitrogen  eliminated,  represents  an  amount  of  al- 
buminate expended,  capable  of  yielding  about  2.4  foot-tons  of  potential  energy. 
Although  some  of  the  excess  of  nitrogen  eliminated  during  exercise,  as  noted  above, 
may  have  been  due  to  disintegration  of  muscle,  part  of  it  was  due  (undoubtedly)  to 
changes  in  other  tissues,  but  a  considerable  amount  is  due  to  direct  oxidation  of  albumi- 
nous food. 


EXEECISE.  69 

and  frequently ;  not  to  deny  it  for  hours,  and  tlien  to  allow  it  to  pass  in 
in  a  deluge.  The  plan  of  gi"\^ng  it  in  small  quantities  frequently,  does 
away  with  two  dangers,  viz.,  the  rapid  passage  of  a  large  quantity  of  cold 
water  iuto  the  stomach  and  blood,  and  the  taking  more  than  is  necessary/ 

In  the  French  army,  on  the  march,  the  men  are  directed  not  to  drink  ; 
but  if  very  tliirsty,  to  hold  water  in  the  mouth,  or  to  carry  a  buUet  in  the 
mouth.  It  is  singular,  in  that  nation  of  practical  soldiers,  to  find  such  an 
order.  Soldiers  ought  to  be  abundantly  supphed  with  water,  and  taught 
to  take  small  quantities,  when  they  begin  to  feel  tliirsty  or  fatigued.  If 
they  are  hot,  the  cold  water  may  be  held  in  the  mouth  a  minute  or  two 
before  swallowing  as  a  jDrecaution  ;  though  there  seems  to  be  no  evidence 
of  any  ill  eifects  from  drinking  a  moderate  quantity  of  cold  water,  even 
during  the  greatest  heat  of  the  body,^ 

General  Effect  of  Exercise  on  the  Body,  as  judged  of  by  the  Preceding 
Facts. — The  main  effect  of  exercise  is  to  increase  oxidation  of  carbon,  and 
perhaps  also  of  hydrogen  ;  it  also  eliminates  water  from  the  body,  and  this 
action  continues,  as  seen  from  Pettenkofer  and  Volt's  experiments,  for  some 
time  ;  after  exercise,  the  body  is  therefore  poorer  in  water,  esjDecially  the 
blood  ;  it  increases  the  rapidity  of  circulation  everywhere,  as  well  as  the 
pressure  on  the  vessels,  and  therefore  it  causes  in  all  organs  a  more  rapid 
outflow  of  plasma  and  absoi-ption, — in  other  words,  a  quicker  renewal.  In 
this  way  also  it  removes  the  j)i'oducts  of  their  action,  which  accumulate  in 
organs  ;  and  restores  the  power  of  action  to  the  various  parts  of  the  body. 
It  increases  the  outflow  of  warmth  from  the  body  by  increasing  perspira- 
tion. It  therefore  strengthens  all  parts.  It  must  be  combined  with  in- 
creased sujDply  both  of  nitrogen  and  carbon  (the  latter  possibly  in  the 
form  of  fatj,  otherwise  the  absorption  of  oxygen,  the  molecular  changes  in 
the  nitrogenous  tissues,  and  the  elimination  of  carbon,  will  be  checked. 
There  must  be  also  an  increased  sujDply  of  salts,  certainly  of  chloride  of 
sodium  ;  probably  of  potassium  phosphate  and  chloride.  There  must  be 
proper  intervals  of  rest,  or  the  store  of  oxygen,  and  of  the  material  in  the 
muscles  which  is  to  be  metamorphosed  during  contraction,  cannot  take 
place.  The  integrity  and  perfect  freedom  of  action  both  of  the  lungs  and 
heart  are  essential,  otherwise  neither  absorption  of  oxygen  nor  ehmiuation 
of  carbon  can  go  on,  nor  can  the  necessary  increased  supply  of  blood  be 
given  to  the  acting  muscles  without  injury. 

In  aU  these  points,  the  inferences  deducible  from  the  physiological  in- 
quiries seem  to  be  quite  in  harmony  with  the  teachings  of  experience. 

^  It  is  but  right  to  say  fhat  many  travellers  of  great  experience  have  expressed  great 
fear  of  water  under  exertion.  Some  of  them  have  most  strongly  urged  that  "  water  be 
avoided  like  poison,"  and  have  stated  that  a  large  quantity  of  butter  is  the  best  pre- 
ventive of  thirst.  At  any  rate,  the  butter  may  be  excellent,  but  a  little  water  is  a 
necessity. 

'  Horses  also  used  to  be,  and  by  some  are  now,  deprived  or  stinted  of  water  during 
exercise.  But  in  India,  the  native  horsemen  give  their  horses  drink  as  often  as  they 
can :  and  Dr.  Nicholson  says  this  is  the  case  with  the  Cape  horses  ;  even  when  the  horses 
are  sweating  profusely,  the  men  will  ride  them  into  a  river,  bathe  their  sides,  and  allow 
them  to  drink. 


70 


PRACTICAL   HYGIENE. 


SECTION  n. 

AMOUNT  OF  EXERCISE  WHICH  SHOULD  BE  TAKEN. 

It  would  be  extremely  important  to  determine,  if  possible,  the  exact 
amount  of  exercise  yrhich  a  healthy  adult,  man  or  woman,  should  take. 
Every  one  knows  that  great  errors  are  committed,  chiefly  on  the  side  of 
defective  exercise.  It  is  not,  however,  easy  to  fix  the  amount  even  for  an 
average  man,  much  less  to  give  any  rule  which  shall  apply  to  all  the  divers 
conditions  of  health  and  strength.  But  it  is  certain  that  muscular  work  is 
not  only  a  necessity  for  health  of  body,  but  for  mind  also  ;  at  least  it  has 
seemed  that  diminution  in  the  size  of  the  body  from  deficient  muscular 
work  seems  to  lead  in  two  or  three  generations  to  degenerate  mental  for- 
mation. 

The  external  work  which  can  be  done  by  a  man  daily  has  been  esti- 
mated at  J-th  of  the  work  of  the  horse  ;  but  if  the  woi'k  of  a  horse  is  con- 
sidered to  be  equal  to  the  1-horse  power  of  a  steam  engine  (viz.,  33,000 
ft)  raised  1  foot  high  per  minute,  or  8,839  tons  raised  1  foot  high  in  ten 
hours),  this  must  be  an  over-estimate,  as  -^th  of  this  would  be  1,263  tons 
raised  1  foot  in  a  day's  work  of  ten  hours. '     The  hardest  day's  work  of 

'  In  some  works  on  physiology  a  man's  work  of  eight  hours  has  been  put  as  high  as 
316,800  kilogrammemetres,  or  1,020  tons  lifted  a  foot ;  but  this  is  far  too  much. 

In  this  country  the  amount  of  work  done  is  generally  estimated  as  so  many  lb  or 
tons  lifted  one  foot.  In  France  it  is  expressed  as  so  many  kilogrammes  lifted  1  metre. 
Kilogrammemetres  are  converted  into  foot-pounds  by  multiplying  by  7.288.  To  bring 
at  once  into  tons  lifted  a  foot,  multiply  kilogrammemetres  by  .003229.  The  following 
table  may  be  useful,  as  expressing  the  amount  of  work  done.  It  is  taken  from  Dr. 
Haughton's  work  (A  New  Theory  of  Muscular  Action).  The  niambers  are  a  little  differ- 
ent from  those  given  by  Coulomb,  as  they  were  recalculated  by  Dr.  Haughton  in  1863. 

Laboring  Force  of  Man. 


Kind  of  Work. 


Pile  driving 

Pile  driving 

Turning  a  winch 

Porters  carrying  goods  and  returning  unladen 

Pedlers  always  loaded 

Porters  carrying  wood  up  a  stair  and  return- 
ing unloaded  

Paviors  at  work 

Military  prisoners  at  shot  drill  (3  hours),  and 
oakum  picking  and  drill 

Shot  drill  alone  (3  hours) 


Amount  of  Work. 

Authority. 

312  tons  lifted  1  foot. 

Coulomb. 

352 

Lamande. 

374 

Coulomb. 

325 

" 

303 

<( 

381 

u 

352 

Haughton. 

310 

u 

160.7 

t( 

It  may  be  interesting  to  give  some  examples  of  work  done  in  India  by  natives,  which 
have  been  noted  by  Dr.  de  Cliaumont:  — 

A  Leptcha  hill-coolie  will  go  from  Punkabarree  to  Darjeeling  (30  miles,  and  an  as- 
cent of  5,500  feet),  in  three  days,  carrying  80  fti  weight;  the  weight  is  carried  on  a 
frame  supported  on  the  loins  and  sacrum,  and  aided  by  a  band  passed  round  the  fore- 
head. 

Work  per  diem,  500  tons  lifted  1  foot. 

Eight  palanquin  bearers  carried  an  officer  weighing  180  tTi,  and  palanquin  weighing 
250  lb,  25  miles  in  Lower  Bengal.  Assuming  each  man  weighed  150  lb,  the  work  was 
600  tons  lifted  a  foot. 


EXERCISE.  71 

twelve  hours  noted  by  Dr.  Parkes  was  in  the  case  of  a  workman  in  a  cop- 
per rolling-mill.  He  stated  that  he  occasionally  raised  a  weight  of  90  ft) 
to  a  height  of  18  inches,  12,000  times  a  day.  Supposing  this  to  be  cor- 
rect, he  would  raise  723  tons  1  foot  high.  But  this  much  overpasses  the 
usual  amount.  The  same  man's  ordinary  day's  work,  which  he  considered 
extremely  hard,  was  raising  a  weight  of  124  lb  16  inches,  5,000  or  6,000 
times  in  a  day.  Adopting  the  larger  number,  this  would  make  his  work 
equivalent  to  442.8  tons  Ufted  a  foot ;  and  this  was  a  hard  day's  work  for 
a  powerful  man.  Some  of  the  puddlers  in  the  iron  country,  and  the  glass- 
blowers,  probably  work  harder  than  this  ;  but  there  are  no  calculations  re- 
corded. From  the  statement  of  a  pedler,  his  ordinary  day's  work  was  to 
carry  28  lb  twenty  miles  daily.  The  weight  is  balanced  over  the  shoulder 
— 14  ft)  behind  and  14  ft)  in  front.  The  work  is  equal  to  419.5  tons  lifted 
1  foot.  It  would,  therefore,  seem  certain  that  an  amount  of  work  equal 
to  500  tons  lifted  a  foot  is  an  extremely  hard  day's  work,  which  perhaps  few 
men  could  continue  to  do.  400  tons  lifted  a  foot  is  a  hard  day's  work, 
and  300  tons  hfted  a  foot  is  an  average  day's  work  for  a  healthy,  strong 
adult. 

The  external  work  is  thus  300  to  500  tons  on  an  average  ;  the  internal 
work  of  the  heart,  muscles  of  respiration,  digestion,  etc. ,  has  been  variously 
estimated  ;  the  estimates  for  the  heart  alone  vary  from  122  to  277  tons 
Hfted  a  foot.  The  former  is  that  given  by  Haughton,  who  estimates  the 
respiratory  movements  as  about  11  tons  lifted  a  foot  in  twenty-four  hours. 
Adopting  a  mean  number  of  260  tons  for  all  the  internal  mechanical  work, 
and  the  external  work  of  a  mechanic  being  300  to  500  tons,  this  will 
amount  to  from  ^-th  to  ^th  of  all  the  force  obtainable  from  the  food. 

The  exertion  which  the  infantry  soldier  is  called  upon  to  undergo  is 
chiefly  drill  and  carrying  weights  on  a  level,  or  over  an  uneven  surface. 

The  Eeverend  Professor  Haughton,  M.D.,  who  is  so  well  known  for  his 
important  contributions  to  physiology  and  medicine,  has  shown  that  walk- 
ing on  a  level  surface  at  the  rate  of  about  3  miles  an  hoiu-  is  equivalent  to 
raising  ^i^th  part  of  the  weight  of  the  body  through  the  distance  walked  ; 
an  easy  calculation  changes  this  into  the  weight  raised  1  foot.  When  as- 
cending a  height,  a  man  of  course  raises  his  whole  weight  through  the 
height  ascended. 

Using  this  formula,'  and  assuming  a  man  to  weigh  150  ft)  with  his 
clothes,  we  get  the  following  table  : — 

„.    J     „  -r,        .  Work  done  in  Tons 

Kmd  of  Exercise.  ^^^^^^  one  foot. 

Walking  1  mile 17.67 

2miles 35.34 

10    " 176.7 

20    " 353.4 

^'         1  mile  and  carrying  60  ft) ... , 24.75 

2mUes      "  "         24-75 

*'       10    "  "  "         247.5 

"      20    "  "  "         495 

It  is  thus  seen  that  a  march  of  10  miles,  with  a  weight  of  60  ft)  (which 

'  The  formula  is  Cw  +  W  )j<  D    ^-^ere  W  is  the  weight  of  the  person,  W  the  weight 
20  X  2,240 
carried;  D  the  distance  walked  in  feet ;  20  the  co-efficient  of  traction;  and  2,240  the 
number  of  pounds  in  a  ton.     The  result  is  the  number  of  tons  raised  1  foot.     To  get 
the  distance  in  feet,  multiply  5,280  by  the  number  of  miles  walked- 


72  PRACTICAL    HYGIENE. 

is  nearly  the  weight  a  soldier  carries  when  in  marching  order,  but  without 
blankets  and  rations),  is  a  moderate  day's  work.  A  20  miles'  march,  with 
60  ft  Aveight,  is  a  very  hard  day's  work.  As  a  continued  laboring  effort 
Dr.  Haughton  believes  that  walking  20  miles  a  day,  without  a  load  (Sun- 
day being  rest),  is  good  work  (353  tons  lifted  a  foot)  ;  so  that  the  load  of 
60  ft  additional  would  make  the  work  too  hard  for  a  continuance. ' 

It  must,  however,  be  remembered,  that  it  is  understood  that  the  walk- 
ing is  on  level  ground,  and  is  done  in  the  easiest  manner  to  the  person, 
and  that  the  weights  which  are  carried  are  properly  disposed.  The  labor 
is  greatly  increased  if  the  walk  is  irksome,  and  the  weights  ai'e  not  well 
adjusted.  And  this  is  the  case  with  the  soldier.  In  marching  his  attitude 
is  stiff ;  he  observes  a  certain  time  and  distance  in  each  step  ;  he  has  none 
of  those  shorter  and  longer  steps,  and  slower  and  more  rapid  motion,  which 
assist  the  ordinary  pedestrian.  It  may  be  questioned,  indeed,  whether 
the  formula  does  not  under-estimate  the  amount  of  work  actually  done  by 
the  soldier.  The  work  becomes  heavier,  too,  i.e.,  more  exhausting,  if  it  is 
done  in  a  shorter  time  ;  or,  in  other  words,  velocity  is  gained  at  the  ex- 
pense of  carrying  power.'     The  velocity,  in  fact,  i.e.,  the  rate  at  which 

'  I  calculated  the  work  done  by  the  sledge-parties  in  the  Arctic  Expedition  of  1875-76, 
and  found  that  the  Northern  party  (Markham's),  did  a  mean  of  574  foot-tons  per  man 
per  diem,  with  a  maximum  of  859  ;  the  Western  party  (Aldrich's)  did  a  mean  of  443, 
and  a  maximum  of  over  OUO.  Even  this  large  amount  was  considered  an  under-esti- 
mate by  the  Commanders.  (See  Report  of  Committee  on  Outbreak  of  Scurvy  (Blue 
Book),  App.  24,  p.  305).— [F.  deC] 

-Dr.  Haughton  (Principles  of  Animal  Mechanics,  2d  ed.,  pp.  56  and  57)  has  deter- 
mined, from  the  calculation  of  the  MM.  Weber,  the  co-efficient  of  resistance  for  three 
velocities,  as  follows  : — 

!.,„„„ , Co-efficient  of 

MUes  per  hour.  Resistance. 

1.818 5-8^7^ 

4.353 Ts^ro 

10.577 T.Vi 

Interpolating  between  these  numbers  we  can  obtain  the  co-efficients  at  other  veloci- 
ties. The  following  table  shows  the  co-efficients,  the  distance  in  miles  that  would 
equal  300  foot-tons  for  a  man  of  150  tb,  and  the  time  in  hours  and  minutes  that  would 
be  required  without  rest:  — 

Velocity  in  Miles  Co-efficient  of  Distance  for  Men  of  Time  required  in 

per  hour.  Resistance.  160  ft),  to  equal  Hours  and  Minutes. 

300  foot-tons.  H.        M. 

1  3^1,-8  30.3  30      12 

2  5/7-4  21.2  10      36 

3  ^5  9  16.3  5      24 

4  r/.n  13.3  3      18 

5  T4V0  11-3  3      36 

6  -r/r-8  9-6  1     36 

7  rif.^-^  8.5  1      12 

8  rVo  "^-^  0     5"^ 

9  W.U  6.9  0     46 
10                                   r^-s                                6.3          .                    0      38 

The  co-efficient  -5V  corresponds  very  nearly  to  3.1  miles  an  hour,  and  this  appears  to  be 
the  rate  at  which  the  greatest  amount  of  work  can  be  done  at  the  least  expenditure  of 
energy.  (See  Table  XVIII. ,  p.  186,  Lectures  on  State  Medicine,  by  F.  de  Chaumont.) 
As  regards  velocity.  Dr.  Haughton  states  the  "  Law  of  Fatigue  "  as  follows: — "  When 
the  same  muscle  (or  group  of  muscles)  is  kept  in  constant  action  till  fatigue  sets  in,  the 
total  work  done,  multiplied  by  the  rate  of  work,  is  constant."  The  "  Law  of  Refresh- 
ment" depends  on  the  rate  at  which  arterial  blood  is  supplied  to  the  muscles,  and  the 
"Co-efficient  of  Refreshment"  is  the  work  restored  to  the  muscles  in  foot-pounds  per 
ounce  of  muscle  per  second  ;  for  voluntary  muscle  it  is  on  an  average  (J.lBoO,  and  for 
the  heart  0.3376,  or  exactly  equal  to  the  work  of  the  heart,  which  never  tires. — 
[F.  de  C.]. 


EXERCISE.  73 

work  is  done,  is  an  important  element  in  the  question,  in  consequence  of 
the  strain  thi-own  on  the  heart  and  lungs.  The  Oxford  boat  races — rowing 
at  racing  speed  (=1  mile  in  7  minutes)  in  an  Oxford  eight-oar,  or  18.56 
foot-tons  in  7  minutes,'  is  not  apparently  very  hard  work,  but  it  is  Tery 
severe  for  the  time,  as  its  effect  is  gTeat  on  the  cii'culatory  system. 

Looking  at  all  these  results,  and  considering  that  the  most  healthy  life 
is  that  of  a  man  engaged  in  manual  labor  in  the  free  au',  and  that  the 
daily  work  will  probably  average  from  250  to  350  tons  lifted  1  foot,  we  can 
perhaps  say,  as  an  appi'oximation,  that  every  healthy  man  ought,  if  possible, 
to  take  a  daily  amount  of  exei'cise  in  some  way,  which  shall  not  be  less 
than  150  tons  lifted  1  foot.  This  amount  is  equivalent  to  a  walk  of  about 
9  miles  ;  but  then,  as  there  is  much  exertion  taken  in  ordinary  business  of 
life,  this  amount  may  be  in  many  cases  reduced.  It  is  not  possible  to  lay 
down  rules  to  meet  all  cases  ;  but  probably  every  man  with  the  above  facts 
before  him  could  fix  the  amount  necessary  for  himself  with  tolerable 
accuracy. 

In  the  case  of  the  soldier,  if  he  were  allowed  to  march  easily,  and  if 
the  weights  were  not  oppressively  arranged,  he  ought  to  do  easily  12 
miles  daily  for  a  long  time,  provided  he  was  allowed  a  periodical  rest. 
But  he  could  not  for  many  days,,  without  great  fatigue,  march  20  miles  a 
day  with  a  60  ft)  load,  unless  he  were  in  good  condition  and  AveU  fed.  If  a 
greater  amount  still  is  demanded  from  him,  he  must  have  long  subsequent 
rest.  But  all  the  long  marches  by  our  own  or  other  armies  have  been 
made  without  weights,  except  arms  and  a  portion  of  ammunition.  Then 
great  distances  have  been  traversed  by  men  in  good  training  and  condi- 
tion. 

SECTION  m. 
trainhstg. 

The  aim  of  the  "  Trainer  "  is  to  increase  breathing  power  ;  to  make 
the  muscular  action  moi'e  vigorous  and  enduring,  and  to  lessen  the  amount 
of  fat.  He  arrives  at  his  result  by  a  very  carefiil  diet,  containing  little  or 
no  alcohol  ;  by  regular  and  systematic  exercise  ;  and  by  increasing  the 
action  of  the  eliminating  organs,  especially  of  the  skin. 

What  the  "Trainer"  thus  accomplishes  is  in  essence  the  follovmig :  a 
concordant  action  is  esta.blished  between  the  heart  and  blood-vessels,  so 
that  the  strong  action  of  the  heart  during  exercise  is  met  by  a  more  perfect 
dilatation  of  the  vessels,  and  there  is  no  blockage  of  the  flow  of  blood  ;  in 
the  lungs,  the  blood  not  only  passes  more  freely,  but  the  amount  of  oxygen 
is  increased,  and  the  gradual  improvement  in  breathing  power  is  well 
seen  when  horses  are  watched  during  training.  This  reciprocal  action  of 
heart  and  blood-vessels  is  the  most  important  point  in  training  ;  the  nutri- 
tion of  nerves  and  muscular  fibres  imjDroves  from  the  constant  action,  and 
the  abundant  supply  of  food  ;  the  tissue  changes  are  more  active,  and  elim- 
ination, especially  of  carbon,  increases.  A  higher  condition  of  health 
ensues,  and  if  not  carried  to  excess,  "  training  "  is  simply  another  word  for 
healthy  and  vigorous  Uving.^ 

'  Training,  by  A.  Maclaren,  p.  168. 

"^  Of  course,  over-training  may  be  hurtful,  but  anything  can  be  carried  too  far. 
Reference  may  be  made  to  Dr.  Morgan's  highly  interesting  and  well-worked  out 
treatise  on  University  Oars,  to  show  that  rowing  is  beneficial.  Dr.  Lee  has  published 
a  useful  little  book,  Exercise  and  Training,  by  R.  Lee,  M.D.,  with  some  good  advice  on 
training. 


CHAPTER  XIII. 

CLOTHING. 

The  objects  of  clothing  are  to  protect  against  cold  and  against  warmth  ;  aU 
other  uses  will  be  found  to  resolve  themselves  into  one  or  other  of  these. 
The  subject  natui-allv  diN-ides  itself  into  two  parts — 1st,  The  materials 
of  clothing  ;  and  2d,  The  make  of  the  garments,  which  will  be  considered 
in  Book  II.,  and  only  as  far  as  the  soldier  is  concerned. 

IVIateeials  of  Clothing, 

The  following  only  will  be  described  : — Cotton,  linen,  jute,  wool,  silk, 
leather,  and  india-rubber. 

Chemical  Reaction. — These  materials  are  all  easily  distinguished  by 
microscopical  characters,  but  certain  chemical  reactions  may  be  useful. 
Wool  and  silk  dissolve  in  boiling  hquor  potassae  or  hquor  sodse  of  sp.  gr. 
1040  to  1050  ;  cotton  and  hnen  ai'e  not  attacked.  Wool  is  little  altered 
by  lying  in  sulphuric  acid,  but  cotton  and  linen  change  in  half  an  hour  into 
a  gelatinous  mass,  which  is  colored  blue  by  iodine.  Silk  is  slowly  dis- 
solved. Wool  and  silk  take  a  yellow  color  in  strong  nitric  acid  ;  cotton 
and  hnen  do  not.  So  also  wool  and  silk  are  tinged  yellow  by  picric  acid  ; 
cotton  and  linen  are  not,  or  the  color  is  slight,  and  can  be  washed  off. 
Silk,  again,  is  dissolved  by  hot  concentrated  chloride  of  zinc,  which  will 
not  touch  wool.  In  a  mixed  fabric  of  silk,  wool,  and  cotton,  first  boil  in 
strong  chloride  of  zinc,  and  wash  ;  this  gets  rid  of  the  silk  ;  tlien  boil  in 
hquor  sodse,  which  dissolves  the  wool,  and  the  cotton  is  left  behind.  An- 
other reagent  is  recommended  by  Schlesinger,  viz.,  a  solution  of  copper  in 
ammonia  ;  this  rapidly  dissolves  silk  and  cotton,  and,  after  a  longer  time, 
linen  ;  wool  is  only  somewhat  swollen  by  it.  By  di-ying  thoroughly  first, 
and  after  each  of  the  above  steps,  the  weight  of  the  respective  materials 
can  be  obtained. ' 

'  If  other  fabrics  than  those  mentioned  in  the  text  have  to  be  examined,  the  best 
book  to  consult  is  Dr.  Schlesinger's  Mikrosoopisfhe  Untersuch.  der  Gespinnst-Fasern 
(Zurich,  1873),  where  plates  will  be  found  of  many  of  the  fibres  of  commerce.  The 
following  are  the  chief  reagents  used  by  Schlesinger  :  -1st,  Strong  and  weak  sulphuric 
acid,  to  dissolve  or  swell  out  the  fibres,  and  also,  with  iodine,  to  test  for  cellulose. 
2d,  Nitric  acid,  especially  to  show  the  markings.  3d,  Chromic  acid,  as  the  best  sol- 
vent for  the  intercellular  substance,  and  for  the  swelling  out  in  solution  of  the  cellulose  ; 
it  is  often  used  with  sulphuric  acid.  4th,  Dilute  tincture  of  iodine,  which  is  added  to 
cellulose,  and  then  sulphuric  acid  is  used.  5th,  Solution  of  copper,  made  bj'  dissolving 
metallic  copper  in  ammonia  ;  this  dissolves  cell-membrane.  (3th,  Sulphate  of  aniline, 
which  colors  lignite  yellow.  7th,  Liquor  potassae  (dilute),  to  render  the  fabrics  trans- 
parent. He  advises  the  fabric  to  be  put  on  a  slip  of  gla.ss,  and  then  a  drop  of  water  to 
be  placed  on  it :  then  a  needle  should  be  drawn  two  or  three  times  in  the  direction  of 
the  fibres,  which  will  be  easily  detached.  Then  the  fibre  is  laid  on  a  glass  and  the  re- 
agent is  applied. 


CLOTHING.  70 

Cotton — Microscopic  Characters. — A  diaphanous  substance  forming  fibres 
a'bout  ^ij-^th  of  an  inch  in  diameter,  flattened  in  shape,  and  ribbon-hke, 
with  an  interior  canal  which  is  often  obhterated,  or  may  contain  some  ex- 
tractive matters,  borders  a  little  thickened,  the  fibres  twisted  at  intervals 
(about  600  times  in  an  inch).  It  has  been  stated  that  the  fresh  cotton 
fibre  is  a  cylindrical  hair  vnth  thin  walls,  which  coUapses  and  twists  as  it 
becomes  dry.  Iodine  stains  them  brown  ;  iodine  and  sulphuric  acid  (in 
very  smaU  quantities)  give  a  blue  or  violet-blue  ;  nitric  acid  does  not  de- 
stroy them,  but  unrolls  the  twists. 

As  an  Article  of  Dress. — The  fibre  of  cotton  is  exceedingly  hard,  it 
wears  well,  does  not  shrink  in  washing,  is  very  non-absorbent  of  water 


Fig.  93.— Cotton  x  285. 


Fig.  94.— Linen  x  285. 


(either  into  its  substance,  or  between  the  fibres),  and  conducts  heat  rathef 
less  rapidly  than  linen,  but  much  more  rapidly  than  wool.' 

The  advantages  of  cotton  are  cheapness  and  durability  ;  its  hard  non- 
absorbent  fibre  places  it  far  below  wool  as  a  warm  water-absorbing  cloth- 
ing. In  the  choice  of  cotton  fabrics  there  is  not  much  to  be  said ;  smooth- 
ness, evenness  of  texture,  and  equality  of  spinning,  are  the  chief  points. 

In  cotton  shu-ting  and  calico,  cotton  is  alone  used  ;  in  merino  and  other 
fabrics  it  is  used  with  wool,  in  the  proportion  of  20  to  50  per  cent,  of  wool, 
the  threads  being  twisted  together  to  form  the  yarn. 

Linen — 3Iicroscopic    Characters. — The  fibres  are  finer  than  those   of 


'  Experiments  on  the  conducting  power  of  materials  by  Couller  (Professor  of  Chem- 
istry at  the  Val  de  Grace),  and  by  Dr.  Hammond  (late  Surgeon-General,  United  States 
Army). 


76 


PRACTICAL    HYGIENE. 


cotton,  diaphanous,  cylindrical,  and  presenting  little  swellings  at  tolerably 
regular  intervals.  The  elementary  fibres  (of  which  the  main  filire  is  com- 
posed) can  be  often  seen  in  these  swellings,  and  also  at  the  end  of  broken 
thi'eads  which  have  been  much  used.     The  hemp  fibre  is  something  like 


Fig.  95.— Silk  x  285. 


this,  but  much  coarser,  and  at  the  knots  it  separates  often  into  a  number 
of  smaller  fibres.  Silk  is  a  httle  hke  linen,  but  finer,  and  with  much  fewer 
knots. 

As  an  Article  of  Clothing. — Linen  conducts  heat  and  absorbs   water 


Fig.  96. — Jute — United  and  single  elongated  Cellular  Tis-sues.     Resinous  (?)  matter  adhering  more  or  le?s  to 

all  the  fibres. 

slightly  better  than  cotton.  It  is  a  little  smoother  than  cotton.  As  an 
article  of  clothing  it  may  be  classed  with  it.  In  choosing  linen  regard  is 
had  to  the  evenness  of  the  threads,  and  to  the  fineness  and  closeness  of  the 


CLOTHIJSTG. 


77 


texture.  Tlie  color  should  be  white,  and  the  surface  glossy.  Starch  is 
often  used  to  give  glossiness.  This  is  detected  by  iodine,  and  rerooved 
by  the  first  washing. 

Jute. — Jute  is  now  very  largely  used,  and  appears  to  enter  into  the 
adulteration  of  most  fabrics.  Jute  is  obtained  from  the  Corchoriis  capsu~ 
I  iris,  and  comes  to  England  from  Eussia  and  India.  The  fibres  are  of 
considerable  length,  are  hollow,  thickened,  and  with  naiTowings  and  con- 
strictions in  the  tubular  portions  ;  sometimes  an  aii'-bubble  may  be  in  the 
fibre,  as  shown  in  the  di'awing.  The  di-awing,  by  Dr.  Maddos,  shows  the 
differences  between  the  jute  and  cotton  or  linen. 

Wool — Microscopic  Characterf^. — Round  fibres,  transparent  or  a  httle 
hazy,  colorless,  except  when  artificially  dyed.  The  fibre  is  made  up  of  a 
number  of  httle  cornets,  which  have  become  united.  There  are  very 
evident  sHghtly  oblique  cross  mai'kings,  which  indicate  the  bases  of  the 
comets  ;  and  at  these  points  the  fibre  is  very  slightly  larger.  There  are 
also  fine  longitudinal  markings.  There  is  a  canal,  but  it  is  often  oblitera- 
ted. "When  old  and  worn,  the  fibre  breaks  up  into  fibrillse  ;  and,  at  the 
same  time,  the  shght  j)rominence  at  the  cross  markings  disappear,  and 
even  the  markings  become  indistinct.  By  these  characters  old  wool  can 
be  recognized.  Size  of  fibres  varies,  but  an 
average  is  given  by  the  figure.  The  finest 
wools  have  the  smallest  fibres. 

As  an  Article  of  Clothing. — "Wool  is  a  bad 
conductor  of  heat  and  a  great  absorber  of 
water.  The  water  penetrates  into  the  fibres 
themselves  and  distends  them  (hygroscopic 
water),  and  also  hes  between  them  (water  of 
interposition).  In  these  respects  it  is 
greatly  superior  to  either  cotton  or  linen, 
its  power  of  hygroscopic  absorption  being 
at  least  double  in  proportion  to  its  weight, 
and  cjuadruple  in  projDoriion  to  its  surface. 

This  property  of  hygi'oscopically  absorb- 
ing water  is  a  most  imporiant  one.  Duiing 
perspiration  the  evaporation  from  the  sur- 
face of  the  body  is  necessary  to  reduce  the 
heat  which  is  generated  by  the  exercise. 
When  the  exercise  is  finished,  the  evajDora- 
tion  still  goes  on,  and,  as  ah'eady  noticed, 
to  such  an  extent  as  to  chill  the  frame. 
When  dry  woollen  clothing  is  put  on  after 
exertion,  the  vapor  from  the  sui-face  of  the 
body  is  condensed  in  the  wool,  and  gives  out 
again  the  large  amount  of  heat  which  had  be- 
come latent  when  the  water  was  vaporizecL 
Therefore  a  woollen  covering,  fi'om  this  cause 
alone,  at  once  feels  wann  when  used  during  sweating.  In  the  case  of  cotton 
and  hnen  the  perspiration  passes  through  them,  and  evaporates  from  the  ex- 
ternal surface  without  condensation  ;  the  loss  of  heat  then  continues.  These 
facts  make  it  plain  why  diy  wooUen  clothes  are  so  useful  after  exertion.' 


Fig  97.— Wool  x  285. 


'  Pettenkofer  gives  (Zt.  fiir  Biol.,  Band  i.,  p.  185)  some  experiments  showing  the  hy- 
groscopic power  of  wool  as  compared  with  linen.  He  shows  that  linen  not  only  absorbs 
much  less  water,  but   parts  with  it  much  more  qi^iekly  ;  thus,  to  cite  one  experiment, 


78  PRACTICAL    HYGIENE. 

In  addition  to  this,  the  texture  of  wool  is  warmer,  from  its  bad  conduct- 
ing power,  and  it  is  less  easily  penetrated  by  cold  winds.  The  disadvantage 
of  wool  is  the  way  in  which  its  soft  fibre  shrinks  in  washing,  and  after  a 
time  becomes  smaller,  harder,  and  probably  less  absorbent.' 

In  the  choice  of  woollen  underclothing  the  touch  is  a  great  guide.  There 
should  be  smoothness  and  great  softness  of  texture  ;  to  the  eye  the  tex- 
ture should  be  close  ;  the  hairs  standing  out  from  the  surface  of  equal 
length,  not  long  and  straggling.  The  hea\T.er  the  substance  is,  in  a  given 
bulk,  the  better.  In  the  case  of  blankets,  the  softness,  thickness,  and  close- 
ness of  the  pile,  the  closeness  of  the  textiu-e,  and  the  weight  of  the  blanket, 
are  the  best  guides. 

In  woollen  cloth  the  rules  are  the  same.  When  held  against  the  light, 
the  cloth  should  be  of  vmiform  texture,  without  holes  ;  when  folded  and 
suddenly  stretched,  it  should  give  a  clear  ringing  note  ;  it  should  be  veiy 
resistent  when  stretched  with  \'iolence  ;  the  "tearing  power"  is  the  best 
way  of  judging  if  "  shoddy  "  (old  used  and  worked-up  wool  and  cloth)  has 
been  mixed  with  fresh  wool.  A  certain  weight  must  be  borne  by  every 
piece  of  cloth.  At  the  Government  Clothing  Estabhshment  at  Pimlico,  a 
machine  is  used  which  marks  the  exact  weight  necessaiy  to  tear  across  a 
piece  of  cloth.  Schlesinger  recommends  the  following  plan  for  the  exam- 
ination of  a  mixed  fabric  containing  shoddy: — Examine  it  with  a  microscope, 
and  recognize  if  it  contains  cotton,  or  silk,  or  linen,  besides  wool.  If  so, 
dissolve  them  by  ammoniacal  solution  of  copper.  In  this  way  a  qualitative 
examination  is  first  made.  Then  fix  attention  on  the  wool.  In  shoddy 
both  colored  and  colorless  wool-fibres  are  often  seen,  as  the  fibres  have 
been  derived  from  different  cloths  which  have  been  jDartiaUy  bleached ; 
the  coloring  matter,  if  it  remains,  is  different — indigo,  purjDiu-in,  or  mad- 
der. The  diameter  of  the  wool  is  never  so  regular  as  in  fi'esh  wool,  and  it 
changes  suddenly  or  gradually  in  diameter,  and  suddenly  widens  again 
with  a  little  swelling,  and  then  thins  off  again  ;  the  cross  marking  or  scales 
are  also  almost  obhterated.  When  liquor  potassse  is  appUed  the  shoddy 
wool  is  attacked  much  more  quickly  than  fresh  wool. 

The  dye  also  must  be  good,  and  of  the  kind  named  in  the  contract, 
and  tests  must  be  applied. 

Leather. — Choice  of  leather  ;  it  should  be  well  tanned,  and  without  any 
marks  of  con-osion,  or  attacks  of  insects.  The  thinner  kind  should  be  per- 
fectly supple. 

Leather  is  not  only  used  for  shoes,  leggings,  and  accoutrements  ;  it  is 
employed  occasionally  for  coats  and  trousers.  It  is  an  extremely  warm 
clothing,  as  no  vrind  blows  through  it,  and  is  therefore  well  adapted  for 
cold,  windy  climates.     Leather  or  sheepskin  coats  are  very  common  in 

equal  surface  of  linen  and  flannel  being  exposed  to  the  air  after  being  placed  in  equal 
conditions  of  absorption,  the  linen  lost  in  75  minutes  5.993  grammes,  and  the  flannel 
only  4.858  grammes  of  water.  Subsequently  the  evaporation  from  the  linen  lessened, 
as  was  to  be  expected,  as  it  was  becoming  drier ;  that  from  the  flannel  continued  to 
pass  off  moderately.     The  much  greater  cooling  effect  of  linen  is  seen. 

The  porosity  of  clothing,  i.e.,  the  rapidity  with  which  air  is  driven  through,  is 
a  point  to  be  noted.  By  an  equal  pressure  equivalent  to  a  column  of  water  4.5  centi- 
metres high,  an  area  of  1  centimetre  diameter  forced  air  through  as  follows  : — Through 
linen,  6.03  litres;  flannel,  10.41  ;  lambskin,  5.07  ;  glove-leather,  .15 ;  wash-leather, 
5.37  ;  silk-fabric,  4.14. 

It  thus  appears  that  the  warmest  clothing  (flannel)  may  be  the  most  porous ;  mere 
porosity,  in  fact,  is  only  one  element  in  the  consideration. 

'  In  washing  woollen  articles,  they  should  never  be  rubbed  or  wruyijj.  They  should 
be  placed  in  a  hot  solution  of  soap,  moved  about,  and  then  plunged  into  cold  water ; 
when  the  soap  is  got  rid  of  they  should  be  hung  up  to  dry  without  wringing. 


CLOTHING.  79 

Tiu'key,  Tartary,  Pei'sia,  tlie  Danubian  Provinces,  and  everywhere  where 
the  cold  north  winds  are  felt.  In  Canada,  coats  of  sheepskin  or  buifalo- 
hide  have  been  found  veiy  useful,  and  are  commonly  used  by  sentries. 

Waterproof  Clothing, — Like  leather  articles,  the  india-rubber  is  an  ex- 
ceedingly hot  dress,  owing  to  the  same  causes,  "viz.,  impermeability  to  wind, 
and  condensation  and  retention  of  perspiration.  It  is  objected  to  by  many 
on  these  gTOunds,  and  especially  the  latter  ;  and  Le^w  informs  us  that  the 
Council  of  Health  of  the  French  Ai-my  have  persistently  refused  (and,  in 
his  oi^inion,  very  j)roperly)  the  introduction  of  waterproof  gai'ments  into 
the  army.  If,  however,  woollen  underthings  are  worn,  the  perspiration  is 
siifficiently  absorbed  by  those  during  the  comparatively  short  time  water- 
proof clothing  is  worn,  and  the  objection  is  properly  not  vahd,  unless  the 
watei-proof  is  continually  worn. 

The  great  use  of  watei-proof  is,  of  course,  its  protection  against  rain, 
and  in  this  respect  it  is  invaluable  to  the  soldier,  and  should  be  largely 
used.  By  the  side  of  this  great  use,  all  its  defects  appear  to  be  minor 
evils. 

India-rubber  cloth  loses  in  part  its  distensibility  in  very  cold  countries, 
and  becomes  too  distensible  in  the  tropics  It  is  also  apt  to  rot  by  absoi'p- 
tion  of  oxygen.  Paraffined  cloth  is  equally  good,  and  the  paraffin  does  not 
rot  the  fibre  hke  common  oil. 

General  Conclusions. 

Protection  against  Cold. — For  equal  thicknesses,  wool  is  much  superior 
to  either  cotton  or  hnen,  and  shoidd  be  worn  for  all  ujaderclothing.  In 
case  of  extreme  cold,  besides  wool,  leather,  or  waterproof  clothing  is  use- 
ful    Cotton  and  hnen  are  nearly  equal. 

Protection  against  Heat. — Texture  has  nothing  to  do  with  protection 
from  the  direct  solar  rays  ;  this  depends  entu-ely  on  color.  White  is  the 
best  color  ;  then  gray,  yellow,  pink,  blue,  black.  In  hot  countries,  there- 
fore, white  or  light  gray  clothing  should  be  chosen. 

In  the  shade,  the  effect  of  color  is  not  marked.  The  thickness,  and 
the  conducting  power  of  the  material,  are  the  conditions  (especially  the 
former)  which  influence  heat. 

Protection  against  Cold  Winds. — For  equal  thicknesses,  leather  and  india- 
rubber  take  the  first  rank  ;  wool  the  second  ;  cotton  and  hnen  about  equal 

Absorption  of  Perspiration. — Wool  has  more  than  double  the  power  of 
cotton  and  hnen. 

Absorption  of  Odors. — This  partly  depends  on  color  ;  and  Stark's 
observations  show  that  the  power  of  absoi-ption  is  in  this  order — black, 
blue,  red,  green,  yellow,  white.  As  far  as  texture  is  concenaed,  the  absorp- 
tion is  in  proportion  to  the  hygi'oscopic  absorption,  and  wool  therefore 
absorbs  more  than  cotton  or  hnen. 

Protection  against  Malaria. — It  has  been  supposed  that  wearing  flannel 
next  the  skin  lessens  the  risk  of  malaiia.  As  it  is  generally  supposed  that 
the  poison  of  malaria  enters  either  by  the  lungs  or  stomach,  it  is  difficult 
to  see  how  protection  to  the  skin  can  prevent  its  action  ;  except  indirectly, 
by  preventing  chiU  in  pei'sons  who  have  already  suffered  from  ague.  But 
the  xerj  great  authority  of  Andrew  Combe,  dra-wn  from  experience  at 
Home,  is  in  favor  of  its  having  some  influence  ;  and  it  has  been  used  on 
the  west  coast  of  Africa  for  this  purpose,  with  apparently  good  results. 


CHAPTER  XIV. 

CLIMATE. 

It  is  not  easy  to  give  a  proper  definition  of  climate.  The  effect  of  cli- 
mate on  the  human  body  is  the  sum  of  the  influences  which  are  connected 
either  wdth  the  solar  agencies,  the  soil,  the  air,  or  the  water  of  a  place, 
and  as  these  influences  are  in  the  highest  degree  complex,  it  is  not  at 
present  possible  to  trace  out  their  effects  with  any  certainty. 

With  regard  generally  to  the  effect  of  climate  on  human  life,  it  would 
seem  certain  that  the  facihty  of  obtaining  food  (which  is  itself  influenced 
by  chmate),  rather  than  any  of  the  immediate  effects  of  climate,  regiilates 
the  location  of  men  and  the  amount  of  population.  The  human  frame 
seems  to  acquire  in  time  a  wonderful  power  of  adaptation  ;  the  Eskimos, 
when  they  can  obtain  plenty  of  food,  are  large  strong  men  (though  nothing 
is  known  of  their  average  length  of  life),  and  the  dwellers  in  the  hottest 
parts  of  the  world  (pro^•ided  there  is  no  malaria,  and  that  their  food  is 
nutritious)  show  a  stature  as  lofty,  and  a  strength  as  great,  as  any  dwellers 
in  temperate  chmates.  Peculiarities  of  race,  indeed,  arising  no  one  knows 
how,  but  probably  from  the  combined  influences  of  chmate,  food,  and  cus- 
toms, acting  through  many  ages,  appear  to  have  more  effect  on  stature, 
health,  and  duration  of  hfe,  than  climate  alone.  StiU,  it  would  seem  prob- 
able that,  in  climatic  conditions  so  diverse,  there  arise  some  special  differ- 
ences of  structure  which  are  most  marked  in  the  skin,  but  may  possibly  in- 
volve other  organs. 

How  soon  the  body,  when  it  has  become  accustomed  by  length  of  resi- 
dence for  successive  generations  to  one  chmate,  can  accommodate  itself  to, 
or  bear  the  conditions  of,  the  climate  of  another  widely  different  place,  is 
a  question  which  can  only  be  answered  when  the  influences  of  climate 
are  better  known.  The  hypotliesis  of  "  acchmatization  "  implies  that  there 
is  at  first  an  injurious  effect  jiroduced,  and  then  an  accommodation  of  the 
body  to  the  new  conditions  within  a  very  limited  time  ;  that,  for  example, 
the  dweller  in  northern  zones  passing  into  the  tropics,  although  he  at  first 
suffers,  acquii'es  in  a  few  years  some  special  constitution  which  I'elieves  him 
from  the  iniu.rious  consequences  which,  it  is  supposed,  the  change  at  first 
brought  with  it.  There  are,  therefore,  two  assumptions,  \iz.,  of  an  injuri- 
ous effect,  and  of  a  relief  from  it.     Are  either  connect  ? 

It  may  seem  a  bold  thing  to  question  the  commonly  received  opinion, 
that  a  tropical  chmate  is  injurious  to  a  northern  constitution,  but  there  are 
some  striking  facts  which  it  is  difficult  to  reconcile  with  such  an  opinion. 
The  army  experience  shows  that,  both  in  the  West  Indies  and  in  India, 
the  mortality  of  the  soldier  has  been  gradually  decreasing,  until,  in  some 
stations  in  the  W^est  Indies  (as,  for  example,  Trinidad  and  Barbadoes),  the 
sickness  and  mortality  among  the  European  soldiers  ai'e  actually  less  than 
ou  home  sei-vice  in  years  which  have  no  yellow  fever.     In  India,  a  century 


CLIMATE.  81 

ago,  people  spoke  witli  horror  of  the  terrible  climate  of  Bombay  and  Cal- 
cutta, and  vet  Europeans  now  live  in  health  and  comfort  in  both  cities. 
In  Algeria  the  French  experience  is  to  the  same  effect.  As  the  climate  and 
the  stations  are  the  same,  and  the  soldiers  are  of  the  same  race  and  habits, 
what  has  removed  the  dangers  which  formerly  made  the  sickness  three- 
fold and  the  moi-tahty  tenfold  the  ratio  of  the  sickness  and  deaths  at  home  ? 

The  explanation  is  very  simple  ;  the  deaths  in  the  "West  Indies  were 
partly  owing  to  the  vu'ulence  of  yellow  fever  (which  was  fostered,  though 
probably  not  engendered  by  bad  sanitaiy  conditions),  and  the  general 
excess  of  other  febrile  and  dysenteric  causes.  The  simj)le  hygienic  -pve- 
cautions  which  are  efficacious  in  England,  have  been  as  useful  in  the  West 
Indies.  Proper  food,  good  water,  piure  aii',  have  been  supplied,  and, 
in  proportion  as  they  have  been  so,  the  deadly  effects  attributed  to  climate 
have  disappeared.  The  effect  of  a  tropical  chmate  is,  so  to  speak,  relative. 
The  temperature  and  the  humidity  of  the  ah'  are  highly  favorable  to  de- 
compositions of  all  kinds  ;  the  efHuvia  from  an  impiu-e  soil,  and  the  putres- 
cent changes  going  on  in  it,  are  gi'eatly  aggravated  by  heat.  The  effects 
of  the  sanitary  evils  which,  in  a  cold  chmate  like  Canada,  are  partly 
neuti'alized  by  the  cold,  are  developed  in  the  West  Indies,  or  in  troj^ical 
India,  to  the  greatest  degree.  In  this  way  a  tropical  chmate  is  evidently 
most  powerful,  and  it  renders  aU  sanitary  precautions  tenfold  more  neces- 
sary than  in  the  temperate  zone.  But  all  this  is  not  the  effect  of  climate, 
but  of  something  added  to  climate. 

Take  away  these  sanitary  defects,  and  avoid  malarious  soils  or  drain 
them,  and  let  the  mode  of  lining  be  a  proper  one,  and  the  Eui'opean  sol- 
dier does  not  die  faster  in  the  tropics  than  at  home. 

It  must  be  said,  however,  that  an  element  of  uncertainty  may  be  pointed 
out  here.  In  our  tropical  possessions  the  Eui'opean  soldier  seiwes  now 
only  for  short  periods  (in  the  West  Indies  for  thi-ee  or  four  years,  in  India, 
under  the  new  regulations  of  short  service,  seven  or  eight  years,  at  most), 
and  dui'ing  this  time  he  may  be  for  some  years  on  the  hills,  or  at  any  rate 
in  elevated  spots.  The  old  statistical  reports  of  the  ai-my  pointed  out  that 
the  mortality  in  the  West  Indies  augmented  regularly  with  prolongation 
of  service,  and  it  may  be  said  that,  after  all,  the  lessened  sickness  and  mor- 
tality in  the  tropics  is  owing,  in  some  degree,  to  avoidance  by  short  ser- 
vice of  the  influence  of  chmate.  But  as  the  whole  long  seiwice  was 
constantly  passed  tmder  the  unfavorable  safiitary  conditions  now  removed, 
it  does  not  follow  that  the  inference  to  be  chawn  from  the  statistical  evi- 
dence as  to  length  of  service  is  really  correct. 

Facts  prove,  then,  that  under  favorable  sanitary  conditions  (general 
and  personal),  Europeans,  during  short  services,  may  be  as  healthy  as  at 
home,  as  far  as  shown  by  tables  of  sickness  and  mortahty,  and  it  is  not 
certain  that  long  service  brings  with  it  different  results. 

It  may,  however,  be  urged  that,  admitting  that  a  non-malarious  tropical 
chmate,  per  se,  may  not  increase  sickness  or  mortality  during  the  most 
vigorous  years  of  hfe  (and  it  is  then  only  that  Emropeans  are  usually  sub- 
jected to  it),  it  may  yet  really  diminish  health,  lessen  the  vigor  of  the  body, 
and  diminish  the  expectation  of  hfe. 

We  have  no  evidence  on  the  latter  point.  With  respect  to  the  former, 
it  will  be  well  to  see  what  is  known  of  the  effects  of  chmatic  agencies  on 
the  frame. 

The  influences  of  locality  and  climate,  as  far  as  they  are  connected  with 
soil  and  water,  have  been  sufficiently  discussed.  The  climatic  conditions 
most  closely  (though  by  no  means  solely;  connected  with  air  will  now  be 
Vol.  II. -6 


82  PRACTICAL    HYGIENE. 

briefly  reviewed.     These  are — temperature,  humidity,  movement,  weight, 
composition,  and  electiicid  condition,  and  the  amount  of  light. 


SECTION  I. 
TEMPERATURE. 

The  amount  of  the  sun's  rays ;  the  mean  temperature  of  the  air  ;  the 
variations  in  temperature,  both  periodic  and  non-periodic  ;  and  the  length 
of  time  a  high  or  low  temperature  lasts,  are  the  most  imjDortant  points. 
Temperature  alone  has  been  made  a  ground  of  classification. 

(a)  Equable,  limited,  or  insw/ar  climates  ;  i.e.,  with  slight  yearly  and  diur- 
nal variations. 

(b)  Extreme,  exce.'^sive,  or  continental ;  i.e.,  with  great  variations. 

The  terms  limited  and  extreme  might  be  applied  to  the  amplitude  of  the 
yearly  fluctuation  {i.e.,  difference  between  hottest  and  coldest  month),  while 
equable  and  excessive  might  be  applied  especially  to  the  non-periodic  varia- 
tions, which  are  slight  in  some  places  and  extreme  in  others. 

A  Hmited  climate  is  generally  an  equable  one,  and  an  extreme  climate 
(with  great  yeai'ly  fluctuation)  is  generally  an  excessive  one  (with  great  un- 
dulations). 

The  effects  of  heat  cannot  be  dissociated  from  the  other  conditions  ;  it 
is  necessary,  however,  briefly  to  notice  them. 

The  efiect  of  a  certain  degree  of  temiDerature  on  the  vital  processes  of  a 
race  dwelling  generation  after  generation  on  the  same  spot,  is  a  question 
which  has  as  yet  I'eceived  no  sort  of  answer.  Does  the  amount  of  heat  per 
se,  independent  of  food  and  aU  other  conditions,  affect  the  development  of 
mechanical  force  and  temperature,  and  the  coincident  vaiious  processes  of 
formation  and  destruction  of  the  tissues  ?  Is  there  a  difierence  in  these  re- 
spects, and  in  the  resulting  action  of  the  eliminating  organs,  in  the  inhabi- 
tants of  the  equator  and  of  50^  or  60^  N.  lat.  ?  This  is  entirely  a  problem 
for  the  future,  but  there  is  no  class  of  men  who  have  more  opportunities  of 
studying  it  than  anny  surgeons. 

The  problem  of  the  influence  of  temperature  is  generally  presented  to 
us  under  the  form  of  a  dweller  in  a  tempei'ate  zone  proceeding  to  countries 
either  colder  or  hotter  than  hi^own.  It  is  in  this  restricted  sense  we  shall 
now  consider  it. 

With  regard  to  the  effect  on  the  Anglo-Saxon  and  Celtic  races  of  going 
to  live  in  a  climate  with  a  lower  mean  temperature  and  gi'eater  variations 
than  their  own,  we  have  the  experience  of  Canada,  Nova  Scotia,  and  some 
parts  of  the  Northern  American  States.  In  all  these,  if  food  is  good  and 
plentiful,  health  is  not  only  sustained,  but  is  perhaps  improved.  The  agri- 
cultural and  out-door  life  of  Canada  or  Nova  Scotia  is  probably  the  cause 
of  this  ;  but  certain  it  is  that  in  those  countries  the  European  not  only  en- 
joys health,  but  jDroduces  a  progeny  as  vigorous,  if  not  more  so,  than  that 
of  the  parent  race. 

The  effects  of  heat  exceeding  the  temperate  standard  must  be  distin- 
guished according  to  origin  ;  radiant  heat,  or  the  direct  rays  of  the  sun, 
and  non-radiant  heat,  or  that  of  the  atmosphere.  In  the  latter  case,  in  ad- 
dition to  heat  there  is  moi'e  or  less  rarefaction  of  the  air,  and  also  coinci- 
dent conditions  of  humidity  and  movement  of  the  aii-,  which  must  be  taken 
into  account.  The  influence,  again,  of  sudden  transitions  from  heat  to  cold, 
or  the  reverse,  has  to  be  considered.     Europeans  fi'om  temperate  climates 


CLIMATE.  83 

flourish,  apparently,  in  countries  not  much  hotter  than  their  own,  as  in 
some  parts  of  Australia,  New  Zealand,  and  New  Caledonia,  though  it  is  yet 
too  soon  to  speculate  whether  the  vigor  of  the  race  will  improve  or  other- 
wise. But  there  is  a  geuei'al  impression  that  they  do  not  flourish  iu  coun- 
tries much  hotter,  i.e.,  with  a  yearly  mean  of  20°  Fahr.  higher,  as  in  many 
parts  of  India  ;  that  the  race  dwindles,  and  finally  dies  out ;  and  therefore 
that  no  acchmatization  of  race  occurs.  And  certainly  it  would  appear  that 
in  India  there  is  some  evidence  to  show  that  the  pure  race,  if  not  inter- 
mixed with  the  native,  does  not  reach  beyond  the  third  generation.  Yet 
it  seems  only  right  to  say  that  so  many  cu'cumstances  besides  heat  and  the 
other  elements  of  climate  have  been  acting  on  the  English  race  in  India, 
that  any  conclusion  oj^posed  to  acclimatization  must  be  considered  as  based 
on  scanty  evidence.  We  have  not  gauged  on  a  large  scale  the  effects  of  cli- 
mate pui'e  and  simple,  uncomphcated  with  malaria,  bad  diet,  and  other 
influences  adverse  to  health  and  longevity. ' 

(a)  Influence  of  the  Direct  Bays  of  the  Sun. — It  is  not  yet  known  to  what 
temperature  the  direct  rays  of  the  ti-opical  sun  can  raise  any  object  on 
which  they  fall.  In  India,  on  the  ground,  the  uncovered  thermometer  will 
mark  160°,  and  perhaps  212°  (Buist)  ;  and  in  this  country,  if  the  movement 
of  air  is  stopped  in  a  small  space,  the  heat  in  the  direct  sun's  rays  can  be 
raised  to  the  same  point.  In  a  box,  with  a  glass  top,  Sir  H.  James  found 
the  thermometer  mark  237°  Fahr.,  when  exposed  to  the  rays  of  the  sun,  on 
July  14,  1864"  In  experiments  on  frogs,  when  temperature  much  over 
the  patural  amount  is  apphed  to  nerves,  the  electrical  ciu-rents  through 
them  are  lessened,  and  at  last  stop.^  E.  H.  "Weber's  observations  show 
that  for  men  the  same  rule  holds  good  ;  the  most  favorable  temperature 
is  30°  E.  (=  99.5°  Fahr.).*  It  appears  also  from  Kuhne's  experiments  that 
the  heat  of  the  blood  of  the  vertebrata  must  not  exceed  113°  Fahr.,  for  at 
that  temperature  the  myosin  begins  to  coagulate.^  Perhaps  this  fact  may 
be  connected  with  the  pathological  indication  that  a  very  high  temperature 
in  any  disease  (over  110°  Fahr.)  indicates  extreme  danger. 

To  what  temperature  is  the  skin  of  the  head  and  neck  raised  in  the 
tropics  in  the  sun's  rays  ?  No  sufficient  experiments  have  been  made,  either 
on  this  point  or  on  the  heat  in  the  interior  of  caps  and  hats  with  and  with- 
out ventilation.  Doubtless,  without  ventilation,  the  heat  above  the  head  ia 
the  interior  of  the  cap  is  very  great.  It  is  quite  possible,  as  usually  as- 
sumed, that  with  bad  head-dresses  the  heat  of  the  skin,  bones,  and  possibly 
even  of  the  deep  nerves  and  centres  (the  brain  and  cord),  may  be  greater 
than  is  accordant  with  perfect  preservation  of  the  currents  of  the  nerves, 
or  of  the  necessary  temperature  of  the  blood,  or  with  the  proper  fluidity  of 
some  of  the  albuminous  bodies  in  the  muscles,  or  nerves. 

The  difficulty  of  estimating  the  exact  effect  of  the  solar  rays  is  not  only 
caused  by  the  absence  of  a  sufficient  number  of  experiments,  but  by  the 
common  presence  of  other  conditions,  such  as  a  hot  rarefied,  and  perhaps 

'  In  India  the  mortality  of  Eurasians  (that  is,  the  mixed  race  of  British,  Portuguese, 
Hindoo,  Malay,  blood)  mixed  in  all  degrees  appears  to  be  below  that  of  the  most  healthy 
European  service,  viz.,  the  Civil  Service.  Mr.  Tait's  facts  "On  the  Mortality  of  Eura- 
sians "  (Statistical  Journal,  September,  1864)  would  show  that  this  mixed  race  will 
m.aintain  itself  in  India. 

-  Mr.  Symons  has  also  obtained  temperature  above  212°  F.  by  the  same  means, 

^Eckhard,  Henle's  Zeitsch.,  Band  x.,  p.  165,  1851. 

^  Weber,  Ludwig's  Phys.,  2d  ed.,  vol.  i.,  p.  126. 

'  Ludwig,  Lehrb.  der  Phys. ,  Band  ii. ,  p.  732.  For  a  collection  of  data,  see  Dr.  H.  C. 
Wood,  jun.,  Thermic  Fever,  1872,  p,  50. 


84  PRACTICAL    HYGIENE. 

impure  air,  and  lieat  of  the  body  produced  by  exercise,  wliicli  is  not  at- 
tended by  i^erspiration.  Two  points  are  remarkable  in  the  history  of  sun- 
stroke, viz.,  the  extreme  rarity  of  sunstroke  in  mid  ocean  '  and  at  great  ele- 
vations.'' In  both  cases  the  effect  of  the  sun's  rays,  ^j<?7'  se,  is  not  less,  is 
even  greater,  than  on  land  and  at  sea-level ;  yet  in  both  sunstroke  is  un- 
common ;  the  temperature  of  the  air,  however,  is  never  excessive  in  either 
case. 

The  effect  of  the  direct  rays  on  the  skin  is  another  matter  requiring  in- 
vestigation. Does  it  aid  or  check  perspii-ation  ?  That  the  skin  gets  dry 
there  is  no  doubt,  but  this  may  be  merely  from  rapid  evaporation.  But  if 
the  nervous  currents  are  interfered  with,  the  vessels  and  the  amount  of 
secretion  are  sure  to  be  affected,  and  on  the  whole  it  seems  probable  that 
a  physiological  effect  adverse  to  perspiration  is  produced  by  the  direct  rays 
of  the  sun.  If  so,  and  if  this  is  carried  to  a  certain  point,  the  heat  of  the 
body  must  rise,  and  supposing  the  same  conditions  to  continue  (intense 
radiant  heat  and  want  of  perspiration),  may  pass  beyond  the  limit  of  the 
temperature  of  possible  hie  (113^  Fahr.).' 

The  effect  of  intense  radiant  heat  on  the  re sj^iration  and  heart  is  another 
point  of  great  moment  which  needs  investigation. 

The  pathological  effect  produced  by  the  too  intense  direct  rays  of  the 
sun  is  seen  in  one  or  two  forms  of  insolation,  and  consists  in  paralysis  of 
the  heart  or  the  respiration. 

A  form  of  fever  (the  Causus  of  some  writers,  or  thermic  fever)  has  been 
supposed  to  be  caused  by  the  direct  rays  of  the  sun  combined  with  exces- 
sive exertion.  Dr.  Parkes  mentions  a  case  of  this  kind  which  corresponded 
closely  to  the  description  in  books.  The  fever  lasted  for  several  days,  and 
its  tyjDe  w^as  not  in  accordance  with  the  hypothesis  that  it  was  malarious 
fever,  or  febricula,  or  typhoid.  No  thermometric  observations  were  made 
on  the  patient. 

(b)  Heat  in  Shade. — The  effect  of  high  air  temperature  on  the  native  of 
a  temperate  climate  jDassing  into  the  tropics  has  not  been  very  well  deter- 
mined, and  some  of  the  conclusions  are  di-awn  from  experiments  on  animals 
exposed  to  an  artificial  temperature. 

1.  The  temjjeratare  of  the  body  does  not  I'ise  greatly — not  more  than  .5 
or  1°  Fahr.  (John  Davy)  ;  from  1°  to  2^°  and  3°  (Eydaux  and  Brown-Se- 
quard).  In  some  experiments  not  yet  published,  Dr.  Becher  determined 
his  own  temperature  in  a  very  careful  way  during  a  voyage  round  the  Cape 
to  India.  He  fovmd  the  body-heat  increased,  and  in  the  proportion  of  0.05° 
Fahr.  for  every  increase  of  1°  Fahr.  in  the  air.  Rattray  also  found  a  de- 
cided increase,  varying  from  0.2°  Fahr.  to  1.2°  Fahr.  ;  the  greatest  increase 
was  in  the  afternoon.  We  may  conclude  that  the  tropical  heat  raises  the 
temperature  of  the  body  of  a  new-comer,  probably  because  the  evaporation 
from  the  skin  is  not  capable  of  counterbalancing  the  great  additional  exter- 
nal heat,  but  it  is  now  known  that  in  old  residents  the  same  fact  does  not  hold 


'  The  cases  of  insolation  in  a  narrow  sea  like  the  Red  Sea  donot  invalidate  this  rule. 

'  This  may  be  due  to  the  absence  of  radiation  from  the  ground  ;  ground  radiation 
affects  unprotected  thermometers  very  markedly. 

•*  In  the  Turkish  bath  it  may  sometimes  be  observed,  that  on  entering  the  hottest 
chamber  the  skin,  which  had  previously  been  acting  freely,  becomes  dry.  A  feeling 
of  oppression  accompanies  this,  but  relief  is  experienced  so  soon  as  perspiration  is  re- 
established. This  would  seem  to  point  more  to  an  actual  arrest  of  function  than  to  a 
mere  drying  up  of  the  secretion.  The  same  thing  in  a  modified  degree  may  occur  in  a 
tropical  climate,  in  which  case  the  intensity  of  fever  will  depend  upon  the  time  that 
elapses  before  accommodation  is  reached. 


CLIMATE.  85 

good.  Brigade-Surgeon  J.  C.  Johnston,  A.M.D.,  has  recorded  a  very  careful 
series  of  experiments,  made  on  soldiers  of  at  least  three  years'  ser-vdce  in 
India,'  in  the  station  of  Bellary.  The  average  of  one  series  was  97.63°,  and  of 
another  97.94'',  thus  showing  if  anything  a  slight  lowering  from  the  normal 
temperature,  98.4°.  Surgeon-Major  Boileau,  from  a  long  series  of  observa- 
tions in  the  West  Indies,  came  to  the  conclusion  that  there  was  no  material 
rise.  The  temperatui-e  of  the  body  is  the  result  of  the  opposing  action  of  two 
factors — 1st,  of  development  of  heat  from  the  chemical  changes  of  the  food, 
and  by  the  conversion  of  mechanical  energy  into  heat,  or  by  direct  absorption 
from  without ;  and,  2d,  and  opposed  to  this,  of  evaporation  from  the  sur- 
face of  the  body,  which  regulates  internal  heat.  So  beautifully  is  this 
balance  preserved,  that  the  stability  of  the  animal  temperature  in  all  coun- 
tries has  always  been  a  subject  of  marvel.  If  anything,  however,  prevents 
this  evaporation,  radiation  and  the  cooling  effect  of  moving  wind  cannot 
cool  the  body  sufficiently  in  the  tropics.  Then,  no  doubt,  the  temperature 
of  the  body  rises,  especially  if  in  addition  there  is  muscular  exertion  and 
production  of  heat  from  that  cause.  The  extreme  discomfort  always  attend- 
ing abnormal  heat  of  body  then  commences.  In  experiments  in  ovens, 
Blagden  and  Fordyce  bore  a  temperature  of  260°  with  a  small  rise  of  tem- 
perature (2^°  Fahr.),  but  the  air  was  dry,  and  the  heat  of  their  bodies  was 
reduced  by  perspiration  ;  when  the  air  in  ovens  is  very  moist  and  evapora- 
tion is  hindered,  the  temperature  of  the  body  rises  rapidly.'^ 

2.  The  respirations  are  lessened  in  number  (Vierordt,  Ludwig)  in  animals 
subjected  to  heat.  According  to  Vierordt,  less  carbonic  acid  and  presum- 
ably less  water  are  eliminated.  Rattray  ^  proved  by  a  great  number  of  ob- 
servations that  the  number  of  respirations  is  lessened  in  persons  passing 
from  a  cold  to  a  hot  chmate.  The  amount  of  diminution  vaiies  ;  in  some 
experiments  the  fall  was  from  16.5  respkations  per  minute  in  England,  in 
winter,  to  12.74  and  13.74  in  the  tropics.  In  another  series  of  experiments 
the  fall  was  from  17.3  respii*ations  per  minute  to  16.1  ;  the  breathing  is 
also  gentler,  i.e.,  less  deep.  Rattray  has  also  shown  that  the  spirometric 
measurement  of  the  expired  air  ("  vital  capacity"  of  Hutchinson)  increases 
in  the  tropics  and  falls  in  temperate  chmates,  the  average  variation  being 
about  8.7  per  cent,  of  the  total  spirometric  measurement.^  This  will  hold 
good  at  all  ages,  but  is  less  at  either  extreme  of  life,  and  is  most  marked  in 
persons  of  largest  frame  and  most  f  uU-blooded.  The  explanation  of  this 
spirometric  increase  in  the  respii'atory  action  of  the  lungs,  as  compared 
with  the  lessened  number  of  inspirations,  is  to  be  found,  according  to 
Rattray,  in  a  lessened  proportion  of  blood  and  a  larger  proportion  of  air  in 
the  lungs  in  the  tropics,  and  this  is  borne  out  by  a  fact  presently  to  be 
noted,  of  the  lessened  weight  of  the  lungs  in  Europeans  in  the  tropics. 

The  effect  of  the  lessened  number  of  respirations  is  (in  spite  of  the 
spirometric  increase)  to  reduce   the  total  respiratory  action  considerably. 

'Army  Medical  Reports,  vol.  xviii.,  p.  255. 

^  It  rises  even  7"  to  8°  Fahr.  (Ludwig,  Lehrb.  desPliys.,  2d  edit.,  b.  ii.,  p. 730).  Ober- 
nier's  late  observMions  are  confirmatory  (Der  Hitzschlag,  Bonn,  1867).  Obernier  con- 
firms the  pathology  generally  received  in  this  country.  From  an  observation  of  four 
cases  of  sunstroke,  and  from  thirty-three  experiments  on  animals  exposed  to  artificial 
heat,  he  traces  all  the  effects  to  the  augmented  temperature  of  the  body,  which  cannot 
cool  by  evaporation  from  the  surface  and  lungs  as  usual.  Dr.  H.  C.  Wood,  jun.,  of 
Philadelphia  (Thermic  Fever  or  Sunstroke,  1872),  also  holds  that  the  "  eificient  cause 
of  sunstroke  is  the  excess  of  temperature." 

^  On  the  Effects  of  Change  of  Climate  on  the  Human  Economy,  by  A.  Rattray, 
M.D.,  Surgeon,  R.N.,  Proceedings  of  the  Royal  Society,  Nos.  122-126,  139  (1869-72), 

■* Proceedings  of  the  Royal  Society,  No.  139,  p.  2. 


86  PRACTICAL    HYGIENE. 

Rattray  has  shown  that  the  average  amount  is  in  the  temperate  zone  (temp.  = 
54°  Fahr.),  239.91  cubic  inches  per  minute,  while  in  the  tropics  {—  82° 
Fahr.)  only  195.69  cubic  inches  were  mspii-ed,  so  that  there  is  a  difterence 
of  38.65  cubic  feet  in  twenty-four  hours,  or  18.43  per  cent,  in  favor  of  a 
temjDerate  chmate.  If  10  ounces  of  carbon  are  expired  in  the  temperate 
zone,  only  8.157  ounces  would  be  expired  in  the  tropics.  Is  there  then 
gTeater  excretion  of  carbon  from  the  skin,  or,  as  used  to  be  supposed, 
from  the  hver  ? 

Dr.  Francis  (Bengal  Ai*my)  has  obsen'ed  that  the  lungs  are  lighter  after 
death  in  Europeans  in  India  than  the  Eiu'opean  standard.  Dr.  Parkes 
made  a  similar  observation  many  years  ago,  ajid  recorded  it  in  a  work  on 
cholera,'  but  the  facts  were  few.  If  this  statement  be  confirmed,  it  would 
show  a  diminished  respiratory  function,  and  would  accord  with  Eattray's 
observations. 

3.  The  heart's  action  has  been  usually  stated  to  be  quickened  in  the 
tropics,  but  Rattray's  numerous  obsei-vations  show  that  this  is  incorrect ;  the 
average  pulse  in  the  tropics  was  lower  by  2^  beats  per  minute  than  in  the 
temperate  zone.  In  experiments  on  animals,  moderate  heat  does  not  quicken 
the  heart,  but  great  heat  does. 

4.  The  digestive  powers  are  somewhat  lessened,  there  is  less  appetite, 
less  desire  for  animal  food,  and  more  wish  for  cool  fruit.  The  quantity  of 
bile  secreted  by  the  liver  is  not  increased,  if  the  stools  are  to  be  taken  as  a 
guide  (Marshall,  in  1819,  John  Davv',  Morehead,  Parkes),  though  Lawson 
believes  that  an  excess  of  coloring  matter  passes  out  with  the  stools  ;  nothing 
is  known  of  the  condition  of  the  usual  hver  work. 

5.  The  skin  acts  much  more  than  usual  (an  increase  of  24  per  cent,  ac- 
coi'ding  to  Rattray),  and  great  local  hypereemia  and  swelling  of  the  papillae 
occur  in  new-comers,  giving  rise  to  the  famihar  eruption  known  as  "  prickly 
heat."  In  process  of  time,  if  exposed  to  great  heat,  the  skin  suffers  ap- 
parently in  its  structure,  becoming  of  a  sUght  yellowish  color  from,  prob- 
ably, pigmentaiy  deposits  in  the  deep  layers  of  the  cuticle. 

6.  The  urine  is  lessened  in  c^uantity.  The  urea  is  lessened,  as  shown 
by  experiments  in  hot  seasons  at  home  and  during  voyages  (Dr.  Forbes 
Watson  and  Dr.  Becher).'^  It  is  probable  that  this  is  simply  from  lessened 
food.  The  pigment  has  been  supposed  to  be  increased  (Lawson),  but  this 
is  doubtfuL  The  chloride  of  sodium  is  lessened ;  the  amount  of  ui'ic  and 
phosphoric  acids  is  uncertain. 

7.  The  effect  on  the  nervous  system  is  generally  considered  as  depress- 
ing and  exhausting,  i.e.,  there  is  less  general  vigor  of  mind  and  body.  But 
it  is  undoubted  that  the  greatest  exertions  both  of  mind  and  body  have  been 
made  by  Eiu'opeans  in  hot  climates.  Robert  Jackson  thought  as  much 
work  could  be  got  out  of  men  in  hot  as  in  temperate  climates.  It  is  prob- 
able that  the  depressing  effects  of  heat  are  most  felt  when  it  is  combined 
with  great  humidity  of  the  atmosphere,  so  that  evaporation  from  the  skin, 
and  consequent  lessening  of  bodily  heat,  are  partly  or  totally  arrested.^ 

•  On  Algide  Cholera,  by  E.  A.  Parkes,  M.D.,  p.  14    (1847). 

'  These  experiments  are  not  yet  fully  published;  they  were  made  during  voyages 
to  Bombay  and  China,  and  show  that  when  the  temperature  reached  a  certain  point 
(75'  in  Dr.  Becher's  experiments),  the  solids  of  the  urine  and  the  urea  lessened  consid- 
erably (Proceedings  of  the  Royal  Society,  1862). 

^  See  Dr.  Kenneth  Mackinnou's  Treatise  on  Public  Health,  p.  27,  on  the  effect  of 
plenty  of  exercise  even  in  the  hot,  and  moist,  and  presumed  imhealthy  climate  of  Tir- 
hoot,  in  Bengal.  He  proves  that  men  can  be  much  in  the  open  air,  even  in  the  hot 
parts  of  the  day,  with  impunity,  and  that  when  "they  take  exercise  they  are  in  the 
highest  state  of  health."     Still  Dr.  Mackinnon  believes  the  climate  is  exhausting. 


CLIMATE.  87 

The  most  exhausting  effects  of  heat  are  felt  when  the  heat  is  continuous, 
i.e.,  very  great,  day  and  night,  and  especially  in  sandy  plains,  where  the  air 
is  highly  rarefied  day  and  night.  There  is  then  really  lessened  quantity  of 
oxygen  in  a  given  cubic  space.  Add  to  this  fact  that  the  respirations  are 
lessened,  and  we  have  two  factors  at  work  which  must  diminish  the  ingress 
of  oxygen,  and  thereby  lessen  one  of  the  great  agents  of  metamorphosis. 

8.  Kattray  made  observations  "  on  the  weight  and  height  of  forty-eight 
naval  cadets,  aged  fi-om  14|-  to  17  years,  during  four  successive  changes  of 
climate  during  a  voyage.  The  results  show  that  in  the  tropics  they  in- 
creased in  height  more  rapidly  than  in  cold  cKmates,  but  that  the}''  lost 
weight  very  considerably,  and,  in  spite  of  their  rapid  growth,  Rattray  con- 
cludes that  the  heat  impaired  the  strength,  Aveight,  and  health  of  these  lads. 
His  figiires  seem  conclusive  on  these  j^oints,  and  show  the  beneficial  in- 
fluence of  cold  on  youths  belonging  to  races  long  resident  in  temperate 
climates. 

On  the  whole,  even  when  sufficient  perspiration  keeps  the  body  tempera- 
ture within  the  hmits  of  health,  the  effect  of  great  heat  in  shade  seems  to  be, 
as  far  as  we  can  judge,  a  depressing  influence  lessening  the  nervous  activity, 
the  gTeat  functions  of  digestion,  respu-ation,  sanguification,  and  dii-ectly  or 
indu-ectly  the  formation  and  destruction  of  tissues.  Whether  this  is  the 
heat  alone,  or  heat  and  lessened  oxygen,  and  gxeat  humidity,  is  not  certain. 

So  bad  have  been  the  general  and  personal  hygienic  conditions  of 
Europeans  in  India,  that  it  is  imj)ossible  to  say  what  amount  of  the  gTeat 
mortality  in  that  country  is  due  to  excess  of  heat  over  the  temperature  of 
Europe.  Nor  is  it  possible  to  determine  the  influence  of  heat  alone  on  the 
endemic  diseases  of  Europeans  in  the  tropics — liver  disease  and  dysentery. 
There  is,  perhaps,  after  all,  little  immediate  connection  between  heat  and 
liver  disease. 

Rapid  Changes  of  Temperature. — The  exact  physiological  effects  have  not 
yet  been  traced  out ;  and  these  sudden  vicissitudes  are  often  met  by  altered 
clothing,  or  other  means  of  varying  the  temperature  of  the  body.  The 
greatest  influence  of  rapid  changes  of  temperature  appears  to  occur  when 
the  state  of  the  body  in  some  way  coincides  with  or  favors  their  action. 
Thus,  the  sudden  checking  of  the  profuse  perspu-ation  by  a  cold  wind  pro- 
duces catarrhs,  inflammations,  and  neuralgia.  It  is  astonishing,  however,  to 
find  how  well  even  phthisical  persons  ■s^all  bear  great  changes  of  temperature, 
if  they  are  not  exposed  to  moving  cui'rents  of  air  ;  and  there  can  be  httle 
doubt  that  the  wonderful  balance  of  the  system  is  soon  readjusted. 


SECTION  n. 

HUMIDITY. 

According  to  their  degree  of  humidity,  cHmates  are  divided  into  moist 
and  di-y.  Professor  Tyndall's  observations  have  shown  how  greatly  the 
humidity  of  the  ah.'  influences  climate,  by  hindering  the  passage  of  heat 
from  the  earth.  As  far  as  the  body  is  concerned,  the  chief  effect  of  moist 
air  is  exerted  on  the  evaporation  from  the  skin  and  lungs,  and  therefore 
the  degTee  of  dryness  or  moistiu-e  of  an  atmosphere  should  be  expressed  in 
terms  of  the  relative  (and  not  of  the  absolute)  humidity,  and  should  always 
be  taken  in  connection  with  the  temperature,  movement,  and  density  of 

'  Proceedings  of  th.e  Royal  Society,  No.  139. 


88  PRACTICAL    HYGIENE. 

the  air,  if  this  latter  varies  much  from  that  of  sea-level.  The  evaporating 
power  of  an  atmosphere  which  contains  75  per  cent,  of  saturation  is  very 
different,  according  as  the  temperature  of  the  air  is  40°  or  80^.  As  the 
temperature  rises,  the  evaporative  power  increases  faster  than  the  rise  in 
the  tliermometer. 

There  is  a  general  opinion  that  an  atmosphere  M^hich  permits  free,  with- 
out excessive,  evaporation  is  the  best ;  but  there  ai*e  few  precise  experi- 
ments. 

The  most  agreeable  amount  of  humidity  to  most  healthy  people  is  when 
the  relative  humidity  is  between  70  and  80  per  cent.  In  chronic  lung  dis- 
eases, however,  a  very  moist  air  is  generally  most  agreeable,  and  allays 
cough.  The  evaporation  from  the  lungs  produced  by  a  dry  atmosjohere 
appears  to  imtate  them. 

The  moist  hot  siroccos,  which  are  almost  saturated  with  water,  are  felt 
as  oppressive  by  man  and  beast ;  and  this  can  hardly  be  from  any  other 
cause  than  the  check  to  evaporation,  and  the  consequent  rise  in  the  tem- 
perature of  the  body. 

It  is  not  yet  knowTi  what  rate  of  evaporation  is  the  most  healthy.  Ex- 
cessive evaporation,  such  as  may  be  produced  by  a  dry  sirocco,  is  weU 
borne  by  some  persons,  but  not  by  aU.  Probably,  in  some  cases,  the 
physiological  factor  of  perspiration  comes  into  play,  and  the  nerves  and 
vessels  of  the  skin  are  altered  ;  and  in  this  way  persj)ii'ation  is  checked. 
We  can  hardly  account,  in  any  other  way,  for  the  fact,  that  in  some  jDer- 
sons,  the  dry  sirocco,  or  dry  hot  land  wind,  produces  harshness  and  dry- 
ness of  the  skin,  and  general  malaise,  which  possible  (though  there  is  yet 
no  thermometric  proof)  may  be  caused  by  a  rise  of  temperature  of  the 
body. 

From  the  experiments  of  Lehmann  on  pigeons  and  rabbits,  it  appears 
that  more  carbon  dioxide  is  exhaled  from  the  lungs  in  a  very  moist  than 
in  a  dry  atmosphere.  The  pathological  effects  of  humidity  are  intimately 
connected  with  the  temperature.  Warmth  and  great  humidity  are  borne 
on  the  whole  more  easily  than  cold  and  great  humidity.  Yet  in  both 
cases,  so  wonderful  is  the  power  of  adaptation  of  the  body,  that  often  no 
harm  results. 

The  spread  of  certain  diseases  is  supposed  to  be  intimately  related  to 
humidity  of  the  air.  Malarious  diseases,  it  is  said,  never  attain  their  full- 
est epidemic  spread  unless  the  humidity  approaches  satui'ation.  Plague 
and  smallpox  are  both  checked  by  a  very  dry  atmosphere.  The  cessation 
of  bubo  plague  in  Upper  Egypt,  after  St.  John's  Day,  has  been  considered 
to  be  more  owing  to  the  dryness  than  to  the  heat  of  the  air. 

In  the  dry  Harmattan  wind,  on  the  west  coast  of  Africa,  smallpox  can- 
not be  inoculated  ;  and  it  is  well  known  with  what  difficulty  cowpox  is 
kept  up  in  very  dry  seasons  in  India.  YeUow  fever,  on  the  other  hand, 
seems  independent  of  moisture,  or  will  at  any  rate  prevail  in  a  dry  air. 
The  observations  at  Lisbon,  which  Lyons  has  recorded,  show  no  relation 
to  the  dew-point. 

With  regard  to  other  diseases,  and  especially  to  diseases  of  sanguifica- 
tion and  nutrition,  observations  are  much  needed. 


CLIilATE.  89 

SECTION  HL  ' 

3I0TZ3IEXT  OF  AIE. 

This  is  a  very  ixaportant  climatic  condition.  The  effect  on  the  body  is 
twofoL;].  A  cold  wind  abstracts  heat,  and  in  proportion  to  its  Telocity ;  a 
L>j:  -7.-i-_  1  C'urries  a^vay  little  heat  by  direct  abstraction, but,  if  dry, increases 
evaporation,  and  in  tiiat  way  may  in  part  counteract  its  own  heating 
power.  Both,  probably,  act  on  the  structure  of  the  nerves  of  the  shin  and 
on  the  c  jntracility  of  the  cutaneoii?  ve.5sels,  and  may  thus  induence  the 
rate  of  evfi.jrrition.  and  pos^iljly  adtct  also  other  organs. 

T;.e  '\:^  j'j.nt  of  the  cooling  enect  oi  moving  bodies  of  air  is  not  easy  to 
detei-^^ii-v,  :.s  it  depends  on  thr-ee  factjrr-,  viz.,  the  velocity  of  movement, 
the  ten/.: Tiuture.  and  the  hunii'dity  of  the  air.  The  effect  of  movement  is 
very  Li-iit,  In  a  c:dm  atmosjjhere  an  extremely  wai-m  temperature  is 
borne  without  difficulty.  In  the  Ai'ctic  expeditions  calm  air  many  de- 
grees below  zero  of  Fahr.  caused  no  discomfort.  But  any  movement  of 
such  cold  ail'  at  once  chills  the  fi'anie.  It  has  been  asserted  that  some  of 
the  hot  anl  very  dry  desert  winls  will,  in  spite  of  their  wannth,  chill  the 
bci:!"  :  :.:_  1  ::  ^  .it  can  scarctly  Ijt  tr  :..  .ny  other  reason  than  the  enor- 
mon-  -■■  .  .::  n  tn^v  r:iuse  n'Oin  Ii^l-  .~„in.  It  is  very  de.su'able,  however, 
that  ti.i-  -  :  ti  :.  -i;tild  be  rej)eatecL  with  careful  ther-mometrical  ol> 
servati'.'n.^  u^jtn  on  inc  uody  in  the  usual  way  and  on  the  sui-face  of  the 
shin, 

SECTIOX  IV. 

WEIGHT  OF  THE  AIE. 

Effects  of  Consider  f:']^  L-^^-^'xing  of  Pressure. 

"When  the  difference  of  press vne  1  jf>*ween  two  places  is  considerable,  a 

ni:.:".:-  1  en-  "  i-  ^  r  1  icel.  and  ther-r  seems  no  doubt  that  the  influence  of 
nijnn-.in  i.j  .Inn.--  n  IcStinei  to  be  of  .sreat  impoi'tance  in  therapeutics. 
It  is  of  r.'-jnliar  int-r^-~t  X\i  tn-  arniv  surne'jn.  as  so  many  regiments  in  the 
tropics  ai'e,  ox  '^.ilj.  ijr.  cjuarterel  at  c-cnsnleraljle  elevations. 

In  ascenan._  :__:untain3  there  is  rarefaction,  i.e.,  lessened  pressure  of 
air ;  on  an  aTein.._c  ^if  the  weight  of  the  air  at  sea-level  is  15  fe  on  every 
square  inch)  an  ascent  of  'jc'ij  feet  takes  off -J- ft) ;  but  this  varies  with 
height  ;  there  are  also  lowere  1  ttmperature,  and  lessened  moisture  above 
4,ij'jij  :-.--".  _r- :.:er  movement  of  the  air,  increased  amount  of  Hghts  greater 
sun  1:.  iiation..  if  clouls  are  absent:  the  air  is  fi-eer  from  genns  of  ia- 
tn-  ::.  ;  owin^  to  the  raiefaction  of  the  air  and  lessened  watery  vapor, 
ther'z-  i-  giTater  diathermancy  of  the  au' ;  the  soil  is  rapidly  heated,  but 
ra'dif.tr-  :J-  c  fa-t.  as  ti^e  heat  is  not  so  much  held  back  by  vapor  in  the  air, 
hen:n  there  is  very  great  coohn,g  of  the  ground  and  the  ah  close  to  it  at 
nignt. 

The  physiological  effects  of  lessened  pressui-e  begin  to  be  perceptible 
at  2, SCO  or  3,000  feet  of  altitude  (  =  dtscent  of  2s-~'to  3  hiches  of  mer- 
cui'v  1  :  they  are — quickened  pulse '  (fifteen  to  twenty  beats  per  minute) ; 

'  Balloon  ascents. — Biot  &  Gav-Lusac  at    9,000  ft.  =increase  of  18-30  beats  of  pxilse. 

Glaisher  .' .at  17,000  "  —        "      of  10-24  *' 

Glaislier . .  . .  .at  24,000  "  =        "      of  24-31  " 

Tr.^  leat;  seem  to  aBgment  in  number  witb  tbe  elevation.  These  are  safer  numbers 
tV.i-  -':.  -  c'  .ii.Ti  in  mountain  ascents,  as  there  is  no  physical  exertion.  In  nionn- 
"iii-    -  iJ.  1   -  :1-T  i II crease  is  much  greater. 


90  PEACTICAL   HYGIENE. 

quickened  respiration  (increase  =  ten  to  fifteen  respirations  per  minute),  with 
lessened  spirometrie  capacity,'  increased  evaporation  from  skin  and  lungs ; 
lessened  luinary  water. '^  At  gi*eat  heights  there  is  increased  pressui'e  of 
the  gases  in  the  body  against  the  containing  parts  ;  swelling  of  suiDerficial 
vessels,  and  occasionally  bleeding  from  the  nose  or  lungs.  A  sensation  of 
weight  is  felt  in  the  hmbs  from  the  lessened  pressure  on  the  joints.  At 
altitudes  under  6,000  or  7,000  feet  the  effect  of  mountain  air  (which  is, 
perhaps,  not  owing  solely  to  lessened  j^ressure,  but  also,  possibly,  to  in- 
creased hght  and  pleasurable  excitement  of  the  senses)  is  to  cause  a  very 
marked  improvement  in  digestion,  sanguification,  and  in  nervous  and 
muscidar  vigor.'  It  is  inferred  that  tissue  change  is  accelerated,  but 
nothing  definite  is  known. 

The  rapid  evaporation  at  elevated  positions  is  certainly  a  most  im- 
portant element  of  mountain  hygiene.  At  Puebla  and  at  Mexico  the 
hygrometer  of  Saussui-e  wiU  often  mark  37',  which  is  equal  to  only  45  per 
cent,  of  satxu-ation,*  and  yet  the  lower  rooms  of  the  houses  are  very  humid, 
so  that,  in  the  town  of  Mexico,  there  are  really  two  chmates, — one  very' 
moist,  in  the  rez-de-chaussee  of  the  houses  ;  one  veiy  day,  in  the  upper 
rooms  and  the  outside  air. 

The  diminution  of  oxygen,  in  a  certain  cubic  space,  is  precisely  as  the 
pressure,  and  can  be  calculated  for  any  height,  if  the  bai'ometer  is  noted. 
Taking  chy  air  only,  a  cubic  foot  of  aii-  at  30  inches,  and  at  32°  Fahr.,  con- 
tains 130.4  gi-ains  of  oxygen.    An  ascent  (about  5,000  feet)  which  reduces  the 

barometer  to  25  inches  will  lessen  this  -Jth,  or  I ^ — '—=  \  108.6  grains. 

But  it  is  sujjposed  that  the  increased  number  of  resphations  compensate,  or 
more  so,  for  this  ;  and,  in  addition,  it  must  be  remembered  that  in  experi- 
ments on  animals,  as  long  as  the  percentage  of  oxygen  did  not  sink  below 
a  certain  point  (14  per  cent.),  as  much  was  absorbed  into  the  blood  as 
when  the  oxygen  was  in  normal  proportion.  Jourdanet  has  indeed 
asserted  °  that  the  usual  notion  that  the  resi^u-ations  are  augmented  in 
number  in  the  inhabitants  of  high  lands  is  "  completely  eiToneous  ;"  that 
the  respu'ations  are  in  fact  lessened,  and  that  from  time  to  time  a  deeper 
resj^iration  is  voluntaiily  made  as  a  partial  compensation.  But  Coindet, 
from  1,500  observations  on  French  and  Mexicans,  does  not  confirm  this; 
the  mean  number  of  respirations  was  19.36  per  minute  for  the  French, 
and  20.297  for  the  Mexicans. 

As  a  curative  agent,  mountain  air  (that  is,  the  consequences  of  lessened 
pressiu'e  chiefly)  ranks  very  high  in  all  anamic  affections  from  whatever 
cause  (malai'ia,  hemorrhage,  digestive  feebleness,  even  lead  and  mercury 
poisoning)  ;  and  it  would  appear,  from  Hermann  "Weber's  obsei-vations, 
that  the  existence  of  valvular  heart  disease  is,  if  proper  i-ules  are  observed, 
no  contradiction  against  the  lower  elevations  (2,000  to  3,000  feet).  Neuralgia, 
gout,  and  rheumatism  are  all  benefited  by  high  Alj^ine  positions  (H.  Weber). 
Scrofula  and  consumption  have  been  long  known  to  be  rare  among  the 
dwellers  on  high  lands,  and  the  cui-ative  effect  on  these  diseases  of  such 
places  is  also  marked ;  but  it  is  possible  that  the  open  au'  hie  which  is  led 

'  Battraj  found  an  ascent  of  2,000  feet  (at  Ascension)  lessened  the  "vital  capacity," 
as  judged  of  by  the  spirometer,  from  266  to  249  and  243  cubic  inches. 

■■'  Vivenot,  Virchow's  Archiv,  1860,  Band  xix.,  p.  492.  This  is  probable,  but  not  jet 
proved. 

^  Hermann  Weber.  Climate  of  the  Swiss  Alps,  1864,  p.  17. 

■*  Jourdanet.  Du  3Iexique,  p.  49. 

*  Du  Mexique,  p.  76. 


CLIMATE.  91 

has  an  influence,  as  it  is  now  known  that  great  elevation  is  not  necessaiy  for 
the  ciu-e  of  phthisis.' 

Dr.  Hermann  Weber,  in  his  important  work  on  the  Swiss  Alps  (p.  22), 
has  given  the  present  evidence,  and  has  shown  how  in  the  true  Alpine 
region— in  Dauphin  e,  in  Peru  and  Mexico,  and  in  Germany — phthisis  is 
decidedly  averted  or  prevented  by  high  altitudes.  The  more  recent  ex- 
perience of  Davos  Platz  is  confirmatory. 

Although  on  the  Alps  phthisis  is  arrested  in  strangers,  in  many  places  the 
Swiss  women  on  the  lower  heights  suffer  greatly  from  it ;  the  cause  is  a 
social  one  ;  the  women  employed  in  making  embroidery  congregate  all  day 
in  small,  ill-ventilated,  low  rooms,  where  they  are  often  obhged  to  be  in  a 
constrained  position  ;  then-  food  is  poor  in  quality.  Scrofula  is  very  common. 
The  men  who  hve  an  open-air  life  are  exempt ;  therefore,  in  the  very  place 
where  strangers  are  getting  well  of  phthisis  the  natives  die  from  it — another 
instance  that  we  must  look  to  local  conditions  and  social  habits  for  the 
great  cause  of  phthisis.  If  would  even  seem  possible  that,  after  aU,  it  is 
not  indeed  elevation  and  rarefaction  of  air,  but  simply  plenty  of  fresh  air 
and  exercise,  which  are  the  great  agents  in  the  cure  of  phthisis. 

Jourdanet,  who  differs  from  so  much  that  is  commonly  accepted  on  this 
point,  gives  additional  evidence  on  the  effect  of  elevation  on  phthisis.  _  At 
Vera  Cruz  phthisis  is  common ;  at  Puebla  and  on  the  Mexican  heights,  it  is 
almost  absent  {d  peu  pres  nulle). 

The  diseases  for  which  mountain  air  is  least  useful  are — rheumatism,  at 
the  lower  elevations  where  the  air  is  moist ;  above  this  rheumatism  is 
improved  ;  and  chronic  inflammatory  affections  of  the  respiratory  organs  (?). 
The  "mountain  asthma"  appears,  however,  from  Weber's  observations,  to 
be  no  specific  disease,  but  to  be  common  pulmonary  emphysema  following 
chronic  bronchitis. 

It  seems  likely  that  pneumonia,  pleurisy,  and  acute  bronchitis  are  more 
common  in  higher  Alpine  regions  than  lower  down. 

IJfeds  of  Increased  Pressure. — The  effects  of  increased  pressure  have 
been  noticed  in  persons  working  in  diving-beUs,  etc.,  or  in  those  submitted 
to  treatment  by  compressed  air.  (At  Lyons  and  at  Eeichenhall '  especially.) 
When  the  pressure  is  increased  to  from  1^  to  2  atmospheres,  the  pulse 
becomes  slower,  though  this  varies  in  individual  cases  ;  the  mean  lessening 
is  10  beats  per  minute  ;  the  respirations  are  sHghtly  lessened  (1  per  minute); 
evaporation  from  the  skin  and  lungs  is  said  to  be  lessened  (?) ;  there  is 
some  recession  of  blood  from  the  peripheral  parts  ;  there  is  a  little  ringing 
and  sometimes  pain  in  the  ears ;  hearing  is  more  acute  ;  the  urine  is  in- 
creased in  quantity  ;  appetite  is  increased  ;  it  is  said  men  will  work  more 
vigorously.  When  the  pressure  is  much  greater  (two  or  three  atmospheres) 
the  effects  are  sometimes  very  marked  ;  great  lowering  of  the  pulse,  heavi- 
ness, headache,  and  sometimes,  it  is  said  deafness.  It  is  said  °  that  more 
oxygen  is  absorbed,  and  that  the  venous  blood  is  as  red  as  the  arterial ; 
the  skin  also  sometimes  acts  more,  and  there  may  even  be  sweating.     The 

>  Some  time  ago  a  remarkable  paper  was  published  by  Dr.  James  Blake,  of  California, 
on  the  treatment  of  phthisis  (Pacific  Medical  Journal,  1860).  He  adopted  the  plan  of 
making  his  patients  live  in  the  open  air;  in  the  summer  months  he  made  them  sleep 
out  without  any  tent ;  the  result  was  an  astonishing  improvement  in  digestion  and 
sanguification  ;  the  resistance  to  any  ill  effects  from  cold  and  wet  is  described  as 
marvellous.  As  Dr.  Blake  is  well  known  to  be  perfectly  trustworthy,  these  statements 
are  worthy  of  all  consideration. 

2  For  an  account  of  the  effects  noted  at  Eeichenhall,  see  Dr,  Burdon-Sanderson's 
account  in  The  Practitioner,  No.  iv.,  1868,  p.  221. 

^  Foley,  ''Du  Travail  dans  I'air  comprime,"  Gaz.  Hebdom.,  1863,  No.  33. 


92  PRACTICAL    HYGIENE. 

main  effect  is  to  lessen  the  quantity  of  blood  in  the  veins  and  auricles,  and 
to  increase  it  in  the  arteries  and  ventricles  ;  the  filling  of  the  ventricle 
during  the  relaxation  takes  place  more  slowly.  The  diastohc  interval  is 
lengthened,  and  the  pulse  is  therefoi'e  slower. 

Wlien  the  workmen  leave  the  compressed  air  they  are  said  to  suffer  from 
hemorrhages  and  occasional  nervous  affections,  which  may  be  from  cerebral 
or  spinal  hemoiThage.'  As  a  curative  agent  in  phthisis,  the  evidence  is 
unfavorable. 

Some  observations  lately  made  by  M.  Bert  ^  show  that  oxygen,  when  it 
enters  the  blood  under  pressure  (such  as  that  given  by  17  atmospheres  of 
atmospheric  ah",  or  3^  atmospheres  of  jDure  oxygen),  is  toxic  to  birds,  pro- 
ducing con^Tilsions.  Convulsions  are  produced  in  dogs  when  the  pressure 
is  only  7  or  8  atmospheres,  and  when  the  oxygen  amounts  to  only  double 
the  normal  amount,  or,  in  other  words,  reaches  32  C.C.  per  100  C.C.  of 
blood.  M.  Bert  conjectures  that  the  toxic  influence  of  oxygen  is  on  the 
nervous  centres,  like  strychnine.  The  animal  temperatm-e  fell  2  or  3 
degrees  (C.)  during  the  convulsions,  so  that  excess  of  oxygen  did  not  cause 
increased  combustion.  In  the  case  of  a  dog  kept  under  a  pressure  of  9^ 
atmospheres  for  some  time,  gas  was  found  in  the  ventral  ca\-ity  and  in  the 
areolar  tissue.  In  man  the  pressure  of  only  5  atmospheres  appears  to  be 
dangerous.' 

7s  Acclimatization  possible  ? 

The  doctrine  of  acclimatization  has  been  much  debated,  but  probably 
we  do  not  know  suflficiently  the  physiological  conditions  of  the  body  mider 
different  circumstances.  In  the  case  of  Europeans  li\dng  till  puberty  in  a 
temperate  region,  near  the  sea-level,  and  in  a  moist  climate  like  England, 
and  then  going  to  the  tropics,  the  question  of  acclimatization  would  be  put 
in  this  form, — Does  the  body  accommodate  itself  to  greater  heat,  to 
lessened  humidity  in  some  cases,  or  greater  in  others,  and  to  vaiying 
altitudes  ? 

There  can  be  little  doubt  that  the  body  does  accommodate  itself  within 
certain  limits  to  greater  heat,  as  we  have  seen  that  the  lungs  act  less,  the 
skin  more,  and  that  the  circulation  lessens  when  Englishmen  pass  into  the 
tropics.  There  is  so  far  an  accommodation  or  alteration  impressed  on 
the  functions  of  the  body  by  unwonted  heat.  And  we  may  believe  that  this 
effect  is  permanent,  i.e.,  that  the  lungs  continue  to  act  less,  and  the  skin 
more,  as  long  as  the  Europeans  remain  in  the  tropics.  Doubtless,  if  the 
race  were  perpetuated  in  the  tropics,  succeeding  generations  would  show 
fixed  alterations  in  these  organs. 

We  may  conclude  that  the  converse  holds  true,  and  that  the  cold  of 
temperate  regions  will  influen,ce  natives  of  the  tropics  in  an  opposite  waj', 
and  this  seems  to  he  rendei'ed  likely  by  the  way  in  which  lung  affections 
arise  in  many  of  them. 

We  may  admit  there  is  an  acclimatization  in  this  sense,  but  in  no  other. 
The  usual  belief  that  the  constitution  acquires  in  some  way  a  power  of 

'  See  Limousin,  in  Canstatt,  1863,  Band  ii.,  p.  ^05,  and  Eabington  in  Dublin 
Quarterly  Journal,  November,  1864. 

-  Chemical  News,  March  28,  1873. 

'  In  the  colliery  accident  at  Pont-y-Prydd,  several  men  were  confined  for  ten  days 
in  a  small  space,  in  which  the  air  was  much  compree-sed.  The  exact  pressure  is  un- 
known, but  it  was  sufficient  to  drive  one  of  the  men,  with  fatal  force,  into  the  opening 
made  for  their  rescue  Although  the  men  were  without  food  all  the  time,  they 
appeared  to  have  suifered  leos  than  might  have  been  anticipated. 


CLIMATE.  93 

resisting  unhealtliy  influences— that  is,  a  power  of  not  being  any  longer 
susceptible  to  them — is  not  supported  by  any  good  evidence.  The  lungs 
in  Europeans  will  not  regain  their  weight  and  amount  of  action  in  the 
tropics ;  a  change  to  a  cold  climate  only  will  cause  this  ;  the  skin  retains 
its  increased  function  until  the  cause  producing  it  is  removed.  So  also 
there  is  no  acclimatization  in  any  sense  of  the  word  for  malaria. 


SECTION  V. 
COMPOSITION  OF  THE  AIR. 

The  proportionate  amounts  of  oxygen  and  nitrogen  remain  very  constant 
in  all  countries,  and  the  range  of  variation  is  not  great. 

So  also,  apart  from  the  habitations  of  men,  the  amount  of  carbon  dioxide 
is  (at  elevations  occupied  by  men)  constant.  The  variations  in  watery 
vapor  have  been  already  noticed. 

The  only  alterations  in  the  composition  of  the  air  which  come  under 
the  head  of  climate,  are  changes  in  the  state  in  which  oxygen  exists  (for  do 
change  is  known  to  occur  in  nitrogen),  and  the  presence  of  impurities. 

Sub-Section  I. — Ozone. 

Ozone  is  now  admitted  by  most  chemists  to  be  an  allotropic  condition 
of  oxygen  ;  and,  as  conjectured  by  Odling,  it  is  now  believed  that  it  is  a 
compound  molecule  made  up  of  thi-ee  molecules  (0.,0)  of  oxygen.  The 
so-called  antozone  is  now  believed  to  be  peroxide  of  hydrogen  diffused  in 
a  large  quantity  of  atmospheric  air.  Variations  in  the  amount  of  ozone 
have  been  supposed  to  be  a  cause  of  chmatie  difference,  but,  in  spite  of  aU 
the  labor  which  has  been  given  to  this  subject,  the  evidence  is  very  uncon- 
clusive.  The  reaction  with  the  ozone  paper  is  liable  to  great  fallacies.' 
Yet  it  seems  clear  that  some  points  are  made  out ;  the  ozonic  reaction  is 
greater  in  pure  than  impure  air  ;  greater  at  the  seaside  than  in  the  interior  ; 
greater  in  mountain  air  than  in  the  plains ;  absent  in  the  centre  of  large 
towns,  yet  present  in  the  suburbs ;  absent  in  an  hospital  ward,  yet  present  in 
the  air  outside.  In  this  country  it  is  greater  with  south  and  west  -^dnds ; 
greater,  according  to  Moffat,  when  the  mean  daily  temperature  and  the 
dew-point  temperature  are  above  the  mean  ;  the  same  observer  found  it  in 
increased  quantity  with  decreasing  readings  of  the  barometer,  and  con- 
versely in  lessened  quantity  with  increasing  readings. 

The  imperfections  in  the  test  render  it  desirable  to  avoid  drawing  con- 
clusions at  present ;  but  one  or  two  points  must  be  adverted  to. 

1.  Owing  probably  to  the  oxidizing  power  of  ozone  when  prepared  in 
the  laboratory,  a  great  power  of  destruction  of  organic  matter  floating  in 
the  air  has  been  ascribed  to  ozone  by  Schonbein,  and  the  absence  of  ozone 
in  the  air  has  been  attributed  by  others  to  the  amount  of  organic  matter  in 
the  air  of  towns.  Even  the  cessation  of  epidemics  (of  cholera,  malarious 
fevers)  has  been  ascribed  to  currents  of  air  bringing  ozone  with  them.  The 
accumulation  of  malaria  at  night  has  been  ascribed  to  the  non-production 
of  ozone  by  the  sun's  rays  (Uhle).  The  effect  of  stagnant  air  in  increasing 
epidemics  has  also  been  ascribed  to  the  absence  of  ozone. 

It  seems  clear  that  the  substance  giving  the  reaction  of  ozone  is  neither 

'  The  subject  of  ozone  will  be  found  fully  discussed  by  Dr.  C.  Fox  (Ozone  and 
Antozone,  1873j.     The  causes  of  fallacy  in  the  tests  are  carefully  explained. 


94  PRACTICAL    HYGIENE. 

deficient  in  marshy  districts,  nor  when  ozone  is  conducted  through  marsh 
dew  does  it  destroy  the  organic  matter.' 

2.  On  account  of  the  irritating  effect  of  ozone,  when  rising  from  an 
electrode,  Schimbein  believed  it  had  the  power  of  causing  catan-h,  and 
inferred  that  epidemics  of  influenza  might  be  produced  by  it.  He  attempted 
to  adduce  evidence,  but  at  present  it  may  safely  be  said  that  there  is  no 
proof  of  such  an  origin  of  epidemic  catarrhs. 

3.  A  pojDular  opinion  is,  that  a  climate  in  which  there  is  much  ozone 
(ie.,  of  the  substance  giving  the  reaction  with  iodide  and  starch  paper)  is 
a  healthy,  and,  to  use  a  common  phi'ase,  an  exciting  one.  The  coincidence 
of  excess  of  this  reaction  with  pure  air  lends  some  support  to  this,  but,  Hke 
the  former  opinions,  it  still  wants  a  sufficient  experimental  basis. 

On  the  whole,  the  subject  of  the  presence  and  elfects  of  ozone,  curious 
and  interesting  as  it  is,  is  very  uncertain  at  present ;  experiments  must  be 
numerous,  and  inferences  drawn  from  them  must  be  received  with  caution. 

Sub-Section  II. — Malaeia. 

The  most  important  organic  impurity  of  the  atmosphere  is  malaria,  and 
when  a  climate  is  called  "unhealthy,"  in  many  cases  it  is  simply  meant  that 
it  is  malarious.  In  the  chapters  on  Soils  and  Air  the  most  impoi'tant 
hygienic  facts  connected  with  malaria  have  been  noted.  In  this  place  it 
only  remains  to  note  one  or  two  of  the  climatic  points  associated  with 
malaria. 

1.  Vertical  Ascevt. — A  marsh  or  malarious  tract  of  country  existing  at 
any  point,  what  altitude  gives  immunity  from  the  malaria,  supposing  there 
is  no  drifting  up  ravines  ?  It  is  well  known  that  even  a  slight  elevation 
lessens  danger — a  few  feet  even,  in  many  cases,  but  complete  security  is 
only  obtained  at  greater  heights.  Low  elevations  of  200  to  300  feet  are 
often,  indeed,  more  malarious  than  lower  lands,  as  if  the  malaria  chiefly 
floated  up. 

At  present  the  elevation  of  perfect  security  in  different  parts  of  the 
world  is  not  certainly  determined,  but  appears  to  be — 

Italy 400  to     500  feet.' 

America  (Appalachia) 3,000      " 

Cahfornia ' 1,000      " 

India 2,000  to  3,000      " 

West  Indies 1,400  to  1,800  up  to  2,200  feet. 

But  these  numbers  are  so  far  unceriain  that  it  has  not  always  been 
seen  that  the  question  is  not,  whether  marshes  can  exist  at  these  elevations 
(we  know  they  can  be  active  at  6,000  feet),  but  whether  the  emanations 
from  a  marsh  will  ascend  that  height  without  drifting  up  ravines  ?  1,000 
to  1,200  feet  would  generally  give  security  in  all  probabiUty. 

2.  Horizontal  Spread. — In  a  calm  air  L6vy  *  has  supposed  that  the 
malaria  will  spread  until  it  occupies  a  cube  of  1,400  to  2,000  feet,  which  is 
equivalent  to  saying  it  will  spread  700  to  1,000  feet  horizontally  from  the 
central  point  of  the  marsh.  But  cun'ents  of  air  take  it  great  distances, 
though  the  best  observations  show  that  these  distances  are  less  than  were 

'  In  addition  to  what  has  been  previously  said  (Vol.  I.,  p.  131),  Grellois  has  lately 
stated  that  he  found  more  ozone  over  a  marsh  than  elsewhere.  An  interesting  series  of 
observations  on  ozone  in  the  Bombay  Presidency  has  been  made  by  Dr.  Cook. 

-  Carriere,  quoted  by  Levy,  t.  i.,  p.  491. 

•  This  information  was  given  Dr.  James  Blake.  ■•  T.  i.,  p.  464. 


CLIMATE.  95 

supposed,  and  seldom  overpass  one  or  two  miles,  unless  tlie  air-currents  are 
rapid  and  strong.  The  precise  limits  are  unknown,  but  it  is  very  doubtful 
if  the  belief  in  transference  of  malaria  by  air-currents  for  10,  20,  dr  even 
100  miles,  is  coi-rect.  * 

3.  Spread  over  Water.  —  The  few  precise  observations  show  that  this 
differs  in  different  countries.  In  the  Channel,  betweeii  Beveland  and 
Walcheren,  3,000  feet  of  water  stopped  it  (Blane).  In  China  and  the  West 
Indies  a  farther  distance  is  necessary.  Li  China  three-quarters  of  a  mile 
has  been  effectual ; '  in  the  West  Indies  one  mile.  Grant  thinks  that  salt 
water  is  more  efficacious  than  fresh. 


SECTION  VI. 
ELECTRICAL  CONDITION— LIGHT. 

That  these,  as  well  as  heat,  are  important  parts  of  that  complex  agency 
we  call  Climate,  seems  clear  ;  but  little  can  be  said  on  the  point.  In  hot 
countries  positive  electricity  is  more  abundant ;  but  the  effect  of  its  amount 
and  variation  on  health  and  on  the  spread  and  intensity  of  diseases  is  quite 
unknown.  All  that  has  been  ascribed  to  it  is  pure  speculation.  The  only 
certain  fact  seems  to  be  that  the  spread  of  cholera  is  not  influenced  by  it. 

With  regard  to  light,  the  physiological  doctrine  of  the  necessity  of 
light  for  growth  and  perfect  nutrition  makes  us  feel  sure  that  this  is  an  im- 
portant part  of  climate,  but  no  positive  facts  are  known. 


Grant  (quoted  by  CLevers),  Indian  Annals,  1859,  p.  636. 


CHAPTER  Xy. 

DESCRIPTION  OF  THE  METEOROLOGICAL  INSTRUMENTS, 
AND  A  FEW  REMARKS  ON  METEOROLOGY.  . 

As  meteorological  observations  are  now  so  commonly  made,  and  as  iu 
the  azTny  instruments  are  pro\dded  at  many  foreign  stations,  it  is  desirable 
to  give  a  few  plain  instructions  on  the  use  of  these  instmments. '  For  the 
convenience  of  beginners,  a  few  observations  on  Meteorology  are  also 
added. 

'  The  following  is  tlie  oflBcial  circular  issued  by  the  Army  Medical  Department :  — 

Official  Instructions  for  Reading  the  Meteorological  Instruments. 

Tlie  observer  should  make  himself  thoroughly  acquainted  with  the  scale  of  every 
instrument,  especially  with  that  of  the  barometer  and  its  attached  vernier,  and  by  fre- 
quent comparisons  ascertain  that  he  and  his  deputy  read  the  instruments  alike,  and 
record  the  observations  accurately. 

All  observations  must  be  recorded  exactly  as  read.  The  corrections  are  to  be  made 
only  at  the  end  of  each  month  on  the  "  means"  of  the  "  sums." 

Barometrical  observations  must  be  recorded  to  the  third  decimal  place  ;  thermomet- 
rical  to  the  first  decimal.  When  the  readings  are  exactly  to  the  inch  or  degree,  the 
places  for  the  decimals  must  be  filled  up  with  ciphers. 

The  observations  should  be  made  as  quickly  as  possible,  consistent  with  perfect 
accuracy,  and  the  observer  must  avoid  breathing  on  the  instruments,  particularly  the 
dry  and  wet  bulb,  and  maximum  thermometers. 

Barometer  Readings. — Note  the  temperature  of  attached  thermometer  in  degrees 
only  ;  by  means  of  the  thumb-screw  at  the  bottom  adjust  the  mercury  in  the  cistern  to 
its  proper  level,  the  point  of  the  ivory  cone,  which  should  just  touch  the  mercury  with- 
out breaking  the  surface ;  then  bring  the  zero  line  of  the  vernier  to  the  level  of 
the  apex  of  column  of  the  mercury,  and  read  off  in  the  manner  described  at  pages  15 
and  16  of  Sir  H.  James's  Book  of  Instructions. - 

Tliermometer  Readings. — The  scales  are  divided  to  degrees  only,  but  these  are  so 
open  that  the  readings  can  be  determined  to  the  tenth  of  a  degree.  Practice  and  at- 
tention will  insure  accuracy. 

Maximum  Tliermometer  in  Shade. — The  maximum  thermometer  must  be  hung  at  such 
a  distance  (2  or  3  inches)  from  the  water-vessel  of  the  wet-bulb  thermometer,  that  its 
readings  may  not  be  affected  by  evaporation. 

In  hanging  the  maximum,  care  must  be  taken  that  the  end  of  the  tube  is  slightly 
indined  doicnirard,  which  will  have  the  effect  of  assisting  in  preventing  the  return  of 
any  portion  of  the  column  of  mercury  into  the  bulb  on  a  decrease  of  temperature.  To 
read  the  instrument,  gently  elevate  the  end  furthest  from  the  bulb  to  an  angle  of 
about  45  °,  in  which  position  of  the  instrument  note  the  reading.  To  re-set  the  ther- 
mometer, a  gentle  shake  or  swing,  or  a  tap  on  the  wooden  frame  of  the  instrument, 
will  cause  the  excess  of  mercury  to  return  to  the  bulb,  and  it  is  again  ready  for  use. 

Maximum  in  Sun^s  Rays,  or  the  Vacuum  Solar  Radiation  Thermometer.- — Being  con- 
structed on  the  same  principle  as  the  last-mentioned  instrument,  it  must  be  read  in  a 
similar   position.     After  completing  the   reading,  by  giving  the   instrument  a  slight 


-  For  these  are  now  pubstitnted  Instructions  in  the  Use  of  Meteorological  Instruwents,  by  R.  H.  Scott, 
M.A.,  F.B.S.,  1877.    The  Barometer  corrections  are  explained  at  pp.  30,  31  of  that  work. 


DESCRIPTION    OF    ilETEOROLOGICAL    IXSTEUMFJSTTS.  97 

SECTION  L 
THEEMOMETERS  FOR  TAKING  THE  TEMPERATURE  OF  THE  AIR. 

Maximum  Thermometers. 

Two  maximum  thermometers  are  issued — one  to  observe  tlie  greatest 
heat  in  the  sun,  the  other  in  the  shade. 

The  Su?i  3Iaximum  or  Solar  Eadiation  Thermometer  is  formed  by  a 
glass  case  (from  which  the  aii"  is  removed),  containing  a  mercurial  thermo- 

shake,  with  th.e  bulb  still  inclined  downward,  tlie  excess  of  mercury  will  return  to  tlie 
bulb,  and  the  thermometer  be  ready  for  the  next  observation. 

Minimum  ThenrMmeter  in  Shude. — The  minimum  thermometer  must  be  so  hung 
that  the  bulb  may  be  about  one  inch  lower  than  the  other  extremity  of  the  instrument, 
because  in  this  position  the  index  is  less  likely  to  be  affected  by  a  rise  in  temperature. 

The  extremity  of  the  index  furthest  from  the  bulb  shows  the  lowest  degree  to 
which  the  spirit  has  fallen  since  the  last  observation.  The  reading  on  the  scale  cor- 
responding to  this  is  the  temperature  to  be  recorded.  Then  by  elevating  the  bulb,  the 
index  will  float  toward  the  end  of  the  spirit.  When  it  has  jiearly  arrived  at  that  pointy 
the  instrument  is  re-set. 

Minimum  on  Grass,  Terrestrial  BadMtion  Thermometer  is  constructed  like  the  last, 
and  the  directions  above  given  are  also  applicable  to  it. 

After  reading  and  re-setting  the  self -registering  thermometers,  compare  them  with 
the  dry-bulb  thermometer  in  order  to  ascertain  that  their  readings  are  nearly  the  same. 

Dry  and-  Wet-Bulb  Thermometers. — Bring  the  eye  on  a  level  with  the  top  of  the 
mercury  in  the  tube  of  the  dry-bulb  thermometer,  and  take  the  reading,  then  complete 
the  observation  by  noting  in  like  manner  the  reading  of  the  wet-bulb  thermometer. 

The  temperature  of  the  air  is  given  by  the  former,  that  of  evaporation  by  the  latter. 
From  these  data  the  hygrometrical  results  are  to  be  calculated  by  Glaisher's  Tables,  3d 
edition. ' 

Bain-Oauge  and  Measure. — Pour  the  contents  of  the  gauge  into  any  convenient  ves- 
sel with  a  lip,  and  from  this  into  the  glass  measure,  which  has  been  graduated  especi- 
ally for  the  gauge,  and  is  only  to  be  used  in  measuring  its  contents.  It  is  graduated  to 
the  hundredths  of  an  inch. 

Anernorneters. — The  dials  are  read  from  left  to  right.  The  first  on  the  left  records 
hundreds  of  miles,  the  second  tens,  the  third  miles,  the  fourth  tenths  of  a  mile,  and 
the-fifth  hundredths  of  a  mile. 

The  reading  of  the  anemometer  is  obtained  by  deducting  from  the  amount  registered 
by  the  dials  the  total  sum  registered  at  the  period  of  the  preceding  observation.  The 
difference  between  those  (subject  to  a  small  correction)  indicates  the  velocity  or  hori- 
zontal movement  of  the  air  in  miles  during  the  interval,  and  must  be  entered  in  the 
return.  When  the  instrument  is  first  set  up,  the  reading  on  the  dials  must  be  noted, 
in  order  that  it  may  be  deducted  from  the  total  registered  by  the  dials  at  the  end  of 
the  first  period  o£  observation. 

In  making  observations  on  the  presence  of  ozone,  a  box  has  been  found  to  be  unne- 
cessary, equally  satisfactory  results  having  been  obtained  by  fixing  the  paper  immediately 
under  the  penthouse  of  the  stand,  which  shelters  it  sufficiently  from  a  strong  light, 
while  it  secures  proper  exposure. 

The  minimum  thermometers  are  liable  to  get  out  of  order — first,  by  carriage,  when 
the  index  may  be  wholly  or  partly  driven  out  of  the  spirit,  or  a  portion  of  spirit  may 
become  detached  from  the  main  column ;  and,  secondly,  by  slow  evaporation  of  the 
spirit,  which  rising  in  the  tube,  condenses  at  the  upper  end.  The  first-mentioned  errors 
are  corrected  by  taking  the  thermometer  in  the  hand,  with  its  bulb  downward,  and 
giving  it  a  swing  up  and  down.  The  second  is  remedied  by  the  inclined  position  of 
the  instrument,  which  allows  the  condensed  spirit  to  trickle  back  to  the  main  column.'^ 

-ZV^.  B. — On  no  account  whatever  is  artificial  heat  to  be  applied  to  a  spirit  thermo- 
meter. In  re-setting  the  minimum,  the  index  should  never  be  brought  quite  to  the 
end  of  the  column  of  spirit. 

'  A  6th  edition  is  now  published. 

2  It  is  generally  necessary  to  swing  the  instrument  to  get  back  the  broken  portion  of  the  column. 

Vol.  II.— 7 


98  PRACTICAL    HYGIENE. 

meter  with  a  blackened  bulb.  The  case  shelters  from  cun-ents  of  air  ;  the 
black  bulb  absorbs  the  sun's  rays.  The  tube  of  the  thei-mometer  is  shghtly 
bent  neai-  the  bulb,  and  a  piece  of  porcelain  is  inserted  which  narrows  the 
tube.  The  efi'ect  of  this  is  to  make  the  thermometer  self-registering,  as, 
after  the  mercur}'  has  expanded  to  its  fullest  extent,  instead  of  retii-ing 
into  the  bulb  on  cooling,  it  is  stopped  by  the  porcelain,  and  the  merciuy 
breaks  between  the  porcelain  and  the  bulb.  The  instrument  is  placed  at  a 
height  of  four  feet  from  the  ground  on  wooden  supports,  and  in  any  place 
where  the  sun's  rays  can  fi-eely  fall  on  it. 

The  Shade  Maximuia  is  a  mercurial  theiTQometer,  not  inclosed  in  a  case, 
but  mounted  on  a  fi-ame.  Its  construction  and  manner  of  reading  are 
otherwise  similar  to  those  of  the  sun  thermometer. 

It  is  placed  in  the  shade  foirr  feet  above  the  gi'ound,  and  sufficiently 
far  fi'om  any  walls  to  be  unaffected  by  radiation.  It  should  be  freely  ex- 
posed to  the  air,  but  perfectly  protected  from  the  sun's  rays. 

Minimum  Thermometers.^ 

Two  minimum  thermometers  are  supplied. 

The  Shade  Minimum  is  an  alcoholic  thermometer  with  a  small  index  in 
the  alcohol  It  is  set  by  allowing  the  index  to  shde  nearly  to  the  end  of 
the  spii'it  ;  as  the  spirit  contracts  during  cold,  it  cames  the  index  do-Rii ; 
when  it  expands  again  it  cannot  move  the  index,  but  leaves  it  at  the  degi-ee 
of  gTeatest  cold.  The  end  of  the  index  farthest  fi'om  the  bulb  is  the  point 
to  read. 

This  thei-mometer  is  placed  in  the  shade  fom-  feet  above  ground,  under 
the  same  conditions  as  the  shade  maximum. 

The  Grass  Minimum  or  Terrestrial  Radiation  Thermometer  is  a  thermo- 
meter of  the  same  kind,  but  protected  by  a  glass  shield.  It  is  placed  al- 
most close  to  the  ground  on  grass,  suspended  on  little  tripods  of  wood, 
but  it  should  not  touch  the  gi-ound  ;  it  is  intended  to  indicate  the  amount 
of  cooling  jDroduced  by  radiation  from  the  ground.  If  snow  hes  on  the 
ground  the  bulb  should  be  placed  in  the  snow.  Scott  recommends  a  black 
board  on  which  to  lay  the  thermometer  where  no  grass  can  be  obtained.'' 

Common  Thermometer. 

The  dry  bulb  of  the  "  wet  and  dry  bulb  thermometer "  is  read  as  a 
common  thermometer. 

Reading  of  the  Thermometers. 

All  these  thermometers  can  be  read  to  tenths  of  a  degree.  The  maxi- 
mum and  minimum  thermometers  are  read  once  a  day,  usually  at  9  a.m.  ; 
the  foi-mer  marks  the  highest  point  reached  on  the  previous  afternoon,  and 
must  be  so  entered  on  the  retui-n  ;  the  latter,  the  lowest  point  reached  on 
the  same  morning.^  For  the  army  returns  the  common  thermometer  is 
read  twice  a  day,  at  9  a.m.  and  3  p.m. 

'  Great  diflBculty  is  found  with  spirit  thermometers  on  account  of  their  being  so 
much  less  sensitive  than  mercurial.  To  remedy  this  the  bulb  is  sometimes  made  fork- 
shaped,  or  otherwise  modified  so  as  to  expose  as  large  a  surface  as  possible. 

'■'  Instructions,  etc.  Scott  adds:  "  Under  any  circumstances,  a  board  gives  a  better 
measure  of  terrestrial  radiation  than  grass. " 

^  It  is  desirable  that  these  thermometers  should  be  read  both  morning  and  evening. 
In  winter  the  maximum  sometimes  occurs  in  the  early  morning  and  the  minimum  in 
the  afternoon.     In  winter   the   range   depends   more   on  the   direction  of  the  wind 


descriptio:n"  oe  meteoeological  instkumejn'ts.         99 

Range  of  the  Temperalare. — The  maximum  and  minimum  in  shade  giye 
most  important  chmatic  indications  ;  the  difference  between  them  on  the 
same  day  constitutes  the  range  of  the  diurnal  fluctuation.  The  range  is 
expressed  in  several  ways. 

The  extreme  daily  range  in  the  month  or  year  is  the  difference  between 
the  maximum  and  minimum  thermometer  on  any  one  day. 

The  extreme  monthly  or  annual  range  is  the  difference  between  the 
gi'eatest  and  least  height  in  the  month  or  year*. 

The  mean  monthly  range  is  the  daily  ranges  added  and  divided  by  the 
number  of  days  in  a  month  (or  between  the  mean  of  all  the  maxima  and 
the  mean  of  all  the  minima). 

The  3'early  mear,  I'ange  is  the  monthly  ranges  added  and  divided  by  12. 

Mean  Temperature. — The  mean  temperatui-e  of  the  day  is  obtained  in 
the  following  ways  : — 

(a)  At  Greenwich  and  other  observatories,  where  by  means  of  photo- 
gi'aphy  the  height  of  the  thermometer  at  every  moment  of  the  day  is  regis- 
tered, the  mean  of  the  hourly  readings  is  taken.  This  has  been  found  to 
accord  with  the  absolute  mean  (foimd  by  taking  the  mean  of  the  whole 
curve)  to  within  -^Qih  of  a  degree. 

ip)  ApiDroximately  in  several  ways.  Taking  the  mean  of  the  shade 
maximum  and  minimum  of  the  same  day.  la  this  country,  during  the  cold 
months  (December  and  Januaiy),  the  result  is  very  close  to  the  truth  ;  but 
as  the  temperatui'e  increases,  a  greater  and  greater  en-or  is  produced,  until 
in  July  the  mean  monthly  error  is  +  1.9^  Fahr.,  and  in  some  hot  days  is 
much  greater.  In  the  tropics,  the  mean  of  the  maximum  and  minimum 
must  give  a  result  still  further  from  the  truth. 

Monthly  corrections  can  be  applied  to  bring  these  means  nearer  the 
truth.     Islx.  Glaisher's  corrections  for  this  country  are  as  follows  : — 

Subtract  fi'om  the  monthly  mean  of  the  maximum  and  minimum  de- 
grees— 


January,    0.2 

May, 

1.7 

September, 

1.3 

Februaiy,  0.4 

June, 

1.8 

October, 

1.0 

March,       1.0 

July, 

1.9 

November, 

0.4 

April,         1.5 

August, 

1.7 

December, 

0.0 

The  result  is  the  ajDproximate  mean  temperatui'e.  But  this  is  true  only  for 
this  country.' 

In  a  great  number  of  places  the  mean  temperature  of  the  day  and  year, 
as  stated  in  books,  is  derived  solely  from  the  mean  of  the  maximum  and 
minimum.-  According  to  Scott,  the  approximation  to  the  time  mean  is  very 
close  in  most  parts  of  the  world,  especially  if  the  obseiwations  be  taken  as 
near  the  end  of  the  period  as  possible,  near  midnight,  for  instance,  for  the 
mean  of  the  civil  day  of  twenty-four  hours. 

The  approximate  mean  temperature  may  also  be  obtained  by  taking 
observations  at  certain  times  diu'ing  the  day,  and  applying  a  correction. 

than  on  the  time  of  day  (Scott).  But  iiuiformity  of  practice  is  the  primary  essential, 
and  at  stations  where  observations  are  made  only  once  a  day,  viz.,  at  9  A.M.,  or  even 
twice,  unless  the  second  reading  is  after  6  p.m.,  the  above  rule  as  to  entry  must  be  fol- 
lowed. 

'  These  numbers  of  Mr.  Glaisher  are  likely  to  be  modified  very  considerably ;  they 
are  largely  dependent  on  the  pattern  of  the  thermometer  stand  employed. 

-  With  a  Stevenson  screen  the  simple  mean  of  the  maximum  and  minimum  is  very 
near  the  truth. 


100  PRACTICAL   HYGIENE. 

Mr.  Glaislier  has  given  some  very  valuable  tables  of  this  kind,'  which  can 
be  consulted." 

If  the  temperature  be  taken  twice  a  day  at  homonymous  hours,  such  as 
9  A.M.  and  9  p.^t.,  the  mean  of  these  does  not  differ  much  from  the  true 
daily  mean  (Scott). 

The  nearest  approach  to  the  mean  temperature  of  the  day  by  a  single 
obsen-ation  is  given  at  from  8  to  9  p.m.  ;  the  next  is  in  the  morning — about 
8  o'clock  in  July  and  10  in  December  and  January. 

The  neai'est  approach  to  the  mean  annual  temperature  is  given  by  the 
mean  of  the  month  of  October.  Observations  made  from  a  week  before  to 
a  "week  after  April  2-4th,  and  again  in  the  con-esponding  weeks  of  October, 
give  a  certain  approximation  to  the  yearly  mean  temperature.^ 

The  changes  in  temperature  of  any  place,  duiing  the  day  or  year,  are 
either  periodic  or  non-periodic.  The  former  are  dependent  on  day  and  night, 
and  on  the  seasons,  i.e.,  on  the  position  of  the  place  with  respect  to  the 
sun.  The  periodic  changes  are  sometimes  termed  fluctuations,  and  the 
differences  between  day  and  night  temperatiu-es,  or  the  temperatiu-es  of 
the  hottest  and  coldest  months,  are  often  called  the  araphtudes  of  the  daily 
or  yearly  fluctuations. 

Daily  Periodic  Changes. — On  land  the  temperature  of  the  air  is  usually 
at  its  lowest  about  3  o'clock  a.m.,  or  just  before  sunrise,  and  at  its  maximum 
about  2  o'clock  p.m.  ;  it  then  falls  nearly  regularly  to  3  o'clock  a.m.  At  sea, 
the  maximum  is  nearly  an  hour  later. 

The  amount  of  diurnal  periodic  change  is  greater  on  land  than  on  water  ; 
in  the  interior  of  continents  than  by  the  sea-side  ;  in  elevated  districts  than 
at  sea-level.  As  far  as  land  is  concerned,  it  is  least  on  the  sea-coast  of 
tropical  islands,  as  at  Kingston  in  Jamaica,  Colombo  in  Ceylon,  Singapore, 
etc. 

Yearly  Periodic  Changes. —In  the  northern  hemisphere,  the  coldest 
month  is  usually  January  ;  in  some  parts  of  Canada  it  is  February.  On 
the  sea,  the  coldest  month  is  later,  \iz.,  March.  The  hottest  month  is  in 
most  places  July,  in  some  few  August  ;  on  the  sea  it  is  always  August. 
The  coldest  days  in  this  countiy  are  toward  the  21st  January ;  the  hottest, 
about  the  18th  to  the  21st  July.  At  Toronto  the  hottest  day  is  37  days 
after  the  summer  solstice  ;  and  the  coldest,  55  days  after  the  winter  sol- 
stice. 

It  is  thus  seen  that  both  for  the  diurnal  and  annual  alterations  of  heat 
the  greatest  heat  is  not  simultaneous  with,  but  is  after,  the  culmination  of 
the  sun  ;  this  is  owing  to  the  slow  absorption  of  heat  by  the  earth. 

The  amplitude  of  the  yearly  fluctuation  is  greater  on  land  than  sea,  and 

'  On  tlie  Corrections  to  be  applied  to  Meteorological  Observations  for  Diurnal  Range, 
prepared  by  the  Council  of  the  British  Meteorological  Society,  1850.  These  corrections 
are  applicable  only  to  this  country. 

•  The  following  rules,  which  are  applicable  in  all  parts  of  the  world,  are  given  by 
Herschel : — ■■ 

If  observations  are  taken  three  times  daily — at  7  A.M.,  2  P.M.,  and  9  P.M., — hours 
which  we  mav  denote  bv  t,  t,  and  t"  ;  then 

2 =  mean  temperature  of  day. 

If  the  hours  are  8  A.M.,  3  P.M.,  and  10  P.M.,  the  formula  is — 
7  t+7  i+10  t" 


24 
'  Herschel,  Meteorology,  p.  180. 


=  mean  of  day. 


■*  Meteorology,  p.  173. 


DESCRIPTION"    OF    METEOEOLOGICAL   INSTEUMENTS.  101 

is  augmented  by  land,  so  that  it  reaches  its  highest  point  in  the  interior  of 
great  extra-tropical  continents. 

It  increases  toward  the  pole  for  three  reasons, — 

1.  The  geographical  fluctuation  of  the  earth's  position  causes  a  great 
yearly  difference  of  the  angle  with  which  the  sun's  rays  fall  on  the  earth. 

2.  The  duration  of  incidence  of  the  sun's  rays  {i.e.,  the  number  of 
hours  of  sunshine  or  shade)  have  greater  yearly  differences  than  in  the 
tropics. 

3.  In  the  northern  hemisphere  especially  there  is  a  very  great  extent  of 
land,  which  increases  radiation. 

The  amphtude  of  the  yearly  fluctuation  is  very  small  in  the  tropical  lands 
at  sea-level.  At  Singapore,  it  is  only  3.6''  Fahr.  (January  78°,  July  82.4°), 
while  it  is  immense  on  continents  near  the  pole.  At  Jakoutsk,  in  North 
Asia,  it  is  112.5°  (January  -445°  and  July  +  68).  All  fluctuations  depend 
to  a  large  extent  upon  the  distance  from  the  sea,  although  local  causes 
may  have  some  influence,  such  as  the  vicinity  of  high  lands. 

In  any  place  there  may  be  great  undulations  and  small  fluctuations,  or 
great  changes  in  each  way.  At  Brussels,  the  greatest  possible  yearly  un- 
dulation is  90°.  In  some  parts  of  Canada,  immense  undulations  sometimes 
occur  in  a  day,  the  thermometer  ranging  even  50°  to  70°  in  one  day. 

The  hot  winds  of  the  rainless  deserts  have  long  puzzled  meteorologists  ; 
they  often  cause  enormous  undulations,  50°  to  as  much  as  78°  Fahi-. 

Temperature  of  the  Air  of  any  Place. 

This  depends  on  the  following  conditions  : — 

1.  Geographical  Position  as  influencing  the  Amount  and  Duration  of  Sun's 
Bays  which  are  received. — The  nearer  the  equator  the  hotter.  For  23|-°  on 
either  side  the  equator  the  sun's  rays  are  vertical  twice  in  the  year,  and  are 
never  more  oblique  than  47°.  The  mean  yearly  temperature  of  the  equator 
is  82°  Fahr.  ;  of  the  pole  about  2.5°  Fahr.  The  decline  from  the  equator 
to  the  pole  is  not  regular  ;  it  is  more  rapid  from  the  equator  to  30°  than  in 
the  higher  latitudes. 

2.  Belative  Amount  of  Land  and  Water. — The  sun's  rays  passing  through 
the  air  with  but  trifling  loss  fall  on  land  or  on  water.  The  specific  heat  of 
land  being  only  one  cjuarter  that  of  water,  it  both  absorbs  heat  and  gives  it 
out  more  rapidly.  Water,  on  the  other  hand,  absorbs  it  more  slowly,  stores 
up  a  greater  quantity,  and  parts  with  it  less  readily.  The  temperature  of 
the  superficial  water,  even  in  the  hottest  regions,  seldom  exceeds  80°  to 
82°,  and  that  of  the  air  is  generally  below  (2°  to  even  6°)  the  temperature  of 
the  water  (J.  Davy).  Consequently  the  more  land  the  greater  is  the  heat, 
and  the  wider  the  diiuTial  and  yearly  amphtudes  of  fluctuation.  The 
kind  of  soil  has  a  great  effect  on  absorption.  The  evapoi'ation  from  the 
water  also  greatly  cools  the  air. 

3.  Elevation  of  the  Place  above  the  Sea-level. — The  greater  the  elevation 
the  colder  the  aii',  on  account — 1st,  of  the  lessening  amount  of  earth  to  ab- 
sorb the  sun's  rays  ;  and,  2d,  on  account  of  the  greater  radiation  into  free 
space.  The  decline  of  temperature  used  to  be  reckoned  at  about  1°  Fahi*. 
for  each  300  feet  of  ascent,  but  the  balloon  ascents  of  Mr.  Welsh,  and  es- 
pecially of  INIr.  Glaisher,  have  proved  that  there  is  no  regtilar  decHne  ;  there 
are  many  cur-rents  of  warm  air  even  in  the  upper  atmosphere.  Still  the  old 
rule  is  useful  as  an  approximation.  The  amotmt  of  decline  varies,  how- 
ever, in  the  same  place  at  different  times  of  the  year.  In  jMi'.  Glaisher's 
balloon  ascents,  in  a  cloudy  sky,  it  was  about  4°  Fahr.  for  each  inch  of 


102  PEACTICAL    HYGIENE. 

barometric  fall,  at  first ;  but  when  the  barometer  had  fallen  11  inches,  the 
decline  of  temperature  was  more  rapid.  Under  a  clear  sky  there  was  a 
fall  of  5°  Fahr.  for  each  of  the  first  tour  inches  of  descent ;  then  4°  per 
inch  till  the  thirteenth  inch  of  descent,  and  then  4.5°  for  fourteenth,  fifteenth, 
and  sixteenth  inches  of  descent. 

The  snow-line  at  any  spot,  or  the  height  at  which  snow  will  lie  the  whole 
year,  can  be  approximately  reckoned  by  taking  the  mean  yearly  temperature 
of  the  latitude  at  sea-level,  and  multiplying  the  difierence  between  that  tem- 
perature and  32°  Fahr.  by  300.  The  aspect  of  a  place,  however,  the  dis- 
tance from  the  sea,  and  other  circumstances,  have  much  to  do  with  the 
height  of  the  permanent  snow-line.  The  mean  temperature  of  any  place 
can  be  apjDroximately  reckoned  in  the  same  way,  if  the  mean  temperature 
of  the  latitude  at  sea-level,  and  the  elevation  of  the  place  in  feet,  be  known. 

4.  Aspect  and  Exposure,  and  Spiecial  Local  Conditions. — These  circum- 
stances chiefly  affect  a  place  by  allowing  free  exposure  to,  or  sheltering 
from  the  sun's  rays,  therefore  lessening  the  number  of  hours  the  rays  reach 
the  soil,  or  by  furnishing  at  certain  times  a  large  moist  surface.  Thus  the 
extensive  sandbanks  of  the  Mersey  cause  very  rapid  alterations  of  temper- 
ature in  the  water  and  air,  by  being  exposed  every  twenty-four  hours 
twice  to  the  sun  and  sky  (Adie). 

5.  Atrial  and  Ocean  Currents. — These  have  a  great  effect,  bringing 
clouds  which  block  out  the  sun  or  produce  rain,  or  which,  in  the  case  of 
ocean  currents,  cool  or  warm  the  air.  The  cold  polar  sea  currents  and  the 
warm  equatorial  (like  the  Gulf  Stream)  in  some  cases  almost  determine, 
and  always  greatly  influence,  the  temperature  of  a  place. 

6.  Nature  of  the  Soil. — On  this  point  little  is  yet  known,  but  it  is  certain 
that  some  soils  easily  absorb  heat ;  others  do  not.  The  moist  and  clayey 
soils  are  cold  ;  the  dry  hard  rocks  and  dry  sands  are  hot. 

The  hottest  places  on  the  earth  are — in  the  eastern  hemisphere,  near  the 
Red  Sea,  at  Massava  and  Khartoum  (15°  N.  L.),  and  on  the  Nile,  in  Lower 
Nubia  ;  annual  temperature  =  90.5°  Fahr.  ;  in  the  western  hemisphere, 
on  the  Continent,  near  the  West  Indies,  the  annual  temperature  is  81.5°. 
These  are  sometimes  called  the  climatic  poles  of  heat.  The  poles  of  cold 
are  in  Sibei'ia  (Jakovitsk  to  Usjausk,  62°  N.),  and  near  Melville  Island. 

Isothermal  Lines. — These  are  lines  drawn  on  charts,  and  were  jjroposed 
by  Humboldt  to  connect  all  places  having  the  same  mean  annual  temper- 
ature. The  various  conditions  just  noted  cause  these  lines  to  deviate  more 
or  less  from  the  lines  of  latitude. 

The  lines  of  mean  summer  temperature  (three  months,  June,  July, 
August)  are  sometimes  called  isotheral ;  those  of  mean  winter  tempei^attu'e 
(December,  January,  and  February)  isocheinional,  or  isocheimal,  but  these 
terms  are  now  seldom  used,  the  terms  summer,  winter,  or  monthly  isother- 
mal, being  substituted.' 


'  It  may  be  well  to  mention  the  relations  between  the  three  principal  thermometer 
scales.  Whilst  the  freezing-point  in  the  Fahrenheit  scale  is  at  83',  it  is  at  0°  in  both  the 
Centigrade  (or  Celsius)  and  the  Reaumur  scales.  Water  boils  at  212''  on  the  Fahrenheit 
scale  (barometer  =  29.905),  at  100"  on  the  Centigrade,  and  at  80°  of  Reaumur. 

Hence  the  formula  of  reduction  is  :  — 

F-32  C         R 

9      ~    5    ~    4' 
from  which  the  corresponding  temperatures  can  easily  be  found. 


DESCRIPTION    OF    METEOROLOGICAL   IJ^STRUMENTS.  103 

SECTION  IL 

HYGROMETERS— HUMIDITY  OF  THE  AIR. 

The  amount  of  watery  vapor  in  the  air  can  be  determined  in  several 
vrays  ;  by  dii-ect  vreighing,  by  Daniell's,  Regnault's  or  Dines'  hygrometer, 
by  the  hair  hygrometers  of  Saussure  and  Wolpert,  and  by  the  dry  and  v^et 
bulbs. '  The  method  by  the  dry  and  wet  bulb  thermometers  has  been 
adopted  by  the  Army  Medical  Department,  and  observations  are  taken  twice 
daily  (9  a.m.  and  3  p.m.).  The  instruments  are  not  self-registering,  and  are 
simply  read  off.  They  are  jjlaced  in  the  shade,  four  feet  above  the  ground, 
the  bulbs  freely  exposed  to  the  air,  but  not  exposed  to  the  effect  of  radiant 
heat  from  brick  walls,  etc.  Tlie  wet  bulb  is  covered  with  muslin,  which  is 
kept  moistened  by  cotton  twisted  round  the  bulb  and  then  passing  into 
the  water -vessel ;  previous  to  use,  the  cotton  is  soaked  in  solution  of  car- 
bonate of  soda,  or  boiled  in  ether  to  free  it  from  fat,  so  that  water  may 
ascend  easily  in  it  by  capillary  attraction  ;  the  muslin  and  cotton  should 
be  renewed  frequently,  once  or  twice  a  month  if  possible  ;  the  water  must 
be  either  rain  or  distilled  water,  and  the  supply  ought  to  be  more  ample 
in  dry  hot  weather  than  in  damp.  When  the  temperature  is  below  the 
freezing-point,  the  passage  of  water  along  the  cotton  is  arrested  ;  it  is  then 
necessary  to  moisten  the  wet  bulb  some  time  before  the  hour  of  observa- 
tion so  as  to  allow  the  moisture  to  freeze.  The  dew-point,  the  weight  of  a 
cubic  foot  of  vapor,  and  the  relative  humidity,  are  to  be  computed  from  Mr. 
Glaisher's  tables.^ 

Definition  of  these  Terms. — The  dew-point  is  the  temperature  when  the 
air  is  just  saturated  with  moisture,  so  that  the  least  cooling  would  cause  a 
deposit  of  water.  The  quantity  of  vapor  which  can  be  taken  up  and  be 
made  quite  invisible  to  the  senses  varies  with  temperature,  and  is  called 
the  loeight  of  a  cubic  foot  of  vapor,  or,  less  accurately,  the  weight  of  vapor 
in  a  cubic  foot  of  air,  at  the  particular  temperature. 

The  dew-point  may  be  obtained  directly  by  Daniell's  or  Regnault's  or 
Dines'  hygrometer,  which  enable  us  to  cool  and  note  the  temperature  of  a 
bright  surface  until  the  dew  is  deposited  on  it,  or  indirectly  by  means  of 
the  dry  and  wet  bulbs. 

Unless  the  air  is  saturated,  the  temperature  of  the  wet  bulb  [i.e.,  the 
temperature  of  evaporation)  is  always  above  the  dew-point,  but  is  below 
the  temperature  of  the  dry  bulb,  being  reduced  by  the  evaporation.  If  the 
dry  and  wet  bulbs  are  of  the  same  temperature,  the  air  is  saturated 
with  moisture,  and  the  temperature  noted  is  the  dew-point ;  if  they  are 
not  of  the  same  temperature,  the  dew-point  is  at  some  distance  below  the 
wet  bulb  temperature.^ 

It  can  then  be  calculated  out  in  two  ways, 

(a)  By  Mr.  Glaisher's  factors. — By  comparison  of  the  result  of  DanieU's 
hygrometer  and  the  dry  and  wet  bulb  thermometers  for  a  long  term  of 
years,  Mr.  Glaisher  has  deduced  an  empirical  formula,  which  is  thus 

'  These  last  are  to  be  considered  as  one  instrument,  and  are  frequently  called  the 
Psychrometer  of  August,  or  (in  this  country)  of  Mason. 

'^  Hygrometrical  Tables,  6th  edition,  1877.     A  copy  is  now  sent  to  each  station. 

^  Occasionally  the  wet  bulb  may  read  higher  than  the  dry,  as  in  thick  fog  or  during 
very  calm,  cold  weather.  This  is  rare,  but,  should  it  be  met  with,  then  the  tempera- 
ture of  the  dry  bulb  is  to  be  taken  and  considered  to  be  at  saturation  (Scott). 


104 


PRACTICAL    HYGIENE. 


worked.  Take  the  difference  of  the  drv*  and  wet  bulb,  and  multiply  it  by 
the  factor  which  stands  opj^osite  the  dry  bulb  temperature  in  the  folJowin"- 
table,  deduct  the  product  from  the  dry  bulb  temperature,  the  result  is  the 
dew-point.     From  this  formula  Glaisher's  tables  are  calculated. 

Glaishers  Factors. 


Beadin? 

ol  I)ry-bulb 

Tnenn. 

Edttbt. 

fit  Dry-bulb 
Theiin. 

Factor. 

Reading 

Of  Dry.-bulB 

THenn. 

Factor.' 

.  neaOlnf,, 

otDrj-ljai) 
Therm. 

Factor. 

10 

8-78 

6 

33 

3-01 

5% 

1-94 

,% 

1-69 

11 

8-78 

34 

2-77 

57 

1-92 

80 

1-68 

12 

8-78 

35 

2-60 

58 

1  90 

81 

1-68 

13 

8-77 

36 

2  50 

59 

1-89 

82 

1-67 

U 

8-76 

37 

2 '42 

60 

1-88 

83 

1-67 

15 

8-75 

38 

2-36 

61 

187 

84 

1-66 

16 

8-70 

39 

2-32 

62 

1-86 

85 

1-65 

17 

8-62 

40 

2-29 

63 

1-85 

86 

1-65 

18 

8-50 

41 

226 

64 

1-83 

87 

1-G4 

19 

8-34 

42 

2-23 

65 

1-82 

88 

1-64 

20 

8-14 

43 

2-20 

66 

1-81 

89 

1-63 

21 

7-88 

44 

2-lS 

67 

1-80 

90 

1-63 

22 

7-60 

45 

2-16 

68 

179 

91 

1-62 

23 

7-28 

46 

2-14 

69 

1-78 

92 

1-62 

24 

6-92 

47 

212 

70 

1-77 

93 

1-61 

25 

6-53 

43 

2-10 

71 

1-76 

94 

1-60 

26 

6-08 

49 

2-03 

72 

1-75 

95 

1-6Q 

27 

5  61 

50 

2 '06 

73 

1-74 

96 

1-59 

28 

5-12 

51 

2-04 

74 

1-73 

97 

1-59 

29 

4-63 

52 

2  02 

75 

1-72 

98 

1-58 

SO 

4  15 

53 

2-00 

76 

1-71 

99 

1-58 

31 

3-60 

54 

1-9S 

77 

1-70 

ioo 

3-57 

32 

3-32 

55 

1-96 

78 

1-69 

» 

(b)  Apjohn's  Formula. — From  a  most  philosophical  and  exhaustive  ana- 
lysis of  the  conditions  of  this  complicated  problem.  Dr.  Apjohn  has  derived 
his  celebrated  formula,  which  is  now  in  general  use.  Reduced  to  its  most 
simple  expression,  it  is  thus  worked  : — A  table  of  the  elastic  tension  of 
vapor,  in  inches  of  mercuiy  at  different  temperatures,  must  be  used. 
From  this  table  take  out  the  elastic  tension  of  the  temperature  of  the  wet 
thermometer,  and  call  it/'.  Let  (/-/')  be  the  difference  of  the  two  ther- 
mometers, and  p  the  observed  height  of  the  barometer.  Apjohn's  fonnida 
then  enables  us  to  calculate  the  elastic  tension  of  the  dew-point,  which  we 
wlU  call/ " ;  and  this  being  known  by  looking  in  the  table,  we  obtain,  op- 
posite this  elastic  tension,  the  dew-point  temperature. 

The  formula  is : 


/"=f-o.oiu7{f-r)-^ 

ity: 
the  formula  then  becomes,  for  the  temperature  above  32°  Fahr. : 

0 

7   • 
(t-f) 


p-f 
The  fraction  ^-y-  differs  but  little  from  unity,  and  may  be  neglected  ; 


If  below  32°  the  formula  is  :  /"  =/'  - 


96 


DESCRIPTIOi^    OF   METEOROLOGICAL    INSTRUMENTS.  105 

The  dew-point  being  known,  the  iceight  of  a  cubic  foot  of  vapor,  and 
the  amount  of  elastic  tension,  expressed  in  inches  of  mercuiy  (if  this  is 
desired),  are  taken  from  tables ;  the  relative  humidity  is  got  by  calcula- 
tion. 

The  relative  humidity  is  merely  a  convenient  term  to  express  compara- 
tive dryness  or  moisture.  Complete  satiu'ation  being  assumed  to  be  100, 
any  degree  of  dryness  may  be  expressed  as  a  percentage  of  this,  and  is  ob- 
tained at  once  by  dividing  the  weight  of  vapor  actually  existing  by  the 
weight  of  vapor  which  would  have  been  present  had  the  air  been  satu- 
rated. 

In  order  to  save  trouble,  all  these  points,  and  other  matters  of  interest, 
such  as  the  weight-  of  a  cubic  foot  of  dry  air,  or  of  mixed  dry  and  moist 
air,  are  given  in  Mr.  Grlaisher's  "  HygTometrical  Tables,"  which  aU  medical 
officers  are  advised  to  get 

The  amount  of  watery  vajoor  can  also  be  told  by  a  hair  hygrometer. 
A  modification  of  Saussure's  hygrometer  is  still  used  in  France,  and  also 
in  Russia  and  Norway.  A  human  hair,  freed  from  fat  by  digestion  in 
liquor  potasses  or  ether,  is  stretched  between  a  fixed  point  and  a  small 
needle,  which  traverses  a  scale  divided  into  100  parts.  As  the  hair  shortens 
or  elongates  the  needle  moves  and  indicates  the  relative  humidity.'  The 
scale  is  graduated  by  wetting  the  hair  for  complete  saturation,  and  by 
placing  it  over  sulphuric  acid  of  known  strength  for  fifteen  degi'ees  of 
saturation."  A  very  delicate  instrument  is  thus  obtained,  which  indicates 
even  momentaiy  changes  in  moisture.  On  comparison  with  the  wet  and 
dry  bulb,  it  has  been  found  to  give  accordant  results  for  three  or  four 
months  ;  it  then  gradually  stretches,  and  requires  to  be  a  Uttle  wound  up. 
If  compared  with  the  dry  and  wet  bulb,  the  hair  hygrometer  seems  to  be 
exact  enough  for  experiments  in  ventilation,  for  which  it  is  adapted  from 
its  rapidity  of  indication.  It  has  also  been  recommended  by  the  Vienna 
congress  for  use  in  extreme  climates,  when  the  indications  of  the  psychro- 
meter  are  either  uncertain  or  entirely  astray.^  The  horse-hau'  hygrometer 
of  Wolpert  is  also  much  used  in  Germany. 

The  amount  of  watery  vapor  in  the  air  has  a  considerable  effect  on  the 
temperature  of  a  place.  Hermann  von  Schlagintweit  *  has  pointed  out  that 
the  differences  between  the  temperature  marked  in  the  sun  and  shade  by 
two  maximum  thermometers  are  chiefly  dependent  on  the  amount  of  hu- 
midity. The  maxima  of  insolation  (measured  by  the  difference  between 
the  sun  and  shade  thermometers)  occur  in  those  stations  and  on  those 
days  when  humidity  is  greatest.  Thus,  at  Calcutta,  the  relative  humidity 
being  80  to  93,  the  insolation  (or  difference  between  the  thermometers)  is 
50°  Fahr.  ;  at  BeUary  the  relative  humidity  being  60  to  65,  the  insolation 
is  8°  to  11°.  These  results  are  explained  hj  Tyndall's  observations,  which 
show  that  the  transparent  humidity  will  scarcely  affect  the  sun's  rays  strik- 
ing on  the  sun  thermometer,  while  it  greatly  obstructs  the  radiation  of  in- 
visible heat  from  the  thermometer  ;  when  the  air  is  highly  charged  with 
moisture,  the  sun  thermometer  is  constantly  gaining  heat  from  the  sun's 
rays,  while  it  loses  little  by  radiation,  or  if  it  does  lose  by  radiation,  gains 
it  again  from  the  air. 

When  watery  vapor  mixes  with  diy  air,  the  volume  of  the  latter  is  aug- 

'  Hair  shortens  when  dry,  and  elongates  when  moist. 

^  The  gradiiatlon  of  the  scale  is  explained  in  The  Arctic  Manual,  p.  16. 

*  See  Scott's  Instructions,  p.  47. 

*  Proceedings  of  the  Royal  Society,  vol.  xiv. ,  p.  Ill,  1865. 


106  PRACTICAL    HYGIENE. 

mented  ;  the  weight  of  a  cubic  foot  of  diy  air  at  60°  Fahr.  is  536.28 
grains,  and  that  of  a  cubic  foot  of  vapor  at  60°  is  5.77  grains  ;  the  conjoint 
weights  would  be  542,05  grains  at  60°,  but,  owing  to  the  enlargement 
of  the  ah',  the  actual  weight  of  a  cubic  foot  of  saturated  air  at  60°  is 
only  532.84  grains. 


SECTION  m. 

BAROMETER. 

A  good  mercurial  barometer  is  supplied  *to  many  army  stations ;  the 
scale  is  brass,  graduated  on  the  scale  to  20ths  or  half-tenths,  and  is  read 
to  y-Q^y-gths  by  means  of  a  vernier.  There  is  a  movable  bottom  to  the  cis- 
tern, which  is  worked  up  and  down  by  a  screw,  so  as  to  keep  the  mer- 
cury in  the  cistern  at  the  same  level.  Connection  for  capacity  is  thus 
avoided. 

To  fix  the  Barometer. — Choose  a  place  with  a  good  light,  yet  protected 
from  du'ect  sunlight  and  rain  ;  fix  the  frame  sent  with  the  barometer  veiy 
carefully  with  a  plumb-line,  so  as  to  have  it  exactly  peiiDcndicular ;  then 
hang  the  barometer  on  the  hook,  and  adjust  it  gently  by  means  of  the 
three  screws  at  the  bottom,  so  that  it  hangs  truly  in  the  centre.  Test  this 
by  the  plumb-line  (a  4  oz.  weight  tied  to  a  string  will  do),  and  then  un- 
screw the  bottom  of  the  cistern  till  the  ivory  point  is  seen,    • 

Before  fixing  the  barometer  the  bottom  should  be  unscrewed  till  the 
mercury  is  two  or  three  inches  from  the  top  ;  the  barometer  should  be 
rather  suddenly  inclined,  so  as  to  let  the  mercury  strike  against  the  top  ; 
if  there  is  no  air  it  will  do  this  with  a  sharp  click  ;  if  there  be  air  there  is 
no  cHck  ;  in  that  case  turn  the  barometer  upside  down,  and  tap  the  side 
forcibly  till  you  see  the  globule  of  air  passing  up  the  tube  through  the 
mercurj'  into  the  cistern.  Do  not  be  afraid  of  doing  this  ;  there  is  no 
danger  of  any  damage  to  the  instrument. 

Reading  of  Barometer. — Read  the  attached  thermometer  first ;  then  ad- 
just the  cistern,  so  that  the  ivory  point,  perceptible  through  the  glass  wall 
of  the  cistern,  seems  just  to  touch  the  point  of  the  image  in  the  mercury. 
Then  adjust  the  vernier,  so  as  to  cut  off  the  Hght  from  the  top  of  the  mer- 
cury'.    Then  read  the  scale  with  the  help  of  the  vernier, 

A  little  difficulty  is  sometimes  experienced,  by  those  who  are  not  ac- 
customed to  such  instruments,  in  understanding  the  vernier.  It  will  be, 
probably,  comprehended  from  a  little  descriiDtion,  read  with  the  instru- 
ment before  us.  On  the  scale  of  the  barometer  itself,  it  will  be  seen  that 
the  smallest  divisions  correspond  to  half-tenths ;  that  is,  to  yl  ^ths  of  an 
inch  (=.05).  The  height  of  the  mercury  can  be  read  thus  far  on  the  scale 
itself.  The  vernier  is  intended  to  enable  us  to  read  the  amount  of  space 
the  top  of  the  mercury  is  above  or  below  one  of  these  half-tenth  lines.  It 
win  be  observed  that  the  vernier  is  divided  into  twenty-five  lines  ;  but  on 
adjusting  it,  so  that  its  lower  line  coiTesponds  with  a  line  indicating  an 
inch,  it  will  be  seen  that  its  twenty-five  divisions  only  equal  twenty-four 
half-tenth  divisions  on  the  scale.  The  result  is,  that  each  division  on  the 
vernier  is  jVth  less  than  a  half-tenth  division  on  the  scale.  One  ^^^th  of  a 
half-tenth  is  y^j^ths  of  an  inch  (.05-^25  =  . 002  inch).  This  being  under- 
stood, adjust  the  vernier  so  that  its  loicest  line  acciu'ately  corresponds  to 
any  line  on  the  scale.  It  wiU  then  be  seen  that  its  lowest  line  but  one  is  a 
little  distance  below  (in  fact,  ,002  inch)  the  next  line  on  the  fixed  scale. 


DESCRIPTIOlSr    OF    METEOEOLOGICAL    LNSTRUMENTS.  107 

Kaise  now  the  vernier,  so  that  its  second  line  shall  corresiDond  to  the  line 
on  the  scale  to  which  it  was  a  httle  below  ;  and  of  course  the  bottom  of 
the  vernier  must  be  raised  .002  inch  above  the  line  it  fii'st  corresponded 
with.  If  the  next  line,  the  third  on  the  vernier,  be  made  to  coiTespond 
with  the  line  on  the  scale  just  above  it,  the  bottom  of  the  scale  must  be 
raised  double  this  (.004  inch)  above  the  line  it  was  first  level  with  ;  if  the  next 
line  on  the  vernier  be  made  to  correspond  with  a  Hne  on  the  scale,  the 
scale  is  raised  .006,  and  so  on.  Each  division  on  the  vernier  equals  .002 
inch,  and  each  five  divisions  equals  yi^^th,  or  .01  inch. 

The  barometer  is  read  thus.  The  vernier  being  adjusted  to  the  top  of 
the  mercury,  read  on  the  scale  to  the  half-tenth  ;  then  look  above,  and  see 
what  line  on  the  vernier  corresponds  exactly  to  a  line  on  the  scale.  Then 
read  the  number  on  the  vernier,  counting  from  the  bottom  ;  multiply 
by  .002,  and  the  result  is  the  number  of  thousaudths  of  an  inch  the  top 
of  the  mercury  is  above  the  half-tenth  hne  next  below  it.'  Add  this 
number  to  that  ah'eady  got  by  direct  reading  of  the  fixed  scale,  and 
the  result  is  the  height  of  the  mercury  in  inches  and  decimals  of  an 
inch. 

Corrections  for  the  Barometer. — The  barometer  sujDpHed  to  military 
stations  requu-es  no  coiTections  for  capacity.  There  are  two  constant 
coiTections  for  all  barometers,  viz.,  capillarity  and  index  error.  The  first 
depends  on  the  size  of  the  bore,  and  whether  the  mercury  has  been  boiled 
in  the  tube  or  not.  Index  error  is  determined  by  compailson  with  a 
standard  barometer.  The  index  and  capillarity  eiTors  are  put  together. 
The  capiRarity  error  is  always  additive  ;  the  index  error  may  be  subtrac- 
tive  or  additive,  but  the  two  together  form  a  constant  c^uantity,  and  the 
certificates  furnished  by  the  Kew  Observatory,  for  all  bai'ometers  verified 
there,  include  both  corrections  above  mentioned. 

Corrections  for  Temperature. — The  barometer  readings  are,  to  facihtate 
compai'ison,  always  reduced  to  what  they  would  have  been  were  both  scale 
and  mercm-y  at  32°  F.  If  the  temperature  of  the  mercury  be  above  this, 
the  metal  exjDands,  and  reads  higher  than  it  would  do  at  32''.  The  amount 
of  expansion  of  mercury  is  .0001001  of  its  bulk  for  each  degi'ee  ;  but  the 
linear  expansion  of  the  brass  scale  must  be  also  considered. 

Schumacher's  formula  is  used  for  the  correction — \\z., 

h  =  observed  height  of  barometer  in  inches. 
t  =  temperatiu'e  of  attached  thermometer  (Fahr.). 
m  =  expansion  of  mercury  per  degree — viz.,  .0001001  of  its  length 
at  32°. 

s  =  linear  expansion  of  scale — viz.,  .00001041 ;  normal  temperature 
being  62°. 

m  (^-32°)-g  (^-62°) 
"^  .       1  +  m  {t-32°)       ■ 

To  facilitate  the  correction  for  temperature,  tables  are  given  in  Mr.  R. 


.  '  Instead  of  multiplying  the  number  on  the  vernier  by  .  003,  a  little  practice  will 
enable  the  calculation  to  be  made  at  once.  On  the  vernier  will  be  seen  the  figures  1, 
2,  3,  4,  and  5  ;  corresponding  to  the  5th,  10th,  loth,  20th,  and  25th  lines,  and  indicating 
.01,  .02,  .03,  .04,  or  .05  inch.  Each  line  between  these  numbered  lines  equals  .002 
inch. 


108  PKACTICAL    HYGIENE. 

H.  Scott's  "  Instructions  iu  the  Use  of  Meteorological  Instmments,"  which 
is  distributed  to  medical  officers. 

Correction  for  Altitude  above  Sea-level. — As  the  mercury  falls  about 
ToW  (-001  inch)'  for  every  foot  of  ascent,  this  amount  multiplied  by  the 
number  of  feet  must  be  added  to  the  height,  if  the  place  be  above  sea-level.^ 
The  temperature  of  the  air  has,  however,  also  to  be  taken  into  account  if 
great  accuracy  is  required.  Tables  for  correcting  for  smaU  altitudes  are 
given  in  Scott's  "Instructions." 

When  all  these  coiTections  have  been  made,  the  exact  height  of  the 
mercury  repi'esents  the  conjoint  weights  of  the  oxygen,  nitrogen,  carbon 
dioxide,  and  watery  vapor  of  the  atmosphere.  It  is  difficult  to  separate 
these  several  weights,  and  late  observations,  which  show  that  the  humidity 
existing  at  any  place  is  merely  local,  and  that  vapor  is  most  unequally  dif- 
fused through  the  air,  render  it  quite  uncertain  what  amount  of  the  mer- 
cury is  supported  by  the  watery  vapor.  Yet  that  this  has  a  considerable 
effect  in  altering  the  barometric  height,  particularly  in  the  tropics,  seems 
certain  (Herschel). 

The  height  of  the  barometer  at  sea-level  differs  at  different  parts  of  the 
earth's  surface  ;  being  less  at  the  equator  (29.974)  than  on  either  side  of 
30°  N.  and  S.  lat.,  and  lessening  again  toward  the  poles,  especially  toward 
the  south,  fi'om  63°  to  74°  S.  lat.,  where  the  depression  is  upward  of  an 
inch.  It  also  differs  in  different  places  according  to  their  geographical 
position.  Like  the  thermometer,  it  is  subjected  to  diumal  and  annual 
periodic  changes  and  to  non-periodic  undulations. 

In  the  tropics  the  diui*nal  changes  are  very  steady  ;  there  are  two 
maxima  and  two  minima  ;  the  first  maximum  is  about  9  a.m.  ;  the  fii'st 
minimum  about  3  to  4  p.m.;  the  second  maximum  at  10  p.m.;  the  second 
minimum  at  4  a.m.  These  changes  are,  perhaps,  chiefly  dependent  on  the 
watery  vapor  (Herschel).  In  this  country  the  diurnal  range  is  less,  but 
occurs  at  about  the  same  hours.  The  undulations  depend  on  the  con- 
stantly shifting  currents  of  air,  rendering  the  total  amount  of  air  over  a 
place  heavier  or  lighter.  The  wind  tends  to  pass  toward  the  locality  of 
least  barometric  pressure.  In  this  country  the  barometer  falls  with  the 
southwest  winds  ;  rises  wdth  the  north  and  east ;  the  former  are  moist  and 
warm,  the  latter  dry  and  cold  winds. 

Isobarometric  lines  are  lines  connecting  places  with  the  same  baro- 
metric pressure. 

Measurement  of  Heights. — The  barometer  falls  when  heights  are  as- 
cended, as  a  certain  weight  of  air  is  left  below  it.  The  diminution  is  not 
uniform,  for  the  higher  the  ascent  the  less  weighty  the  air,  and  a  gi-eater 
and  greater  height  must  be  ascended  to  depress  the  barometer  one  inch. 
This  is  illustrated  by  the  following  table  :  ^ 

^  The  exact  amount  is  a  little  below  this,  but  varies  with  altitude ;  at  sea-level  the 
amount  is  .000886  for  every  foot  of  ascent. 

■^  For  the  British  Isles,  the  mean  sea-level  at  Liverpool  has  been  selected  by  the 
Ordnance  Survey  as  their  datum. 

^  The  height  can  be  taken  readily  from  this  table,  by  calculating  the  number  of  feet 
which  must  have  been  ascended  to  cause  the  observed  fall,  and  then  making  a  correc- 
tion for  temperature,  by  multiplying  the  number  obtained  from  the  table,  which  may 
be  called  A,  by  the  formula  {t  is  the  temperature  of  the  lower,  and  t'  of  the  upper 
station) — 

/,         t  +  t'-QA\  . 


DESCRIPTION    OF    METEOEOLOGICAL    IXSTKUMENTS. 


109 


To  lower  from  31  inch 

es  to  30  =     857 

< 

30 

29  =     886 

< 

29 

28  =      918 

( 

28 

27  =     951 

( 

27 

'        26  =     986 

c< 

26 

25  =  1,025 

e 

25 

24  =  1,068 

c 

24 

23  =  1,113 

e 

23 

22  =  1,161 

t 

22 

21  =  1,216 

:c 

21 

20  =  1,276 

e 

20 

19  =  1,341 

C( 

19 

18  =  1,413 

857  feet  must  be  ascended. 


The  measurements  of  heights  in  this  way  is  of  great  use  to  medical 
oflQ-cers  ;  aneroid  barometers  can  be  used,  and  are  very  delicate  instru- 
ments.   The  new  pocket  aneroids  wiU  measure  up  to  12,000  or  14,000  feet. 

A  great  number  of  methods  are  in  use  for  calculating  heights.  It  can 
be  done  readily  by  logarithms,  but  then  a  medical  officer  may  not  possess 
a  table  of  logarithms. 

The  simplest  rule  of  all  is  one  derived  from  Laplace's  formula.  Mr. 
Ellis'  has  stated  this  formula  as  follows : — Multiply  the  difference  of  the 
barometric  readings  by  52,400,  and  divide  by  the  sum  of  the  barometric 
readmgs.  If  the  result  be  1,000,  2,000,  3,000,  4,000,  or  5,000,  add  0,  0,  2, 
6,  14,  respectively.  Subtract  2^  times  the  difference  of  the  temperatures  of 
the  mercury.  Multiply  the  remainder  by  a  number  obtained  by  adding 
836  to  the  sum  of  the  temperatures  of  the  air,  and  dividing  by  900.  A 
correction  must  also  be  made  for  latitude,  which  can  be  done  by  Table  m., 
p.  111. 

Tables  such  as  those  given  by  Delcros  and  Oltmanns  are  very  con- 
venient for  estimating  heights  by  the  barometer.  A  table  less  long  than 
these,  but  based  on  the  same  principle,  has  been  given  by  Negretti  & 
Zambra  in  their  useful  work,^  and  is  copied  here. 

A  good  mercurial  barometer,  with  an  attached  thermometer,  or  an 
aneroid  compensated  for  temperature,  and  a  thermometer  to  ascertain  the 
temperature  of  the  air,  are  required.  Two  barometers  and  two  thermo- 
meters, which  can  be  observed  at  the  same  moment  at  the  upper  and  lower 
stations,  are  desirable. 

Supposing,  however,  there  is  but  one  barometer,  take  the  height  at  the 
lower  station,  and  correct  for  temperature  to  32°.  Take  the  temperature 
of  the  air.  Ascend  as  rapidly  as  possible  to  the  upper  station,  and  take 
the  height  of  the  barometer  (correcting  it  to  32°)  and  the  temperature  of 
the  air ;  then  use  the  accompanying  tables,'  taken  from  Negretti  &  Zam- 
bra's  work.  If  the  height  is  less  than  300  feet,  Tables  11.,  III.,  and  IV. 
need  not  be  used. 

"Table  I.  is  calculated  irom  the  formula,  height  in  feet  ==60,200  (log. 
29.922 — log.  5) +  925  ;  where  29.922  is  the  mean  atmospheric  pressure  at 
32°  Fahr.,  and  at  the  mean  sea-level  in  latitude  45°;  and  B  is  any  other 
barometric  pressure ;  the  925  being  added  to  avoid  minus  signs  in  the 
table. 


'  Proceedings  of  the  Royal  Society,  1865,  No.  75,  p.  283. 

-  A  Treatise  on  Meteorological  Instruments,  by  Negretti  &  Zambra,  1864. 


no 


PRACTICAL   nYGIENE. 


Table  I. — Approximate  Height  due  to  Barometric  Pressure. 


Inches  of 

Feet. 

Inches  of 

Feet. 

Inches  of 

G>Ani 

Barometer. 

Barometer. 

Barometer. 

reel. 

31-0 

0 

27-3 

3.323 

23-6 

7,131 

SO -9 

84 

•2 

3,419 

•5 

7,242 

•8 

169 

•1 

3,515 

•4 

7,353 

•7 

254 

27-0 

3,612 

•3 

7,465 

•6 

339 

26-9 

3,709 

•2 

7,577 

•5 

425 

•8 

3,806 

•1 

7,690 

•4 

511 

•7 

3,904 

23-0 

7,803 

•3 

697 

•6 

4,002 

22-9 

7,917 

'2 

683 

•5 

4,100 

•8 

8,032 

•1 

770 

'4 

4,199 

•7 

8,147 

30-0 

857 

•3 

4,298 

•6 

8,262 

29-9 

944 

•2 

4,398 

•5 

8,378 

•8 

1,032 

•1 

4,498 

•4 

8,495 

-7 

1,120 

26-0 

4.588 

•3 

8,612 

•■6 

1,208 

25-9 

4,699 

•2 

8,729 

•6 

1,296 

•8 

4,800 

•1 

8.847 

•4 

1,385 

•7 

4,902 

22-0 

9,966 

•3 

1,474 

•6 

6,004 

21-9 

9,085 

•2 

1,563 

•5 

6,106 

•8 

9,205 

•1 

1,653 

•4 

5,209 

•7 

9,325 

29-0 

1,743 

•3 

5;312 

•6 

9,446 

28-9 

1,833 

•2 

5,415 

•5 

9,567 

•8 

1,924 

•1 

6;  51 9 

•4 

9,689 

•7 

2,015 

25-0 

6j623 

•3 

9,811 

•6 

2,016 

24-9 

5,728 

♦2 

9,934 

•5 

2,198 

•8 

6,833 

•1 

10,058 

•4 

2,290 

•7 

5,939 

21-0 

10,182 

'3 

2,382 

•6 

6,045 

20-9 

.  10,307 

•2 

2,475 

•5 

6,152 

•8 

10,432 

■1 

2,568 

•4 

6,259 

•7 

10,558 

28-0 

2,661 

•3 

6,366 

•6 

10,684 

27-9 

2,754 

•2 

6,474 

•5 

10,812 

•8 

2,848 

•I 

6,582 

•4 

10,940 

'7 

2,942 

24-0 

9,691 

'3 

11,069 

•6 

3,037 

23-9 

6,800 

•o 

Hi  198 

■5 

3,132 

•8 

6,910 

•1 

lli328 

27-4 

3,227 

237 

7,020 

20-0 

li;458 

"  Table  IL  contains  the  correction  necessary  for  the  mean  temperature 
of  the  sti-atum  of  air  between  the  stations  of  observation  ;  and  is  computed 
from  Regnault's  co-efficient  for  the  expansion  of  air,  which  is  .002036  of 
its  volume  at  32°  for  each  degree  above  that  tempei-ature. 

"  Table  III.  is  the  coiTCction  due  to  the  difference  of  gravitation  in 
any  other  latitude,  and  is  found  from  the  formula,  .r  =  1  +  .00265  cos.  2  lat. 

"  Table  IV.  is  to  correct  for  the  diminution  of  gravity  in  ascending  from 
the  sea-level. 

"  To  use  these  tables  :  The  barometer  readings  at  the  upper  and  lower 
stations  having  been  corrected  and  reduced  to  temperature  32°  Fahr., 
take  out  from  Table  I.  the  numbers  opposite  the  corrected  readings  of  the 
two  barometers,  and  subtract  the  lower  from  the  upper.  Multiply  this 
difference  successively  b}''  the  factors  found  in  Tables  11.  and  HI.  The 
factor  from  Table  III.  may  be  neglected  unless  great  precision  is  de- 
sired. Finally,  add  the  correction  taken  from  Table  IV."  (Negretti  & 
Zambra. ) 

In  the  table  the  barometer  is  only  read  to  lOths,  but  it  should  be  read 


DESCRIPTION    OF    METEOROLOGICAL    INSTRUMENTS. 


Ill 


to  lOOths  (.01)  and  l,000ths  (.001),  and  the  number  of  feet  corresponding 
to  these  amounts  calculated  from  the  table,  which  is  easy  enough. 


Table  U. — Correction  due  to  Mean  Temperatures  of  the  Air  ;   the  Tempera- 
ture of  the  Upper  and  Lower  Stations  being  added  and  divided  by  2. 


Mean  Temp. 

Factor. 

Mean  Temp. 

Factor. 

Mean  Temp. 

Factor. . 

10' 

0-955 

35= 

1-006 

60° 

1-057 

11 

•957 

36 

1-008 

61 

1-059 

12 

•959 

37 

1-010 

62 

1-061 

•  13 

•961 

38 

1-012 

63 

1-063 

14 

'■J63 

39 

1'014 

64 

1-065 

16 

•963 

40 

1-016 

65 

1-067 

16 

•967 

41 

1-018 

66 

1-069 

17 

-969 

42 

1-020 

67 

1-071 

18 

•971 

43 

1-022 

68 

1-073 

19 

'974 

44 

1-024 

69 

1-075 

20 

•976 

45 

1-026 

70 

1-077 

21 

'978 

46 

1-029 

71 

1-079 

22 

•980 

47 

1-031 

72 

1-081 

23 

^982 

48 

1-033 

73 

1-083 

24 

•984 

49 

1-035 

74 

l-08f5 

25 

•986 

50 

l-0'37 

75 

1-088 

26 

•988 

51 

1-039 

76 

1-090 

27 

•990 

52 

1-041 

77 

1-092 

28 

•992 

53 

1-043 

78 

1-094 

29 

•994 

54 

1-045 

79 

1-09Q 

SO 

-996 

55 

1-047 

80 

1-098 

SI 

0-998 

53 

1-049 

81 

1-100 

32 

1-000 

57 

1051 

82 

1-102 

S3 

1-002 

58 

1-053 

83 

1-104 

Si 

1-004 

59 

1-055 

84 

1-106 

Table  HL — Correction  due  to  Difference  of  Gravitation  in  different 

Latitudes. 


Latitude. 

Factor. 

Latitude. 

Factor, 

Latitude. 

Factor. 

80' 

0-99751 

50' 

0-99954 

20° 

1-00203 

75 

0-99770 

.45 

1-00000 

15 

1-00230 

70 

0  99797 

40 

1-00046 

10 

1-00249 

65 

0-99'830 

35 

1  -000.90 

5 

1-00261 

60 

0-99868 

30 

1 '00132 

0 

1-00265 

55 

0  99910 

25 

1-00170 

Table  IV. 


f    Height  in 

Ccn-ection 

Height  in 

Gorrectiott . 

Tliousand  Feet. 

Additive. 

Thousand  Feet. 

Additive. 

1 

3 

9 

26 

2 

5 

10 

30 

3 

S 

11 

33 

4, 

11 

12 

37 

5 

14 

13 

41 

6 

17 

14 

44 

7 

20 

35 

48 

8 

23 

112  PRACTICAL    HYGIENE. 

Example. — At  two  stations  the  barometer  read  respectively  29.9  and 
21.2,  the  temperatures  of  the  air  being  60°  and  40°. 

Barometer  at  upper  station 21.2,  Table  1 9,934 

"  lower        "     29.9,      "       944 


Approximate  mean  height 8,990 

Mean  temperature  50°,  Table  11.,  Factor 1.037 


Height  corrected  for  temperature 9,323 

Latitude  (say)  30°,  Table  in..  Factor 1.00132 


Height  corrected  for  latitude 9,335 

Correction  from  Table  IV 26 


Height  coiTected  for  direct  altitude 9,361 

Height  of  lower  station  above  sea-level  (say) 150 


Final  con-ected  height  of  upper  station  above  sea-level.        9,511 

A  very  simple  nile  for  approximative  determinations  has  been  given  by 
Mr.  R.  Strahan. '  Read  the  aneroid  to  the  nearest  hundredth  of  an  inch ; 
subtract  the  upper  reading  from  the  lower,  leaving  oxit  or  neglecting  the 
decimal  point ;  multiply  the  difierence  by  9  ;  the  product  is  the  elevation 
in  feet. 

Example.  inches. 

Lower  station 30.25 

Upper      "       29.02 

123 
9 


Elevation l,170feet. 

If  the  barometer  at  the  upper  station  is  below  26  inches,  or  the  tempera- 
ture above  70°,  the  multiplier  should  be  10. 

Weight  of  the  Air. — The  barometer  expresses  the  weight  of  the  air  in 
inches  of  mercury.  The  actual  weight  can  be  determined  if  the  reading 
of  the  barometer,  temperature,  and  humidity  are  all  known. 

The  weight  of  a  cubic  foot  of  dry  air,  at  32°  Fahr.  and  normal  pres- 
sure, is  566.85  grains.  For  any  other  temjoerature  the  weight  can  be  calcu- 
lated. Multiply  the  coefficient  of  the  exi)ansion  of  air  (viz.,  .0020361  for 
1°  Fahr.)  by  the  number  of  degrees  above  32,  the  sum  added  to  unity  wiU 
give  the  volume  of  a  cubic  foot  of  dry  air  at  that  temperature.  Divide 
566.85  by  the  number  so  obtained.  The  result  is  the  weight  of  the  dry 
air  at  the  given  temperature. 

SECTION  IV. 

RAIN, 

Rain  is  estimated  in  inches  ;  that  is,  the  fall  of  an  inch  of  rain  implies 
that  on  any  given  area,  say  a  square  yard  of  surface,  rain  has  fallen  equal 
to  one  inch  in  depth.     The  amount  of  rain  is  determined  by  a  rain-gauge. 

'  Pocket  Altitude  Tables,  by  G.  J.  Symoiis,  F.R.S.,  3d  ed.,  1880,  p.  5. 


DESCRIPTION    OF    METEOROLOG-ICAL    IXSTRUMEXT3.  113 

Two  gauges  ai-e  supiDlied  for  military  stations  ;  one  to  be  placed  on  the 
ground,  one  20  feet  above  it  ;  in  all  parts  of  the  world  the  latter  indicates 
less  rain  than  the  lower  placed  gauge  ;  this  is  due  to  wind.' 

Several  kinds  of  gauges  are  in  use.  The  one  used  by  the  Army  Medical 
Department  is  a  cyhndiical  tin  box  with  a  rim  or  groove  at  the  top  ;  a 
circular  top  with  a  funnel  inside  fits  on  to  this  groove,  which,  when  tilled 
with  water,  forms  a  water-valve.  The  opening  above  is  circulai*  (the  circle 
being  made  very  carefully,  and  a  rim  being  cai-ried  round  it  to  j^revent  the 
rain-drops  from  being  whuied  by  wind  out  of  the  mouth),  and  descends 
funnel-shaped,  the  small  end  of  the  funnel  being  turned  up  to  prevent 
evaporation.  But  leaves,  dust,  or  insects  sometimes  choke  this  tube,  so  that 
it  is  now  generally  straightened,  the  loss  by  evaporation  being  insignificant, 
compared  with  that  caused  by  obstruction.  The  best  size  for  the  open 
top,  or,  in  other  words,  the  area  of  the  receiving  surface,  is  from  50  to  100 
square  inches.  The  lower  part  of  the  box  is  sunk  in  the  ground  nearly  to 
the  groove  ;  the  upper  pai't  is  then  put  on,  and  a  glass  vessel  is  placed  below 
the  funnel  to  receive  the  water.'  At  stated  times  (usually  at  9  a.m.  daily) 
the  top  is  taken  off,  the  glass  vessel  taken  out,  and  the  water  measui'ed  in 
a  glass  vessel,  gTaduated  to  hundredths  of  an  inch,  which  is  sent  with  the 
gauge.' 

If  snow  falls  instead  of  rain,  it  must  be  melted  and  the  resulting  water 
measui'ed.  This  may  be  easily  done  by  adding  a  measured  cpantity  of 
warm  water,  and  then  subtracting  the  amount  from  the  total  bulk  of 
water. 

From  a  table  of  the  weight  of  vapor  it  will  be  seen  that  the  amount  of 
vapor  which  can  be  rendered  insensible,  increases  with  the  temperatru^e, 
but  not  regularly  ;  more,  comparatively,  is  taken  up  by  the  high  tempera- 
tures ;  thus,  at  40^,  2.86  grains  are  supported  ;  at  50',  4.10  gi'ains,  or  1.24 
grain  more  ;  at  60^,  5.77  grains,  or  1.67  grain  more  than  at  50".  There- 
fore, if  two  currents  of  air  of  unequal  temperatures,  but  equally  saturated 
with  moisture,  meet  in  equal  volume,  the  temjDerature  ■v\ill  be  the  mean  of 
the  two,  but  the  amount  of  vapor  which  wiU  be  kept  invisible  is  less  than 

1  See  Britisli  Rainfall  (G.  J.  Symons,  F.R.S.),  1872,  p.  33,  and  1881,  p.  41. 

-  A  glass  vessel  should  not  be  used  in  winter,  for  fear  of  breakage  in  frost. 

"  If  tbis  glass  is  broken  it  can  be  replaced  by  tbe  following  rule,  or  a  rain-gauge  can 
be  made.  It  need  not  be  round,  tliougb  tbis  is  now  thought  the  best  form,  but  may  be 
a  square  box  of  metal  or  wood,  and  may  be  of  any  size  between  3  and  2-i  inches  in  dia- 
meter, but  5  to  8  is  the  most  couyenient  range. 

Determine  the  area,  in  square  inches,  of  the  receiving  surface,  or  top  of  the  gauge, 
by  careful  measurement.  This  area,  if  covered  with  wafer  to  the  height  of  one  inch, 
would  give  us  a  corresponding  amount  of  cubic  inches.  This  number  of  cubic  inches 
is  the  measure  for  that  gauge  of  one  inch,  because  when  the  rain  equals  that  quantity 
it  shows  that  one  inch  of  rain  has  fallen  over  the  whole  surface. 

Let  us  say  the  area  of  the  receiving  surface  is  100  square  inches.  Take  100  cubic 
inches  of  water  and  put  it  into  a  glass,  put  a  mark  at  the  height  of  the  fluid,  and  divide 
the  glass  below  it  into  100  equal  parts.  If  the  rainfall  comes  up  to  the  mark,  one  inch 
of  rain  has  fallen  on  each  square  inch  of  surface  ;  if  it  only  comes  up  to  a  mark  below, 
some  amount  less  than  an  inch  (which  is  so  expressed  in  -piths  and  jj^T;ths)  has  fallen. 

To  get  the  requisite  number  of  cubic  inches  of  water  we  can  weigh  or  measure.  A 
cubic  inch  of  water  at  62'^  weighs  252.458  grains,  consequently  100  cubic  inches  will  be 
(252.458  X  100)  =25245.8  grains,  or  57.7  ounces  avoir.  But  an  earner  way  still  is  to 
measure  the  water, — an  ounce  avoir,  is  equal  to  1.738  ciibic  inches,  therefore  divide 
100  by  1.733,  and  we  obtain  the  number  of  ounces  avoir,  which  corresponds  to  100 
cubic  inches.  It  is  always  best,  however,  to  use  a  gauge  made  by  a  regular  maker,  if 
possible,  as  inaccurate  records  are  worse  than  none. 

Usually  a  one-inch  measure  is  so  large  a  glass,  that  half  an  inch,  is  considered  more 
convenient. 

YoL.  n.— 8 


114  PRACTICAL    HYGIENE. 

tlie  mean,  aiid  some  va,por  therefore  necessarily  falls  as  fog  or  rain.  Thus 
one  saturated  current  being  at  40^,  and  the  other  at  6i)^,  the  resultant 
temperature  will  be  50"^,  but  the  amount  of  invisible  vapor  'nill  not  be  the 
mean,  \dz.,  4.315,  but  4.1 ;  an  amount  equal  to  .215  will  therefore  be  de- 
posited. 

Rain  is  therefore  o\\ang  to  the  cooling  of  a  sat\u*ated  air,  and  rain  is 
heaviest  under  the  following  conditions, — when,  the  temperature  being 
high,  and  the  amount  of  vapor  large,  the  hot  and  moist  air  soon  encounters 
a  cold  air.  These  conditions  are  chiefly  met  with  in  the  tropics,  when  the 
hot  air,  saturated  with  vapor,  impinges  on  a  chain  of  lofty  hills  over  which 
the  ail'  is  cold.  The  fall  may  be  130  to  160  inches,  as  on  the  Malabar 
coast  of  India,  or  180  to  220  in  Southern  Bui-mah,  or  600  at  Cherrapoonjee, 
in  the  Khasyah  Hills.  Even  in  our  own  country  the  hot  air  from  the 
Gulf  Stream  impinging  on  the  Cumberland  Hills  causes,  in  some  districts, 
a  fall  of  80,  100,  200,  and  even  more  inches  in  the  year. 

The  rainfall  in  different  places  is  remarkably  irregular  from  year  to 
year  ;  thus  at  Bombay  the  mean  being  76,  in  1822  no  less  than  112  inches, 
while  in  1824  only  34  inches  fell. 

The  amount  of  rain  at  the  different  foreign  stations  is  given  under  the 
respective  headings. 

SECTION  V. 
EVAPORATION. 

The  amount  of  evaporation  from  a  given  moist  surface  is  a  problem  of 
gi'eat  interest,  but  it  is  not  easy  to  detennine  it  exjjerimentally,  and  no  in- 
strument is  issued  by  the  Army  Medical  Department.  A  shallow  vessel  of 
known  area,  protected  around  the  rim  by  wire  to  prevent  birds  from  drink- 
ing, is  filled  with  a  known  quantity  of  water,  and  then,  weekly  or  monthly, 
the  diminution  of  the  water  is  determined,  the  amount  added  by  rain  as 
shown  by  the  rain-gauge  being  of  course  allowed  for. 

Water  has  been  placed  under  a  cover,  which  may  protect  it  from  rain 
and  dew,  and  yet  permit  evaporation,  and  the  loss  weighed  daily  ;  but  it 
is  impossible  to  insure  that  the  evaporation  shall  be  equal  to  that  under 
the  free  heavens. 

A  third  plan  is  calculatiug  the  rate  of  evaporation  from  the  depression 
of  the  wet  bulb  thermometer,  by  deducting  the  elastic  force  of  vapor  at 
the  dew-point  temperature  from  the  elastic  force  at  the  air  temperature, 
and  taking  the  diflerence  as  expressing  the  evaporation.  This  difference 
expresses  the  force  of  escape  of  vapor  from  the  moist  surface. 

Instruments  termed  ^/??io»fe^ers  have  been  used  for  tliis  purpose;  the 
fii'st  was  invented  by  Leslie.  A  ball  of  porous  earthenware  was  fixed  to  a 
glass  tube,  with  di\isions,  each  corresponding  to  an  amount  of  water  which 
would  cover  the  siu-face  of  the  ball  with  a  fihn  equal  to  the  thickness  of 
YjL^th  part  of  an  inch.  The  evaporation  from  the  surface  of  the  ball 
was  then  read  off.  Dr.  Babington  has  also  invented  an  ingenious  Atmi- 
dometer. ' 

The  amount  of  evaporation  is  influenced  by  temperature,  wind,  hu- 
midity of  the  air,  rarefaction  of  the  air,  degree  of  exposin-e  or  shading, 
and  by  the  nature  of  the  moist  surface  ;  it  is  greater  fi-om  moist  soil  than 
from  water. 

'  See  Negretti  &  Zambra's  Treatise,  p.  141,  for  details. 


DESCRIPTION    OF   METEOROLOGICAL   INSTRUMENTS.  115 

The  amount  of  vapor  annually  rising  from  each  square  inch  of  water 
surface  in  this  country  has  been  estimated  at  from  20  to  24  inches  ;  in  the 
tropical  seas  it  has  been  estimated  at  from  80  to  130,  or  even  more  inches, 
Tn  the  Indian  Ocean  it  has  been  estimated  at  as  much  as  an  inch  in  twenty- 
four  hours,  or  365  in  the  year,  an  almost  incredible  amount.  No  doubt, 
however,  the  quantity  is  very  great. 

It  requires  an  effort  of  imagination  to  realize  the  immense  distillation 
which  goes  on  from  the  tropical  seas.  Take  merely  60  inches  as  the  an- 
nual distillation,  and  reckon  this  in  feet  instead  of  inches,  and  then  pro- 
ceed to  calculate  the  weight  of  the  water  rising  annually  from  such  a  small 
space  as  the  Bay  of  Bengal.     The  amount  is  almost  incredible. 

This  distillation  of  water  serves  many  great  purposes  ;  mixing  with  the 
air  it  is  a  vast  motive  power,  for  its  specific  gravity  is  very  low  (.6230,  air 
being  1),  and  it  causes  an  enlargement  of  the  volume  of  air  ;  the  moist  air 
is  therefore  much  lighter,  and  ascends  with  great  rapidity  ;  the  distillation 
also  causes  an  immense  transference  of  heat  from  the  tropics,  where  the 
evaporation  renders  latent  a  great  amount  of  heat,  to  the  extra-tropical 
region  where  this  vapor  falls  as  rain,  and  consequently  parts  with  its  latent 
heat.  The  evaporation  also  has  been  supposed  to  be  a  great  cause  of  the 
ocean  currents  (Maury),  which  play  so  important  a  part  in  the  distribution 
of  winds,  moisture,  and  warmth. 


SECTION  VI. 
WIND. 

Direction. — For  determining  the  direction  of  the  wind  a  vane  is  neces- 
sary. It  should  be  placed  in  such  a  position  as  to  be  able  to  feel  the  in- 
fluence of  the  wind  on  all  sides,  and  not  be  subjected  to  eddies  by  the 
vicinity  of  buildings,  trees,  or  hills.  The  points  must  be  fixed  by  the  com- 
pass ; '  the  magnetic  declination  being  taken  into  account  ;  the  declination 
of  the  place  must  be  obtained  from  the  nearest  observatory  ;  in  this 
country  it  is  now  about  21°  (or  two  points)  to  the  westward  of  true  north.  ^ 
The  direction  of  the  wind  is  registered  twice  daily  in  the  army  returns,  but 
any  unsual  shifting  should  receive  a  special  note.  The  course  of  the  wind 
is  not  always  parallel  with  the  earth  ;  it  sometimes  blows  slightly  down- 
ward ;  contrivances  have  been  employed  to  measure  this,  but  the  matter 
does  not  seem  important. 

Various  plans  are  resorted  to  for  giving  a  complete  summary  of  the 
winds,  but  this  is  not  required  from  the  medical  officer. 

Velocity. — A  small  Robinson's  anemometer  is  now  supplied  to  each 
station  ;  it  is  read  every  twenty-four  hours,  and  marks  the  horizontal 
movement  in  the  preceding  twenty-four  hours. 

This  anemometer  consists  of  four  small  cups,'  fixed  on  horizontal  axes 
of  such  a  length  (1.12  foot  between  two  cups),  that  the  centre  of  a  cup,  in 
one  revolution,  passes  over  y^oQ-th  of  a  mile,  the  circumference  being  3.52 
feet.  These  cups  revolve  with  about  a  third  of  the  wind's  velocity  ;  500 
revolutions  of  the  cups  are  therefore  supposed  to  indicate  one  mile,  and 

'  Or,  better  still,  by  the  pole  star. 

^  Thus  N.  magnetic  will  be  N.N.W.  true,  S.  magnetic  S.S.E.  true,  and  so  on. 
°  The  current  of  air  is  opposed  one-fourth  more  by  a  concave  eunace  than  by  a 
convex  one  the  same  size. 


116  PRACTICAL    HYGIENE. 

by  an  ai-rangement  of  wheels,  the  number  of  miles  traversed  by  the  wind 
can  be  approximately  ascertained. 

Osier's  anemometer  is  a  large  and  veiy  beautiful  instrument.  It  reg- 
isters simultaneously  on  a  piece  of  paper  fitted  on  a  drum,  which  is 
turned  by  clock-work,  direction,  velocity,  and  pressure. 

Other  anemometers,  Lind's,  Whe well's,  etc.,  need  not  be  described. 

The  average  velocity  of  ■s\-ind  in  this  country  neai"  the  siu'face  of  the 
earth  is  from  six  to  eight  miles  per  hour  ;  its  range  is  from  zero  to  60  or 
even  70  miles  per  hour,  but  this  last  is  veiy  rare  ;  it  is  seldom  more,  even 
in  hea^y  winds,  than  35  to  45  miles  per  hour.  In  the  hurricanes  of  the 
Indian  and  China  seas  it  is  said  to  reach  100  to  110  miles  per  hour. 

Force. — The  force  of  the  wind  is  reckoned  as  equal  to  so  many  pounds 
or  parts  of  a  pound  on  a  square  foot  of  surface.  Osier's  anemometer,  as 
just  stated,  registers  the  force  as  weU  as  the  velocity  and  direction,  but 
Robinson's  (used  in  the  army)  marks  only  the  velocity  ;  the  force  must 
then  be  calculated.  The  rule  for  the  calculation  of  the  force  from  the  ve- 
locity is  as  follows  : — 

Ascertain  the  mean  velocity  per  hour  by  observing  the  velocity  for  a 
minute,  and  multiplying  by  60  ;  then  square  the  hoiuly  velocity  and  mul- 
tiply by  .005.  The  result  is  the  pressure  in  pounds  or  parts  of  a  pound 
per  square  foot. 

The  formula  is,  if  V  =  velocity  per  hour, 

Y'y  .005  =  P. 

If  the  force  be  given,  the  velocity  may  be  found : 

V2WP~=  V. 

"When  no  anemometer  is  in  use,  the  Beaufort  scale  may  be  employed, 
0  =  calm,  about  3  miles  an  horn-,  and  12  =  hurricane,  90  miles  and  over. 


SECTION  vn. 

CLOUDS  (Plate  IX.). 

The  nomenclature  proposed  by  Howard'  is  now  almost  universally 
adopted. 

There  are  three  principal  forms  and  four  modifications. 

Principal  Forms. 

Cirrus. — Thin  filaments,  which  b\  association  form  a  bmsh,  or  woolly 
hail*,  or  a  slender  network.  They  are  very  high  in  the  atmosphere,  i:)rob- 
ably  more  than  ten  miles,  but  the  exact  height  is  unknown.  It  has  even 
been  questioned  whether  they  are  composed  of  water ;  if  so,  it  must  be 
frozen.     In  this  climate  they  come  from  the  northwest. 

Cumidus. — Hemisioherical  or  conical  heaps  like  mountains  rising  fi'om 
a  horizontal  base  ;  cumuli  are  often  compared  to  balls  of  cotton. 

Stratus. — A  widely  extended,  continuous  horizontal  sheet,  often  forming 
at  sunset. 

Modifications. 

Cirro-cuvndus. — Small  rounded,  well-defined  masses,  in  close,  horizontal 
arrangement ;  when  the  sky  is  covered  with  such  clouds  it  is  said  to  be 
fleecy. 

'  Climate  of  London. 


DESCEIPjriOX    OF    METEOEOLOGICAL    I]S"STEUMEXTS.  117 

Cirro-stratus. — Horizontal  strata  or  masses,  more  compact  than  the  cini  ; 
at  the  zenith  they  seem  composed  of  a  number  of  thin  clouds  ;  at  the  horizon 
they  look  Kke  a  long  naiTow  band. 

Cumulo-stratus. — Stratus  blended  with  the  cumulus. 

Curaulo-drro-stratus,  Ximbus,  or  Eain-doud. — A  horizontal  sheet  above 
which  the  cirrus  spreads,  while  the  cumulus  enters  it  laterally  or  from 
below. 

Of  the  above  forms  Nos.  1,  2,  and  3  of  the  plate  (copied  by  permission 
from  ]\Ir.  Scott's  "  Instructions  ")  are  "  upper  "  clouds  ;  the  others  are  "  lower  " 
clouds.  To  those  described  is  added  the  form  shown  in  Xo.  5,  viz.,  Eoll- 
cumulus,  which  consists  of  portions  of  cumulus  rolled  into  a  cyhndi-ical 
shape,  and  either  separate  or  joached  together,  as  shown  in  the  plate. 
Alongside  the  names  in  the  plates  are  contractions,  which  ought  to  be  used 
in  description. 

Estimation  of  Amount  of  Cloud. — This  is  done  by  a  system  of  numbers  : 
0  expresses  a  cloudless  sky,  10  a  perfectly  clouded  sky,  the  intermediate 
numbers  various  degrees  of  cloudiness.  To  get  these  numbers,  look  mid- 
way between  the  horizcai  and  zenith,  and  then  turn  slowly  round,  and  judge 
as  well  as  can  be  done  of  the  relative  amount  of  clear  and  clouded  sky. 
This  is  to  be  entered  without  reference  to  the  thickness  of  the  cloud. 


SECTION  \TII. 
OZOXE.i 

Papers  covered  with  a  composition  of  iodide  of  potassium  and  starch, 
and  exposed  to  the  air,  are  supposed  to  indicate  the  amount  of  ozone  present 
in  the  atmosphere.  Schonbein,  the  discoverer  of  ozone,  originally  j)repared 
such  papers,  and  gave  a  scale  by  which  the  depth  of  blue  tint  was  estimated. 
Subsequently  similar  but  more  sensitive  papers  were  prej)ared  by  Dr. 
Moffat,  and  ]\Ir.  Lowe  afterward  improved  on  Moffat's  papers,  and  also 
prepared  some  ozone  powders. 

The  papers  are  exposed  for  a  definite  time  to  the  air,  if  possible  with 
the  exclusion  of  light,  and  the  alteration  of  color  is  compared  with  a  scale. 

Schonbein's  proj^ortions  are — 1  part  of  pure  iodide  of  potassium,  10 
parts  starch,  and  200  parts  of  water.  Lowe's  proportion  is  1  part  of  iodide 
to  5  of  starch ;  Moffat's  proportion  is  1  to  2^.  The  starch  should  be  dis- 
solved in  cold  water,  and  filtered  so  that  a  clear  solution  is  obtained  ;  the 
iodide  is  dissolved  in  another  portion  of  water,  and  is  gradually  added. 
Both  must  be  perfectly  pure  ;  the  best  arrowroot  should  be  used  for 
starch. 

The  paper,  prepared  by  being  cut  into  shps  (so  as  to  dry  quicker  and 
to  avoid  loss  of  the  powder  in  cutting)  and  soaked  in  distilled  water,  is 
placed  in  the  mixed  iodide  and  starch  for  four  or  five  hoiu's,  then  removed 
with  a  pail'  of  pincers,  and  slowly  dried  in  a  cool  dark  place,  in  a  horizontal 
position.  The  last  point  is  important,  as  otheinvise  a  large  amount  of  the 
iodide  drains  down  to  one  end  of  the  paper,  and  it  is  not  equally  diffused. 
The  papers  when  used  should  hang  loose  in  a  place  protected  from  the  sun 
and  rain  ;  a  box  is  unnecessaiw  ;  they  should  not  be  touched  with  the  fingers 
more  than  can  be  helped  when  they  are  adjusted. 
e_ 

'  For  a  full  account  of  the  tests  of  ozone,  see  Dr.  Fox's  -n-ork  on  Ozone  and  Antozone, 
1873,  already  referred  to.  After  discussing  all  the  tests,  he  gives  the  preference  to  the 
iodine  plan.     He  has  not  found  Schonbein's  thallium  method  satisfactory. 


118  PRACTICAL    HYGIENE. 

When  Schonbein's  papers  are  used  they  are  moistened  with  water  after 
exposure,  but  before  the  tint  is  taken.  Moffat's  papers  are  prepared  sorue- 
M'hat  similarly  to  Schi'mbeiu's,  but  do  not  require  moistening  with  water. 

The  estimation  of  ozone  is  still  in  a  veiy  unsatisfactoiy  state,  and  this 
aiises  from  two  cuTumstances. 

1.  The  fact  that  other  substances  besides  ozone  act  on  the  iodide  of 
potassium,  especially  nitrous  acid,  which  is  formed  in  some  quantity  dming 
electrical  storms.  Cloez  has  shown  that  air  taken  about  one  metre  above 
the  gi'oimd  often  contains  nitrous  acid  in  sufficient  quantity  to  redden 
litmus.  Starch  and  iodide  paper  is  colored  when  air  contains  .00005  of  its 
volume  of  nitrous  acid. 

2.  The  fact  that  the  papers  can  scarcely  be  put  under  the  same  condi- 
tions from  day  to  day  ;  light,  wind,  humidity,  and  temperatiire  (by  expel- 
ling the  free  iodine)  all  affect  the  reaction. 

Chemical  objections  have  also  been  made.'  Supposing  that  iodine  is 
set  free  by  ozone,  a  portion  of  it  is  at  once  changed  by  additional  ozone 
into  iodozone,  which  is  extremely  volatile  at  ordinary  temj^eratures,  and  is 
also  changed  by  contact  with  water  into  free  iodine  and  iodic  acid.  Hence 
a  portion  of  the  iodine  originally  set  free  never  acts  on  the  starch,  being 
either  volatilized  or  oxidized.  Again,  the  iodine  and  caustic  potash  set 
free  by  the  ozone  combine  in  part  again,  and  form  iodate  and  iodide  of 
potassium  f|th  of  the  former  and  |ths  of  the  latter),  and  in  this  way  the 
blue  color  of  iodide  of  starch  first  produced  may  be  removed.  The  ozone 
may  possibly,  and  probably,  act  on  and  oxidize  the  starch  itself,  and  hence 
another  error. 

The  conclusion  an'ived  at  by  the  Vienna  congi-ess  was  the  foUowing: 
"  The  existing  methods  of  determining  the  amount  of  ozone  in  the  atmos- 
phere are  insufficient,  and  the  congress  therefore  recommends  investiga- 
tions for  the  discoveiy  of  better  methods." 


SECTION  IX. 

ELECTRICITY. 

The  instruments  used  by  meteorologists  are  simjDle  electroscopes,  with 
two  gold-leaf  pieces  which  diverge  when  excited,  or  diw  galvanic  piles  act- 
ing on  gold-leaf  plates  or  an  index  attached  to  a  Leyden  jar  (Thomson's 
electrometei-).     For  further  details,  see  Scott's  "  Instinictions,"  op.  cit. 


SECTION  X. 
THERMOMETER  STAN'D. 

A  stand  is  issued  by  the  War  Office,  and  provided  at  every  station.  Or 
it  would  be  very  easy  to  make  a  stand  by  two  or  three  strata  of  boards, 
placed  about  6  inches  apart,  so  as  to  form  a  kind  of  sloping  roof  over  the 
thermometers,  which  are  suspended  on  a  vertical  board. 

The  diy  and  wet  bulb  thermometers  ai'e  placed  in  the  centre  ;  the 
maximum  on  the  right  side,  and  the  minimum  on  the  left.     The  wood 

'  Beitrage  zur  Ozonometrie,  von  Dr.  v,  Maach  ;  Archiv  fiir  Wiss.  Heilk.,  Band  ii., 
p.  29. 


DESCRIPTIOlSr    OP    METEOROLOGICAL   INSTRUMENTS.  119 

should  be  cut  away  behind  the  bulbs  of  the  maximum  and  minimum  ther- 
mometers, so  as  to  expose  them  freely  to  the  au\  The  bulbs  of  the  dry 
and  "wet  bulbs  should  also  fall  below  the  board.  These  stands  are  made 
to  rotate  on  the  pole  so  as  to  turn  the  roof  always  to  the  sun. 

A  much  better  stand  is  Stevenson's  screen,  a  square  or  oblong  box, 
with  double  louvred  sides  and  open  below.  This  is  raised  upon  legs,  four 
feet  from  the  ground,  placed  upon  grass. ' 


SECTION  XI. 

WEATHER. 

In  registering  the  kind  of  weather  it  is  well  to  adhere  to  the  Beaufort 
notation  and  symbols,  which  are  carefully  explained  in  Scotfs  "  Instruc- 
tions."    Columns  are  given  in  the  return  to  be  filled  up  in  this  way. 

SECTION  xn. 

DISEASES  AND  VARIATIONS  IN  THE  METEOROLOGICAL  ELEMENTS. 

The  variation  in  the  prevalence  of  different  diseases  at  a  particular 
place,  in  connection  with  the  simultaneous  variation  of  meteorological 
elements,  is  an  old  inquiry  which  has  at  present  led  to  few  results.  The 
reason  of  this  is  that  the  meteorological  elements  are  only  a  few  out  of  a 
great  many  causes  affecting  the  prevalence  and  severity  of  diseases.  Con- 
sequently, in  order  to  estimate  the  real  value  of  changes  of  temperature, 
pressure,  humidity,  ozone,  etc.,  the  other  causes  of  disease,  or  of  varia- 
tions in  prevalence  or  intensity,  must  be  recognized  and  eliminated  from 
the  inquiry.  The  best  of  the  late  observations  are  those  by  Guy,  Ran- 
some,  Vernon,  Moffat,  Tripe,  Scoresby-Jackson,  and  Ballard.  Observa- 
tions have  also  been  made  by  Fodor  and  others  on  the  continent  of  Europe, 
and  by  various  observers  in  America  and  elsewhere.  But  they  must  be 
much  more  extended  and  numerous  before  anything  practical  can  be 
drawn  from  them. 

'  Scott's  Instructions,  Fig.  10,  p.  41. 


CHAPTER  XVL 

INDIVIDUAL  HYGIENIC   MANAGEMENT. 

This  subject  is  an  extremely  large  one,  and  the  object  of  tliis  book  does 
not  jDermit  of  its  discussion.  It  would  require  a  volume  to  itself.  Only  a 
few  very  general  remarks  can  be  made  here.  The  aj)i3lication  of  general 
hygienic  rules  to  a  particular  case  constitutes  individual  management. 

It  is  impossible  to  make  general  rules  sufficiently  elastic,  and  yet  pre- 
cise enough,  to  meet  every  jDossible  case.  It  is  sufficient  if  they  contain 
principles  and  precepts  which  can  be  applied.  While  individual  hygiene 
should  be  a  matter  of  study  to  all  of  us,  it  is  by  no  means  desu-able  to  pa}'  a 
constant  or  minute  attention  to  one's  own  health.  Such  care  will  defeat 
its  object.  We  should  only  exercise  that  reasonable  care,  thought,  and 
prudence  which,  in  a  matter  of  such  moment,  every  one  is  bound  to  take. 

Every  man,  for  example,  who  considers  the  subject  bond  fide,  is  the 
best  judge  of  the  exact  diet  which  suits  him.  If  he  understands  the  gen- 
eral principles  of  diet,  and  remembers  the  Hippocratic  rule,  that  the 
amount  of  food  and  exercise  must  be  balanced,  and  that  evil  results  fi'om 
excess  of  either,  he  is  hardly  liliely  to  go  wrong. 

"  Temperance  and  exercise,"  was  the  old  rule  laid  down,  even  before 
Hippocrates,'  as  containing  the  essence  of  health;  and  if  we  translate  tem- 
perance by  "sufficient  food  for  wants,  but  not  for  luxuries," we  shall  ex- 
press the  present  doctrine. 

The  nutrition  of  the  bod}'  is  so  affected  by  individual  peculiarities,  that 
there  is  a  considerable  variety  in  the  kind  of  food  taken  by  difi'erent  j^er- 
sons.  The  old  inile  seems  a  good  one,  viz.,  while  conforming  to  the  gen- 
eral jDrinciples  of  diet,  not  to  encourage  too  great  an  attention  either  to 
quantity  or  to  quality,  but  avoiding  what  experience  has  shown  to  be  mani- 
festly bad,  either  generally  or  for  the  particular  individual,  to  allow  a 
considerable  variety  and  change  in  amount  from  day  to  day,  according  to 
appetite.  °     Proper  and  slow  mastication  of  the  food  is  necessary  ;  and  it  is 

'  It  is  quite  pLain  from  the  context,  that  Hippocrates,  by  temperance,  meant  such 
an  amount  of  food  as  would  balance,  and  neither  exceed  nor  fall  short  of  the  exercise. 
He  had  a  clear  conception  of  the  development  of  mechanical  force  from,  and  its  re- 
lation to,  food.  He  lays  down  rules  to  show  when  the  diet  is  in  excess  of  exercise,  or 
the  exercise  in  excess  of  diet.     In  either  case  he  traces  disease. 

'  Celsus  carried  the  plan  of  variety  so  far  as  to  recommend  that  men  should  some- 
times eat  and  drink  more  than  is  proper,  and  should  sometimes  not  exceed  ;  and  Lord 
Bacon  has  a  remark  which  leads  one  to  believe  he  held  a  similar  opinion  ;  but  there 
can  be  no  doubt  of  the  incorrectness  of  this  opinion.  It  has  been  truly  said  that  the 
first  general  rule  of  Hippocrates,  which  prescribes  continual  moderation,  is  much  truer, 
and  the  best  writers  on  hygiene,  ancient  and  modern,  have  decided  against  Celsus. 
Besides  being  erroneous,  the  rule  of  Celsus  opens  a  door  to  intemperance,  and,  like  a 
harmless  sentence  in  Hii)pocrates,  has  been  twisted  to  serve  the  argument  of  gour- 
mands.    Its  influence  is  felt  even  at  the  present  day.     This  much  is  certain,  that  prob- 


INDIVIDUAL    HYGIENIC    MANAGEMENT.  121 

extraordinary  how  many  affections  of  the  stomach  called  dyspepsia  arise 
simply  from  faulty  mastication,  from  deficient  teeth,  or  from  swallowing 
the  food  too  rapidly.  Many  persons  who  are  too  thin  are  so  from  their 
own  habits  ;  they  eat  chiefly  meat,  and  eat  it  very  fast ;  they  should  eat 
slowly,  and  take  more  bread  and  starchy  substances.  Fat  persons,  on  the 
other  hand,  by  lessening  the  amount  of  starch,  and  taking  more  exercise, 
can  lessen  with  the  greatest  ease  the  amount  of  fat  to  any  amount.  It 
must  be  remembered,  however,  that  there  is  a  certain  individual  con- 
formation in  this  respect ;  some  persons  are  normally  fatter  or  thinner 
than  others. 

The  exact  amount  of  exercise  must  also  be  a  matter  of  individual  de- 
cision, it  being  remembered  that  exercise  in  the  free  air  is  a  paramount 
condition  of  health,  and  that  the  healthiest  persons  are  those  who  have 
most  of  it.  As  a  rule,  persons  take  far  too  little  exercise,  especially 
educated  women,  who  are  not  obliged  to  woi'k,  and  the  muscles  are  too 
often  flaccid  and  ill-nourished.' 

Attention  to  the  skin  is  another  matter  of  personal  hygiene.  The  skin 
must  be  kept  perfectly  clean  and  well  clothed.  Some  writers,  indeed, 
have  advised  that,  if  food  be  plentiful,  few  clothes  be  worn  ;  but  the  best 
authors  do  not  agree  in  this,  but  recommend  the  surface  to  be  well  pro- 
tected. For  cleanliness,  cold  bathing  and  friction  hold  the  first  rank. 
The  effect  of  cold  is  to  improve  apparently  the  nutrition  of  the  skin,  so 
that  it.  afterward  acts  more  readily,  and  when  combined  with  friction,  it 
is  curious  to  see  how  the  very  color  and  textiire  of  the  skin  manifestly  im- 
prove. 

The  effect  of  heat  on  the  skin,  and  especially  the  action  of  the  Eoman 
or  Turkish  baths,  and  their  action  on  health,  have  certainly  not  yet  beert 
properly  worked  out,  in  spite  of  the  numerous  papers  which  have  been 
written.  It  has  not  been  proved  that  the  strong  action  of  the  Turkish 
bath  is  more  healthy  in  the  long  run  than  the  application  of  cold  water. 
As  a  curative  agent,  it  is  no  doubt  extremely  useful ;  but  as  a  daily  cus- 
tom, it  is  yet  sub  judice.  Certainly  it  should  not  be  used  without  the 
concluding  application  of  cold  to  the  surface. 

Attention  has  been  often  very  properly  directed  to  the  effect  of  lead 
and  mercurial  hair-dyes.  It  may  be  worth  while  to  notice  that  there  is  a 
case  on  record  ^  in  which  not  only  was  paralysis  produced  by  a  lead  hair- 
wash,  but  lead  was  recovered  from  the  base  of  the  left  hemisphere  of  the 
brain.     Snuff  containing  lead  has  also  caused  poisoning. 

The  care  of  the  bowels  is  another  matter  of  personal  hygiene,  and  is  a 
matter  of  much  greater  difficulty  than  at  first  sight  appears.  Constipation, 
as  allowing  food  to  remain  even  to  decomposition,  as  leading  to  distention 
and  sacculation  of  the  colon,  and  to  hemorrhoids,  is  to  be  avoided.  But, 
on  the  other  hand,  the  constant  use  of  purgative  medicine  is  destructive 
of  digestion  and  proper  absorption ;  and  the  use  of  clysters,  though  less 

ably  30  per  cent,  of  the  persons  who  consult  physicians  owe  their  diseases  in  some  way 
to  food,  and  in  many  cases  they  are  perfectly  aware  themselves  of  their  error  or  bad 
habit,  but,  with  the  singular  inconsistency  of  human  nature,  either  conceal  it  from 
the  man  to  whom  they  are  professing  perfect  openness,  or  manage  to  blind  themselves, 
to  its  existence. 

'  Compare  the  imperfect  development  of  the  muscles  of  the  arms  in  ladies,  as  shown 
by  the  low  evening  dresses,  with  the  women  of  the  working  classes.  No  one  can  doiibt 
which  is  healthiest  or  which  is  the  most  beautiful,  until  excess  of  work  develops  in 
the  muscles  of  the  laboring  women  the  too  hard  outlines  of  middle  life. 

2  Virchow's  Archiv,  Band  viii.,  p.  177. 


122  PRACTICAL    HYGIENE. 

hurtful  to  the  stomach,  and  less  objectionable  altogether,  is  by  no  means 
desirable.  On  the  whole,  it  would  seem  that  proper  relief  of  the  bowels 
can  be  usually  iusui'ed  by  exercise,  and  esi^ecially  by  bringing  the  abdomi- 
nal muscles  into  play,  and  by  the  use  of  certain  ai-ticles  of  diet — viz.,  piu'e 
water  in  good  quantity  with  meals,  the  use  of  bran  bread,  honey,  and  such 
gently  laxative  food ;  and  that  if  these  do  not  answer  well,  it  is  better  to 
allow-  a  certain  amount  of  constipation  than  to  fall  into  the  frequent  use  of 
purgative  medicines. 

The  regulation  of  the  passions  must  also  be  left  to  the  indi^iduaL  The 
control  of  morals  has  baffled  the  exertions  of  the  priest  and  the  statesman  ; 
but  perhaps  the  influence  of  sexual  ii'regularities  on  health  has  never  been 
made  the  subject  of  judicious  education.  The  period  of  puberty  corre- 
sponds •«"ith  the  most  important  period  of  gi'owth,  when  the  bones  are 
consohdating  and  uniting,  and  both  muscles  and  nerves  are  lai'gely  ab- 
sorbing nouiishment,  and  are  developing  to  their  fullest  power.  The  too 
early  use  of  sexual  congi'ess,  and  even  more  the  di*ain  on  the  system  pro- 
duced by  sohtary  vice,  arrests  this  development  to  a  considerable  extent, 
and  prevents  the  attainment  of  the  strength  and  endurance  which  would 
insure  a  healthy,  rigorous,  and  happy  life.  The  venereal  diseases,  which 
so  waste  many  of  the  younger  men,  form  only  an  item  in  the  catalogue  of 
erils — evds  which  effect  at  a  subsequent  period  wives  and  children,  and  by 
imdermining  the  health  and  hapjDiness  of  the  family,  influence  the  state 
itself.  "We  know  that  a  wide-sj)read  profligacy  has  eaten  away  the  rigor  of 
nations  and  caused  the  downfall  of  states  ;  but  we  hardly  recognize  that, 
in  a  less  degree,  the  same  causes  ai^e  active  among  us,  and  never  realize 
what  a  state  might  be  if  its  citizens  were  temperate  in  all  things.  It  may 
be  difficult  to  teach  these  points  to  the  young,  and  to  ui-ge  upon  them,  for 
their  o\vn  and  others'  sakes,  the  regulation  of  the  passions  which  physi- 
ology teaches  to  be  necessaiy  for  personal  happiness,  for  the  welfare  of  the 
offspiing,  and  for  healthy  family  life  ;  but  I  think  few  can  doubt  that,  in 
some  way,  the  knowledge  should  be  given. 

The  amount  of  mental  work,  and  the  practice  of  general  good  temper 
and  cheerfulness  and  hope,  are  other  points  which  each  man  must  himself 
control.  Great  mental  work  can  be  borne  well  if  hygienic  principles  of 
diet,  exercise,  etc.,  be  attended  to.  The  old  authors  paid  gi-eat  attention 
to  the  regimen  of  men  engrossed  in  literary  M'ork,  and  laid  down  particular 
rides,  insisting  especially  on  a  very  cai'eful  and  moderate  diet,  and  on  ex- 
ercise. ' 

Hope  and  cheertvdness  are  great  aids  to  health,  no  doubt,  from  their 
effect  on  digestion.  Usually,  too,  they  are  combined  with  a  quick  and  ac- 
tive temiDerament,  and  with  rapid  bodUy  movements  and  love  of  exercise. 

The  individual  application  of  general  hygienic  miles  will  differ  accord- 
ing to  the  sex  and  age,"  and  the  circumstances  of  the  person.  In  the  case 
of  children,  we  have  to  apj)ly  the  general  i-ules  with  as  much  caution  and 
care  as  possible,  as  we  must  depend  on  external  evidence  to  prove  their 

'  Plutarcli,  whose  rules  on  health  are  excellent  and  chiefly  taken  from  Hippocrates, 
compares  the  over-studious  man  to  the  camel  in  the  fable,  who,  refusing  to  ease  the  ox 
in  due  time  of  his  load,  was  forced  at  last  to  carry  not  only  the  ox's  own  load,  but  the 
ox  himself,  when  he  died  under  his  burden. 

-'  Galen  was  the  first  who  pointed  out  explicitly  that  hygiene  rules  must  be  diffes- 
ent  for  in.ancy,  youth,  manhood,  and  old  age  — a  fourfold  division  which  is  still  the 
best.  Pythagoras,  Iccus,  Herodicus,  Hippocrates,  Polybius,  Diodes,  Celsus,  and  others 
who  preceded  Galen,  appear  to  have  framed  rules  chiefly  for  male  adults.  Galen  sub- 
divided the  sub'ect  much  more  systematically.  (For  a  good  short  account  of  the  early 
systems,  see  .Jlackenzie  on  Ihe  History  of  Health,  and  the  Art  of  Preserving  it,  1758.) 


INDIVIDUAL    HYGIENIC    MANAGEMENT.  123 

utility.  In  the  case  of  adults,  individual  experience  soon  shows  whether 
or  not  a  prescribed  rule  is  or  is  not  beneficial,  and  what  modification  must 
be  made  in  it.  It  is  not,  however,  every  grown  person  who  has  the  power 
to  modify  or  change  his  condition.  He  may  be  under  the  influence  of 
others  who,  in  fact,  arrange  for  him  the  cii'cumstances  of  his  life.  But 
still,  in  no  case  is  aU  self-control  taken  away  ;  the  individual  can  always 
influence  the  conditions  of  his  own  health. 

Were  the  laws  of  health  and  physiology  better  understood,  how  great 
would  be  the  effect !  Let  us  hope  that  matters  of  such  gTeat  moment  may 
not  always  be  considered  of  less  importance  than  the  languages  of  extinct 
nations,  or  the  unimportant  facts  of  a  dead  history. 


CHAPTER  XVII. 

DISPOSAL   OF  THE   DEAD. 

In  densely  populated  countries  the  disiDosal  of  the  dead  is  always  a  ques- 
tion of  diificulty.  If  the  dead  are  buried,  so  great  at  last  is  the  accumula- 
tion of  bodies  that  the  whole  country  round  a  gTeat  city  becomes  gradually 
a  vast  cemeter)'.'  In  some  soils  the  decomposition  of  bodies  is  veiy  slow, 
and  it  is  many  years  before  the  risk  of  impui'ities  passing  into  au-  and  wa- 
ter is  removed. 

After  death  the  buried  body  returns  to  its  elements,  and  gradually,  and 
often  by  the  means  of  other  forms  of  hfe  which  prey  on  it,  a  large  amoiuit 
of  it  forms  carbon  dioxide,  ammonia,  carburetted  hydrogen  and  hydi-ogen 
sulphide,  nitrous  and  nitric  acids,  and  vaiious  more  complex  gaseous  prod- 
ucts, many  of  which  are  veiy  fetid,  but  which,  however,  are  eventually  all 
oxidized  into  the  simpler  combinations.  The  non-volatile  substances,  the 
salts,  become  constituents  of  the  soil,  pass  into  plants,  or  are  carried  away 
into  the  water  percolating  through  the  gi-ound.  The  hardest  parts,  the 
bones,  remain  in  some  soils  for  many  centui'ies,  and  even  for  long  periods 
retain  a  portion  of  their  animal  constituents. 

If,  instead  of  being  buried,  the  body  is  burned,  the  same  process  occirrs 
more  rapidly  and  with  different  combinations ;  carbon  dioxide,  cai'bon  mon- 
oxide (?),  nitrogen,  or  perhaps  combinations  of  nitrogen,  water,  etc.,  are 
given  off,  and  the  mineral  constituents,  and  a  little  carbon,  remain  behind. 

A  community  must  always  disj)ose  of  its  dead  either  by  burial  in  land 
or  water,  or  by  burning,  or  chemical  destruction  equivalent  to  burning,  or 
by  embalming  and  pi*eserving.  Accustomed  as  Ave  are  to  land  burial,  there 
is  something  almost  revolting,  at  first  sight,  at  the  idea  of  making  the  sea 
the  sepulchre,  or  of  burning  the  dead.  Yet  the  eventual  disj)ersion  of  our 
frames  is  the  same  in  all  cases  ;  and  it  is  probably  a  matter  merely  of  cus- 
tom which  makes  us  think  that  there  is  a  want  of  affection,  or  of  cai'e,  if 
the  bodies  of  the  dead  are  not  suffered  to  repose  in  the  earth  that  bore 
them. 

In  reality,  neither  affection  nor  religion  can  be  outraged  by  any  manner 
of  disposal  of  the  dead  which  is  done  with  proper  solemnity  and  respect  to 

'  Nothing,  perhaps,  testifies  more  strongly  to  the  antiquity  and  the  extent  of  the  an- 
cient cities  in  Anatolia  than  the  vast  sepulchral  remains.  On  the  site  of  Old  Dardanus, 
the  mother  of  Troy,  and  stretching  from  the  Hellespont  for  two  or  three  miles  into  the 
hills,  the  -whole  country  is  honeycombed  with  tombs.  It  is  the  same  in  the  neighbor- 
hood of  Troy.  The  burial  of  the  dead,  though  practised  by  the  most  ancient  nations, 
was  afterward  superseded  by  burning,  and  was  only  subseqviently  returned  to.  As, 
therefore,  these  graves  represent  only  a  portion  of  the  duration  of  the  city,  the  immense 
assemblage  of  tombs  is  the  more  remarkable,  and  it  is  impossible  to  avoid  the  conclu- 
sion that  these  great  cities  must  have  flourished  for  periods  far  longer  than  those  which 
have  elapsed  since  London  or  Paris,  for  example,  became  large  centres  of  population. 


DISPOSAL    OF   THE   DEAD.  125 

the  eartlily  dwelling-place  of  our  friends.  Tlie  question  should  he  placed 
entii'ely  on  sanitary  gi'ounds,  and  we  then  shall  judge  it  rightly. 

What,  then,  is  the  best  plan  of  disposing  of  the  dead,  so  that  the  hving 
may  not  suffer  ? 

It  seems  hardly  hkely  that  the  practice  of  embalming  or  mummifying 
will  ever  again  become  common.  What  is  the  use  of  preserving  for  a  few 
more  years  the  remains  which  will  be  an  object  of  indifference  to  future 
generations  ?  The  next  logical  step  would  be  to  enshi'ine  these  remains  in 
some  way  so  as  to  insui-e  theii'  preservation,  and  we  should  return  to  the 
vast  burial  mounds  of  Egypt.  The  question  will  he  between  buiial  in  the 
land  or  at  sea,  and  burning. 

At  present  the  question  is  not  an  urgent  one  ;  but  if  the  population  of 
Europe  continues  to  increase,  it  will  become  so  in  another  century  or  two, 
Akeady  in  this  country  we  have  seen,  in  our  own  time,  a  great  change ; 
the  objectionable  practice  of  interment  under  and  round  churches  in  towns 
has  been  given  up,  and  the  population  is  bmied  at  a  distance  from  their 
habitations.  For  the  present  that  measui-e  will  jDrobably  sulfice,  but  in  a 
few  years  the  question  will  again  inevitably  present  itseh. 

Burying  in  the  ground  appears  certainly  the  most  insanitaiy  plan  of  the 
three  methods.  The  air  over  cemeteries  is  constantly  contaminated,  and 
water  (which  may  be  used  for  drinkingj  is  often  highly  impui-e.  Hence,  in 
the  vicinity  of  graveyards  two  dangers  to  the  population  arise,  and  in  addi- 
tion, from  time  to  time,  the  disturbance  of  an  old  gTaveyard  has  given  rise 
to  disease.  It  is  a  matter  of  notoriety  that  the  vicinity  of  graveyards  is 
unhealthy.  How  are  these  dangers  to  be  avoided?  The  dead  may  be 
buried  in  more  or  less  aii'-tight  vaults  ;  here  decay  is  slow  ;  the  products 
form  and  escape  slowly,  though  they  must  eventually  escape  ;  the  air  and 
water  are  less  contaminated.  But  the  immense  expense  of  such  a  plan  ren- 
ders it  impossible  to  adopt  it  for  the  community  generally.  Deep  buning 
has  the  advantage  of  greater  filtration,  both  for  air  and  water,  than  shallow 
burying,  and  hence  it  is  a  good  rule  to  make  the  gTave  as  deep  as  possible, 
and  to  allow  no  more  than  one  body  in  a  grave.  The  admixtui'e  of  quick- 
lime has  been  advised  ;  it  absorbs  some  carbon  dioxide,  and  forms  calcium 
sulphide  with  the  sulphiu"  and  hydrogen  sulphide,  but  this  itself  soon  de- 
composes, so  that  the  expense  of  quicklime  seems  hardly  commensurate 
with  the  result.  Charcoal  would  absorb  and  oxidize  the  fetid  organic  mat- 
ter, and,  if  sufficiently  cheap,  would  be  a  valuable  substance  to  be  heaped 
in  graves  ;  but  its  cost  would  be  probably  too  great,  nor  does  it  entirely 
hinder  putrefaction  and  the  evolution  of  foul-smelling  substances  (H.  Bar- 
ker). If  a  body  has  to  be  kept  unburied  for  some  time,  sawdust  and  sul- 
phate of  zinc,  in  the  proportion  of  two  parts  to  one,  has  been  found  by  Her- 
bert Barker, '  to  be  the  best  apphcation  ;  a  thin  layer  is  put  over  the  dead 
body  ;  or  sawdust  is  spiinkled  on  the  body,  and  then  two  or  thi'ee  inches 
of  carboUc  acid  thrown  over  it. 

The  only  means  which  present  themselves,  as  apphcable  in  all  cases,  are 
the  deep  burial  and  the  use  of  j^lants,  closely  placed  in  the  cemetery.  There 
is  no  plan  which  is  more  efficacious  for  the  absorjDtion  of  the  organic  sub- 
stances, and  perhaps  of  the  carbon  dioxide,  than  plants,  but  it  would  seem 
a  mistake  to  use  only  the  dark,  slow-growing  evergi-eens.  The  object 
should  be  to  get  the  most  rapidly  growing  trees  and  shrubs,  and,  in  fact, 
there  is  no  reason,  except  a  feeling  of  sentiment,  why  we  should  introduce 
into  our  cemeteries  the  gloomy  and  melancholy  cypress  and  yew.     Mr. 

'  Deodorization  aud  Disinfection,  Britisli  Medical  Journal,  January,  1866. 


126  PRACTICAL    HYGIENE. 

Seymour  Haden  has  called  attention  to  the  supposed  advantages  of  perish- 
able coffins,  so  that  the  putrefactive  changes  may  be  carried  out  as  quick- 
ly as  possible.  And  certainly,  if  buiying  is  to  continue,  it  seems  reasonable 
that  no  undue  obstacle  should  be  placed  in  the  way  of  changes  which  are 
sooner  or  later  inevitable. 

When,  in  the  course  of  years,  it  becomes  imperative  to  reconsider  this 
question,  and  land  burial  will  have  to  be  modified,  some  arguments  may 
present  themselves  to  maritime  nations  in  favor  of  bur^ing  in  the  sea  ra- 
ther than  of  burning.  In  the  burial  at  sea,  some  of  the  body  at  least  would 
go  at  once  to  siipport  other  forms  of  life,  more  rapidly  than  in  the  case  of 
land  burial,  and  without  the  danger  of  evolution  of  hurtful  products. 

Burning,  or  cremation,  has  attracted  much  attention  of  late  years.  In 
this  country  the  subject  has  been  discussed  by  Sii'  Henry  Thompson  and 
]Mi'.  Eassie,  and  abroad  much  has  been  written,  especially  in  Germany  and 
Italy,  in  both  which  countries  the  method  has  been  practically  tried.  It 
would  ceriainly  appear  that  the  body  can  be  disposed  of  in  a  veiy  short 
time  and  in  an  inoffensive  manner,  while  the  expense  would  unquestion- 
ably be  much  reduced  if  the  practice  became  general.  One  hour  appears 
sufficient  to  reduce  a  body  to  ashes,  and  it  has  been  successfully  tried  in 
this  country. 

The  only  really  valid  argument  against  cremation  is  the  possible  con- 
cealment of  crime,  such  as  poisoning.  This,  however,  might  be  guarded 
against  by  suitable  precautions. 

In  time  of  war,  and  especially  in  the  case  of  beleaguered  fortresses,  the 
disposal  of  the  dead  becomes  often  a  matter  of  difficiilty.  In  that  case 
burning  may  have  to  be  resorted  to.  If  the  bodies  are  bm-ied,  they  should 
always  be  at  as  gi'eat  a  distance  as  possible,  and  as  deep  as  they  can  be. 
If  procui'able,  charcoal  should  be  thrown  over  them  ;  if  it  cannot  be  ob- 
tained, sawdust  and  sulphate  of  zinc,  or  carbohc  acid  may  be  employed. 
Quickhme  is  also  commonly  employed,  but  it  is  less  useful. 

At  Metz,  in  1870,  the  following  plan  was  adopted  : — A  pit  of  about  17 
feet  in  depth  was  filled  with  dead,  disposed  of  as  follows  : — A  row  of  bodies 
was  laid  side  by  side  ;  above  this  a  second  row  was  placed,  with  the  heads 
laid  against  the  feet  of  the  first  row  ;  tlie  thu-d  row  were  placed  across, 
and  the  fourth  row  in  the  same  way,  but  with  the  heads  to  the  feet  of  the 
former ;  the  fifth  row  were  placed  as  No.  1,  and  so  on.  Between  each 
layer  of  bodies  about  an  inch  of  lime,  in  powder,  was  placed.  From  90  to 
100  bodies  were  thus  arranged  on  a  length  of  6^  feet,  and  reached  to 
about  6  feet  fi-om  the  sm-face  ;  the  pit  was  then  fiUed  up  \\-ith  earth,  and 
though  8,400  bodies  were  put  in  that  pit,  there  were  no  perceptible 
emanations  at  any  time. 

Around  Metz  the  graves  of  men  and  horses  and  cattle  were  disinfected 
with  lime,  chai'coal,  and  stdphate  of  u'on.  Immense  exeiiions  were  made 
to  clean  and  disinfect  the  camps  and  battle-fields,  and  in  the  month  of 
May,  1871,  from  1,200  to  1,  GOO  laborers  were  employed  by  the  Gei-mans. 
Wherever  practicable,  the  groimd  was  sown  "s\dth  oats  or  barley  or  grass. 
The  hillocks  formed  by  the  graves  were  planted  with  trees. 

In  many  cases,  at  Metz,  bodies  were  dug  up  by  the  Germans  when 
there  was  any  fear  of  watercourses  being  contaminated,  or  if  houses  were 
near.  On  account  of  the  danger  to  the  workmen,  graves  containing  more 
than  six  bodies  were  left  untouched,  and  the  work  was  always  done  under 
the  immediate  superintendence  of  a  physician.  The  earth  was  removed 
carefully,  but  not  far  enough  to  uncover  the  coi-jDse  ;  then  one  end  of  the 
coi-pse  was  uncovered,  and  as  soon  as  unifonn  or  parts  of  the  body  were 


DISPOSAL    OF    THE    DEAD.  127 

seen,  cliloride  of  lime  and  sawdust,  or  charcoal  and  carbolic  acid,  put  in  ; 
the  whole  earth  round  the  body  was  thus  treated,  and  the  body  at  length 
laid  bare,  lifted  and  carried  away.  The  second  body  was  then  treated  in 
the  same  way. 

Near  Sedan,  where  there  were  many  bodies  very  superficially  biuied, 
biu'ning  was  had  recourse  to.  Straw  mixed  with  pitch  was  put  into  the 
graves,  and  was  Ughted  ;  1  ton  of  pitch  sufficed  for  from  15  to  20  bodies. 
Opinions  as  to  this  practice  were  divided,  and  it  is  not  certain  how  many 
graves  were  thus  dealt  with.  It  seems  probable  that  only  the  surface  of 
the  body  was  bm-nt,  and  when  many  bodies  were  together  in  one  grave 
some  were  not  touched  at  all.  On  the  whole,  the  exj)eriment  appears  to 
have  been  unsuccessful. 

The  Belgian  experience  at  Sedan  was  in  favor  of  employing  chloride  of 
Hme,  nitric  acid,  sulphate  of  ii'on,  and  chloiine  gas.  Carbohc  acid  did  not 
answer  so  well.  The  sulphate  of  zinc  and  charcoal,  which  Barker  found' 
so  useful,  was  not  tried. 

Mr.  Eassie  has  lately  called  attention  to  the  desirability  of  an  ambula- 
tory cremation  furnace  for  the  disposal  of  bodies  in  war.  If  such  an 
arrangement  proved  practicable,  it  would  unquestionably  be  of  immense 
advantage  from  a  hygienic  point  of  view. 


.       CHAPTER  XVIII. 

ON  THE  PREVENIION  OF  SOME  IMPORTANT  AND 
COMMON  DISEASES. 

There  are  two  modes  by  which  we  may  attempt  to  prevent  the  occurrence 
of  disease. 

1.  By  conforming  with  the  general  rules  of  hygiene,  by  which  the  body 
and  mind  ai-e  bi'ought  into  a  state  of  more  vigorous  health. 

2.  By  investigating  and  removing  the  causes  of  the  diseases  which  we 
find  actually  in  operation.  This  pai-t  of  the  inquiiy  is  in  fact  a  necessary 
sujDplement  to  the  other,  tliough  in  proportion  to  the  obsei-vance  of  the 
general  niles  of  hygiene,  the  causes  of  disease  will  gradually  be  removed. 
At  present,  however,  we  have  to  deal  -with  the  facts  before  us, — viz.,  that 
there  are  a  great  number  of  diseases  actually  existent  which  must  form  the 
subject  of  investigation.  We  proceed  in  this  case  from  the  particular  to 
the  general,  whereas,  in  the  first  mode,  we  deduce  general  rules  which  have 
to  be  apphed  to  individual  instances. 

Hygiene  is  in  this  dii-ection  an  aj^plication  of  etiology,  and  etiology  is 
the  philosophy  of  medicine  ;  while  in  its  turn  the  veiy  foundation  and  basis 
of  etiology  is  an  accurate  diagnosis  of  disease.  Unless  diseases  are  com- 
pletely identified,  all  inquuy  into  causes  is  hopeless.  Let  us  remember, 
for  example,  what  utter  confusion  prevailed  in  our  opinions  as  to  causes 
and  preventive  measures  at  the  time  when  typhus  and  typhoid  fevers 
were  considered  identical,  or  when  paroxysmal  fever  and  the  true  yellow 
fever  or  vomito  were  thought  to  o^vn  a  common  cause.  Auy  useful  rules 
of  prevention  were  simply  impossible — as  impossible  as  at  present  in  many 
of  the  diseases  of  nutrition,  which,  in  the  projjer  sense  of  the  word,  are  yet 
undiagnosed. 

The  advance  of  diagnosis  has  of  late  years  been  owing  not  merely  to 
improved  methods  of  observation,  but  to  the  more  complete  recognition  of 
the  great  principle  of  the  invaiiableness  of  causation.  The  sequence  of 
phenomena  in  the  diseased  body  proceeds  with  the  same  regularity  and 
constancy  as  in  astronomy  or  chemistiw.  Like  causes  always  produce  like 
effects.  To  suppose  that  from  the  same  cause  should  proceed  a  sequence 
of  phenomena  so  utterly  distinct  as  those  of  typhus  and  typhoid  fever,  now 
seems  incredible  ;  yet  ■nith  a  full,  or  at  any  rate  a  sufficient  knowledge  of 
the  phenomena,  it  was  at  one  time  almost  universally  beheved  that  these 
two  perfectly  distinct  diseases  owned  a  common  origin.  At  the  present 
moment,  the  superficial  resemblance  between  gout  and  rheumatism  causes 
them  to  be  put  together  in  almost  all  systems  of  nosolog}',  although,  with 
the  exception  of  the  joints  being  affected,  the  diseases  have  almost  nothing 
in  common. 

In  proportion  as  this  great  piinciple  is  still  more  constantly  apphed, 


PEEVENTION    OF    DISEASE.  129 

and  as  our  means  of  diagnosis  advance,  and  consequently,  causes  are  more 
satisfactorily  investigated,  methods  of  prevention  will  become  obvious  and 
precise.  At  present  they  are  very  far  from  being  so.  In  many  cases  they 
are  founded  on  very  imjDerfect  observation  ;  and  very  frequently  all  that 
can  be  done  is  to  apply  general  sanitary  rules,  without  attempting  to  de- 
termine w^hat  are  the  special  preventive  measures  which  each  disease  re- 
quires. 

It  is  not  necessary,  however,  that  we  should  wait  until  the  causation  of 
any  disease  is  perfectly  understood.  We  must  act,  as  in  so  many  other 
affairs,  on  probability  ;  and  endeavor  to  remove  those,  conditions  which,  in 
the  present  state  of  our  knowledge,  seem  to  be  the  most  likely  causes  of  the 
disease.  It  may  be  that,  in  some  cases,  we  may  be  attacking  only  subsidiary 
or  minor  causes,  and  may  overlook  others  equally,  or  more  important.  In 
some  cases,  indeed,  we  may  overlook  entirely  the  effective  causes,  and  may 
be  fighting  with  shadows.  Still,  even  from  mistakes,  progress  often  arises 
— indeed,  the  difficult  path  of  human  knowledge  is  perhaps  always  through 
error. 

The  term  cause  is  applied  by  logicians  to  any  antecedent  which  has  a 
share  in  producing  a  certain  sequence  ;  and  it  is  well  known  that  in  many 
diseases  two  sets  of  causes  are  in  operation — one  external  and  one  internal 
to  the  body  (exciting  and  predisposing).  The  investigation  of  the  internal 
causes,  which  in  some  cases  are  necessary  to  the  action  of  the  external  causes, 
is  equally  curious  and  intricate  as  that  of  the  external  causes,  and  in  some 
respects  it  is  even  more  obscure  ;  but  measures  of  prevention  must  deal 
with  them,  as  well  as  with  the  external  causes. 

In  this  chapter  we  can,  of  course,  only  venture  to  enumerate  very  briefly, 
and  without  discussion,  what  seem  to  be  the  best  rules  of  prevention  for 
the  principal  diseases  of  soldiers.  To  enter  on  the  great  subject  of  the  pre- 
vention of  disease  generally,  and  to  discuss  all  the  complicated  questions 
connected  with  causation,  would  demand  a  volume. 


SECTION  I 

THE  SPECIFIC  DISEASES. 

Paroxysmal  Fevers. 

External  Cause. — This  was  presumed  to  be  putrescent,  or,  at  any  rate, 
decomposing  vegetable  matter  derived  from  a  moist  and  putrescent  soil, 
which  was  carried  into  the  body  by  the  medium  of  water  or  of  air.  But  the 
later  views  of  Klebs  and  Tommasi-Crudeli  attribute  it  to  a  low  organism  of 
the  nature  of  Bacillus,  to  which  they  have  given  the  name  Bacillus  malarice, 
propagated  in  the  presence  of  decaying  vegetable  matter. 

If  the  ingestion  is  by  water,  a  fresh  source  must  be  obtained.  Well- 
water  is  generally  safe,  but  not  always.  Eain-water  may  be  unsafe,  if  the 
tanks  are  not  clean. '  If  a  fresh  source  cannot  be  obtained,  boiling,  filtra- 
tion, and  alum  appear  to  be  the  best  preventive  measures,'^ 

If  the  introduction  be  by  air,  and  if  the  locality  cannot  be  left,  the  most 
approved  plan  is  elevation  to  at  least  500  feet  above  the  source  of  the  poison 

'  For  an  instance  of  propagation  Tby  so-called  rain-water,  see  cases  at  Tilbury  Fort, 
Volume  I.,  page  49. 

^  Dr.  Blanc  and  Mr.  Prideaux  preserved  themselves  from  intermittent  fever,  in  a 
march  in  Abyssinia,  by  always  using  water  in  the  form  of  tea  or  coffee. 
Vol.  II.— 9 


130  PRACTICAL    HYGIENE. 

in  temperate  climates  ;  and  1,000  to  1,500  feet  in  the  tropics,  or  higher  still, 
if  ix)ssible.'  If  this  phiu  camiot  be  adopted,  two  jjoints  must  be  aimed  at 
— \'iz.,  to  obviate  local,  and  to  avoid  daifting  malaria.  Thorough  subsoil 
draining  ;  filling  up  moist  gi'ound  when  j^racticable  ;  pacing  or  coveriug 
the  ground  -nith  herbage  kept  closely  cut,  are  the  best  plans  for  the  first 
point.  For  the  second,  belts  of  trees,  even  walls  can  be  interposed  ;  or 
houses  can  be  so  built  as  not  to  present  ojDenings  toward  the  side  of  the 
malarious  cun-ents. 

The  houses  themselves  should  be  raised  above  the  gi'ouud  on  arches  ; 
or,  if  wooden,  on  piles.  Uj^per  floors  only  should  be  occupied.  The  early 
morning  air,  for  thi-ee  houi-s  after  sunrise,  should  be  avoided  ;  and  next  to 
this,  night  air. 

IiUernal  Causes. — The  conformation,  or  structui'al  condition,  which 
pei-mits  the  external  cause  to  act,  is  e"S"idently  not  equal  in  different 
individuals,  or  in  different  races  ;  but  we  ai-e  quite  ignorant  of  its  natvu-e. 
It  is  not  removed  by  attacks  of  the  disease  ;  but,  on  the  contraiy,  after  re- 
peated attacks  of  ague,  a  pecuhar  condition  is  produced,  in  which  the  dis- 
ease can  be  brought  on  by  causes,  such  as  cold  or  dietetic  eiTors,  which 
could  never  have  caused  it  in  the  first  instance.  The  internal  predisposi- 
tion is  gi-eatly  heightened  by  poor  feeding,   anaemia,   and   jn-obably   by 

SCUVYJ. 

To  remove  the  internal  causes  our  only  means  at  present  are  the 
administration  of  antiperiodics,  especially  quinine  ;  and  good  and  gen- 
erous hving,  with  ii'on  medicines.  The  use  of  flannel  next  the  skin,  and 
of  warm  clothing  generally ;  waiTu  coffee,  and  a  good  meal  before  the  time 
of  exjDosiu-e  to  the  malaria,  and  perhajDS  moderate  smoking  (?),  are  the 
other  chief  measures.  "Wine  in  modei'ation  is  part  of  a  generous  diet ; 
but  spirits  are  useless,  and  probably  hurtful,  unless  given  considerably 
dilute  d. 

Yelloiv  Fever. 

External  Cause. — Dui-ing  the  last  few  years  the  progress  of  inquiry  has 
entirely  disconnected  ti-ue  yellow  fever  from  malaria,  though  yellowness  of 
the  skin  is  a  symptom  of  some  malarious  fevers.  Yellow  fever  is  a  disease 
of  cities  and  of  parts  of  cities,  being  often  singidarly  localized,  hke  cholera. 
In  the  "West  Indies  it  has  repeatedly  attacked  a  bairack  (at  Bermuda, 
Trinidad,  Bai-badoes,  Jamaica),  while  no  other  place  in  the  whole  island 
was  affected.  In  the  same  way  (at  Lisbon,  Cadiz,  and  many  other  places) 
it  has  attacked  only  one  section  of  a  town,  and,  occasionally,  like  cholera, 
only  one  side  of  a  street.  In  the  "West  Lidies,  it  has  repeatedly  commenced 
in  the  same  pari  of  a  baiTack.  In  all  these  jjoints,  and  in  its  frequent  oc- 
ciu'rence  in  non-malarious  places,  in  the  exemption  of  highly  malarious 
places,  in  its  want  of  relation  to  moistm-e  in  the  atmosphere,  and  its  as  evi- 
dent connection  with  putrefying  fecal  and  other  animal  matters,  its  cause 
differs  entirely  from  malaria.^ 

If  these  points  were  not  sufficient,  the  fact  that  the  agent  or  poison 
■which  causes  yellow  fever  is  portable,  can  be  carried  and  introduced  among 

'  It  must  be  understood  that  these  heights  are  assumed  to  be  abore  a  marsh.  They 
will  not  secure  from  malaria  from  marshes,  if  situated  at  tliat  or  a  much  greater  height. 
A  marsh  at  Erzeroum  is  6,()0U  feet  above  sea- level ;  one  at  Puebla,  in  New  Mexico,  is 
5,00U  feet ;  both  cause  fevers. 

'-'  The  belief  in  the  malarious  origin  of  yellow  fever,  so  long  and  tenaciously  held 
by  many  American  physicians,  seems  to  be  losing  ground.  (See  paper  by  Dr.  Ferry, 
read  before  the  American  Health  Association,  The  Daily  Picayune,  November  23,  1873.) 


PKEVENTION    OF    DISEASE.  131 

a  community, '  and  is  increased  in  the  bodies  of  those  whom  it  attacks,  in- 
dicates that  the  two  agencies  of  yellow  fever  and  paroxysmal  fevers  are 
entirely  distinct.^ 

That  great  point  being  considered  settled,  the  inquity  into  the  condi- 
tions of  the  spread  of  yellow  fever  becomes  easier.  The  points  to  seize 
are  its  frequent  and  regular  localization  and  its  transportation.  The  locali- 
zation at  once  disconnects  it  from  any  general  atmospheric  wave  of  poison  ; 
it  is  no  doubt  greatly  influenced  by  temperature,  and  is  worse  when  the 
temperature  is  above  70°  Fahr.  Though  it  wih  continue  to  spread  in  a 
colder  air  than  was  formerly  supposed,  it  does  not  spread  rapidly,  and  ap- 
pears to  die  out ;  but  even  temperature  does  not  cause  it  to  become  gen- 
eral in  a  place. 

The  localizing  causes  are  evidently  (cases  of  Lisbon,  Gibraltar,  West 
Indies,  etc.)  connected  with  accumulation  of  excreta  round  dwellings,  and 
overcrowding.  Of  the  former  there  are  abundant  instances,  and  it  is  now 
coming  out  more  and  more  clearly  that,  to  use  a  convenient  phrase,  yel- 
low fever,  like  cholera  and  typhoid  fever,  is  a  fecal  disease.  And  here  we 
find  the  explanation  of  its  localization  in  the  West  Indian  barracks  in  the 
olden  time.  Eound  every  barrack  there  were  cesspits,  often  open  to  sun 
and  air.  Every  evacuation  of  healthy  and  sick  men  w^as  thrown  into  per- 
haps the  same  places.  Grant  that  yellow  fever  was  somehow  or  other  in- 
troduced, and  let  us  assume  (what  is  highly  pi'obable)  that  the  vomited 
and  fecal  matters  spread  the  disease,  and  it  is  evident  why,  in  St.  James' 
Barracks  at  Trinidad,  or  St.  Ann's  Barracks  at  Barbadoes,  men  were  dying 
by  dozens,  while  at  a  little  distance  there  was  no  disease.  The  prevalence 
on  board  ship  is  as  easily  explained.  Granted  that  yellow  fever  is  once 
imjDorted  into  the  ship,  then  the  conditions  of  spread  are  probably  as  fa- 
vorable as  in  the  most  crowded  city ;  planks  and  cots  get  impregnated  vsdth 
the  discharges,  which  may  even  find  their  way  into  the  hold  and  bilge. 
No  one  who  knows  how  difficult  it  is  to  help  such  impregnation  in  the  best 
hospitals  on  shore,  and  who  remembers  the  imperfect  ai-rangements  on 
board  ship  for  sickness,  will  doubt  this.  Then,  in  many  shijjs,  indeed  in 
almost  all  in  unequal  degrees,  ventilation  is  most  imperfect,  and  the  air 
is  never  cleansed. 

Overcrowding,  and  what  is  equivalent,  defective  ventilation,  is  another 
great  auxiliary  ;  and  Bone  ^  relates  several  striking  instances.^ 

'  Cases  of  the  Bann,  Eclair,  Icarus,  and  several  others.  The  remarkable  introduc- 
tion of  yellow  fever  from  Havana  into  St.  Nazaire,  in  France  (near  Brest),  is  most 
striking,  and  cannot  be  explained  away.  It  spread  both  from  the  ship,  and.  in  one 
instance,  from  persons.  (See  Aitken's  Medicine,  7th  edit. ,  1880 ;  and  Report  on  Hy- 
giene for  1862,  in  the  Army  Medical  Report,  by  Dr.  Parkes.)  The  introduction  into 
Rio  in  1849,  and  into  Monte  Video,  are  still  more  striking  cases  of  importation  ;  and  a 
case  very  similar  to  that  of  St.  Nazaire  occurred  some  years  ago  at  Swansea.  (See  Re- 
port (by  Dr.  Buchanan)  to  the  Medical  Officer  of  the  Privy  Council,  1866.) 

^  As  more  care  is  taken,  the  symptoms  of  the  two  diseases  also  are  found  to  be  diag- 
nostic, and  if  it  were  not  for  the  constant  use  of  the  unhappy  term  '"remittent,"  the 
confusion  would  not  have  so  long  prevailed. 

An  interesting  instance  of  good  diagnosis  was  made  by  the  French  at  Vera  Cruz  in 
1861.  In  the  spring  the  vomito  prevailed,  and  then  disappeared.  Some  months  after- 
ward, cases  of  a  disease  occurred  so  like  yellow  fever  that  they  were  at  first  taken  to 
be  that  disease,  but  on  a  closer  examination  they  were  found  to  be  clearly  paroxysmal, 
and  to  yield  to  quinine. — Rec.  de  Mem.  de  Med.  Milit.,  1868. 

2  Yellow  Fever,  by  G-.  F.  Bone,  Assistant,  Surgeon  to  the  Forces. 

*  For  example,  in  the  same  barrack,  the  windward  rooms  have  been  quite  healthy, 
and  the  leeward  rooms  attacked.  Men  in  the  latter  have  ceased  to  have  cases  of  the 
disease  when  moved  to  the  former  locality.     (See  a  good  case  in  Bone,  op.  cit.,  p.  13.) 


132  PRACTICAL    HYGIENE. 

The  question  of  the  origin  of  yellow  fever  is  one  which  cannot  be  con- 
sidered in  this  work,  and  at  present  no  preventive  rules  of  importance 
can  be  drawn  from  the  discussion. 

The  chief  preventive  measures  for  the  external  cause  ai-e  these  : — 

1.  The  portability  being  proved,  the  gi-eatest  care  should  be  taken  to 
prevent  introduction,  either  by  sick  men,  or  by  men  who  have  left  an  in- 
fected ship.  The  case  of  the  Anne  Marie  '  has  made  it  quite  uncertain 
what  period  of  time  should  have  elajDsed  before  an  infected  ship  can  be 
considered  safe  ;  in  fact,  it  probably  cannot  be  safe  until  the  cai'go  has 
been  discharged  and  the  ship  thoroughly  cleansed.  Still,  it  appears,  that 
if  men  leaving  an  infected  place  or  ship  pass  into  places  well  ventilated 
and  in  fair  sanitary  condition,  they  seldom  carry  the  disease ;  in  other  words, 
the  disease  is  seldom  portable  by  men,  but  it  will  occur.  It  appears  neces- 
sary, also,  to  consider  that  the  incubative  period  is  longer  than  usually 
supposed,  probably  often  fourteen  or  sixteen  days.  In  the  case  of  a  ship, 
it  seems  desirable  not  to  consider  danger  over  imtil  at  least  twenty  days 
have  elapsed  since  the  cure  or  death  of  the  last  case,  and  even  at  that  time 
to  thoioughly  fumigate  the  ship  with  chlorine  and  nitrous  acid  before  the 
cargo  is  touched.  Men  Avorkiug  on  board  such  a  ship  should  work  by  re- 
lays, so  as  not  to  be  more  than  an  hoiu-  at  a  time  in  the  hold," 

In  case  men  sick  with  yellow  fever  must  be  received  into  a  barrack  or 
hospital,  they  should  be  isolated,  placed  in  the  best  ventilated  rooms  at  the 
top  of  the  house,  if  possible,  or,  better  still,  in  separate  houses,  and  all  dis- 
charges mixed  with  zinc  sul^Dhate  and  zinc  chloride,  and  separately  disposed 
of,  and  not  allowed  to  pass  into  any  closet  or  latrine. 

2.  The  introduction  by  drinking-water  not  being  disproved,  care  should 
be  taken  that  the  possibility  of  this  mode  of  introduction  be  not  over- 
looked. 

3.  Perfect  sewerage  and  ventilation  of  any  station  would  probably  in 
great  measure  preserve  fi'om  yellow  fever,  but  in  addition,  in  the  yellow 
fever  zone,  elevation  is  said  to  have  a  very  great  effect,  though  the  confusion 
between  malarious  fevers  and  the  vomito  renders  the  evidence  on  this  point 
less  certain,  and  its  introduction  into  Newcastle  in  Jamaica  (4,200  feet), 
and  itsfi'equent  occurrence  at  Xalapa  (4:,330  feet),  as  well  as  its  prevalence 
on  high  points  of  the  Andes  (9,000  feet)  (A.  Smith),  show  that  the  effect  of 
mere  elevation  has  been  overrated.  Still,  as  a  matter  of  precaution,  stations 
in  all  yellow  fever  districts  should  be  on  elevations  above  2,000,  and  if  j)ossi- 
ble  3,000  feet. 

4.  If  an  outbreak  of  yellow  fever  occiu'  in  a  barrack,  it  is  impossible 
then  to  attempt  any  cleansing  of  sewers  ;  the  only  plan  is  to  evacuate  the 
barracks.  This  has  been  done  many  times  in  the  West  Indies  with  the 
best  effects.  As  a  preventive  measure,  also,  evacuation  of  the  barracks, 
and  encamjiment  at  some  little  distance,  is  a  most  useful  plan.  Before  the 
barrack  is  I'eoccupied,  every  possible  means  should  be  taken  to  cleanse  it ; 
sewers  should  be  thoroughly  Hushed  ;  walls  scraped,  limewashed,  and  fu- 
migated with  nitrous  acid.  If  a  barrack  cannot  be  altogether  abandoned, 
the  gi'ound  floors  should  be  disused.  There  are  several  instances  in 
which  persons  living  in  the  lowest  story  have  been  attacked,  while  those 
above  have  escaped. 

'  See  Aitken's  Medicine,  and  Report  on  Hjgiene  in  the  Army  Medical  Report  for 

^  Dr.  Perry  (op.  cit.)  considers  quarantine  useless,  and  advises  a  most  rigorous  sys- 
tem of  disinfection.  He  cites  eight  instances  of  the  introduction  of  yellow  fever  through 
a  strict  quarantine,  seven  to  New  Orleans,  and  one  to  Pensacola. 


PEEVENTION    OF    DISEASE.  133 

5.  In  all  buildings  where  sick  are,  or  where  yellow  fever  prevails,  there 
should,  be  constant  fumigation  with  nitrous  acid,  which  seems  to  be,  as  far 
as  we  know,  the  best  disinfectant  for  this  disease. 

6.  If  it  appeal's  on  board  ship,  take  the  same  precautions  ■v\ith  regard 
to  evacuations,  bedding,  etc.  Treat  all  patients  in  the  open  air  on  deck,  if 
the  weather  permit  ;  run  the  ship  for  a  colder  latitude  ;  land  all  the  sick  as 
soon  as  possible,  and  cleanse  and  fumigate  the  ship. 

Internal  Cause. — Recent  arrival  in  a  hot  country  has  been  usually  as- 
signed as  a  cause,  but  the  confusion  between  true  yellow  fever  and  severe 
febricula  (ardent  fever  or  causus)  and  malarious  fevers,  renders  it  un- 
cei-tain  how  far  this  cause  operates. '  Still,  as  a  matter  of  precaution,  the 
present  plan  of  three  or  four  years'  MediteiTanean  seiwice  before  pafesing 
to  the  West  Indies  seems  desirable,  although  this  has  been  questioned  by 
some  experienced  officers.  Difterent  races  possess  the  peculiar  habit  which 
allows  the  external  cause  to  act  in  veiy  different  degi'ees  ;  this  is  marked 
in  the  cases  of  negroes  and  muJattoes  as  compared  with  white  men,  but  even 
in  the  European  nations  it  has  been  supposed  that  the  northern  are  more 
subject  than  the  southern  nations.  Of  the  sexes,  women  are  said  to  be  less 
liable  than  men. 

This  predisposition  is  increased  by  fatigue,"  and  it  is  said,  especially 
when  combined  -mih.  exposui'e  to  the  sun  ;  by  drinking,  and  by  improper 
food  of  any  kind  which  lowers  the  tone  of  the  body. 

No  prophylactic  medicine  is  known  ;  quinine  is  quite  useless. 

Little,  therefore,  can  be  done  to  avert  the  internal  causes,  except  care 
in  not  undergoing  gi-eat  fatigue,  temperance,  and  proper  food.  The  exter- 
nal conditions  are  the  most  imj^ortant  to  attend  to. 

Dengue. 

This  disease,  which  has  attracted  much  attention  of  late  years,  appears 
to  bear  some  relation  to  yellow  fever,  not  in  its  pathological  characters,  but 
in  the  time  of  its  ajDpearance  and  geographical  distribution.  It  has,  how- 
ever, prevailed  in  Asia,  where  yellow  fever  has  hitherto  been  unknown.  In 
Egypt  (according  to  Vauvray)  it  is  seen  at  the  time  of  the  date-harvest,  and 
is  known  as  "  date  fever."  In  other  parts  of  the  world  it  has  been  attributed 
to  vegetable  emanations.  Although  its  symptoms  are  those  of  blood- 
poisoning,  it  may  be  doubted  if  this  is  due  to  vegetable  emanations  only. 
Dr.  J.  Christie  ^  thinks  that  the  Deng-ue  of  the  Eastern  and  the  Dandy 
fever  of  the  Western  Hemisphere  are  varieties  of  the  same  disease,  pro- 
duced in  the  one  case  by  the  virus  of  yellow  fever,  and  in  the  other  by  that 
of  cholera,  modified  by  local  conditions  of  an  insanitary  kind,  chiefly  de- 
composition of  bodies  improperly  interred.  He  suggests  general  hygienic 
measm-es,  and  especially  improved  methods  of  burial,  as  the  best  preven- 
tives. 

'  In  the  old  times  in  Jamaica  it  was,  ho-n-ever,  always  noticed  that  the  worst  attacks 
occurred  in  regiments  during  the  first  twenty-four,  and  especially  the  first  twelve 
months.  In  thirteen  epidemics  in  different  regiments,  four  occurred  in  less  than  six 
months  after  landing,  seven  in  less  than  twelve  months,  and  two  in  less  than  twenty- 
four  months.  But  it  has  been  stated  that  residence  in  one  place,  though  it  may  secure 
against  the  yellow  fever  of  that,  does  not  protect  against  the  disease  in  another  locality. 
It  is  much  to  be  wished  that  all  these  assertions  which  abound  in  books  should  be 
tested  by  figures.     That  is  the  only  way  of  coming  to  a  decision. 

-  Arnold,  Bilious  Remittent  Fever,  "1840,  p.  82. 

^  Transactions  of  the  International  Medical  Congress,  1882,  vol.  iv.,  p.  636. 


134  PRACTICAL    HYGIENE. 


Cholera. 

External  Cause. — As  in  the  case  of  yellow  fever,  we  have  no  cei-tain  clue 
to  the  origin  of  cholera,'  and  in  some  respects  the  propagation  of  the  dis- 
ease is  veiy  enigmatical.  The  way,  for  example,  in  whicli  the  disease  has 
sjDread  over  vast  regions,  and  has  then  entirely  disappeared)^  and  the  mode 
in  which  it  seems  to  develop  and  decline  in  a  locality,  in  a  sort  of  regular 
order  and  at  certain  seasons,  are  facts  which  we  can  only  imjDerfectly  ex- 
plain. 

But  as  far  as  preventive  measures  are  concerned,  the  researches  of  late 
yeai's  seem  to  have  given  us  indications  on  which  we  are  bound  to  act, 
though  they  ai'e  based  only  on  a  partial  knowledge  of  the  laws  of  spread 
of  this  poison. 

These  indications  are — 

1.  The  portabihty  of  the  disease,  i.e.,  the  carriage  of  cholera  from  one 
place  to  another  by  persons  ill  with  the  disease,  both  in  the  earliest  stage 
(the  so-called  premonitory  diarrhoea),  and  the  latter  period,  and  in  conva- 
lescence.^ The  caiTiage  by  healthy  persons  coming  from  infected  districts  is 
not  so  certain  ;  but  there  is  some  evidence.^  It  is  clear  this  last  point  is  a 
most  important  one,  in  which  it  is  desirable  to  have  more  complete  evidence. 
The  occasional  can-iage  by  soiled  clothes,  though  not  on  the  whole  common, 
has  also  evidence  in  its  favor.  All  these  points  were  affirmed  by  the 
Vienna  Conference  of  1874.  Even  Pettenkofer  admitted  that  inan  is  the 
carrier  of  the  disease  germ,  although  the  locality  may  be  the  means  of 
rendering  it  potent.  On  the  other  hand,  Dr.  J.  M.  Cuningham  ''  makes 
a  tabula  I'asa  of  eveiwthing,  denies  the  transportabihty  of  the  disease  either 
by  persons  or  by  water,  and  says  there  is  a  mysterious  factor  still  to  be 
sought  for.     His  evidence,  however,  cannot  be  considered  as  conclusive. 

WTiatever  may  be  the  final  opinion  on  all  these  points,  we  are  bound  to 
act  as  if  they  were  j^erfectly  ascertained.  It  is  usually  impossible  to  have 
rigid  quarantines  ;  for  nothing  short  of  absolute  non-communication  would 
be  useful,  and  this  is  impossible  except  in  exceptional  cases.  For  persons 
very  shghtly  ill,  or  who  have  the  disease  in  them  but  are  not  yet  ajDparent- 
ly  ill,  or  possibly  who  are  not  and  ^-ill  not  be  ill  at  aU,  can  give  the  disease, 
and  therefore  a  selection  of  dangerous  persons  cannot  be  made.  Then  as 
the  incubative  stage  can  certainly  last  for  ten  or  twelve  days,  and  there  are 
some  good  cases  on  record  where  it  has  lasted  for  more  than  twenty,  it  is 
clear  that  quarantine,  unless  enforced  for  at  least  the  last  period  of  time, 

'  The  researches  of  Lewis  and  D.  D.  Cunningham  in  India,  and  of  Eberth,  of 
Zurich  (Zur  Kenntniss  der  Bacteritischen  Mvkosen,  von  J.  C.  Eberth,  1873),  have 
shown  that  no  specific  germ  has  been  yet  discovered,  and  have  disproved  the  fungoid 
and  other  origins  proposed  bv  Hallier,  etc. 

'^  There  is,  of  course,  no  doubt  that  the  common  autumnal  cholera,  however  much 
it  may  resemble  superficially  the  Indian  cholera,  is  quite  a  separate  disease. 

^  With  respect  to  convalescence,  the  only  evidence  is  apparently  that  given  by  Tolz, 
quoted  by  Hirsch,  Jahresb.  fiir  ges.  Med.,  1868,  Band  ii.,  p.  221. 

*  Especially  in  the  Mauritius  outbreaks,  where  parties  of  coolies  coming  from  places 
where  cholera  prevailed,  but  being  themselves  healthy,  gave  cholera  to  other  parties  of 
coolies  who  had  arrived  from  India,  and  had  no  disease  among  them.  Dr.  Leith 
Adams  (Army  Medical  Report,  vol.  vi.,  p.  348),  in  his  excellent  Report  on  Cholera  in 
Malta,  states :  "  There  are  many  pointed  facts  to  show  that  cholera  may  be  introduced 
and  communicated  to  susceptible  persons  by  healthy  individuals  from  iufected  dis- 
tricts. " 

*  Ninth  Annual  Report  of  the  Sanitary  Commissioner  with  the  Government  of 
India. 


PEEVENTIOIT    OF   DISEASE.  135 

may  be  useless.  The  constant  eyasions  also  of  the  most  strict  cordon  render 
such  plans  always  useless.  An  island,  or  an  inland  village,  far  removed 
from  commerce,  and  capable  for  a  time  of  doing  w^ithout  it,  may  practise 
quarantine  and  preserve  itself ;  but,  in  other  circumstances,  both  theory 
and  actual  experience  show  that  quarantine  fails.*  M.  Fauvel  ^  believes 
that  the  quarantine  measures  adopted  in  the  Red  Sea  have  been  instrumen- 
tal in  preventing  the  spread  of  cholera  to  Europe  on  three  separate  oc- 
casions, namely,  1872,  1877,  and  1881. 

This  difficulty,  however,  of  carrying  out  efficient  isolation  is  no  argument 
against  taking  every  precaution  against  communication,  and  keeping  a 
strict  watch  and  control  over  every  possible  channel  of  introduction.  In 
this  waj^,  by  isolation  of  the  individual,  or  of  bodies  of  men,  as  far  as 
possible,  and  by  looking  out  for  and  dealing  with  the  earliest  case,  an  out- 
break may  perhaps  be  checked,  especially  by  discovering  the  diarrhoeal 
attacks,  and  by  using  disinfectants  both  to  the  discharges  and  to  linen.^ 
In  the  case  of  troops  coming  from  infected  districts  they  should  be  kept 
in  separate  buildings  for  twenty  days,  and  ordered  to  use  only  the  latrines 
attached  to  them,  in  which  disinfectants  should  be  freely  used. 

2.  The  introduction  of  the  disease  into  any  place  by  j)ersonsis  considered 
by  most  observers  to  be  connected  with  the  choleraic  discharges,  either 
when  newly  passed,  or,  according  to  some,  when  decomposing.  The 
reasons  for  this  are  briefly  these  :  the  portability  being  certain,  the  thing 
carried  is  more  likely  to  be  in  the  discharges  from  the  stomach  and  bowels 
than  from  the  skin  or  breath  (the  urine  is  out  of  the  question),  and  for 
these  reasons  :  Water  can  communicate  the  disease,  and  this  could  only  be 
by  contamination  with  the  discharges  ;  water  contaminated  by  discharges 
has  actually  given  the  disease,  as  in  Dr.  Macnamara's  cases  ;  in  some  cases 
a  singTilarly  local  origin  is  proved,  and  this  is  nearly  always  a  latrine,  sewer, 
or  receptacle  of  discharges,  or  a  soil  impregnated  with  choleraic  evacuations  ; 
soiled  linen  has  sometimes  given  it,  and  this  is  far  more  likely  to  be  from 
discharges  than  from  the  perspiration  ;  animals  (white  mice  and  rabbits) 
have  had  cholera  produced  in  them  from  feeding  on  the  di'ied  discharges. 
Finally,  in  the  history  of  the  portability  of  cholera,  there  are  many  in- 
stances in  which,  while  there  has  been  decided  introduction  by  a  diseased 
person  into  a  place,  there  has  been  no  immediate  relation  between  that 
person  and  the  next  case  ;  in  other  words,  the  cause  must  be  completely 
detachable  from  the  first  case,  and  must  be  able  to  act  at  a  distance  from 
his  body  ;  it  is  therefore  far  more  probable  that  the  discharges  are  this 

'  When  circumstances  are  favorable  (as  respects  trade  and  intercourse),  however, 
good  quarantine  may  be  successful  even  on  the  mainland.  This  was  shown  in  Algeria 
in  1861.  See  Dr.  Dukerley's  Notice  sur  les  Mesures  de  Preservation  prises  a.  Batna 
(Algerie)  pendant  le  Cholera  de  1867,  Paris,  1868,  for  a  very  interesting  account  of 
those  successful  measures  of  which  strict  isolation  and  constant  hygienic  measures  were 
the  principal.  So  also  in  America,  Dr.  Woodward  states  (Circular  on  Cholera,  No.  5, 
Surgeon-General's  Oflce,  Washington,  1867)  that  "the  general  tenor  of  army  experience 
is  strongly  in  favor  of  quarantine."  Quarantine  on  land  was  condemned  by  the 
Vienna  Conference,  but  recommended  on  the  Red  Sea  and  the  Caspian.  In  Europe, 
however,  only  rigorous  inspection  was  recommended,  with  various  rules  for  preventing 
spread  as  much  as  possible. 

■■^  Revue  d'Hygiene,  vol.  iv.,  1882,  p.  754. 

^  The  Indian  Government  are  now  cautiously  attempting  to  limit  the  spread  of 
cholera  by  superintending  and  controlling  the  pilgrimages,  which  are  so  common  a 
cause  of  the  spread  of  cliolera  in  India.  The  Report  of  the  Cholera  Committee  (In- 
spector-General Mackenzie,  Colonel  Silva,  and  Dr.  Ranking)  to  the  Madras  Government, 
published  at  Madras  in  1868,  gives  a  great  deal  of  important  evidence  on  this  point, 
and  in  addition  lays  down  excellent  rules  for  the  management  of  pilgrimages. 


136  PRACTICAL    HYGIENE. 

carrying  agency,  tlian  that  any  effluvia  should  pass  off  from  the  lungs  and 
skin  which  could  spread  to  a  great  distance. 

Enough  has  been  said  to  show  that  the  discharges  must  receive  the  most 
careful  attention.  Every  discharge  ought  to  he  disinfected  with  strong 
substances  liberally  used  ;  the  best  are  carbolic  acid  (in  large  quantity), 
perchloride  of  iron,  chloride  of  zinc,  chloride  of  lime,  or,  if  none  of  these 
are  at  hand,  good  quicklime.  Although  the  results  of  disinfection  of  the 
discharges  have  not  hitherto  been  encouraging,  the  plan  has  seldom  been 
completely  tried.  All  latrines  should  be  disinfected,  sewers  flushed,  car- 
bolic acid  poured  down  them,  and  every  means  taken  to  keep  them  ven- 
tilated. 

What  should  be  done  with  the  disinfected  discharges?  Should  they  be 
allowed  to  j)ass  into  sewers,  or  buried  in  the  ground  ?  They  must  in  some 
way  be  got  rid  of.  Sewers  certainly  afford  an  easy  mode  of  disposing  of 
them  ;  and  as  the  discharges  are  mixed  with  much  watex',  and  are  rapidly 
swept  away  in  them,  and  as  the  temperature  of  the  sewers  is  low,  and 
decomposition  is  delayed,  it  is  quite  possible  that  sewers  may  be  a  means  of 
freeing  a  town  from  choleraic  discharges  more  easily  than  any  other  jDlan. 
And  it  appears  to  be  a  fact,  that  in  the  well-sewered  towns  in  England  the 
cholera  of  1865  and  18G6  never  attained  any  wide  spread.  In  Munich,  in 
the  cholera  epidemic  of  1873,  the  well-sewered  parts  of  the  town  had  only 
one-half  the  sickness  and  mortality  of  the  others,  which  were  either  im- 
perfectly drained  or  not  at  all. '  In  large  towns,  also,  there  are  no  other 
means  of  disposing  of  the  discharges.  But  may  not  sewers  be  a  means  of 
dissemination,"  and  thus,  as  in  some  outbreaks  of  enteric  fever,  be  a  source 
of  danger  ?  And  again,  when  sewerage  is  poured  over  land,  as  it  will  be 
soon  throughout  all  England,  are  we  quite  sure  that  no  choleraic  effluvia 
will  pass  off,  or  that  the  choleraic  particles  passing  into  the  ground  may 
not  develop  there,  as  Pettenkof er  supposes  is  the  case  ?  There  are  no  facts 
to  enable  us  to  decide,  but  the  possibility  of  mischief  arising  in  this  way 
should,  at  any  rate,  make  us  still  more  urgent  in  the  use  of  disinfectants 
to  all  discharges. 

Again,  as  to  disposal  in  the  earth,  if  Pettenkofer  is  correct,  that  a  loose 
moist  earth  is  the  place  where  the  supposed  germ  of  cholera  acquires  its 
powei',  the  last  place  we  should  put  a  choleraic  discharge  would  be  the 
earth  ;  and  there  would  be  even  an  argument  against  the  use  of  the  earth 
plan  of  deaUng  with  sewage.  Still,  as  there  is  much  to  be  said  against 
Pettenkofer's  views,  and  as  in  small  towTis  and  villages  there  is  only  the  al- 
ternative of  allowing  the  discharges  to  pass  mto  cessj^ools  or  streams,  or  to 
be  disposed  of  in  the  earth,  it  wovald  seem  to  be  the  safest  course  to  deeply 
bury  all  disinfected  discharges,  cai-e  being  taken  to  place  them  at  a  distance 
from  houses  and  from  sovu'ces  of  water  supply.  Another  plan  would  be 
to  mix  them  with  sawdust  and  burn  them. 

That  hnen  and  bedding  should  be  carefully  disinfected,  needs  no  argu- 
ment. In  some  English  towns  all  cholera  clothing  has  been  burnt,  but 
whether  this  measui'e  is  necessary  or  not  is  uncertain.  But  thorough  steep- 
ing and  boiling  befoi'e  washing  is  essential,  as  Avasherwomen  have  certainly 
suffered  in  many  cases. 

3.  The  introduction  of  the  agent  by  the  medium  of  the  air  is  generally 

»  Soyka,  Deutsche  Viertlj.  f.  OS.  Ges.,  Band  xiv.,  Heft  1,  p.  54,  1883. 

^  That  these  may  be  so,  in  a  particular  way,  was  shown  to  be  probable  in  Dr.  Parkes' 
Report  on  Cholera  in  Southampton  (Sixth  Report  of  the  Medical  Officer  to  the  Privy 
Council,  p.  251) ;  but  still  there  is  very  little  evidence  on  this  point. 


PREVENTION    OF    DISEASE.  137 

admitted,  on  the  plea  that  cases  occur  in  wliich  any  other  mode  of  entrance 
is  impossible.  It  is  also  held  by  some  that,  existing  in  the  aii-,  it  can  be  car- 
ried for  great  distances  by  winds  ;  and  some  observers  indeed  beheve  this 
to  be  its  usual  mode  of  transit,  though  this  opinion  appears  opposed  to  all 
we  know  of  its  spread. 

Without  attempting  to  decide  the  point  or  to  state  the  limits  of  the 
transmission,  it  is  a  matter  of  piiidence  to  act  as  if  the  winds  did  cany  the 
poison.  The  Indian  inile  is  to  march  at  right  angles  to  the  wind,  and 
never  against  it  or  with  it  if  it  can  be  avoided.  The  spreading  by  the  winds 
in  India  has  been  usually  ascribed  to  the  custom  of  throwing  all  the  cholera 
evacuations  on  the  ground  ;  there  they  get  di-ied,  and  then  are  lifted  by  the 
wind  and  driven  to  other  parts.  This  seems  probable,  but  no  decided 
proof  has  been  given  ;  and  an  argument  against  it  may  be  raised  on  the 
difficulty  of  accounting  for  the  immunity  of  adjacent  places  if  such  trans- 
mission were  common.  So  also  the  use  of  aerial  disinfectants  in  cholera  is 
rendered  imperative  by  the  chance  that  the  cause  may  be  in  the  air.  The 
use  of  sulphiu'  fires  has  been  advocated  and  tried  in  India,  apjoarently  with 
good  effect  (Crerax-).  The  Vienna  Conference  affirmed  transmission  by  the 
au',  but  only  to  a  short  distance,  and  never  faster  than  man  travels.  They 
also  recognized  the  great  safeguard  aiforded  by  deserts,  as  the  disease  has 
never  been  known  to  be  imported  into  Egypt  or  Spia  across  the  desert  by 
caravans  from  Mecca.' 

4.  The  occasional,  perhaps  frequent,  introduction  by  water  seems  cer- 
tain. It  was  unanimously  affirmed  at  the  Vienna  Conference,  even  by 
Pettenkofer,  who  has,  however,  since  abandoned  this  view.  It  is  a  good 
plan  always  to  change  the  source  of  supply,  to  use  rain-water  if  no  other 
fresh  soiu'ce  is  procurable  ;  and  in  eveiw  case  to  boil,  and  filter,  and  to  use 
also  potassium  permanganate.'  It  remains  yet  uncertain  whether  a  water 
which  gives  cholera  is  always  chemically  impure,  or  whether  the  choleraic 
matter  may  be  in  so  small  a  quantity  as  to  be  absolutely  indetectable.  In 
the  two  cases  examined  by  Dr.  Parkes  in  which  the  water  was  the  cause, 
it  was  highly  impure.  In  India  it  is  now  ordered  that  all  the  water  should 
be  boiled.^ 

5.  The  introduction  by  food  has  been  noted  in  some  cases  (although 
the  Vienna  Conference  decided,  by  11  to  7,  that  present  facts  do  not  warrant 
a  decision).  Every  article  of  food,  soUd  and  liquid,  should  therefore  be 
passed  in  review,  and  the  cooking  arrangements  gone  over  step  by  step.^ 

'  On  this  point  the  history  of  Chili  is  interesting,  as  cholera  has  never  reached  it. 
It  is  separated  on  the  north  from  Peru  bv  the  desert  of  Attacama,  and  from  the  Argen- 
tine Confederation  on  the  east  bv  the  Andes  range,  to  Tvhich  circumstances  its  im- 
munity hitherto  from  epidemic  diseases  has  been  ascribed  by  the  inhabitants. 

-  In  the  very  able  Report  on  Epidemic  Cholera  in  the  United  States  Army  (Circular 
No.  5,  War  Department ;  Surgeon-General's  Office,  Washington),  is  -wliat  appears  to  be 
a  good  instance  of  the  effect  of  changing  the  supply.  At  Ne\y  Orleans  rain,  and  in 
some  cases  distilled  -water,  was  supplied  instead  of  river  water,  with  the  apparent  effect 
of  checking  the  spread  (p.  xvii.j;  see  also  the  cases  of  Utrecht  and  Rotterdam,  as  re- 
ported by  Buys-Ballot. 

^  G.  O.  C.  C,  No.  192,  clause  53.  Forster,  of  Breslau  (Die  Verbreitung  der  Cholera 
durch  die  Brunnen,  1873),  urges  two  recommendations  which  he  thinks  will  prevent 
cholera  in  the  future— 1st,  Lead  to  every  town,  even  if  at  great  cost,  abundant  and  pure 
water,  as  indeed  was  done,  he  says,  much  better  2.000  years  ago  than  now.  2d,  Protect 
the  ground  from  contamination  in  any  way  from  excrement,  and  banish  all  cesspits. 
The  ground  raust  be  absolutely  pure,  and  this  can  only  be  if  all  fecal  matter  is  removed 
to  a  distance. 

"*  See  Dr.  Fairweather's  Delhi  case  in  the  Sanitary  Report  of  the  Punjab  for  1871 ; 
also  given  in  Report  on  Hygiene,  in  the  Army  Medical  Report,  vol.  xiii.  (1873). 


138  PRACTICAL    HYGIENE. 

6.  The  localization  of  cholera  is  a  marked  feature  in  its  history.*  It  is 
often  as  marked  as  in  yellow  fever,  and  may  be  confined  to  a  Teiy  small 
ai*ea.  At  other  times,  in  India,  the  "  tainted  district "  may  be  of  some  ex- 
tent. From  this  fact  of  localization  arises  the  important  vule  of  always 
leaving  the  locahty  when  j^racticable,  and  in  a  large  town  of  clearing  out 
the  house  where  cholera  lias  happened.  In  India  the  present  itile  is  to 
march  the  men  out  and  encamp  ui  a  healthy  spot  at  some  httle  distance, 
changing  the  encamping  gi-ound  from  time  to  time.  On  the  whole,  tbis 
has  acted  well,  and  should  be  adhered  to,  though  occasionally  it  has  failed, 
generally,  however,  it  would  seem,  from  error  in  choice  of  locahty.  The 
men  should  be  tented  ;  the  tents  shotdd  be  weU  ventilated,  and  often 
stinick  and  repitched  ;  an  elevated  spot  should  be  chosen,  and  damp  and 
low  soils  and  river  banks  avoided.  Orders  lay  down  with  precision  the 
exact  steps  to  be  taken  by  a  regiment  when  cholera  threatens."  This  nile 
of  marcbing  out  must,  of  coflrse,  be  subject  to  some  exceptions.  It  has 
been  adrised  that  it  sliould  not  be  done  in  the  rainy  season  in  India.  Tbis 
must  depend  on  the  locality.  It  appears  sometimes  to  have  answered  well, 
even  in  hea^y  rains ;  but  in  other  cases  the  rains  may  be  too  hea%y.  No 
absolute  rule  can  be  laid  down  ;  but  the  cu'cumstances  which  are  allowed 
to  set  aside  the  gi-aud  rule  of  evacuation  of  a  tainted  jolace  should  be 
unequivocal. 

In  connection  -^-ith  change  of  locality,  the  opinions  of  Pettenkofer  should 
be  borne  in  mind.  Pettenkofer  believes  that,  of  all  conditions,  the  effect 
of  soil  is  the  most  important.  It  is  necessary,  then,  to  consider  particu- 
lai'ly  the  nature  of  the  soil  where  the  fresh  camps  ai^e  to  be  j^laced,  and  to 
select  perfectly  dry  and,  if  possible,  pvu-e,  impermeable,  uncontaminated 
soils,  and  to  prevent  the  cholera  discharges  from  percolating  through  the 
ground. 

7.  Men  sick  from  cholera  are  also  best  treated  in  well-ventilated  tents, 
"whenever  the  season  admits  of  it.  Even  in  cold  countries,  up  to  the  end 
of  October  or  the  middle  of  November,  tents  can  be  used  if  properly 
warmed.  In  India  it  should  be  a  nile  to  treat  eveiy  cholera  patient  in  a 
tent,  as  far  as  circumstances  permit  it. 

Internal  Cau.<ei>. — General  feebleness  of  health  gives  no  predisposition, 
nor  is  robust  health  a  safeguard  ;  some  even  have  thought  that  the  strongest 
men  suffer  most.  Great  fatigue,  and  especially  if  continued  from  day  to 
day,  greatly  predispo.ses  ;  of  this  there  seems  no  doubt.  ^  Xo  certain  influ- 
ence has  yet  been  traced  to  diet,  altbough  it  has  been  supposed  that  a 
vegetable  diet  and  alkalinity  of  the  intestinal  contents  may  predispose.     It 

^  Surgeon  P.  Cullen  (Indian  Medical  Gazette,  July  1,  1873)  notices  a  very  singular 
case  of  localization  at  Etarsi. 

'  The  order  in  India  is,  if  a  single  case  occur  in  a  barrack,  to  vacate  that  part  of  the 
barrack,  and  to  encamp  the  men  in  the  cantonment.  If  a  second  case  occur  among  the 
body  of  men  thus  removed,  they  are  again  moved,  and  the  building  or  tent  is  vacated 
and  purified.  If  a  third  case  occur  in  this  body  of  men  within  a  week,  they  are  re- 
moved to  the  preparatory  camp. 

Buildings  are  purified  by  scraping  and  washing  walls  with  hot  caustic  limewash  ; 
boiling  punkah  fringes,  ropes,  curtains,  etc.,  and  iising  chloride  of  lime  or  other  disin- 
fectant. Tents  are  purified  b}-  being  fumigated  with  either  chlorine,  nitrous  acid,  or 
sulphurous  acid,  and  then  exposed  to  the  weather  for  ten  days.  Railway  carriages, 
after  occupation  by  troops  carrying  cholera,  are  purified  by  washing  with  boiling  water 
containing  in  each  gallon  a  wineglassful  of  carbolic  acid,  and  burning  sulpliur  in  the 
closed  carriages  for  two  hours.  If  troops  are  moved  by  rail,  they  are  not  to  use  latrines, 
but  trenches  are  to  be  dug  for  them  (G.  O.  C.  C,  Xo.  19y). 

"  There  are  many  instances  of  the  effects  of  long  marches.  See  Orton,  Lorimer,  and 
Thom,  quoted  in  Brit,  and  For.  Med.  Chir.  IUjv.,  July,  lb48,  pp.  85-87. 


PREVENTION    OF    DISEASE.  139 

does  not  appear  that  insufficient  diet  has  any  great  effect,  tliough  there  is 
some  shght  evidence  that  scurvy  increases  the  mortahty,  and  perhaps  the 
predisposition/  The  strictest  temperance  does  not  preserve  from  attacks  ; 
but  every  one  agrees  that  spirits  are  no  protection,  and  that  debauchery 
increases  habihty. 

Of  pre-existing  diseases,  it  has  been  supposed  that  cardiac  affections  and 
pulmonary  emphysema  predispose  ;  the  evidence  is  very  unsatisfactory.  If 
Bsale's  observations  be  correct,  post-mortem  examinations  often  show  pre- 
vious affection  of  the  vilh  and  mucous  membranes  of  the  intestines  generally  ; 
but  it  is  very  desirable  there  should  be  more  proof  of  this. 

Diarrhoea  predisposes,  and  any  causes  which  lead  to  diarrhoea,  especially 
impure  water,  dietetic  errors,  etc.,  should  be  carefully  looked  after. 

With  regard  to  prophylactic  measures  (except  in  respect  to  proper  diet, 
free  ventilation,  and  pure  water)  nothing  has  yet  been  made  out.  Quinine 
has  been  recommended,  and  should  certainly  be  given,  especially  in  malari- 
ous countries,  as  it  is  a  fact  that  the  choleraic  poison  and  malaria  may  act 
together,  and  even  give  a  slight  periodical  character  to  choleraic  attacks, 
which  is  never  seen  in  non-malarious  districts,  and  is  therefore  merely 
grafted  on  cholera.  Peppers,  spices,  etc.,  have  been  used  ;  but  there  is  no 
good  evidence  respecting  them.  All  diarrhoea  should  be  immediately 
checked,  and  this  is  well  known  to  be  the  most  important  point  connected 
with  the  prevention  of  the  internal  causes.  The  universal  order  in  India 
is,  that  any  man  going  twice  in  one  day  to  the  latrine  should  report  him- 
self ;  and  non-commissioned  officers  are  usually  stationed  at  the  latrines  to 
watch  the  men.  The  reason  of  this  rule  should  be  fuUy  explained  to  the 
men.  In  two  attacks  of  cholera  in  India,  Dr,  Parkes  found  it  almost  im- 
possible to  get  the  men  to  report  themselves  properly  ;  the  shght  diarrhoea 
of  early  cholera  is  so  painless  that  they  think  nothing  of  it.^  In  England 
and  Grermany  house-to-house  visitation  has  been  found  very  useful.^ 

'  For  some  evidence  as  to  scurvy,  see  Pearce  and  Staw  "On  the  Cholera  of  the  Jail 
at  Calicut,"  Madras  Medical  Journal,  July,  1863. 

■■*  Several  points  have  been  taken  from  Mr.  Dickinson's  useful  little  pamphlet  on  the 
Hygiene  of  Indian  Cholera,  1.863. 

^  Great  importance  has  been  attached  to  the  meteorological  condition  attending  out- 
breaks of  cholera  ;  they  do  not  appear  to  be  very  important,  except  in  two  or  three 
cases. 

1.  Temperature. — A  high  temperature  favors  the  spread  by  increasing  the  putrefac- 
tion of  the  stools,  and  by  augmenting  generally  the  impurity  of  the  air.  When  cholera 
has  prevailed  at  a  low  temperature  (it  has  been  severe  at  a  temperature  below  freezing), 
the  drinking-water  has  possibly  been  the  cause. 

2.  Pressure  has  no  effect.  The  old  observation  of  Prout,  that  the  air  is  heavier  in 
cholera  epidemics,  has  never  been  confirmed. 

3.  Moisture  in  ^^V. —Combined  with  heat,  this  seems  an  accessory  cause  of  impor- 
tance, probably  by  aiding  transmission.  Moisture  in  the  ground,  combined  with  heat 
of  the  soil,  has  always  been  recognized  as  an  aiding  cause  of  great  importance. 

4.  Dryness  of  Air  seems  decidedly  to  check  it. 

5.  Rain  sometimes  augments,  sometimes  checks  it.  This,  perhaps,  depends  on  the 
amount  of  rain,  and  on  whether  it  renders  the  drinking-water  more  or  less  pure.  A 
very  heavy  rain  is  a  great  purifier. 

6.  Movement  of  Air. — It  is  certainly  wotst  in  the  stagnant  atmospheres,  as  in  the 
cases  of  all  the  specific  poisons. 

7.  Electricity  is  not  known  to  have  any  effect.  This  was  particularly  examined  by 
Mr.  Lamont  in  Munich,  one  of  the  most  celebrated  physical  philosophers  of  our  time, 
but  with  entirely  negative  results. 

8.  Ozone  has  no  effect,  either  in  its  presence  or  absence  (Schultze,  Voltotine,  De 
Wethe,  Lamont,  Strambio,  Wunderlich). 


140  PRACTICAL    HYGIENE. 


Typhus  Exanthematicus  {Spotted  Typhus). 

External  Cause. — An  auimal  poison,  origin  unkno^Aii,  but  communicable 
from  person  to  person,  probably  through  the  excretions  of  the  skin  and 
lungs  floating  in  the  air.  Not  known  to  be  communicated  by  water  or 
food.  Its  spread  and  its  fataUty  are  e^identl}'  connected  with  overcrowd- 
ing and  debihty  of  body  fi'om  deficient  food.  That  it  can  be  produced  by 
overcrowding  is  yet  uncertain.'  The  preventive  measures  may  be  thus 
shortly  summed  up :  Adopt  isolation  '"  of  j^atients  ;  use  the  freest  ventila- 
tion (5,000  to  6,000  cubic  feet  per  head  per  hour  or  more)  ;  evolve  nitrous 
acid  and  chlorine  fumes  ;  thoroughly  fumigate  with  sulphurous  acid,  heat 
(to  220"  Fidir),  wash,  and  expose  to  arr  all  bedding  (including  mattresses) 
and  clothes.  Tliis  last  point  is  extremely  impoiiant.  In  fact,  it  may  be 
said  that,  for  the  prevention  as  well  as  ti-eatment  of  typhus,  the  cardinal 
measiu'es  are  abundance  of  pure  air  and  pure  water.  Whenever  practi- 
cable, treat  all  tv-phus  patients  in  tents,  or  wooden  huts  with  badly  joined 
walls,  not  in  hospitals.  Fumigate  tents  and  scrape  and  hmewash  huts,  and 
remove  earth  from  time  to  time  from  the  iloors.  A  number  of  typhus 
patients  should  never  be  aggregated  ;  they  must  be  dispersed  ;  and  if  cases 
begin  to  spread  in  an  hospital,  clear  the  ward,  and  then,  if  the  disease  con- 
tinues, the  hospital  itself ;  then  wash  with  chloride  of  lime,  and  then  Hme- 
wash or  scrape  walls  and  floors,  and  thoroughly  fumigate  with  nitrous  acid. 
It  has  been  often  shown  that  even  exposure  to  weather,  bad  diet,  and 
insufiicient  attendance  are  less  dangerous  to  the  patients  than  the  aggrega- 
tion of  cases  of  t^'phus. 

Internal  Causes. — A  special  condition  of  body  is  necessary,  as  in  the 
case  of  small-pox,  and  one  attack  protects  to  a  great  extent  from  another. 
The  nature  of  the  internal  condition  is  unknown  ;  but  general  feebleness 
fi'om  bad  diet,  overwork,  exhaustion,  and  especially  the  scorbutic  taint, 
greatly  increase  the  intensity  of  the  disease  in  the  individual,  and  perhaps 
aid  its  spread.  These  conditions,  then,  must  be  avoided.  But  the  strongest 
and  best  health  is  no  guai'antee  against  an  attack  of  tj^hus. 

Bubo  or  Oriental  Plague  {Pali  Plague  in  India).^ 

The  preventive  measures  should  be  the  same  as  in  typhus,  to  which  this 
disease  shows  gTeat  analogv'.  The  history  of  the  plague  at  Cairo  (from 
which  it  has  been  now  banished  for  many  years,  simply  by  improving  the 

'  During  the  Frencli  war  of  1870,  althongli  there  was  miieh  crowding,  wretched- 
ness, and  misery  in  Paris,  and  particularly  in  IMetz,  there  was  but  little  typhus ;  it  was 
nothing  like  the  amount  in  the  first  Napoleon's  time  (Grellois,  Histoire  Medicale  du 
Blocus  de  Metz,  1872,  Chaiiffard,  Academie  de  Medecine). 

'^  By  the  term  isolation  is  meant  the  placing  a  patient  in  a  separate  building,  not  in 
anotlier  room  in  the  same  building  ;  in  the  case  of  small-pox,  typhiis,  and  scarlet  fever, 
this  partial  isolation,  thoiigh  sometimes  successful,  cannot  be  depended  upon.  If  a 
room  must  be  chosen  in  the  same  building,  choose  the  top  story,  if.  a  room  can  be  there 
found. 

^  The  Pali  plague  (Maha  Murree),  which  was  most  common  in  Eajpootana,  was 
evidently  propagated  by  the  filthy  habits  of  the  inhabitants  (see  Ranken  and  others), 
and  was  some  years  ago  almost  entirely  got  rid  of  by  sanitary  measures.  Subsequently, 
these  were  neglected,  and  the  disease  returned.  It  has  now  again  greatly  lessened. 
Hirsch  has  pointed  out  that  the  Pali  plague  di.Ters  from  the  Egyptian  plague  in  having 
a  marked  lung  disease,  and  in  this  it  resembles  the  black  death  in  the  fourteenth  cen- 
tury, with  which  Hirsch,  in  fact,  considers  it  identical. 


PEEVENTIO]Sr    OF   DISEASE.  141 

ventilation  of  the  city)/  and  the  disappearance,  after  sanitaiy  improve- 
ments, of  the  Pali  plague  in  India,  and  its  recurrence  on  the  cessation  of 
preventive  measures,  show  that,  like  typhus,  the  bubo  plague  is  easily  pre- 
ventible.  Elevation,  as  in  so  many  other  specific  diseases,  has  a  considerable 
effect ;  the  village  of  Alum  Dagh,  near  Constantinople  (1,640  feet  above  the 
sea),  and  freely  ventilated,  has  never  been  attacked  ;  the  elevated  citadel  of 
Cairo  has  generally  been  spared ;  and  when  Barcelona  was  attacked,  the 
elevated  citadel  also  escaped. 

Typhoid  or  Enteric  Fever, 

External  Cause. — A  poison  of  animal  origin  ;  one  mode  of  propagation 
is  by  the  intestinal  discharges  of  persons  sick  of  the  disease  ;  other  modes 
of  origin  and  transmission  are  not  dis^Droved.  There  is  doubtless  a  fre- 
quent transmission  of  the  disease  by  the  diarrhoea  of  mild  cases  which  are 
often  not  diagnosed.  There  is  some  evidence  that  persons  considered 
convalescent  may  carry  the  disease,^  but  it  is  possible  that  this  may  have 
been  owing  to  badly  washed  clothes.  The  mode  of  entrance  into  the  body 
is  both  by  air  and  water.  Entrance  by  food  (milk)  has  been  lately  also 
proved.  As  means  of  arresting  the  disease,  isolate  the  patients ;  receive 
all  evacuations  (fseces  and  ui'ine)  into  the  vessels  strictly  kejDt  for  one  sick 
person ;  place  zinc  chloride,  or  ferrous  sulphate,  or  carbolic  acid,  etc.,  in 
the  vessels  ;  never  empty  any  evacuation  into  a  closet,  sewer,  or  cesspool ; 
bury  it  several  feet  deep,  and  mix  it  well  with  earth.  Fumigate,  and  heat 
to  220°  Fahr.,  all  clothes  and  bedding.  As  means  of  prevention,  attend 
especially  to  the  purity  of  the  drinking  water,  and  to  the  disposal  of  sew- 
age ;  although  the  origin  of  typhoid  merely  from  putrefying  non-typhoid 
sewage  is  not  considered  at  present  to  be  probable,  it  is  not  disproved, 
and  it  is  certain  that  the  disease  may  spread  by  the  agency  of  sewers  and 
fecal  decomposition.  A  single  case  of  tj'phoid  fever  should  at  once  be 
held  to  prove  that  something  is  wrong  with  the  mode  of  getting  rid  of  the 
excretions.  If  neither  water  nor  sewers  can  be  proved  to  be  in  fault,  con- 
sider the  milk  and  other  food  supply. 

Internal  Causes. — As  a  first  attack  preserves  in  a  great  measure  from  a 
second,  a  peculiar  condition  of  body  is  as  essential  as  in  small  pox  ;  and 
looking  to  the  special  effect  produced  on  Peyer's  patches,  and  to  the  fact  that 
at  the  period  of  hfe  when  these  patches  naturally  degenerate,  the  suscep- 
tibility to  typhoid  fever  materially  lessens,  or  even  ceases,  it  seems  possi- 
ble that  the  internal  cause  or  necessary  second  condition  is  the  existence 
of  these  patches,  the  structures  in  which  are  brought  into  an  abnormal 
state  of  activity  by  the  direct  or  indirect  action  of  the  poison  on  them. 
The  other  internal  causes  are  anything  which  causes  gastro-intestinal  dis- 
order, such  as  bad  water,  and  general  feebleness. 

Relapsing  Fever. 

No  preventive  measures  have  been  yet  pointed  out,  but  the  occurrence 
of  the  disease  in  times  of  famine  seems  to  indicate  that  feebleness  and  in- 
anition are  necessary  internal  causes. 

'  Stamm,  in  Pappenheim's  Beitriige,  1862-63,  p.  80.  The  measures  adopted  in  Cairo 
were  levelling  some  hillocks,  which  stopped  the  air  from  blowing  over  the  city,  filling 
up  some  marshes,  and  adopting  a  better  mode  of  burial.  The  peculiar  sepulture  cus- 
toms of  the  Copts  have  indeed  even  been  assigned  as  the  sole  cause  of  the  origin  of 
'  igue. 

''  Gietl.,  Die  Ursachen  der  enterischen  Typhus  in  Miinchen,  1865,  pp.  74  and  94. 


142  PEACTICAL    HYGIENE. 


BUious  Remittent  Fevers. 

Under  this  vagne  term,  a  disease  or  diseases,  whicli  in  many  points 
ai'e  like  relapsing  fever,  but  yet  are  not  identical  (Marston),  have  been 
described  as  occurring  especially  in  Egypt  (Griesinger),  and  in  the  Levant 
generally.  It  has  also  been  described  by  Drs.  Marston  and  Boileau,'  at 
Malta.  The  exact  causes  are  not  known  ;  but  in  some  of  the  T\Titings  of 
the  older  army  surgeons,  the  fevers  which  are  produced  by  foul  camps  (in 
addition  to  tyjihoid)  appear  to  have  a  close  resemblance  to  the  bilious  re- 
mittent fevers  of  the  Mediterranean.  They  appear  to  be  connected  with 
bad  sanitary  conditions,  but  their  exact  causation  is  not  clear. 

Cerebro-Spinal  Meningitis. 

This  disease,  which  has  occasionally  been  noticed  in  France,  and  espe- 
cially among  soldiers,  for  the  last  half  centuiy,  has  within  late  years  ap- 
peared in  several  parts  of  Germany,  and  a  few  cases  among  civilians  have 
occiuTed  in  England.  It  seems  to  depend  on  a  specific  agent,  but  vers'- 
little  is  yet  known  about  it.  It  does  not  appear  to  be  contagious.  No 
preventive  measures  can  be  at  present  suggested. 

The  Eruptive  Fevers. 

Small-pox  is  guai'ded  against  in  the  army  by  repeating  vaccination  in 
the  case  of  reciiiits,  and  by  occasional  re-vaccination  of  all  the  men  in  a 
regiment.  In  the  statistical  reports,  great  attention  is  always  paid  to  this 
important  point,  and  the  evidence  from  foreign  ai-mies  proves  the  necessity 
of  careful  re-vaccination. 

If  the  disease  does  occur,  isolation "  (in  separate  buildings)  is  most  im- 
portant, but  the  aggi'egating  of  a  large  number  of  cases  together  ought  to 
be  avoided. 

In  the  case  of  scarlet  fever  and  measles,  nothing  definite  is  known  with 
regard  to  prevention,  except  that  a  good  sanitary  condition  seems  to  lessen 
their  intensity,  and  probably  their  spread.  The  evidence  with  regard  to 
belladonna  in  scarlet  fever  is  contradictoiy,  but  on  the  whole  unfavorable. 
All  the  discharges  should  be  disinfected,  and  the  skin  well  rubbgd  over 
with  camphorated  oil  and  a  Httle  weak  carbolic  acid. 

The  most  difficult  case  is  when  either  measles  or  scarlet  fever  appears 
on  board  ship,  and  especially  if  children  are  on  board.  If  the  weather 
permit,  the  best  plan  is  then  to  treat  all  patients  on  the  upper  deck  under 
an  awning.  If  this  cannot  be  done  (and  scarlet  fever  patients  must  not 
be  exposed  to  cold),  they  must  be  isolated  as  much  as  possible.  Both  in 
scarlet  fever  and  small-pox  there  is  some  evidence  to  show  that  the  incu- 
bative joeriod  may  be  very  long.^ 

Perhaps,  in  the  present  state  of  evidence,  it  might  be  desirable  to  try 
the  prophylactic  effects  of  belladonna  on  board  shijD,  directly  the  first  case 
occurs. 

'  Army  Med.  Reports,  vols.  iii.  and  viii. 

^  Buclianan  gives  a  good  example  of  the  advantages  of  isolation  in  the  case  of  Chel- 
tenham, where  small  pox  was  introduced  into  the  town  six  times,  but,  in  consequence 
of  proper  hospital  accommodation  for  all  classes,  never  made  good  its  footing. 

*  See  a  case  by  Bryson  (Trans.  Soc.  Science  Assoc,  1802,  p.  677),  for  a  case  in  which 
the  incubative  period  of  small-pox  appeared  to  be  thirtj-oue  days.  lu  scarlet  fever  it 
is  said  to  be  sometimes  even  longer. 


PREVENTION    OF    DISEASE.  143 


Erysipelas  {Hospital  or  Epidemic). 

External  Cause. — It  is  well  known  that  in  the  surgical  wards  of  hos- 
pitals erysipelas  occasionally  occurs,  and  then  may  be  transmitted  from 
patient  to  patient.  The  exact  causes  of  its  appearance  have  not  been  made 
out,  but  it  is  evidently  connected  with  overcrowding  and  impure  air. 
Moisture  of  the  floors,  causing  constant  great  humidity  of  air,  has  also 
been  supposed  to  aid  it.  It  is  much  more  common  in  fixed  hosj)itals  than 
in  tents  and  huts,  and  indeed  is  exceedingly  rare  in  the  two  latter  cases. 
The  agencies  or  agent  can  scarcely  be  supposed  to  be  other  than  putre- 
fying organic  matter  and  pus-cells  passing  into  and  accumulating  in  the 
air,  or  organisms  developed  in  connection  with  them.  It  is  remarkable 
that  pus-cells  derived  from  purulent  sputa  do  not  cause  erysipelas  in 
medical  wards,  but  this  may  be  from  a  want  of  open  wounds  to  give  the 
necessary  personal  condition. 

When  hospital  erysijDelas  has  once  apj)eared  in  a  ward,  nothing  will 
avail  except  complete  clearance  of  the  ward,  scraping  the  floors,  and  often 
the  walls,  washing  with  chloride  of  lime,  and  then  with  solution  of  caustic 
lime,  and  thorough  fumigation  with  chlorine  and  nitrous  acid  alternately. 
The  erysipelatous  cases  should  be  placed  in  well-ventilated  tents. 

Considering  the  undoubted  beneficial  influence  of  tent  life,  it  may  be  a 
question  whether,  even  in  civil  life,  hospitals  which  possess  gardens  should 
not,  during  the  summer,  treat  their  surgical  cases  with  suppurating  wounds 
in  the  tents.'  In  many  continental  towns  the  large  hospitals  have  now 
wooden  huts  attached  to  them,  in  which  the  surgical  cases  are  treated. 

Of  course,  extreme  care  in  conservancy  of  wards  or  tents,  the  immediate 
removal  of  all  dressings,  great  care  in  dressing  wounds,  so  that  neither  by 
instruments,  sj)onges,  lint,  or  other  ajDphances,  pus-ceUs  or  molecular  or- 
ganic matter  shall  be  inoculated,  are  matters  of  familiar  hospital  hygiene. 
The  use  of  carbolic  acid  and  other  antiseptics,  as  introduced  by  Professor 
Lister,  wiU,  it  is  hoped,  greatly  lessen  the  chances  of  spread  in  the  case  of 
erysipelas  as  well  as  of  hospital  gangrene.'^ 

Internal  Causes. — Nothing  is  known  on  this  point,  except  that  there 
must  be  some  abrasion  or  wound  of  the  surface  or  of  the  passages  near  the 
surface,  as  the  vagina  or  throat.  The  erysipelas  commences  at  the  point 
of  abrasion.  If  there  is  no  open  wound,  the  atmospheric  impurity  seems 
to  have  no  bad  effect  on  the  persons  who  are  exposed  to  it,  but  it  would 
be  interesting  to  know  if  some  forms  of  internal  disease  are  not  produced. 
Is  it  possible  that  some  forms  of  tonsillitis  and  diphtheritic-like  inflamma- 
tion of  the  throat  may  be  caused  in  this  way,  although  there  is  no  solution 
of  continuity  ? 

Hospital   Gangrene. 

Almost  the  same  remarks  apply  to  hospital  gangrene  as  to  erysipelas. 
One  of  the  most  important  facts,  which  has  been  pointed  out  by  many 
writers,  and  which  has  been  thoroughly  j)i'oved  by  the  American  and  the 
Italian  wars,  is  that  perfectly  free  ventilation  prevents  hospital  gangrene. 
Hammond,  the  late  Surgeon-General  of  the  United  States  Army,  declares ' 

'  See  Hammond's  Hygiene,  1863;  Kraus'  Das  Kranken  und  Zerstrenungs-System, 
1861 ;  and  a  Report  on  Hygiene,  by  Dr.  Parkes,  in  the  Army  Medical  Report  for  1862, 
for  the  effects  of  tents  on  erysipelas  and  hospital  gangrene. 

-  T  was  informed,  in  Munich,  that  Lister's  system  has  completely  banished  hospital 
gangrene  from  that  city,  and  I  believe  the  same  result  has  been  noticed  in  other  Ger- 
man towns. — (F.  de  C.)  s  Hygiene,  p.  897. 


14 J:  PRACTICAL   HYGIENE. 

that  only  one  instance  has  come  to  his  knowledge  in  which  hospital  gan- 
grene has  originated  in  a  wooden  pavilion  hospital,  and  not  one  which  has 
occurred  in  a  tent.  Kraus  also,  from  the  experience  of  the  Austrians  in 
1859,  states  that  it  never  could  be  discovered  that  gangrene  originated  in 
a  tent.  On  the  contrary  cases  of  gangrene  at  once  commence  to  impi-ove 
when  sent  from  hospital  wards  into  tents.  On  the  other  hand,  the  tenacity 
wdth  which  the  organic  matters  causing  the  gangrene  adhere  to  walls  is 
well  known. 

The  measures  to  be  adopted  in  wards  when  hospital  gangrene  occurs, 
and  the  ward  cannot  be  at  once  evacuated,  are  the  same  as  for  erysipelas.' 
It  is  not  necessary  to  do  more  than  allude  to  the  undoubted  transference 
by  dirty  sponges,  etc.,  and  to  the  beneficial  effects  of  antiseptic  dressings. 


SECTION  n. 

VARIOUS  NON-SPECIFIC  DISEASES. 

Dysentery  and  Diarrhcea. 

At  present  there  is  no  evidence  that  the  dysentery  arising  from  various 
causes  has  different  anatomical  characters,  or  runs  a  different  course,  ex- 
cept perhaps  in  the  case  of  malarious  dysentery'.     The  chief  causes  are — 

1.  Impure  Water. — Both  Annesley  and  Twining  have  directed  attention 
to  this  cause,  in  their  accounts  of  Indian  dysentery.  It  is  scarcely  possible 
that,  with  common  attention,  this  cause  should  not  be  discovered  and  re- 
moved. 

2.  Impure  Air. — The  production  of  dysentery  and  diarrhoea  from  the 
effluvia  of  putrefying  animal  substances  is  an  opinion  as  old  as  CuUen,  and 
probably  older  ;  and  there  seems  little  doubt  of  its  correctness.  The  gases 
and  vapors  from  sewers  also  will,  in  some  persons,  cause  diarrhoea  ;  and 
also  effluvia  fi'om  the  foul  bilge-water  of  ships. '^  On  the  other  hand,  very 
disagreeable  effluvia  from  many  animal  substances,  as  in  the  case  of  bone- 
bvu'ners,  fat-boilers,  etc.,  do  not  seem  to  cause  diarrhoea.  In  India  there 
appears  to  be  a  decided  relation  between  the  prevalence  of  dysentery  and 
overcrowding  and  want  of  ventilation  in  barracks  ;  massing  a  large  number 
of  men  together  is  certainly  an  accessory  cause  of  great  weight.'' 

The  air  from  very  foul  latrines  has  caused  dysentery  in  nvimerous  cases. 
Pringle,  and  many  other  army  surgeons,  record  cases.'  In  war  this  is  one 
of  the  most  common  causes.  The  occasional  production  of  dysentery  from 
sewage  applied  to  land,  seems  to  be  proved  by  Clouston's  observations  on 

'  With  regard  to  pyaemia,  observations  show  that  one  of  the  external  causes  is  fetid 
organic  emanations.  Spencer  Wells  (Med.  Times  and  Gazette,  18G2)  states,  that  in 
1859  the  mortality  from  pyaemia  was  great  in  some  wards  over  a  dissecting-room.  On 
removing  all  the  cases  after  operation  to  the  opposite  side  of  the  building,  pyaemia  al- 
most disappeared.     Other  similar  cases  are  on  record. 

-  Fonssagrives  (Traite  d'Hygiene  Navale,  p.  60)  records  a  good  case  of  this  kind.  It 
commenced  after  a  gale  at  sea  had  stirred  up  the  bilge,  and  on  clearing  it  out  the  attack 
ceased. 

3  Wood  on  the  Health  of  European  Soldiers  in  India,  1864,  p.  45  et  seq. 

''  Sir  James  M'Grigor,  Vignes  (who  give  many  cases  from  the  French  experience  in 
the  Peninsula),  Chomel,  Copland;  see  also  the  Die.  des  Sciences  Med.,  art.  "Dysen- 
teric." D'Arcet  (Ann.  d'Hygiene,  vol.  xii.,  p.  390)  records  a  good  case,  in  which  a 
whole  regiment  was  affected  in  the  Hanoverian  war,  from  having  used  too  long  the 
same  trench  as  a  latrine.     The  disease  disappeared  when  another  was  dug. 


PEEVENTIOJSr    OF   DISEASE.  145 

the  cause  of  the  attack  of  dysentery  in  the  Cumberland  Asyhim.'  Still 
sewage  matter  has  been  often  applied  in  this  way  without  bad  effects.  In 
Dr.  Clouston's  case  the  sewage  was  300  yards  from  the  ward  where  the 
dysentery  occurred.  Calm  and  nearly  stagnant  nights,  or  with  a  gentle 
movement  of  air  from  the  sewage  toward  the  ward,  were  the  conditions 
which  preceded  most  of  the  attacks. 

Of  all  the  organic  eflftuvia,  those  from  the  dysenteric  stools  appear  to  be 
the  worst.  Some  evidence  has  been  given  to  show  that  dysentery  arising 
from  a  simple  cause  (as  from  exposure  to  cold  and  wet),  when  it  takes  on 
the  gangrenous  form,  and  the  evacuations  are  very  fetid,  produces  dysen- 
tery in  those  who  use  the  latrines,  or  unclean  closets,  into  which  such  gan- 
grenous evacuations- are  passed.  If  correct,  this  is  a  most  interesting  point, 
as  it  seems  to  show  the  origin  of  a  communicable  poison  de  novo.  Possi- 
bly, in  all  these  cases,  effluvia,  or  organic  matters,  or  particles  disengaged 
from  the  putrefying  evacuations,  act  at  once  on  the  anus,  and  the  disease 
then  spreads  up  by  continuity. 

There  is  some  reason,  also,  to  think  that  retaining  dysenteric  stools  in 
hospital  wards  spreads  the  disease  ;  and,  perhaps,  in  this  case,  the  organic 
particles  floating  up  may  be  swallowed,  and  then  act  on  the  mucous  mem- 
brane of  the  colon.  In  the  epidemic  of  dysentery  in  Sweden  in  1859,  there 
was  good  evidence  to  show  that  it  spread  by  means  of  the  diarrhoeal  and 
dysenteric  evacuations.^  In  all  cases  the  stools  must  be  mixed  with  disin- 
fectants, and  immediately  removed  from  the  wards  and  buried. 

3.  Improper  Food. — Any  excess  in  quantity,  and  many  alterations  in 
quality  (especially  commencing  decomposition  in  the  albuminates,  and, 
perhaps,  the  rancidity  of  the  fatty  substances)  cause  diarrhoea,  which  w'ill 
pass  into  dysentery.  But  the  most  important  point  in  this  direction  is  the 
production  of  scorbutic  dysentery,  A  scorbutic  taint  plays  a  far  more  im- 
portant part  in  the  production  of  dysentery  than  is  usually  imagined,  and 
there  is  now  no  doubt  that  the  fatal  dysentery,  which  formerly  was  so 
prevalent  in  the  "West  Indies,  was  of  this  kind.  Much  of  the  Indian  dys- 
entery is  also  often  scorbutic. 

4.  Exposure  to  Cold  and  Wet. — Exposure  to  cold,  especially  after  exer- 
tion, and  extreme  variations  of  temperature,  have  been  assigned  as  the 
chief  cause  of  dysentery  by  numerous  writers  ; '  great  moisture  has  been 
assigned  by  some  writers  (Twining,  Annesley,  Griesinger)  as  a  cause  ;  and 
great  dryness  of  the  air  by  others  (Mouat)  ;  while  a  third  class  of  obser- 
vers have  considered  the  amount  of  moisture  as  quite  immaterial. 

Hirsch,*  after  summing  up  the  evidence  with  respect  to  the  temperature 
with  great  care,  decides  that  sudden  cold  after  great  heat  is  merely  a 
"  causa  occasionalis  "  ^  which  may  aid  the  action  of  the  more  potent  cause 

'  Medical  Times  and  Gazette,  June,  1865. 

2  British  and  Foreign  Med.  Chir.  Rev.,  January,  1866,  p.  140. 

'  A  few  only  can  be  noted  ;  Stall,  Zimmermann,  Huxham,  Durandeau,  Willan, 
Irvine,  James  Johnson,  Annesley,  Bampfield,  Morehead,  Vignes,  Fergusson,  etc.  Fer- 
gusson  says  :  ' '  True  dysentery  is  the  offspring  of  heat  and  moisture  ;  of  moist  cold  in 
any  shape  after  excessive  heat.  Nothing  that  a  man  can  put  into  him  would  ever  give 
him  true  dysentery." 

■*Handbuch  der  Historisch-Geograph.  Pathol.,  Band  ii.,  p.  234. 

^  The  so-called  ' '  hill  diarrhoea, "  which  was  formerly  prevalent  on  some  of  the  liill 
sanitaria  in  India,  especially  on  the  spurs  of  the  Himalayas,  has  been  attributed  to  the 
effect  of  cold  and  moisture,  and  sudden  changes  of  temperature.  But,  as  remarked 
by  Dr.  Alexander  Grant,  many  hill  stations  have  these  atmospheric  conditions  without 
having  any  hill  diarrhcea.  There  is  great  reason  to  suppose  the  hill  diarrhoea  to  be 
entirely  unconnected  with  either  elevation  or  climate.  In  some  cases  it  has  been 
Vol.  II.— 10 


146  PRACTICAL    HYGIENE. 

of  dysentery.  This,  probably,  is  the  tnie  readinp^  of  the  facts.  The 
amount  of  moisture  in  the  atmosphere  would  appear  to  be  a  matter  of  no 
moment. 

Although  we  cannot  assign  its  exact  causative  value,  the  occurrence  of 
chill  is,  of  covu'se,  as  a  matter  of  prudence,  to  be  carefully  guarded  against  ; 
and  especially  chills  after  exertion.  It  is  when  the  body  is  profusely  per- 
spmng,  and  is  then  exposed  to  cold,  that  dysentery  is  either  produced,  or 
that  other  causes  are  aided  in  their  action.  In  almost  all  hot  countries 
chilling  of  the  abdomen  is  considered  particularly  hurtful,  and  shawls  and 
waist-bands  (kummerbund  of  India)  are  usually  worn.' 

5.  Malaria  has  been  assigned  as  another  cause  ;  and  it  was  noticed 
especially  by  the  older  wi'iters,  that  the  dysenteiy  was  then  often  of 
the  kind  termed  "  Dysenteria  Incruenta " — the  stools  being  cojdIous, 
sei'ous,  and  vdth  httle  blood ;  in  fact,  a  state  somewhat  resembling 
cholera. 

Veiy  gi'eat  difference  of  opinion  has  prevailed  in  regard  to  this  opinion.^ 
Possibly  the  "  malarious  dysentery  "  is  in  part  connected  with  the  use  of 
marsh  water.  More  evidence  is  desirable,  certainly,  with  regard  to  this 
point ;  but  it  Seems  probable,  from  the  observations  of  Annesley  and 
Twining,  that  marsh  water  has  an  effect  in  this  dii-ectiou. 


Liver  Diseases  {Indian). 

The  production  of  diseases  of  the  Hver  is  so  obscure,  and  so  many 
states  of  hepatic  disorder  are  put  together  under  the  term  "  hepatitis," 
that  it  is  impossible  to  treat  this  subject  properly  without  entering  fully 
into  the  question  of  causes.  But,  as  this  could  not  be  done  here,  we  must 
content  ourselves  with  a  short  summary  of  the  preventive  measures  which 
appear  to  be  of  the  gi-eatest  importance. 

Dr.  Parkes  had  long  been  convinced  that  many  cases  of  hj'peraemia, 
bilious  congestion,  and  enlargement  of  the  hver,  with  increase  of  cell- 
gi'owth  and  connective  tissue  (but  without  tendency  to  abscess),  and  en- 
largement and  j)artial  fatty  degeneration  of  the  liver-cells,  are  caused  sim- 
ply by  diet.'  He  had  a  good  opportunity  of  obsein-ing  this  on  landing  in 
India  in  1842  with  an  European  regiment,*  and  his  later  experience  made 
him  certain  that  the  observation  was  correct. 

clearly  caused  bj  bad  water,  possibly  by  suspended  scales  of  mica  or  by  magnesian 
salts  in  the  water  ;  in  other  cases,  its  exact  causes  remained  unexplained.  Of  late 
years  it  has  lessened  in  amount  at  all  stations,  and  will  probably  disappear. 

'  It  is  a  remarkable  circumstance,  that  in  temperate  climates  the  most  common 
months  for  dysenteric  epidemics  are  the  hot  months — June  to  {September.  Taking 
North  America  and  Nortliern  and  Western  Europe,  Hirsch  has  assembled  546  outbreaks. 
Of  these,  176  occurred  in  summer  ;  228  in  summer  and  autumn  ;  107  in  autumn  ; 
only  16  in  spring ;  and  19  in  winter.  This  does  not  look  as  if  cold  had  any  effect. 
The  heat  of  summer  is  far  more  influential. 

■■'  The  very  varying  opinions  are  given  very  fully  by  Hirsch.  Morehead's  great 
authority  was  altogether  against  the  presumed  action  of  malaria ;  but  possibly  here,  as 
in  many  other  cases,  we  shall  have  to  draw  a  complete  distinction  between  malarious 
and  non-malarious  dysentery. 

^In  the  great  and  admirable  works  of  Ranald  Martin  and  Morehead,  the  influence 
of  diet  in  producing  liver  affections,  though  alluded  to,  has  been  passed  over  much  too 
lightly.  Annesley,  on  the  other  hand,  has  fully  recognized  the  immense  influence  of 
diet  (vol.  i..  p.  192). 

*  Remarks  on  the  Dysentery  and  Hepatitis  of  India,  by  E.  A.  Parkes,  M.B.,  1846, 
p.  228. 


PREVENTION    OF   DISEASE.  147 

Very  similar  opinions  have  been  expressed  by  Macnamara,'  and  Nor- 
man Chevers  has  also  pointedly  alluded  to  this  subject.^ 

The  supply  of  food  for  the  soldier  in  India  has  erred  in  two  ways  :  it  is 
too  much  in  quantity,  especially  when  the  amount  of  exercise  is  hmited. 
Macnamara  has  calculated  that  each  European  soldier  in  Bengal  consumed 
(at  the  time  he  wrote,  in  1855)  76  ounces  of  solid  (i.e.,  water-containing) 
food  daily,  so  that  there  must  have  been  an  excess  of  all  the  dietetic  prin- 
ciples. Then,  in  every  case,  there  was  added  to  this  a  very  large  amount 
of  condiments  (spices  and  peppers),  articles  of  diet  which  are  fitted  for 
the  rice  and  vegetable  diet  of  the  Hindu,  but  are  particularly  objectionable 
for  Europeans.  In  the  West  Indies,  where  the  diet  has  never  been  so 
rich  in  condiments,  Hver  diseases  have  always  been  comparatively  infre- 
quent. 

Some  orders  for  improving  the  cooking  in  India  were  issued  by  Lord 
Strathnairn,  and  if  these  were  earned  out,  and  if  medical  officers  would 
thoroughly  investigate  the  quantity  of  food  taken  by  the  men,  and  compare 
it  with  their  work,  and  examine  into  the  cooking,  it  is  quite  certain  that 
many  cases  of  dyspepsia  and  hejoatitis  would  be  prevented. 

In  cases  not  simply  of  hypersemia  and  bilious  congestion,  but  of  ab- 
scess, it  is  probable  that  a  certain  number  are  consecutive  to  dysentery, 
and  are  caused  by  the  absorption  of  jDutrid  matters  from  the  intestine,  ^ 
which  are  arrested  by  the  liver,  and  there  set  up  suppuration.  There  is 
no  true  pytemia  or  inflammation  of  the  vena  portse  as  a  i-ule.  When 
caused  by  phlebitis  or  special  aifection  of  the  vena  porta?,  the  suppuration 
is  in  the  course  of  the  vena  portae,  or  at  any  rate  commences  there.  The 
reason  why  some  cases  of  dysentery  cause  abscess  and  others  do  not,  is 
uncertain.  The  prevention  of  this  form  of  abscess  is  involved  in  the  pre- 
vention of  dysentery. 

In  other  cases  of  abscess,  however,  there  is  no  antecedent  dysentery, 
but  there  are  collections  of  pus  or  fetid  debris  somewhere  else,  which  act 
in  the  same  way  by  allowing  absoi'ption.  There  are,  however,  other  cases 
in  which  no  such  causes  have  been  pointed  out,  and  the  genesis  of  these 
cases  of  abscess  remains  quite  obscure.  Much  effect  has  been  attributed  to 
the  influence  of  sudden  changes  of  temperature  ;  to  the  rapid  supervention 
of  an  exceedingly  moist  and  comparatively  cold  air  on  a  hot  season,  where- 
by the  profuse  action  of  the  skin  is  suddenly  checked  ;  and  to  the  influence 
of  malaria.  But  the  extraordinary  disproportion  of  cases  of  abscess  in  dif- 
ferent parts  of  the  woi'ld  seems  to  negative  all  these  surmises. 

One  fact  seems  to  come  out  clearly  from  Dr.  Waring's  observations, 
viz.,  that  recent  arrival  in  India  is  favorable  to  the  occurrence  of  abscess, 
and  that  (all  kinds  of  abscesses  being  put  together)  50  per  cent,  occur  in 
men  under  three  years'  service.  No  length  of  residence,  however,  confers 
perfect  immunity.  It  would  be  very  important  to  determine  whether  the 
efiect  of  recent  arrival  is  marked,  both  in  cases  of  abscess  consecutive,  and 
in  those  anterior,  to  dysentery. 

It  is  possible,  also,  that  some  entozoic  influence  may  be  at  work,  espe- 

'  Indian  Annals,  1855.  Dr.  Macnamara  found  a  most  extraordinary  amount  of  fatty 
degeneration  of  the  liver. 

^  Health  of  European  Troops  in  India,  Indian  Annals,  1858,  p.  109.  It  is  particu- 
larly recommended  that  this  chapter  should  be  carefully  perused. 

•^  It  is,  however,  remarkable  how  many  cases  of  dysentery  occur  without  producing 
hepatic  abscess  ;  still  our  general  knowledge  of  the  causation  of  disease  makes  it  highly 
probable  that  dysentery  acts  in  this  way.  Is  it  the  sloughing  dysentery  which  is  fol- 
lowed by  hepatic  abscess  ? 


148  PRACTICAL    HYGIENE. 

cially  in  some  parts  of  Lidia,  and  hydatid  disease  of  the  liver  or  other 
diseases  of  the  same  class  may  be  more  common  than  is  supposed. 

In  the  absence  of  perfect  knowledge,  great  care  in  preserving  from 
qhills,  and  j^roper  diet,  are  the  only  preventive  measures  which  can  be 
suggested  for  immaiy  hepatic  abscess. 

Insolation. 

Under  this  convenient  term,  a  number  of  cases  are  put  together  which 
seem  to  be  produced  by  one  or  more  of  the  following  causes  : — 

External  Causes. — 1.  Direct  rays  of  the  sun  on  the  head  and  spine. 
Adopt  light  coverings,  covered  with  white  cotton  ;  permit  a  good  current 
of  an-  between  the  head  and  the  covering,  and  use  a  light  muslin  or  cotton 
rag,  dipped  in  water,  over  the  head  under  the  cap.  2.  Heat  in  the  shade, 
combined  esj^ecially  with  stagnant  and  impure  air.  In  houses  (and  men 
have  been  attacked  with  insolation  both  in  tents  and  barracks)  means  can 
always  be  taken  to  move  the  air,  and  thus  keep  it  pure,  even  if  it  cannot 
be  cooled.  In  tents  the  heat  is  often  exceedingly  great,  simply  from  the 
fact  that  there  is  not  sufficient  movement  of  air ;  in  the  tropics  a  simple 
awning  is  much  better  than  tents,  and  if  the  awning  is  sloped  a  little,  the 
top  of  the  slope  being  toward  the  north,  the  movement  of  air  will  be  more 
rapid  than  if  the  canvas  be  quite  flat.  But  in  the  dry  season,  in  the  tropics, 
the  men  should  sleep  in  the  open  air  in  all  non-malarious  districts,  when 
they  are  on  the  march  or  in  campaigns. 

The  general  prophylaxis  has  been  thus  sximmed  up  by  Professor  Mac- 
lean :' — "Men  will  bear  a  high  temperature  in  the  open  air*  with  compara- 
tive impunity,  provided  (a)  it  is  not  too  long  continued  ;  (b)  that  the  dress 
be  reasonably  adapted  to  the  temperature  ;  (c)  that  the  free  movement  of 
the  chest  be  not  interfered  with." 

Internal  Causes. — It  is  only  known  that  spirit  drinking,  even  in  modera- 
tion, powerfully  aids  the  external  causes  of  insolation  ;  even  wine  and  beer 
probably  have  this  effect.  Tea  and  coffee,  on  the  other  hand,  probably 
lessen  the  susceptibility. 

A  full  habit  of  body,  or  any  tendency  to  fatty  heart  or  emphysematous 
lungs,  have  been  supposed  also  to  predisj^ose. 

It  seems  certain  that  any  embarrassment  of  the  pvdmonaiy  circrdation 
aids  the  action  of  the  heat,  and  therefore  the  most  perfect  freedom  from 
belts  and  tight  clothes  over  the  chest  and  neck  is  essential. 

Great  exhaustion  from  fatigue  aids  the  action,  either  from  failure  of  the 
heart's  action  or  w-ant  of  water.  In  this  case  difliisible  stimuli,  such  as 
ammonia,  tincture  of  red  lavender,  tinctui*e  of  cardamoms,  etc  ,  with  strong 
coffee  are  the  best  preventives.  Spirits  should  not  be  given,  unless  the  ex- 
haustion be  extreme,  and  the  diffusible  stimuli  cannot  be  obtained.  A 
small  quantity  in  hot  water  may  then  be  tried. 

Cold  baths,  and  especially  cold  douching  to  the  head  and  spine,  are 
most  useful  as  preventive  as  well  as  curative  measures. 

Phthisis  Pulmonalis. 

In  respect  of  causes,  we  must  distinguish  those  usually  rapid  cases  of 
tuberculosis  which  arise  from  hereditary  constitutional  causes,  or  from  the 
influence  of  exanthemata  (especially  measles),  or  of  typhoid,  or  other  fevers, 
and  w^hich  run  their  course  with  imphcation  of  several  organs  at  an  early 


'  Reynolds'  System  of  Medicine,  vol.  ii. ,  p.  157. 


PEEVENTIOX    OF    DISEASE.  1^0 

stage,  and  the  more  chronic  forms  of  phthisis,  in  -which  the  lung  in  adults 
is  the  first  seat  of  the  disease,  and  other  organs  are  secondai-ily  afi'ected. 
Several  distinct  diseases  are  confounded  under  the  one  term  of  phthisis, 
and  it  is  therefore  not  possible  at  present  to  trace  out  their  precise  origin. 

Taking  only  the  common  cases  of  subacute  or  chronic  phtliisis,  it  has 
been  already  intimated  that  most  Eui-opean  armies  have  been  found  to  fur- 
nish an  undue  proportion  of  such  cases/ 

A  few  years  ago  much  influence  was  ascribed  to  food  as  a  cause  of 
phthisis  ;  the  occurrence  of  a  sort  of  dyspejDsia  as  a  forerunner  (though  this 
does  not  seem  very  common),  and  the  great  effect  of  the  treatment  by  diet 
(by  cod-hver  oil),  seemed  to  show  that  the  fault  lay  in  some  peculiar  mal- 
nutrition, which  affected  the  blood,  and  through  this  the  lungs. 

Probably  there  is  truth  in  this  ;  but  of  late  yeai's  the  effects  of  conditions 
which  influence  immediately  the  j^ulmonary  circulation  and  the  lungs  them- 
selves have  attracted  much  attention.  The  effect  of  want  of  exercise  (no 
doubt  a  highly  complex  cause,  acting  on  both  digestion  and  circulation), 
and  of  impure  air,  have  been  found  to  be  very  potent  agencies  in  causing 
phthisis,  and  conversely,  the  conditions  of  prevention  and  treatment  which 
have  seemed  most  useful  are  nutritious  food  and  proportionate  gi'eat  exer- 
cise in  the  free  and  oj^en  air.  So  important  has  the  last  condition  jDroved 
to  be,  that  it  would  appear  that  even  considerable  exposui-e  to  weather  is 
better  than  keeping  phthisical  patients  in  close  rooms,  provided  there  be  no 
bronchitis  or  tendency  to  pneumonia  or  pleurisy. 

Three  poiats,  then,  are  within  oui*  control  as  regards  phthisis — ai'range- 
ment  of  food,  exercise,  and  pure  aii'. 

That  food  should  contain  a  good  deal  of  the  nitrogenous  and  fatty 
principles  if  phthisis  is  apjn-ehended.  Milk  has  been  long  celebrated,  and 
lately  the  koumiss  of  Tartary  has  obtained  a  gTeat  reputation  in  Russia  as 
an  agent  of  cure,  and  is  now  a  good  deal  used  (made  from  cow's  milk)  in 
this  country. 

Exercise  is  of  the  gi'eatest  importance,  and  it  would  seem  quite  clear 
that  this  must  be  in  the  open  au'.  The  best  climates  for  phthisis  are  per- 
haps not  necessarily  the  ecj^uable  ones,  but  those  which  permit  the  gi'eatest 
number  of  hours  to  be  passed  out  of  the  house. 

In  the  house  itself,  attention  to  thorough  ventilation,  i.e.,  to  constant, 
though  imperceptible  movement  of  the  ah",  is  the  point  to  be  attended  to. 

In  the  case  of  soldiers,  it  must  also  be  seen  that  no  weights  or  sti'aps 
impede  the  circulation  of  blood  through  the  lungs  and  heart. 

The  effect  of  a  wet  subsoil  in  the  causation  of  phthisis  must  not  be 
overlooked.  Whatever  may  be  the  exact  amount  of  truth,  we  are  bound 
to  act  as  if  it  were  certain. 

That  the  syphihtic  disease  of  the  lungs  has  sometimes  a  com^Dletely 
phthisical  character  is  tolerably  clear,  but  syphilis  -^"111  not  account  for  the 
amount  of  phthisis  in  the  army.  The  influence  of  masturbation  in  pro- 
ducing phthisis  is  uncertain. 

The  researches  of  Koch,  and  the  discovery  of  a  supposed  phthisis 
bacillus,  have  revived  the  notion  of  the  commuuicabdity  of  the  disease,  an 
idea  long  held  by  Italian  physicians.  This  would  only  be  a  still  greater 
argument  for  the  freest  ventilation  indoors,  and  for  a  large  part  of  the 

'  There  are  two  valuable  pieces  of  evidence  of  phthisical  and  scrofulous  disease  be- 
ing developed  in  a  healthy  popxilation  from  impure  air,  viz  .  ~Slv.  I\Iorgan's  essav  on 
"  Phthisis  on  the  West  Coast  of  Scotland"  (Brit,  and  For.  Med.-Chir.  Rev.),  and  the 
analogous  case  of  Western  Canada,  given  by  Mr.  Mackeleave  (Medical  Times  and  Gazette, 
August,  ISGd). 


150  PEACTICAL    HYGIENE. 

patient's  time  being  spent  out  of  doors.  It  -would  also  indicate  the  inadvi- 
sability  of  allowing  healthy  individuals  (especially  childi-en)  to  sleep  with  or 
occupy  the  same  sleeping-rooms  as  phthisical  persons.  It  would  also  be 
an  argument  against  massing  phthisical  persons  together,  although  there 
does  not  seem  to  be  any  direct  e\idence  of  injury  arising  from  consump- 
tion hospitals,  which  are,  however,  always  freely  and  carefully  ventilated. 

Scurvy. 

The  pecuHar  state  of  malnutrition  we  call  scurvy  is  now  known  not  to 
be  the  consequence  of  general  starvation,  though  it  is  doubtless  greatly 
aided  by  this.  Men  have  been  fed  with  an  amount  of  nitrogenous  and 
fatty  food  sufficient  not  only  to  keep  them  in  condition,  but  to  cause  them 
to  gain  weight,  and  yet  have  got  scurvy.  The  starches  also  have  been 
given  in  quite  sufficient  amount  without  preventing  it.  It  seems,  indeed, 
clear  that  it  is  to  the  absence  of  some  of  the  constituents  of  the  fourth 
dietetic  group,  the  salts,  that  we  must  look  for  the  cause.' 

Facts  seem  to  show  with  certainty  that  in  the  diet  which  gives  scurvy 
there  is  no  deficiency  of  soda  or  of  iron,  lime,  or  magnesia,  or  of  chloride 
of  sodium.  Nor  is  the  evidence  that  salts  of  potash  or  phosphoric  acid  are 
deficient  at  all  satisfactory.  And  w^hen  we  think  of  the  quantity  of  jDhos- 
phoric  acid  which  must  have  been  supplied  in  many  diets  of  meat,  and 
cereaha,  which  yet  did  not  prevent  scurvy,  it  seems  veiy  unlikely  that  the 
absence  of  the  phosphates  can  have  anything  to  do  with  it.'' 

The  same  may  be  said  of  sulphur.  Considering  the  quantity  of  meat 
and  of  leguminosae  which  some  scorbutic  patients  have  taken,  it  is  almost 
impossible  that  deficiency  in  sulphur  should  have  been  the  cause. 

By  exclusion,  we  are  led  to  the  oj^inion  that  if  the  cause  of  scurvy  is  to 
be  found  in  deficiency  of  salts,  it  must  be  in  the  salts  whose  acids  form 
carbonates  in  the  system.  For,  if  we  are  right  in  looking  to  a  deficiency 
in  the  fourth  class  of  alimentary  principles  as  the  cause  of  scui-yj',  and  if 
neither  the  absence  of  soda,  potash,  lune,  magnesia,  iron,  sulphur,  or  phos- 
phoric acid  can  be  the  cause,  then  the  only  mineral  ingredients  which 
remain  are  the  combinations  of  alkalies  with  those  acids  which  form  car- 
bonates in  the  system,  viz.,  lactic,  citric,  acetic,  tartaric,  and  malic.  That 
these  acids  are  most  important  nutritional  agents  no  one  can  doubt.  The 
salts  containing  them  are  at  first  neutral,  afterward  alkaline,  from  their 
conversion  into  carbonates  ;  they  thus  play  a  double  part,  and  moreover, 
when  free,  and  in  the  presence  of  albumen  and  chloride  of  sodium,  these 
acids  have  peculiar  powers  of  precipitating  albumen,  or  perhaps  of  setting 
free  hydrochloric  acid.  Whatever  may  be  their  precise  action,  their  value 
and  necessity  cannot  be  doubted.  Without  them,  in  fact,  one  sees  no 
reason  why  there  should  not  be  a  continual  excess  of  acid  in  the  system, 

'  For  a  good  deal  of  evidence  up  to  1848,  reference  may  be  made  to  a  review  on 
Scurvy,  contributed  by  Dr.  Parkes  to  the  British  and  Foreign  Medico-Chirurgical 
Review  in  that  year.  The  evidence  since  that  period  has  added  little  to  our  knowledge, 
except  to  show  tliat  the  preservative  and  curative  powers  of  fresh  meat  in  large  quan- 
tities, and  especially  raw  meat  (Kane's  Arctic  Expedition),  will  not  only  prevent,  but 
will  cure  scurvy.  Kane  found  the  raw  meat  of  the  walrus  a  certain  cure.  For  the 
most  recent  evidence  and  much  valuable  information,  see  the  Report  of  the  Admiralty 
Committee  on  the  Scurvy  which  occurred  in  the  Arctic  Expedition  of  1875-76  (Blue 
Book,  1877). 

■'  Professor  Galloway  of  Dublin,  and  Mr.  Anderson  of  Coventry,  have  lately  written 
pamy^hlets  urging  the  claims  of  potash  and  phosphoric  acid  to  attention,  but  without 
bringing  any  fresh  evidence  of  sufficient  importance  to  support  their  views. 


preventio:n"  of  disease.  151 

as  during  nutrition  a  continual  excess  of  acids  (phosphoric,  sulphuric, 
uric,  hiiDpuric)  is  produced,  sufficient,  even  when  the  salts  with  decom- 
posable acid  are  supplied,  to  render  all  excretions  (urinary,  cutaneous, 
intestinal)  acid.  The  only  mode  of  supplying  alkaU  to  the  acids  formed  in 
the  body  is  by  the  action  of  the  phosphates,  which  is  hmited.  The  only 
manufacture  of  alkali  in  the  body  is  the  formation  of  ammonia,  so  that 
these  salts  are  most  important  as  antacids.  Yet  it  is  not  solely  the  absence 
of  alkali  which  produces  scurvy,  else  the  disease  would  be  prevented  or 
cured  by  supply  of  pure  or  carbonated  alkalies,  which  is  not  the  case. 

When,  in  pursuing  the  argument,  we  then  inquire  whether  there  is 
any  proof  of  the  deficiency  of  these  particular  acids  and  salts  fi'om  the 
diets  which  cause  scurvy,  we  find  the  strongest  evidence  not  only  that 
this  is  the  case,  but  that  their  addition  to  the  diet  cures  scurvy  with  great 
certainty.'  They  will  not,  of  course,  cure  coincident  starvation  arising 
from  deficiency  of  food  generally,  or  the  low  intercuiTent  inflammations 
which  occur  in  scurvy,  or  the  occasionally  attendant  pui'pura,  but  the  true 
scorbutic  condition  is  cured  with  certainty. 

Of  the  five  acids,  it  would  appear  rmhkely  that  the  lactic  should  be  the 
most  efficacious.  If  so,  how  is  it  that  in  starch  food,  during  the  digestion 
of  which  lactic  acid  is  probably  formed  in  large  quantities,  scurvy  should 
occur?  Is,  in  such  a  case,  an  alkali  necessary  to  insure  the  change  of  the 
acid  into  a  carbonate  ? 

Vinegar  is  an  old  remedy  for  scurvy,  and  acetic  acid  is  known  to  be 
both  a  jDreventive  of  (to  some  extent)  and  a  cure  for  scurv}^  But  it  has 
always  been  considered  much  inferior  to  both  citric  and  tartaric  acids. 
Possibly,  as  in  the  case  of  lactic  acid,  an  alkali  should  be  supplied  at  the 
same  time,  so  as  to  enable  the  acid  to  be  more  rapidly  transformed. 

Tartaric  and  (especially)  citric  acids,  when  combined  with  alkahes, 
have  always  been  considered  to  be  the  antiscorbutic  remedies,  par  excel- 
lence, and  the  evidence  on  this  point  seems  very  complete.'^ 

Of  mahc  acid  little  is  known  as  an  antiscorbutic  agent,  but  it  is  well 
worthy  of  extended  trials. 

Deficiency  of  fresh  vegetables  imphes  deficiency  in  the  salts  of  these 

'  This  was  most  clearly  shown  in  the  last  Arctic  Expedition  (1875-76).  The  rations 
on  board  ship  during  winter  were  ample,  containing  dried  potatoes  and  other  vegeta- 
bles, preserved  vegetables,  pickles,  bottled  fruits,  vinegar,  and  a  daily  ration  of  lime 
juice,  besides  raisins  and  currants.  In  the  sledge  expeditions  all  these  were  cut  off  ex- 
cept two  ounces  of  preserved  potatoes,  an  inadequate  ration  under  any  circumstances. 
The  meat  was  pemmican  and  bacon,  and  there  was,  of  course,  no  fresh  bread.  The 
result  was,  that  this  imperfect  diet,  conjoined  with  most  laborious  work,  produced  a 
severe  outbreak  of  scurvy,  which  nearly  proved  fatal  to  the  wliole  party.  The  rapidity 
with  which  the  sick  recovered,  on  being  supplied  with  lime  juice  and  more  favorable 
diet,  was  noticeable  (see  Report,  op.  cit.). 

'■'  It  is  based  on  a  very  wide  experience,  and  should  not  be  set  aside  by  the  state- 
ments of  men  who  have  seen  only  three  or  four  cases  of  scurvy,  often  complicated, 
which  happen  not  to  have  been  benefited  by  lemon  juice.  The  process  of  preventive 
medicine  is  checked  by  assertions  drawn  from  a  very  limited  experience,  yet  made 
with  great  confidence.  We  must  remember  that  many  cases  of  scurvy  are  complicated 
— that  the  true  scorbutic  condition,  inanition,  and  low  inflammation  of  various  organs, 
lungs,  spleen,  liver,  and  muscles,  may  be  all  present  at  the  same  time.  See  paper  by 
Dr.  Ralfe,  of  the  Seamen's  Hospital  (1877,  reprinted  from  the  Lancet).  The  Merchant 
Shipping  Act  of  1887  was  soon  followed  by  a  great  decrease  of  scurvy  in  our  mercan- 
tile marine  ;  but  since  1873  there  has  been  a  steady  increase,  which  has  been  attributed 
by  Mr.  Thomas  Gray  (see  Official  Memorandum  on  Sea  Scurvy  and  Food  Scales, 
1882)  to  want  of  more  varied  food  scales.  It  may,  however,  have  resulted  from 
neglect  of  lime  juice,  or  the  use  of  a  damaged  article  (see  British  Medical  Journal, 
September,  1883). 


152  PRACTICAL    HYGIENE. 

acids,  and  scurvy  ensues  witli  certainty  on  their  disuse.  Its  occun'ence  is, 
however,  greatly  aided  by  accessory  causes,  especially  deficiency  in  food 
generally,  by  cold  and  wet,  and  mental  and  moral  depression. 

The  preventive  measvires  of  scurvy  are,  then,  the  supply  of  the  salts  of 
citric,  tartaiic,  acetic,  lactic,  and  maHc  acids,  and  of  the  acids  themselves, 
and  perhaps  in  the  order  here  given,  and  by  the  avoidance,  if  it  can  be 
done,  of  the  other  occasional  causes. 

Experience  seems  to  show  that  the  supply  of  these  acids  in  the  juices 
of  the  fi*esh  succulent  vegetables  and  fruits,  especially  the  potato,  the  cab- 
bage, orange,  hme,  and  grape,  is  the  best  form.  But  fresh  fruits,  tubers, 
roots,  and  leaves  are  better  than  seeds.  The  legniminosse,  and  many  other 
vegetables,  are  useless. 

Fresh,  and  especially  raw  meat  is  also  useful,  and  this  is  conjectiired  to 
be  from  its  amount  of  lactic  acid  ;  but  this  is  uncertain. 

The  dried  vegetables  are  also  antiscorbutic,  but  far  less  so  than  the 
fresh  ;  and  the  experience  of  the  American  war  was  not  so  favorable  to 
them  as  might  have  been  anticipated.  Do  the  citric  and  other  acids  in  the 
di-ied  vegetables  decompose  by  heat  or  by  keeping?  It  would  be  very- 
desirable  to  have  this  question  settled  by  a  good  chemist.  We  know  that 
the  citric  acid  in.  lemon  juice  gradually  decomposes.  It  does  not  follow 
that  it  should  be  quite  stable  in  the  dried  vegetables. 

The  measures  to  be  adoj^ted  in  time  of  war,  or  in  prolonged  sojourn  on 
board  ship,  or  at  stations  where  frasli  vegetable  are  scarce,  are — 

1.  The  supply  of  fresh  vegetables  and  fruits  by  aU  the  means  in  our 
power.  Even  unripe  fruits  are  better  than  none,  and  we  must  i-isk  a  httle 
diarrhoea  for  the  sake  of  their  antiscorbutic  properties.  In  time  of  war 
every  vegetable  should  be  used  which  it  is  safe  to  use,  and,  when  made 
into  soups,  almost  all  are  tolerably  pleasant  to  eat. 

2.  The  supply  of  the  dried  vegetables, '  especially  potato,  cabbage,  and 
cauliflowers ;  turnips,  parsnips,  etc.,  are  j^erhaps  less  useful ;  dried  peas 
and  beans  are  useless.  As  a  matter  of  precaution,  these  di-ied  vegetables 
should  be  issued  early  in  a  campaign,  but  should  never  supersede  the 
fresh  vegetables. 

3.  Good  lemon  juice  should  be  issued  daily  (1  oz.),  and  it  should  be 
seen  that  the  men  take  it. 

4.  Vinegar  {k  oz.  to  1  oz.  daily)  should  be  issued  with  the  rations,  and 
used  in  the  cooking. 

5.  Citrates,  tartrates,  lactates,  and  malates  of  potash  should  be  issued 
in  bulk,  and  used  as  drinks,  or  added  to  the  food.  Potash  should  be 
selected  as  the  base,  as  there  is  seldom  any  chance  of  the  supply  of  soda 
being  lessened.  The  easiest  mode  of  issuing  these  salts  would  be  to  have 
packets  containing  enough  for  one  mess  of  twelve  men,  and  to  insti-uct  the 
men  how  important  it  is  to  place  them  in  the  soups  or  stews.  Possibly 
they  might  be  mixed  with  the  salt,  and  issued  merely  as  salt.  Lozenges 
made  of  citric  acid  or  desiccated  lime  juice  and  sugar  are  well  worth  a 
trial 

*  Probably  dried  fruits,  such  as  raisins  and  currants  (which  contain  some  acid  and 

vegetable  salts)  are  useful  as  antiscorbutics.  The  American  pemmican  contains  them, 
and  men  are  said  to  live  upon  it  for  months  together  without  suffering  from  scurvy. 
It  appears  to  have  been  that  kind  of  pemmican  on  which  the  crew  of  the  "Polaris" 
lived,  who  drifted  on  an  iceberg  for  six  months.  Other  dried  fruits,  such  as  apples, 
would  probably  also  be  efficacious. 


PREVENTION    OF    DISEASE.  153 


Military  Ophthalmia. 

The  term  "  military  ophthalmia "  is  often  appHed  particularly  to  that 
disease  in  which  the  peculiar  gray  granulations  form  on  the  palpebral  con- 
junctiva. But  any  severe  form  of  purulent  ophthalmia  spreading  in  a 
regiment  is  often  classed  under  the  same  heading.  Diseases  of  the  eyes 
are  a  source  of  very  considerable  inefficiency  in  the  army,  and  even  a  casual 
visitor  to  the  Royal  Victoria  Hospital  must  be  struck  by  the  large  number 
of  men  he  will  meet  with  who  have  some  affection  of  the  eyes.  A  refer- 
ence to  the  "Army  Medical  Reports"  will  also  show  what  great  attention  is 
being  paid  to  this  important  subject  by  mihtary  surgeons,  especially  by 
Professor  Longmore. ' 

'  Epidemics  of  military  ophthalmia  (gray  or  vesicular  granulations,  and 
rapid  purulent  ophthalmia),  seem  to  have  been  uncommon,  or  perhaps 
unknown,  on  the  large  scale  in  the  wars  of  the  eighteenth  century. 

The  disease,  as  we  now  see  it,  is  one  of  the  legacies  which  Napoleon 
left  to  the  world.  His  system  of  making  war  with  httle  intermission,  rapid 
movements,  abandonment  of  the  good  old  custom  of  winter  quarters,  and 
intermixture  of  regiments  from  several  nations,  seem  to  have  given  a  great 
spread  to  the  disease  ;  and  though  the  subsequent  years  of  peace  have 
greatly  lessened  it.  it  has  j^revailed  more  or  less  ever  since  in  the  French, 
Prussia,  Austrian,  Bavarian,  Hanoverian,  Itahan,  Spanish,  Belgian,  Swedish, 
and  Russian  armies,  as  well  as  in  our  ovm..  It  has  also  been  evidently 
propagated  among  the  civil  population  by  the  armies,  and  is  one  more 
heritage  with  winch  glorious  war  has  cursed  the  nations.  Our  last 
Egyptian  campaign  (1882),  which  was  very  short,  does  not  appear  to  have 
produced  much  ophthalmia  among  the  troops  engaged. 

In  some  cases,  as  in  the  Danish  army,  it  has  been  absent  till  manifestly 
introduced  (in  1851)  ;  in  other  instances  it  has  been  supposed  to  originate 
spontaneously  from  overcrowding  and  foul  barrack  atmosphere,  and  from 
defective  arrangements  for  ablution.^  Here,  as  in  so  many  other  cases,  we 
find  that  the  question  of  origin  de  novo,  however  important,  need  not  be 
mixed  up  with  that  of  the  necessary  preventive  measures.  What  is  im- 
portant for  us  is  to  know — first,  that  it  is  contagious,  that  is,  transmissible  ; 
and,  secondly,  that  if  not  produced,  its  transmissibihty  is  singularly  aided 
by  bad  barrack  accommodation. 

The  measures  to  be  adopted  if  military  ophthalmia  prevails — 

1.  Good  Ventilation  and  Purity  of  the  .4m-.— In  the  Hanoverian  army, 
Stromeyer  reduced  the  number  of  cases  in  an  extraordinary  degree,  simply 
by  good  ventilation.  The  only  explanation  of  this  must  be  that  the  dried 
particles  of  pus  and  epithelium,  instead  of  accumulating  in  the  room,  were 
carried  away,  and  did  not  lodge  on  the  eyelids  of  the  healthy  men.  The 
evolution  of  ammonia  from  decomposing  urine  has  also  been  assigned  as  a 
cause,  and  this  would  be  also  lessened  by  good  ventilation. 


'  Ophthalmoscopes  are  now  issued  to  the  different  stations,  and  an  Oplithalmoscopic 
Manual  has  been  drawn  up  by  Mr.  Longmore  for  the  use  of  army  medical  officers.  As 
giving  a  good  survey  of  military  ophthalmia  in  the  British  army,  the  excellent  papers 
of  Dr.  Frank  (Army  Medical  Report  for  1860)  and  Dr.  Marston  (Beale's  Archives)  should 
be  also  referred  to.  A  very  interesting  paper  has  also  been  published  by  Mr.  Welch 
(A.M.D.,  formerly  22d  Regimenti,  (Army  Medical  Report,  vol.  v.,  p.  494,  1865),  on  the 
"Causes  aiding  the  Development  of  Granulations  at  Malta."  A  warm,  moist,  impure 
atmosphere  is  shown  to  have  a  great  influence. 

-  See  Frank's  papers  (Army  Medical  Report  for  1860,  p.  406)  for  some  remarks  on  its 
spontaneous  origin. 


15-i  PRACTICAL    HYGIENE. 

It  would  appear  likely  that  bad  barrack  air  predisposes  to  granidar  con- 
junctivitis by  producing  some  pecidiar  state  of  the  palpebral  conjunctiva 
and  glands  (Stronieyer  and  Frank),  and  if  a  diseased  person  then  intro- 
duces the  specific  disease,  it  sj^reads  with  great  rapidity,  or  possibly,  as 
'Mi:  Welch's  facts  seem  to  show,  the  impiU'e  atmosj)here  is  the  great  cause, 
and  contagion  only  secondary. 

2.  Careful  Ablution  Arrangements. — An  insufficient  quantity  of  water 
for  cleansing  basins,  and  the  use  of  the  same  towels,  are  great  means  of 
spreading  the  disease,  if  it  has  been  introduced.  Whenever  men  use  the 
same  basins,  they  should  be  taught  to  thoroughly  cleanse  them  ;  and  it 
would  be  well  if,  in  every  mihtary  ablution  room,  the  men  were  taught  not 
only  to  allow  the  dirty  water  to  run  away,  but  to  refill  the  basin  with  water, 
which  the  next  comer  would  let  off  before  filling  with  fresh  water  for  hiiji- 
self.  If  some  mechanism  could  be  devised  for  this,  it  would  be  very  useful. 
The  same  towel  is  a  most  common  cause  of  propagation  ;  or  a  diseased 
man  using  always  the  same  towel  may  reinoculate  himself.  The  towels 
should  be  ver}'  frequently  washed  (probably  every  day),  and  should  be 
dried  in  the  open  air,  never  in  the  ablution  room  or  barrack. 

In  some  cases  special  ablution  arrangements  may  cause  a  good  deal  of 
gi-anular  conjunctivitis.  In  1842  and  1843  Dr.  Parkes  witnessed,  in  a 
regiment  newly  landed  in  India  from  England,  a  very  great  number  of 
cases  of  this  kind.  The  supply  of  water  was  very  insufficient  ;  many  men 
used  the  same  basins,  which  Avere  very  imperfectly  cleaned  ;  the  same 
basins  were  used  for  washing  and  also  for  dyeing  clothes  ;  at  that  time  the 
men  in  the  cold  months  wore  trousers  of  a  black  drill,  and  when  the  dye 
came  off  they  were  accustomed  to  rudely  replace  it ;  they  themselves 
ascribed  the  very  j:)revalent  ophthalmia  to  the  u-ritating  effect  of  the  parti- 
cles of  the  dye  left  in  the  basins  and  getting  into  the  eyes.  There  were 
enormous  granulations  on  both  upper  and  lower  lids,  and  the  disease  was 
believed  to  be  communicable,  but  whether  the  affection  was  strictly  to  be 
classed  with  the  vesicular  granulations  is  not  known. 

3.  In  some  cases  the  use  of  the  bedding  (pillows  and  pillow-cases), 
which  has  been  used  by  men  with  gray  granulations,  has  given  the  disease 
to  others,  and  this  has  especially  occurred  on  board  transports.  In  time 
of  war  especially  this  should  be  looked  to.  If  any  cases  of  oiDlithahnia 
have  occiu'red  on  board  ship,  all  the  pillows  and  mattresses  should  be 
washed,  fumigated,  and  thoroughly  aired  and  beaten.  The  transference 
has  been  in  this  case  direct,  particles  of  pus,  etc.,  adhering  to  the  pillow 
and  mattresses,  and  then  getting  into  the  eyes  of  the  next  comers. 

4.  Immediately  the  disease  j^resents  itself,  the  men  sliovdd  be  complete- 
ly isolated  and  allowed  to  have  no  communication  with  then-  comrades. 
It  has  been  a  great  question  whether  a  Government  is  justified  in  sending 
soldiers  home  to  their  friends,  as  the  disease  has  been  thus  earned  into 
previously  healthy  villages.  It  would  seem  clear  that  the  State  should 
bear  its  own  burdens  and  provide  means  of  isolation  and  perfect  cure,  and 
not  throw  the  risk  on  the  friends  and  neighbors  of  the  soldier. 

An  important  matter  to  remember  in  connection  with  gray  granula- 
tions is  that  relapses  are  very  frequent  ;  a  man  once  affected  has  no  safety 
( Warlomont)  ;  simple  causes  of  catarrh  and  inflammation  may  then  rein- 
duce  the  specific  gray  granulations  with  their  contagious  characters ;  so 
that  a  man  who  has  once  had  the  disease  is  a  source  of  danger,  and  should 
be  watched. 


PKEVENTION    OF   DISEASE.  155 


Venereal  Diseases  in  the  Army. 

It  is  convenient  for  our  purpose  to  put  together  all  diseases  arising 
from  impure  sexual  intercourse,  whether  it  be  a  simple  excoriation  which 
has  been  inoculated  with  the  natural  vaginal  mucus  or  with  leucorrhoeal 
discharges,  and  which  may  produce  some  inguinal  swelling,  and  may  either 
get  well  in  a  few  days  or  last  for  several  days  ;  or  whether  it  be  an  inflam- 
mation of  the  urethra  produced  by  specific  (or  non-specific?  leucorrhoeal?) 
discharge  ;  or  whether  it  be  one  of  the  forms  of  syphilis  now  diagnosed  as 
being  in  all  probability  separate  and  special  diseases,  having  particular 
courses  and  terminations. 

In  the  army  men  enter  the  hospital  from  all  these  causes,  and  from  the 
remoter  effects  of  gonorrhoea  or  syphilis,  orchitis,  gleet,  stricture,  bladder 
and  kidney  affection  ;  or  syphilitic  diseases  of  the  skin,  bones,  eyes,  and 
internal  organs. 

The  gross  amount  of  inefficiency  in  the  army  is  tolerably  well  known, 
but  it  will  require  a  few  more  years  before  the  several  items  of  the  gross 
amount  are  properly  made  out.  This  arises  partly  from  an  occasional 
great  difficulty  in  the  diagnosis  of  true  infecting  syphilis,  and  partly  from 
a  want  of  uniformity  in  nomenclature. 

The  comparative  amount  of  army  and  civil  venereal  diseases  is  not 
known,  because  we  have  no  statistics  of  the  civil  amount.  It  is  no  doubt 
great.  It  is  a  question  whether  a  large  majority  of  the  young  men  of  the 
upper  and  middle  classes  do  not  suffer  in  youth  from  some  form  of  venereal 
disease.     In  the  lower  classes  it  is  perhaps  equally  common. 

The  sequences  are  most  serious  ;  neglected  gleet,  stricture,  secondary 
and  tertiary  syphilis,  are  sad  prices  to  pay  for  an  unlawful  (in  some  cases 
a  momentary)  gratification  ;  and  in  the  army  the  State  yearly  suffers  a  large 
pecuniary  loss  from  inefficiency  and  early  invaliding.  In  campaigns  the 
inefficiency  fi'om  this  cause  has  sometimes  been  great  enough  to  alarm  the 
generals  in  command  and  to  increase  considerably  the  labor  and  suffer- 
ings of  the  men  who  are  not  affected. 

The  preventive  measures  against  venereal  diseases  are — 

1.  Continence. — The  sexual  passion  in  most  men  is  very  strong — strong 
enough,  indeed,  to  lead  men  to  defy  all  clangers  and  to  risk  all  conse- 
quences. It  has  been  supposed  by  some  that,  in  early  manhood,  conti- 
nence is  impossible,  or,  if  practised,  is  so  at  the  risk  of  other  habits  being 
formed  which  are  more  hurtful  than  sexual  intercourse,  with  all  its  dangers. 
But  this  is  surely  an  exaggeration  ;  the  development  of  this  passion  can 
be  accelerated  or  delayed,  excited  or  lowered,  by  various  measures,  and 
continence  becomes  not  only  possible,  but  easy. 

For  delaying  the  advent  of  sexual  puberty  and  desire  two  plans  can  be 
suggested — absence  from  exciting  thoughts  and  temptation,  and  the  system- 
atic employment  of  muscular  and  mental  exercise.  The  minds  of  the 
young  are  often  but  too  soon  awakened  to  such  matters,  and  obscene  com- 
panions or  books  have  lighted  up  in  many  a  youthful  breast  thai  feu-d'enfer 
which  is  more  dangerous  to  many  a  man  than  the  shai'pest  fire  of  the  battle- 
field would  be.  Among  young  soldiers  this  is  especially  the  case  ;  while, 
in  spite  of  the  exciting  literature  of  the  day,  and  of  the  looseness  of  some 
of  the  older  boys  at  the  public  schools  or  at  the  universities,  the  moral  tone 
of  the  young  gentlemen  of  our  day  is  better  than  it  was  some  half  century 
ago,  the  conversation  of  the  classes  from  which  the  soldier  is  drawn  is  still 
coarse  and   lewd  as  in  the   middle   ages.     There  is  too  close  a  mixture  of 


156  PRACTICAL    HYGIENE. 

the  sexes  in  the  English  cottages  for  much  decency,  and  the  young  recruit 
does  not  often  require  the  tone  of  the  ban-ack  to  destroy  his  modesty.  In 
fact,  it  is  possible  that,  in  good  regiments,  he  will  find  a  higher  moral  tone 
than  in  the  factory  or  the  harvest-field. 

We  must  ti'ust  to  a  higher  cultivation  and  moral  training  to  introduce 
among  the  male  youth  of  this  nation,  in  all  its  grades,  a  purer  moral  tone. 
In  the  army,  the  example  of  the  officers  and  their  exertions  in  this  way 
would  do  great  things  if  we  could  hope  that  the  high  moral  tone  which 
happily  exists  in  some  cases  could  inspire  all. 

It  is  not  the  less  necessary  to  save  the  young  from  direct  temptation. 
The  youth  of  this  nation  are  now  solely  tempted,  for  in  oiu-  streets  prosti- 
tation  is  at  every  comer.  Whatever  may  be  the  objection  to  police  I'egula- 
tions,  we  have  surely  a  right  to  demand  that  the  present  system  of  temp- 
tation shall  be  altered.  It  may  not  be  easy  to  exclude  all  prostitutes, 
especially  of  the  better  class  (whose  calling  is  less  easilj'  brought  home  to 
them),  from  pubhc  thoroughfares,  but,  practically,  open  prostitution  can 
be  recognized  and  made  to  disappear  from  our  streets.  It  has  been  said 
our  j)olice  regulations  are  sufficient  for  this  ;  they  have  never  yet  proved 
so  ;  and  in  no  European  country  but  England  is  prostitution  so  open  and  so 
undisguised. ' 

In  the  Acts  passed  in  1864,"  1866,  and  1869,  and  in  the  Licensing  Act 
of  1872  (Acts  of  the  greatest  importance  as  the  first  steps  in  an  efficient 
legislation),  authority  has  been  now  taken  to  prevent  prostitutes  fi'om  as- 
sembling in  the  public-houses,  and  to  a  certain  extent  sources  of  tempta- 
tion have  been  removed. 

If  young  men  can  thus  escape  an  appeal  to  their  passions,  continence 
is  much  more  easy.  There  are  times  when  the  strictest  \'ii'tue  may  well 
dread  such  an  appeal.  Human  nature  is  but  too  weak,  and  needs  eveiy 
safeguard  it  can  get. 

As  aids  to  continence,  great  physical  and  mental  exertion  are  most 
powerful.  It  would  seem  that,  during  gi-eat  exercise,  the  nervous  energy 
is  expended  in  that  way,  and  erotic  thoughts  and  propensities  are  less 
prominent ;  so  also  with  mental  exercise,  in  perhaps  a  less  degree.  The 
establishment  of  athletic  sports,  gymnasia,  and  comfortable  reading-rooms 
in  the  army,  may  be  expected  to  have  some  influence. 

Temperance  is  a  great  aid  to  continence.  In  the  army  the  intemperate 
men  give  the  greatest  number  of  cases  of  s^'phiUs  ;  and  when  a  man  gets 
an  attack,  it  is  not  infi-equently  found  that  he  was  drunk  at  the  time. 

The  measures  which  promote  continence  are,  then — 

(a)  The  cultivation  of  pm-e  thought  and  conversation  among  the  young 
soldiers,  by  every  means  in  our  power. 

(b)  Removing  temptation. 

(c)  Constant  and  agi'eeable  employment,  bodily  and  mentally  ;  as  idle- 
ness is  one  great  cause  of  debauchery. 

(d)  Temperance. 

'  The  effect  of  this  upon  the  virtuous  female  population  is  very  serious.  Every  ser- 
vant in  London  sees  the  fine  clothes  and  hears  of  the  idle  luxurious  lives  of  the  women 
of  the  town,  and  knows  that  occasionally  respectable  marriage  ends  a  life  of  vice. 
What  a  temptation  to  abandon  the  hard  work  and  the  drudgery  of  service  for  such  a 
career,  of  which  she  sees  only  the  bright  side  !  It  is  a  temptation  from  which  the 
State  should  save  her.  She  should  see  prostitution  as  a  degraded  calling  only,  with  its 
restrictions  and  its  inconveniences. 

-  An  Act  for  the  Prevention  of  Contagious  Diseases  at  Certain  Naval  and  Military 
Stations,  1864;  an  Act  for  the  Better  Prevention,  etc.,  lb()6  (cited  as  Contagious  Dis- 
eases Act,  18(36). 


PEETE^'TIOX    or    DISEASE.  157 

2.  3Iarriage. — It  is  very  doubtful  Triiether  those  -wlio  condemn  early 
marriages  among  the  working-classes,  on  account  of  improvidence,  are  en- 
tirely right  in  theij;  argument.  The  moral  effect  of  prolonged  cehbacy  has 
seldom  been  considered  by  them.  Probably  the  early  marriages  are  the 
salvation  of  the  working  youth  of  this  country  ;  and  in  the  present  condi- 
tion of  the  labor  mai'ket,  the  best  tiling  a  working-man  can  do  is,  as  early 
as  possible,  to  make  his  home,  and  to  secure  himself  both  from  the  temp- 
tations and  expenses  of  bachelorhood.  In  the  case  of  the  soldier  the  con- 
ditions were  formerly  different  for  different  men  ;  the  private  soldier  who 
had  enhsted  for  long  service  (twelve  years,  and  prospect  of  renewal)  could 
not  marry  for  seven  years,  and  then  only  7  per  cent,  could  many  with 
leave.  It  was  difi&ctilt  to  avoid  this,  and  the  consecjuences  were  certainly 
most  serious.  Under  the  new  system  of  seven  years'  enhstment,  and  pas- 
sage into  the  reserve,  a  soldier  will  not  marry  at  all,  and  it  is  of  course  de- 
sirable he  should  not  do  so.  If  he  enhsts  at  nineteen,  at  twenty-six  he  will 
be  free  ;  and  if  kept  in  fuLl  occupation,  and  as  far  as  possible  shielded  from 
temptation,  the  biu'den  of  cehbacy  ■^•ih  not  weigh  upon  him.  Continence 
would  be  desirable  for  his  health  and  for  the  welfare  of  his  futui-e  off- 
spring. The  short  ser\'ice  now  introduced  may  indeed  greatly  influence 
this  matter,  and  certainly  has  removed  from  pressing  discussion  the  ques- 
tion of  marriage  in  the  infantry  of  the  army. 

3.  Precautions  against  the  Disease. — Admitting  that,  in  the  case  of  a 
body  of  unmarried  men,  a  certain  amount  of  prostitution  will  go  on,  some- 
thing may  be  done  to  prevent  disease  by  extreme  cleanliness,  instant  ablu- 
tion, and  by  the  use  of  zinc,  alum,  and  u'on  washes,  or  similar  lotions,  after 
connection,  and  by  the  constant  use  by  prostitutes  of  similiar  washes.  It 
may  seem  an  offence  against  morahty  to  speak  of  such  things ;  but  we 
must  deal  with  things  as  they  are,  and  our  object  now  is  not  to  enforce 
morahty,  but  to  prevent  disease.  The  use  in  brothels  of  these  measures 
appears  to  be  more  efficacious  than  any  other  plan.  In  some  of  the  French 
towns  the  use  of  lotions  and  washings  is  rigorously  enforced,  with  the 
effect  of  lessening  disease  considerably. 

4.  Detection  and  Cure  of  Diseased  Men  and  Women. — In  the  case  of  the 
soldier  who  has  medical  advice  at  hand,  it  seems  of  the  gi'eatest  impor- 
tance to  have  instant  medical  aid  at  the  first  sign  of  disease.  But  instead 
of  this  the  soldier  conceals  his  ailment  as  long  as  possible,  because  he  will 
be  sent  to  hospital,  put  under  stojopages,  etc.  A  late  regulation  made  this 
even  more  stringent,  but  it  is  now  happily  rescinded.  The  soldier  should 
be  encouraged  to  make  immediate  apphcation,  and  he  should  certainly  not 
be  punished  for  a  fault  which  his  superiors  commit  with  impunity,  and  for 
which  the  State  is  in  pari  answerable  by  enforcing  cehbacy.  Our  object 
is  to  preserve  the  man's  health  and  seiwices  for  the  State  ;  we  shall  not 
accomphsh  this  by  ignoring  what  is  a  common  consequence  of  his  condi- 
tions of  service. 

It  has  been  proposed  to  detect  and  cure  the  disease  in  prostitutes.  A 
great  outciy  has  been  raised  against  this  prososal,  which  is  ^ei  a  matter  of 
precaution  which  the  State  is  sui'ely  bound  to  take.  A  woman  chooses  to 
follow  a  dangerous  trade — as  dangerous  as  if  she  stood  at  the  comer  of  a 
street  exploding  gunpowder.  By  practising  this  trade  she  ought  at  once 
to  bring  herself  under  the  law,  and  the  State  must  take  what  ^precautions 
it  can  to  prevent  her  doing  mischief.  The  State  cannot  prevent  prostitu- 
tion. We  shall  see  no  return  to  the  stem  old  Scandinavian  law  which 
punished  the  prostitute  with  stripes  and  death  ;  but  it  is  no  more  in- 
terference  with   the   liberty  of   the   subject   to   prevent   a  woman  from 


158  PRACTICAL    HYGIENE. 

propagating  sj'philis  than  it  would  be  to  prevent  her  propagating  small- 
l^ox. 

The  difficulty  is  to  detect  when  she  is  diseased.  Abroad,  an  elaborate 
system  is  in  use  for  this  purpose  ;  brothels  are  registered* and  their  inmates 
regularly  examined.  In  this  country  such  a  system  seems  to  many  people 
too  hke  a  recognition  of  the  inevitableness  of  prostitution,  and  to  a  certain 
extent  a  sanction  of  it ;  it  is  really,  however,  a  simple  matter  of  precavition. 
A  custom  exists  which  we  cannot  set  aside  ;  let  us  ob\date  its  effects  as  best 
w^e  may,  while,  at  the  same  time,  by  higher  culture  and  other  efforts,  we 
endeavor  to  gradually  remove  the  custom.' 

A  partial  adoption  of  this  plan  has  been  commenced  by  the  military  and 
naval  authorities  in  this  country,  and  Acts  have  been  passed  (1864,  1866, 
and  1869)  by  means  of  which  the  prostitutes  of  certain  military  and  naval 
stations  are  brought  under  supervision."  The  important  clause  in  the  Act 
for  1866  is  clause  15,  which  provides  that  when  an  information  is  made  on 
oath  that  a  woman  is  a  common  prostitute,  living  within  the  limits  of  any 
place  to  which  the  Act  applies,  or  having  been  within  those  hmits  for  the 
purpose  of  j)rostitution,  a  justice  may  issue  notice  to  such  woman,  through 
the  superintendent  of  police,  to  aj)pear  for  medical  examination.  She  is 
then  kept  under  continued  inspection,  and  certified  Lock  hospitals  are 
provided  for  her  treatment  if  she  is  discovered  to  be  ill.  Clause  36  is  also 
an  important  one  ;  it  imposes  a  penalty  of  £20,  or  imprisonment,  with  or 
without  hard  labor,  on  any  brothel-keeper  or  owner  of  a  house  who,  having 
reasonable  cause  to  know  a  woman  to  be  a  prostitute,  and  to  be  affected 
with  a  contagious  disease,  allows  her  to  resort  to  the  house  for  the  purpose 
of  prostitution. 

This  Act  came  into  force  on  October  1,  1866  ;  and  in  some  stations,  as 
at  Aldershot,  it  was  really  more  than  half  a  year  after  this  time  before  it 
could  be  put  into  force. 

Since  the  passing  of  these  Acts  there  has  been  a  most  decided  decrease 
in  the  number  of  primary  venereal  sores  at  all  the  military  stations  under 
the  Acts,  compared  with  non-jDrotected  stations.  And  this  is  ihe  more 
satisfactory  because  the  frequent  movement  of  the  troops,  and  the  number 
of  stations  where  there  is  no  control  of  disease,  render  the  working  of  the 
Acts  difficult." 

'  Those  persons  who  shut  their  eyes  to  the  enormous  prostitiition  of  this  countrj',  as 
of  all  others,  or  think  nothing  can  be  done  because  it  is  impossible  to  deal  with  private 
or  "  sly  "  prostitution,  and  with  tlie  higher  grades  of  the  calling,  should  remember  that 
some  movement  in  the  interest  of  the  unhappy  girls  themselves  is  necessary.  In  the 
low  brothels  in  London  the  system  is  a  most  cruel  one.  A  girl  is  at  first  well  treated, 
and  encouraged  to  fall  into  debt  to  her  employer.  As  soon  as  she  is  fairly  involved 
she  is  a  slave  ;  there  is  no  relief  till  she  can  make  no  more  money,  when  she  is  cast  out. 
Surely  something  should  be  done  to  save  her.  Possibly  it  might  be  well  to  try  the  plan 
of  recognizing  no  debts  from  a  girl  to  the  procuress  or  brothel-keeper,  and  to  also  devise 
means  lor  at  once  giving  her  the  means  of  release  from  her  life  if  she  desires  it.  Also, 
if  such  houses  must  exist — and  who  can  venture  to  hope  they  will  not  ? — they  may  at 
least  be  made  less  indecent,  quieter,  and  safer  from  theft,  and  even  murder.  At  pres- 
ent, the  system,  as  it  exists,  is  a  gigantic  scandal  to  Christianity,  and  Jeannel's  singular 
work  has  lately  shown  how  curious  a  parallel  there  is  between  modern  prostitution  and 
that  which  dimmed  the  splendor,  and  perhaps  hastened  the  fall,  of  Imperial  and  Pagan 
Home.     Eighteen  centuries  after  the  death  of  Christ,  are  we  still  at  such  a  point  ? 

■■'  The  military  stations  named  in  the  Contagious  Diseases  Act  in  1866  are  Forts- 
mouth,  Plymouth,  and  Devonport ;  Woolwich,  Chatham,  and  Sheerness ;  Aldershot, 
Windsor,  Colchester,  Shornclifle,  Curragh,  Cork,  and  Queenstown.  Others  have  since 
been  added.     Adjoining  parishes  are  in  many  cases  included. 

'  For  the  statistics  of  this  question,  see  Army  Medical  Report  for  1880,  vol.  xxii. , 
pp.  12-17  and  ;368-371. 


PKEYENTIOX    OF    DISEASE.  159 

But  the  following  figui-es,  from  the  "A.  3L  D.  Eeport"  for  1880,  ai-e  quite 
coll^"iIlcing. 

In  1880  there  were  foui'teen  stations  under  the  Contagious  Diseases 
Act,  with  a  mean  strength  of  -44,026  men  ;  putting  against  these  all  other 
stations  not  under  the  Act,  with  an  average  strength  of  39,869  men,  we 
haye  the  following  ratio  : — 

Admission  per  1,000  of  Strength. 

^.n'r^r^nr.  Gonorrhoea. 

•  venereal  bore. 

Foui'teen  stations  under  the  Act  1880 74  100 

Ah  other  stations  not  under  the  Act  1880 119  114 

It  must  be  remembered  that  at  present  gonon-hcea  has  not  been  touched 
by  the  Act,  for  want  of  hospital  accommodation,  so  that  the  nearly  equal 
amount  of  gonoiThcea  of  the  two  classes  shows  th^t  the  enormous  lessen- 
ing of  primary  venereal  sore  in  the  controlled  stations  is  owing  to  a  real 
diminution  of  syphilis,  and  not  to  lessened  frequency  of  intercourse.  This 
is  proved  again  by  the  foUo^^ing  figures  given  by  Dr.  Balfour. 

In  1864,  the  yeai-  before  the  Act  came  into  operation,  the  average  ad- 
missions at  all  the  stations  from  primary  venereal  sore  were  1G8.6  per 
1,000.  In  1872,  at  the  uncontroUed  stations,  the  number  was  still  higher, 
being  12.3.2,  so  that  s;\"|:)hihs  had  not  declined  in  the  uncontroUed  stations. 
But  in  the  controlled  stations  in  1872  the  admissions  were  only  53.3. 
Therefore,  the  gain  to  the  State  in  the  controlled  stations  was  (108.9-53.3) 
55  admissions  less  per  1,000  of  strength ;  and  in  a  mean  strength  of 
50,000  men  the  State  was  saved  the  cost  of  2,750  cases  of  primary  venereal 
sore  in  that  year,  and  the  men  were  saved  the  enormous  injuiy  to  their 
health  which  would  otherwise  have  resulted. 

Let  the  facts  be  put  in  another  form.  Taking  the  first  seven  years  that 
the  Acts  were  in.  operation  (before  the  introduction  of  the  stoppage  regu- 
lation in  1873),  viz.,  1865-72  (though  in  the  early  yeai'S  the  operation  was 
partial  and  imperfect),  we  have  the  following  figiii-es  : 

Admission  per  1,000  of  Strength,  1865-72  inclusive. 

Primary  Sores.     Gonorrhcea 

AH  stations  not  under  the  Act  (mean  strength  32,528 

men) 103.1  111.7 

Stations  under  the  Act  (mean  strength  30,765  men) .  .        62.8  115.0 

There  was  therefore  a  practical  identity  in  gonorrhceal  admissions,  but 
the  annual  admissions  for  primary  venereal  sores  were  reduced  in  the  con- 
trolled stations  by  40.3  per  1,000.  In  the  eight  years  the  State  was  there- 
fore saved  very  nearly  10,000  cases  of  syphilis ;  and  supposing  each  de- 
manded twenty  days  of  treatment  (which  is  moderate),  200,000  days  of 
sickness  have  been  saved  in  eight  years. 

Such,  then,  has  been  the  operation  of  the  Act  under  many  disadvan- 
tages, but  this  has  not  been  its  only  beneficial  effect. 

The  Act  at  the  large  stations  has  done  gTeat  good  in  some  other  direc- 
tions, especially  as  regards  the  women.  Many  women  have  been  reclaimed  ; 
the  horrible  juvenile  prostitution  has  almost  ceased,  and  comparative  de- 
cency has  been  taught  in  the  hospitals.  StiU.  the  act  is  too  feebly  drawn, 
and  too  partially  canied  out,  to  cope  entu-ely  with  the  evil.  The  jirosti- 
tutes  are  not  thoroughly  under  inspection  ;  many  are  not  inspected  at  all ; 


160  PRACTICAL    HYGIENE. 

ueighboring  towns  send  in  prostitutes  ;  and  liospital  accommodation  is 
insufficient. 

The  prostitutes  from  suiTounding  districts  not  in  the  Act  also  come 
into  these  towns  and  camps,  either  remaining  for  a  few  days  and  then  dis- 
ai3j)earing,  or,  if  diseased,  stopping  tiU  they  can  get  admitted  into  hospital. 
Kegiments  coming  from  other  quarters  not  under  the  Act ;  men  coming 
from  furlough  or  detachment,  also  introduce  the  disease  ;  in  fact  the  means 
of  evasion  and  of  reintroduction  are  numerous. 

One  consequence  of  the  Contagious  Diseases  Act  was  to  make  public  the 
most  frightful  state  of  things  among  the  women  of  our  garrison  towns. 
The  vivid  jDicture  of  the  Chatham  prostitute's  life,  drawn  by  IVIr.  Berkeley 
Hill,'  was  no  exaggeration.  Eejjorts  from  the  Lock  hospitals  at  other 
places  would,  if  ixiblished,  have  borne  out  all  Mr.  HiU  alleged.  Shocking 
as  these  disclosures  are,  and  mortifying  as  they  may  be  to  our  national 
pride,  it  is  by  far  the  best  plan  to  have  them  made.  An  evil  like  tliis  must 
not  be  treated  in  the  shade  ;  it  will  never  be  overcome  till  the  public  know  its 
proportions  ;  the  deadly  mists  which  cling  round  and  poison  the  very  basis 
of  society  can  be  dispersed  only  when  the  healing  light  of  the  sun  falls  on 
them.  It  is  at  any  rate  encouraging  to  learn  that  the  effect  of  the  Act  has 
been  greatly  to  improve  the  manners  and  habits  of  the  women — to  impose 
some  restraint  on  them,  and  to  restore  to  them  something  that,  in  compari- 
son with  their  former  life,  may  be  called  decency. 


'  British  Medical  Journal,  18G7. 


CHAPTER  XIX. 

DISINFECTION  AND  DEODORIZATION. 

The  term  disinfectant,  which  has  now  come  into  popular  use,  has  unfor- 
tunately been  employed  in  several  senses.  By  some  it  is  applied  to  every 
agent  which  can  remove  imp uiity  from  the  air  ; '  by  others,  to  any  sub- 
stance which,  besides  acting  as  an  air  purifier,  can  also  modify  chemical 
action,  or  restrain  putrefaction  in  any  substance,  the  efflmia  from  which 
may  contaminate  the  au- ;  while,  by  a  thii-d  party,  it  is  used  only  to  desig- 
nate the  substances  which  can  prevent  infectious  diseases  from  spreading, 
by  destroj-ing  theh'  specific  jDoisons.  This  last  sense  is  the  most  coiTect, 
and  it  is  that  which  is  solely  used  here.  The  term  disinfectant  might  also 
be  ajDphed  to  substances  destroying  entozoa  or  ectozoa,  or  epiphytes  or  ento- 
phytes,  but  there  is  a  disadvantage  in  gi's'ing  it  so  extended  a  meaning.  The 
mode  in  which  the  poisons  are  destroyed,  whether  it  be  by  oxidation, 
deoxidation,  or  arrest  of  growth,  is  a  matter  of  indifference,  pro%*ided  the 
destruction  of  the  poison  is  accomplished.  The  general  term  air  imrifier 
is  given  in  this  work  to  those  agents  which  in  any  way  cleanse  the  air,  and 
which  therefore  include  disinfectants  ;  and  the  term  sewage  deodorants,  to 
those  substances  which  are  used  to  prevent  putrefaction  in  excreta,  or  in 
waste  animal  or  vegetable  matters,  or  to  remove  the  products  of  putrefac- 
tion. In  a  great  mauy  instances  the  substances  which  are  recommended  as 
disinfectants  are  little  more  than  deodorants,  and  ought  properly  to  be  spoken 
of  as  such. 

The  chief  human  diseases  which  are  supposed  to  spread  by  means  of 
special  agencies  (conveniently  designated  vmder  the  name  of  "  contagia"),^ 
are,  the  exanthemata  ;  typhus  exanthematicus  ;  enteric  (typhoid)  fever  ;  re- 
lapsing fever  ;  yellow  fever  ;  paroxysmal  and  the  allied  remittent  fevers  ; 
dengue  ;  cholera  ;  bubo-plague  ;  influenza  ;  whooping-cough  ;  diphtheria  ; 
erysipelas  ;  dysentery  (in  some  cases) ;  puerperal  fever  ;  s^-j^hilis  ;  gonor- 
rhoea ;  glanders  ;  farcy  ;  malignant  pustule  ;  and,  perhaps,  phthisis.  There 
are  some  few  others  more  uncommon  than  the  above. 

It  has  long  been  a  belief  that  the  spread  of  the  infectious  diseases  might 
be  prevented  by  destroying  the  agencies  in  some  way,  and  vai'ious  fumiga- 
tions, fires,  and  similar  plans  have  been  employed  for  centui'ies  during 
great  epidemics. 

In  oi'der  to  ajoply  disinfection  in  the  modern  sense  of  the  teiTu,  we 
ought  to  know — 1st,  the  nature  of  these  contagious  agencies  ;  2d,  the  media 

^  Tardieu,  for  example,  Diet.  d'Hyg.,  art.  "Desinfection,"  and  many  other  authors. 

^  It  will  be  seen  that  the  old  distinctions  between  infectious  and  contagious  diseases, 
and  between  miasmata  and  contaf,ia,  are  not  adhered  to.     They  were  at  no  time  thor- 
oughly definite,  and  are  now  better  abandoned. 
Vol.  II. -11 


162  PRACTICAL    HYGIENE. 

tkrougli  which  they  spread ;  and  3d,  the  effect  produced  upon  them  by  the 
chemical  methods  which  are  supposed  to  destroy  or  modify  them. 

1.  THE  NATURE  OF  THE  CONTAGIA.' 

This  point  is  at  present  the  object  of  eager  inquiry.  In  the  case  of  one 
or  two  of  the  above  diseases,  the  question  has  been  narrowed  to  a  small 
compass.  In  variolous  and  vaccine  discharge,  and  in  glanders,  tlie  poison 
certainly  exists  in  the  form  of  solid  particles,  which  can  be  seen  by  high 
powers  as  glistening  points  of  extreme  minuteness.^  In  cattle  plague 
blood-serum  there  are  also  excessively  small  particles  discovered  by  Beale, 
which  are  probably  the  poison.  The  size  of  the  particles  supijosed  to  be 
contagia  is  minute  ;  some  of  them  are  not  more  than  -^u^^ooth  of  an  inch, 
and  Beale  believes  that  there  may  be  smaller  still  to  be  discovered  with 
higher  powers.  Cliauveau  has  washed  the  vaccine  solid  particles  in  water ; 
the  water  did  not  become  capable  of  giving  the  disease  ;  the  washed  par- 
ticles retained  their  power.  The  epidermic  scales  of  scarlet  fever  and  the 
pellicle  of  the  diphtheric  membrane  certainly  contain  the  respective  poi- 
sons, and  after  exposure  to  the  air  for  weeks,  and  consequent  drying,  still 
retain  their  jjotency.  It  is  more  likely  that  solid  matters  should  thus  re- 
main unchanged  than  liquids,  but  it  has  not  yet  been  proved  that  this  is 
so,  and  at  present  the  exact  physical  condition  of  the  contagia  of  the  other 
infectious  diseases  remains  doubtful. 

The  extraordinary  power  of  increase,  and  capability  of  producing  their 
like,  jiossessed  by  some  of  the  contagia  when  placed  luider  special  foster- 
ing cii'cumstances,  as  in  the  bodies  of  susceptible  animals,  lead  to  the  belief 
that  they  are  endowed  with  an  indejDenclent  life.  The  old  doctrines  that 
they  are  simply  either  poisonous  gases  or  animal  substances  in  a  state  of 
chemical  change,  and  capable  of  communicating  this  change,  or  that,  like 
the  so-called  ferments  (ptyalin,  pancreatin,  diastase,  emulsin),  they  split 
up  certain  bodies  they  meet,  are  not  now  in  favor. 

The  retention  of  the  power  of  contagion  for  some  time,  and  its  final 
loss,  the  destruction  of  the  power  by  antiseptics  which  do  not  affect  the 
action  of  such  bodies  as  ptyalin  or  diastase,  and  the  peculiar  incubative 
period  which  is  most  easily  explained  by  supposing  a  gradual  development 
of  the  active  agent  in  the  body,  are  more  in  accordance  with  the  h;^'pothe- 
sis  of  independent  life  and  power  of  growth. 

The  independent  living  nature  of  the  contagia  is  a  belief  which  has  long 
been  held  in  various  forms.  At  the  present  time  there  are  three  views, 
each  of  which  has  some  arguments  in  its  favor. 

(1)  The  particles  are  supposed  to  be  of  animal  origin,  born  in,  and  only 
growing  in  the  body  ;  they  are,  in  fact,  minute  portions  of  bioplasm  (to 
use  Dr.  Beale 's  phrase),  or  protoplasm.^ 

This  is  the  old  doctrine  of  "  fomites  "  expressed  in  a  scientific  form, 
and  supported  by  a  fact  which  was  not  known  until  recently.  This  is  that 
the  independent  life  ascribed  to  these  particles  of  bioplasm  is  no  assump- 

'  See  Report  on  Hygiene  for  1872  (Army  Medical  Department  Report,  vol.  xiii.). 

^  The  observations  of  Chauveau,  Beale,  and  Bnrdon-Sanderson,  and  still  more  re- 
cently, of  Braidwood  and  Vacher,  prove  tliis  very  important  point  by  wliat  seems  in- 
disputable evidence.  It  does  not  follow  that  all  small  bodies  are  in  such  fluids  the 
contugm,  but  the  experiments  prove  that  some  of  them  must  be.  In  many  kinds  of 
blood  there  are  numerous  small  particles,  derived,  according  to  Riess,  from  retrograde 
metamorphosis  of  white  blood-cells  and  which  have  no  contagious  property. 

^  This  view  has  been  advocated  with  great  force  by  Beale  (Disease  Germs,  2d  edi- 
tion) ;  and  Morris  (The  Germ  Tlieory  of  Disease,  2d  edition). 


DTSIlSrFECTIOlSr    AND    DEODORIZATION.  163 

tion,  since  we  are  now  aware  that  many  of  the  small  animal-cells  or  bio- 
plastic  molecules  are  virtually  independent  organisms,  having  movements, 
and  apparently  searching  for  food,  growing,  and  djdng. 

This  view  explains  singularly  well  the  fact  of  the  frequent  want  of  power 
of  the  contagia  of  one  animal  to  affect  another  family ;  as,  for  example,  the 
non -transference  of  many  human  diseases  to  brutes,  and  the  reverse.  It 
also  partly  explains  the  non-recurrence  of  the  disease  in  the  same  animal 
by  supposing  an  exhaustion  of  a  special  limited  supply  of  food,  which  can- 
not be  restored,  since  it  may  be  supposed  that  some  particular  bodily 
structure  is  altogether  destroyed,  as,  for  example,  Peyer's  patches  may  be 
in  enteric  fever.  One  objection  to  this  view  is,  on  the  other  hand,  that 
living  animal  particles  die  with  great  rapidity  after  exit  from  the  body, 
while  the  contagia  do  certainly  last  for  some  considerable  time.' 

(2)  The  particles  have  been  conjectured  to  be  of  fungoid  nature,  and 
to  simply  grow  in  the  body  after  being  introduced  ab  externo.  This  view 
is  supported  by  the  peculiarities  of  the  rapid  and  enormous  growth  of 
fungi,  by  their  penetrative  powers  and  splitting-up  action  on  both  starchy, 
fatty,  and  albuminoid  substances,  and  by  the  way  in  which  certain  diseases 
of  men  and  animals  ^  are  undoubtedly  caused  by  them.  It  is  clearly  a  view 
which  would  explain  many  phenomena  of  the  contagious  diseases,  and  has 
been  supported  by  the  experimental  evidence  of  Hallier  and  many  others, 
who  have  believed  either  that  they  have  invariably  identified  special  fungi 
in  some  of  these  diseases,  or  that  they  have  succeeded  in  cultivating  fungi 
from  particles  of  contagia.  At  the  present  time,  however,  the  evidence  of 
true,  recognizable  and  special y^<?^(;^  being  thus  discovered  and  grown,  and 
forming  the  efficient  causes,  is  very  much  doubted  by  the  best  observers. 
The  micrococci  of  Hallier,  supposed  to  be  formed  by  the  disintegration  of 
the  protoplasm  of  fungi,  which  Hallier  considers  can  again  develop  to 
fungi,  are  looked  upon  by  many  as  mere  detritus  " 

(3)  The  particles  of  contagia  are  thought  to  be  of  the  nature  of  the 
Schizomycetes,  i.e.,  of  that  class  of  organisms  which  Nageli  has  separated 
from  the  fungi,  and  which  form  the  lowest  stratum  at  present  known  to  us 
of  the  animate  world.  They  are  termed  Bacteria,  Bacilli,  Microzymes,  Vibrios, 
Spirilla,  Monads,  etc.  Their  relation  to  the  fungi,  or  to  the  Oscillarinece, 
to  which  they  are  perhaps  closer,  is  yet  a  matter  of  warm  debate. 

That  these  creatures  are  concerned  in  many  diseases  is  clear.  Lister's 
genius  first  brought  their  practical  importance  forward,  and  the  late  re- 

'  A  modification  of  this  view,  under  the  name  of  the  Glandular  Origin  of  Disease, 
is  advocated  by  Dr.  B.  W.  Pdchardson,  F.R.S.  (Address  to  the  Sanitary  Institute  of  Great 
Britain,  Leamington,  1877  ;  Nature,  No.  414,  October  4,  1877,  p.  480).  Admitting  that 
the  disease  poison  generally  comes  from  without,  he  looks  upon  its  action  as  catalytic, 
causing  an  altered  glandular  secretion  or  a  change  in  the  blood,  the  changed  secretion 
reacting  on  the  nervous  centre  supplying  the  gland  or  glands.  He  also  conceives  that 
during  epidemic  periods  a  strong  nervous  impression  may  have  the  same  effect  as  the 
direct  introduction  of  poison  from  without,  so  that  the  disease  may  occasionally  arise 
spontaneously.  He  looks  upon  many  diseases  as  hereditary,  in  the  sense  that  the  con- 
dition of  the  child  resembles  that  of  the  parent,  and  will  therefore  be  open  to  similar 
influences. 

^  Not  only  some  skin  and  hair  diseases  of  men  and  animals,  and  diseases  of  insects 
and  fishes,  are  caused  by  the  growth  of  fungi  which  fall  on  the  surface  of  the  body,  or 
are  drawn  into  the  mouth,  but  internal  diseases  are  caused  by  the  growth  of  undoubted 
fungi,  such  as  Aspergillus. 

'^  The  supposed  fungus,  which  Klein  (Reports  of  the  Medical  OfB.cer  of  the  Privy 
Council,  new  series,  No.  vi  ,  1875)  thought  he  had  discovered  in  the  patches  of  typhoid 
ulceration,  was  shown  by  Creighton  to  be  merely  an  altered  condition  of  fibrine  simu- 
lating an  independent  organism  (see  Proceedings  of  the  Royal  Society,  June  15,  1876). 


164  PRACTICAL    HYGIENE. 

searches  of  Klebs,  Eecklinghausen,  and  others,  have  shown  how  great  a 
l^art  they  plav  in  the  production  of  Septicemia.  The  carbuncular  disease 
of  cattle  and  sheep  (splenic  apoplexy)  is  also  intimately  connected  with 
Bacilli ;  and  if  the  observations  of  Coze,  Feltz,  and  others  are  correct,  the 
same  is  true  of  typhoid  fever.  Ferdinand  Cohn  has  asserted,'  that  even 
the  glistening  particles  of  vaccine  lymph  are  Bacteria.  Bacteria  have  been 
proA-ed  to  cause  disease  of  the  intestinal  mucous  membrane,  the  utems, 
the  kidneys,  and  the  heart,  and  they  play  some  part  in  hemorrhagic  small- 
pox. Bacilli  were  found  to  be  the  active  agents  in  the  poisoning  by  ham 
at  Welbeck.  Klebs  and  Tommasi-Crudeli  have  shown  the  probability  of 
malarial  poisoning  being  due  to  a  Bacillus.  Still  more  recently,  Koch  has 
essaved  to  connect  phthisis  with  a  similar  organism.  The  peculiar  form 
of  febrile  disease  observed  at  Aberdeen  by  Dr.  Beveridge  was  distinctly 
connected  with  the  existence  of  minute  organisms  in  milk.'  The  researches 
of  Pasteur  on  fowl  cholera  and  charbon  have  shown  not  only  that  those 
diseases  are  due  to  Bacteria,  but  that  they  can  probably  be  prevented  or 
modified  by  inoculation  with  cultivated  virus. 

.  Yet  in  some  of  the  epidemic  diseases  no  Bacteria  have  been  as  yet  de- 
monstrated. In  cholera,  Lewis  and  Cunningham  have  failed,  in  spite  of  the 
most  persevering  search,  to  find  Bacteria  (or  fungi)  in  the  discharges  or 
blood  of  cholera. 

The  reasons  for  attributing  in  many  cases  great  influence  to  Bacteria, 
which  are  undoubtedly  present,  are  ob\'ious  enough. 

They  are  so  widely  spread  in  nature  (in  both  air  and  water)  ;  their 
powers  of  growth,  bv  di\dsion,  are  so  wonderful ;  their  food  (ammonia, 
phosphates,  and  perhaps  starches  or  sugars)  is  so  plentiful,  and  their  tenac- 
itv  of  Hfe  so  great,  that  it  is  no  wonder  great  consequence  is  now  attached 
to  them.  Yet  it  is  their  veiy  universality  which  is  the  strongest  argument 
against  the  view  that  they  constitute  the  contagia  of  any  of  the  specific  dis- 
eases, and  any  one  who  "considers  the  peculiar  spread  of  the  contagious 
diseases  will  admit  the  force  of  this  objection.  To  meet  this  objection  it 
has  been  surmised  that  they  are  not  the  contagia,  but  merely  their  carriers. 
This  view  has  not  been  defined  ;  but  as  the  plasma  of  Bacteria  is  albuminoid, 
it  may  perhaps  be  taken  to  mean  that  while  the  Bacteria  are  usually  harm- 
less, their  plasma  may  become,  in  certain  cases,  altered  in  composition, 
and'  then  becomes  poisonous  in  different  specific  ways.  Bacteria  feeding 
in  the  blood  of  a  t\'phus  patient  will  become  nourished  with  morbid 
plasma,  and  thus,  so  to  speak,  it  is  diseased  Bacteria  which  become  dan- 
gerous. AVe  get  here  beyond  the  range  of  present  observation,  and  are 
conscious  how  impossible  it  is  with  our  present  instruments  to  investigate 
such  an  h^^othesis.^  ac  •     . 

The  belief  which  some  entertain  that  Schizomycetes  are  the  etlicient 
agents  of  the  contagious  diseases  has  led  to  a  number  of  experiments  on  the 
destruction  of  Bacteria  by  heat  and  by  chemical  agents,  in  the  belief  that 
the  doctrine  of  disinfection  was  thereby  elucidated.     This  could  hardly  be 


1  Virchow's  Archiv,  Bandiv.,  p.  229  (1872). 

2  See  note  by  Professor  Ewart,  Proceedings  of  the  Eoyal  Society,  1881,  vol.  xxxn  , 

'For  further  information,  see  the  "Address  in  Medicine,"  by  W.  Roberts,  M.D^., 
F  R  S  ,  delivered  at  the  Manchester  Meeting  of  the  British  Medical  Association,  18(7 
(Brit.  Med.  Journal,  No.  867,  August  11,  1877,  p.  168).  Also  Prof essor  Tyndall's  papers 
in  the  Royal  Society's  Proceedings  and  Tr.ansactions  (see  Transactions  of  the  Koyal  so- 
ciety, 1876,  pnrt  i.,  p.  27);  Floating  Matter  in  the  Air,  by  the  same  author;  Nagelis 
Niedere  Pilze  ;  Fodor's  Uutersuchungen,  op.  cit. 


DISINFECTION   Aim    DEODOEIZA.TION.  165 

tlie  case,  imless  we  are  certain  that  the  Bacteridia  are  the  contagia,  which 
is  not  yet  proved  to  be  the  case.  Disinfection  must  rest  at  present  on  its 
own  experimental  evidence. 

The  belief  in  the  part  played  by  Bacteridia  has  led  also  to  much  interest 
being  taken  in  the  discussion  on  ferments,  and  in  the  question  of  sponta- 
neous generation,  as  it  is  imagined  that  a  clew  might  thus  be  found  to  the 
origin,  de  novo,  of  the  contagia.  j\Ii\  Darwin's  doctrine  of  Pangenesis  has 
even  been  pressed  into  the  discussion,  though  it  rather  makes  the  darkness 
greater  than  before.  It  is  cui'ious  to  find  so  practical  a  matter  as  that  of 
disinfection  brought  into  relation  with  some  of  the  most  subtle  and  con- 
troverted questions  of  the  day  ;  but  the  important  bearing  which  the  ac- 
ceptance of  one  or  other  of  these  views  would  have  on  the  practice  of  disin- 
fection is  evident. 

2.    THE   MEDIA   IX   WHICH   THE   CONTAGIA   AEE    SPEEAD. 

Our  knowledge  of  this  point  is  far  more  defined,  and  may  be  thus 
summarized  : — 

The  special  and  distinctive  phenomena  of  each  disease  are  usually  at- 
tended with  special  implication  of  some  part  of  the  body,  and  it  is  especially 
these  parts  which  contain  the  contagia.  In  these  parts  there  is  frequently 
rapid  growth,  and  if  the  parts  are  on  the  surface,  frequent  detachment. 
The  pus  and  epidermis  of  small-pox ;  the  epidermis  and  the  mouth  and 
throat  epithelium  of  scarlet  fever  ;  the  skin  and  bronchial  secretions  of 
measles  ;  the  stools  containing  the  discharged  detritus  of  Peyer's  glands  in 
typhoid  fever  ;  the  discharges  of  cholera  ;  the  discharges  and  eruptions  of 
syphilis,  glanders,  farcy,  and  mahgnant  pustule,  are  instances  of  this.  In 
typhus  fever  the  skin  is  greatly  affected,  and  it  is  generally  supposed  that 
it  is  from  the  skin  that  the  virus  spreads,  since  this  disorder  is  so  easily 
carried  by  clothes  ;  the  same  is  the  case  with  plague.  In  fact,  those  parts 
of  the  body  which  are  the  breeding -places  of  the  contagious  particles  give 
off  the  poison  in  greatest  amount.  The  portions  of  the  body  thus  thrown 
off,  and  containing  the  contagia,  may  then  pass  into  air,  or  find  their  way 
into  water  or  food,  and  in  this  way  be  introduced  by  breathing,  drinking, 
or  eating,  or  through  broken  surfaces  of  the  body. 

The  principles  of  disinfection  ought  evidently  then  to  deal  with  the  poi- 
sons at  theu'  seats  of  origin,  as  far  as  these  are  accessible  to  us.  It  was  the 
instinct  of  genius  which  led  Dr.  William  Budd  to  ]Doiut  out  that  the  way 
to  prevent  the  spread  of  scarlet  fever  is  to  attack  the  skin  from  the  very 
first ;  to  destroy  the  poison  in  the  epidermis,  or  failing  that,  to  prevent  the 
breaking  up  and  passage  into  the  air  of  the  particles  of  the  detached  epi- 
dermic scales.  Oily  disinfectant  inunctions  of  the  skin,  and  the  most  com- 
plete disinfection  of  the  clothing  which  touches  the  skin  of  the  patient,  are 
the  two  chief  means  of  arresting  the  spread  of  scarlet  fever.  The  rules  for 
small-pox  are  almost  identical,  though  it  is  more  difficult  to  carry  them 
out.  In  enteric  fever  the  immediate  desti'uction  of  all  particles  of  poison 
in  the  stools  by  very  strong  chemical  reagents,  and  the  prevention  of  the 
poison  getting  into  sewers  or  drinking  water  or  food,  are  the  measures  ob- 
viously demanded  by  the  peculiarities  of  this  special  disease. 

The  more  completely  these  points  are  investigated,  and  the  more  per- 
fectly the  breeding-places  in  the  body  are  known,  the  more  perfect  wiU  be 
our  means  of  disinfection. 


166  PRACTICAL   HYGIENE. 

3.    EFFECTS   OF   HEAT    AS   A   DISINFECTANT. 

If  the  contagia  are  simply  excessively  minute  portions  of  bioplastic 
particles,  in  BeaJe's  sense,  we  may  be  sure  they  will  be  easily  killed  ;  a  heat 
far  below  that  of  boiling  water,  and  very  weak  chemical  agents,  destroy  all 
signs  of  ^-itality  in  animal  cells  and  molecules.  We  might,  therefore,  hope 
much  from  disinfection.  Fungi  in  water  are  destroyed  by  a  compai-atively 
low  heat  ;  while  in  dry  air  renicillium  glaucum  is  not  completely  destroyed, 
according  to  Pasteur, 'till  127''  C.  (=  260"  Fahr.),  and  Oidium  aurantiacvm 
dies  at  about  the  same  temperature.  On  the  contrary,  the  Bacteroid 
bodies  are  often  extremely  stable.  Lex  found  a  temperature  of  127°  C.  or 
260^  Fahi-.  insufficient  to  kill  them,  and  after  boihng  them  for  half  an  horn* 
they  still  showed  vital  movements  ;  and  in  Calvert's  experiments  a  heat  of 
no  less  than  400"  Fahr.  (=  204°  C.)  was  required  to  thoroughly  destroy 
them,  and  some  kinds  seem  unaffected  even  by  strong  acids  and  caustic 
alkalies.  Bastian  has,  however,  stated  '  that  Bacteria  and  Vibrios  are  killed 
at  a  much  lower  temperatiu'e  ;  his  experiments  show  that  a  brief  exposure 
to  a  temperature  of  70"  C.  (=  158"  Fahr.)  either  killed  the  germs  of  Bac- 
teria, or  completely  deprived  them  of  their  powers  of  multipHcation. 
Sanderson  found  that  Bacteria  in  water  are  not  developed  in  fluids  heated 
to  366"  Fahr.  or  even  boiled.  Disinfection,  if  Bacteridia  are  to  be  destroyed, 
would  be  then  a  matter  of  much  greater  difficulty.  Tyndall '  has  since 
pointed  out  what  appears  to  be,  at  least,  a  partial  explanation  of  the  above 
discrepancies.  He  shows,  that  whilst  prolonged  boiling  failed  to  sterilize 
an  infusion,  successive  heatings  for  a  short  time,  even  below  the  boLling- 
point,  were  successful.  The  explanation  proposed  is,  that  during  the 
period  of  latency  the  spores  are  in  a  hard  state  capable  of  resisting  high 
temperatui-e,  but  that  just  before  the  period  of  active  germination,  they 
become  softened,  and  therefore  amenable  to  the  influence  of  heat.  As, 
however,  spores  in  various  stages  may  exist  in  the  same  fluid,  successive 
heatings  are  necessary  so  as  to  aiTCst  each  group  at  the  proper  time  ;  but 
by  repeating  the  heatings  sufficiently  often  an  infusion  may  be  sterilized 
at  a  point  below  the  boiling-point  of  water.  Important  in  aU  ways,  this 
question  of  the  nature  of  contagia  is  especially  so  in  a  practical  sense,  viz., 
that  of  the  easy  or  difficult  desti-uction  of  these  agents.  It  does  not,  how- 
ever, follow  that  ordinary  putrefactive  Bacteria  are  identical  with  those 
which  may  be  supposed  to  produce  disease.  It  is  probable  that  they  are 
quite  different,  and  that  disease  Bacteria  are  more  easily  destructible  by  heat 
at  least 

Purification  of  Clothes  and  Bedding. — The  best  plan  of  doing  this  is 
certainly  by  the  agency  of  heat.  Dr.  Henry,  of  Manchester,  after  showing 
that  vaccine  matter  lost  its  power  if  heated  to  140"  Fahr.  for  three  hours, 
proposed  to  disinfect  clothing  by  dry  heat.  He  disinfected  scarlet  fever 
clothing  bv  exposure  to  212"  Fahr.  for  one  hour  ;  woollen  clothing  fi'om 
plague  patients,  after  being  heated  twenty-four  hours  from  144°  to  167° 
Fahr.,  was  worn  -vs-ith  impunity  by  fifty-six  healthy  persons  for  fourteen 
davs.  Heat  was  lai'gely  used  to  disinfect  clothing  by  the  Americans  in 
their  civil  war,  both  in  the  form  of  dry  heat  and  boiling  water.  It  is  be- 
lieved that  the  cessation  of  the  plague  in  Egypt,  after  St.  John's  day,  was 
due  to  the  increased  heat  of  the  air  ;  but  possibly  the  hygrometric  condi- 
tion of  the  ail-  may  have  more  to  do  vdih  this.     It  has  also  been  surmised 

'  Proceedings  of  Eoval  Society,  No.  143,  p.  224,  Jlarch.  1873. 
sibid.,  No.  178,  p.  "569. 


DISINFECTION    AND    DEODORIZATION.  1G7 

tliat  the  yellow  fever  poison  is  destroyed  by  an  intense  heat.     Dr.  Shaw 
has  collected  the  few  facts  which  we  know  on  this  subject/ 

Disinfecting  Chambers,  that  is,  hot-air  chambers,  into  which  clothing, 
linen,  and  bedding  are  put,  are  used.  The  usual  arrangement  is  a  furnace 
with  the  smoke-shaft  passing  under  or  on  one  side  of  a  brick  chamber,  and 
with  a  hot-air  blast  from  a  shaft  running  through  or  under  the  fire  into 
the  chamber  itself,  or  into  a  passage  below  it,  whence  it  passes  into  the 
chamber  through  a  valve  ;  an  exit  for  the  hot  air  is  provided  at  the  top  of 
the  chamber  ;  the  clothes  are  suspended  in  the  chamber,  at  a  little  distance 
from  the  walls. 

In  other  cases  the  bottom  of  the  chamber  is  made  of  iron,  and  the 
smoke-flue  passes  beneath  it ;  the  iron  becomes  red  hot,  and  is  covered 
with  sand,  to  prevent  the  clothes  taking  fire.  Hot  air  is  then  poured  into 
the  chamber  in  the  same  way.  The  disadvantage  of  the  hot-air  blast  is 
the  uncertainty  and  variation  in  the  amount  of  heat. 

Fraser  has  devised  a  good  form  of  stove,  in  which  high  temperature 
and  the  use  of  sulphurous  acid  are  combined.  The  articles  are  wheeled 
into  the  stove  in  the  cart  that  brings  them.  Dr.  Ransom,  of  Nottingham, 
has  devised  a  gas  stove,  viz.,  an  iron  box  well  covered  with  non-conducting 
material  ;  in  a  channel  leading  to  it  a  gas-jet  burns  ;  by  means  of  a  regula- 
tor (modified  from  Kemp's  regulator)  the  heat  is  kept  uniform  day  and 
night ;  the  hourly  consumption  of  gas  is  9  cubic  feet  for  a  small  stove, 
which  is  sufficient  for  the  hospital  at  Nottingham. 

Steam  has  been  also  used  ;  and,  at  Berlin,  a  steam  disinfecting  chamber 
proposed  by  Dr.  Esse,"  is  said  to  work  well.  This  chamber  is  in  the  form 
of  two  iron  cylinders  of  different  diameters,  one  inside  the  other,  and  with 
walls  strong  enough  to  withstand  the  pressure  of  the  steam  ;  between  the 
two  cylinders  steam  enters  from  a  neighboring  boiler,  and  heats  the  inter- 
nal cylinder  in  which  the  clothes  are  suspended  ;  at  the  top  of  the  cylinder 
is  a  brass  box  which  dips  a  little  way  down,  and  is  pierced  with  holes  at 
the  bottom,  so  that  the  air  of  the  inner  cylinder  can  rise  into  it ;  in  the 
box  is  a  thermometer.  The  outer  cylinder  is  covered  with  wood,  and  the 
top  of  the  cylinder  with  felt,  to  economize  heat ;  the  steam,  when  it  con- 
denses in  space  between  the  cylinders,  flows  out  by  means  of  a  valve, 
which  is  lifted  when  the  water  reaches  a  certain  point  in  the  condenser. 
The  clothes  are  introduced  at  the  top,  the  hd  of  the  cylinder  being  lifted 
up  by  a  pulley ;  they  are  not  allowed  to  touch  the  cylinder,  but  are  sus- 
pended fit'om  wooden  pegs.  In  an  hour's  time  the  heat  can  be  brought  to 
90°  R  [—  234.5°  Fahr.).  Another  apparatus  has  been  contrived  by  Esse  for 
mattresses.  It  is  an  iron  case  with  a  spiral  steam  pipe  in  the  centre,  which 
heats  with  compressed  steam  (two  atmospheres). 

A  steam  cylinder  has  also  been  used  at  the  London  Fever  Hospital,  for 
disinfecting  the  feathers  used  as  bedding. 

The  ordinary  drying  closet  in  a  good  laundry  will  sometimes  give 
heat  enough,  but  not  always.  A  baker's  oven  can  also  be  used  on  emer- 
gency. 

The  question  of  temperature  has  been  much  discussed.  It  is  desirable 
to  get  as  high  a  temperature  as  possible  so  as  to  insure  the  destruction  of 
disease  poison.  On  the  other  hand,  the  temperature  must  not  be  too 
high,  for  fear  of  destroying  the  fabrics. 

Ransom  found  that  fine  fabrics  began  to  scorch  at  255°  to  260°  Fahr. 

'  Trans.  Soc.  Science  Assoc,  for  1864,  p.  558. 

'  Deutsche  Vierteljahrscb.  fiir  off.  Gesundheitspfiege,  Band  iii.,  p.  534  (1871). 


168  PRACTICAL    HYGIENE. 

In  some  experiments,  undertaken  at  the  request  of  the  Dii-ector-General, 
A.M.D.,'  the  following  results  were  obtained  : — Woollen  fabrics  changed 
color  after  six  hours'  exposure  at  212°  Fahr.,  or  after  two  hours  at  220° 
Fahr.;  generally  length  of  exposure  and  elevation  of  temperature  were 
complementary.  Cotton  and  linen  showed  signs  of  change  of  color  after 
six  hours  at  2i2°  Fahr.,  or  four  hours  at  220°  Fahr.  Professor  E.  Vallin,* 
of  Val  de  Grace,  found  that  a  piece  of  new  white  Jlaimel  was  not  more  dis- 
colored after  two  hours  at  230^  Fahr.  than  after  one  ordinary  washing,  and 
that  even  after  three  hours  a  piece  already  washed  showed  no  change  ;  two 
hours,  however,  at  240°  Fahr.  to  250°  Fahr.  showed  distinct  change. 
Cotton  and  liiien  did  not  change  until  they  had  been  exposed  for  two  hours 
to  257°  Fahr.  The  strength  of  the  material  was  not  diminished  (as  shown 
by  a  dynamometer)  until  after  two  hours  at  300°  Fahr.  Horse-hair  became 
friable  after  exposure  to  heat,  but  this  was  chiefly  an  efiPect  of  drying,  as 
it  regains  its  ordinary  condition  after  a  short  time  (Vallin,  Lake).  In 
Ransom's  stove  the  heat  is  arranged  to  be  between  235°  and  255°  Fahr. 
After  an  accident  at  the  Southampton  Infirmary,  where  all  the  clothes,  etc., 
in  the  chamber  were  consumed,  a  modification  was  introduced  by  Dr. 
Ransom  ;  a  chain  wath  a  link  of  fusible  metal  is  set  free  by  the  melting  of 
the  link  as  soon  as  300°  Fahi\  are  reached  ;  this  closes  a  door,  shuts  off  the 
gas,  and  prevents  any  further  rise  of  heat.  In  the  Liverpool  Chambers 
280°  Fahr.  has  been  registered,  and  no  less  than  380°  Fahr.  in  the  drying 
closet  over  the  Cockle  stove. 

There  is  no  doubt  considerable  variation  in  the  temperature  of  different 
parts  of  the  chamber,  and  the  effects  on  fabrics  vary  according  as  they  are 
placed  on  or  near  the  floor  and  sides,  or  suspended  in  the  centre  or  upper 
parts.  At  the  Southampton  Infirmary,  all  bedding  and  clothing  are  ex- 
posed in  the  chamber  after  every  occasion  of  use,  the  mean  temperatm-e 
being  under  230°  Fahr.,  but  there  is  distinct  deterioi-ation  of  fabric,  a  loss 
incurred  designedly  in  order  to  secure  complete  destruction  of  disease 
poison. 

As  before  stated,  we  have  no  reason  to  believe  that  disease  germs  will 
resist  a  temperature  of  220°  Fahr.,  or  even  212°  Fahr.,  if  completely  and 
thoroughly  exposed  to  it.  Even  when  liquids,  such  as  water  or  milk,  have 
been  infected,  no  case  of  disease  has  ever  been  traced  to  the  use  of  such 
liquids  after  being  bjiled.  It  seems  therefore  unnecessary  to  carry  the 
heat  to  excess,  220°  Fahr.  being  in  all  likelihood  sufficient,  or  even  212° 
Fahr.  with  some  length  of  exposure.  In  the  "  Army  Medical  Regulations" 
(1878)  (655a),  exposure  to  a  temperature  of  not  less  than  212°  Fahr.  for  at 
least  two  hours  is  ordered. 

Soaking  mid  Boiling  Clothe.'^. — The  boiling  of  clothes  is  not  generally 
considered  so  good  as  baking,  but  still  is  very  useful.  It  is  desirable  to 
add  some  chemical  agent  to  the  water,  and  chloride  of  lime  is  frequently 
used  in  the  propoi'tion  of  1  gallon  of  the  strong  commercial  solution  to  20 
or  30  gallons  of  water.  Carbolic  acid  (1  part  of  pure  acid  and  2  parts  of 
commercial  acid  to  100  of  water)  is  also  much  employed.  The  German 
military  regulations. order  the  clothes  to  be  laid  for  twenty-four  hours  in  a 
solution  of  sulphate  of  zinc,  in  the  jDroportion  of  1  part  to  120,  or  of  chloride 
of  zinc,  in  the  proportion  of  1  part  to  240,  and  then  to  be  washed  with 
soap  and  water,  if  the  clothes  cannot  be  baked.     The  routine  Dr.  Parkes 

1  By  Dr.  F.  de  Chaiimont,  Lancet,  December  11,  1876. 

°  "De  la  Dcsinfection  par  I'Air  chaurl,"  Mcmoires  de  la  Socit't^  de  M^decine  Pu- 
blique  et  d'HygiL-ne  Professioiuielle,  1877. 


DISINFECTIOlSr    AND    DEODORlZATIOlSr.  169 

followed  in  the  case  of  a  large  military  hospital  during  war  was  to  receive 
all  dirty  clothes  into  a  large  open  shed,  and  to  plunge  them  at  once  into 
tubs  of  cold  water  with  chloride  of  lime.  After  twelve  to  twenty-foiir  hours' 
soaking,  according  to  their  condition,  they  were  put  into  coppers  and 
boiled,  chloride  of  lime  being  again  added  to  the  water  ;  they  were  then 
put  into  the  washing-machine,  and  then  dried  and  baked  in  a  dry  closet, 
heated  to  the  highest  point  that  could  be  got,  about  200°  to  230°  Fahr. 
If  lice  were  very  numerous,  it  was  a  good  plan  to  bake  the  clothes  before 
soaking  ;  the  lice  were  mostly  killed,  but  some  were  only  torpid,  and  were 
still  Uving,  after  a  temperature  of  probably  200°  Fahr.  They  could,  how- 
ever, be  shaken  out  of  the  clothes  easily  even  if  not  dead. 

Fumigating   Clothes. — ^This  is  best  done  with  sulphur,  which  may  be 
used  in  the  hot  chamber,  as  in  Fraser's  oven,  or  the  clothes  are  suspended^ 
in  a  small  close  chamber  or  large  vat,  and  a  large  quantity  of  sulphur  is  set 
on  fire,  cars  being  taken  that  the  clothes  are  not  burnt.     Hair  mattresses 
must  be  taken  to  pieces  before  fumigation  if  they  be  much  defiled. ' 

4.     EFFECTS    OF    OHEMICAIi    AGENTS. 

Although  numerous  experiments  have  been  made  upon  this  point,  yet 
our  knowledge  still  remains  somewhat  obscure.  A  large  number  of  sub- 
stances have  been  pro]30sed,  and  many  actually  tried,  with  varying  results. 
One  cause  of  discrepancy  has  been  the  somewhat  loose  way  in  which  the 
term  disinfectant  has  been  employed  in  cases  where  the  action  has  been 
little  more  than  deodorant.  Chemical  agents  may  be  divided  into — (a) 
those  which  actually  destroy  disease  poison  and  minute  organisms  ;  (h) 
those  which  suspend  vitality  and  propagation  ;  and  (c)  those  which  merely 
deodorize,  that  is,  destroy  or  mask  smell.  Even  such  a  division  cannot  be 
carried  out  consistently,  and  all  that  we  can  say  is,  that  some  substances 
act  powerfully  as  destroyers  of  disease  poison  and  minute  hfe,  if  used  in 
sufficient  quantity  and  degree  of  concentration  ;  such  substances  are  also 
generally  deodorants.  Other  substances  do  not  appear  positively  to  destroy 
disease  poison  or  minute  hfe,  but  they  certainly  suspend  its  vitality  for  a 
time,  and  we  may  therefore  use  this  interval  of  suspension  advantageously 
by  getting  rid  of  the  infected  matter  without  danger  in  transit. 

A  further  division  of  chemical  agents  might  be  into  gaseous,  liquid, 
and  solid,  and  other  divisions  might  also  be  suggested.  Perhaps  the  most 
convenient  plan  will  be  to  state  the  objects  to  be  attained,  and  consider 
the  agents  which  may  be  used. 

Purification  of  the  Air  by  Chemical  Methods. 

The  great  purifying  actions  of  Nature  are  diffusion,  dilution,  transfer- 
ence by  winds,  oxidation,  and  the  fall  of  rain.  In  houses  the  power  of 
ventilation  is  the  only  safe  method,  but  some  effect  can  be  produced  by 
chemical  agencies  in  aid  of  ventilation. 

The  foreign  matters  in  the  air  which  can  be  removed  by  chemical  means, 
are  carbon  dioxide,  hydi'ogen  sulphide,  ammonia  (usually  in  the  form  of 
ammonium  sulphide),  and  various  organic  substances,  arising  in  an  infinity 
of  ways,  some  being  odorous,  others  not,  and  of  the  physical  and  chemical 
nature  of  which  little  or  nothing  is  knovyn.  Air  purifiers  are  also  used  to 
check  the  growth  of  fungoid,  infusorial,  or  bacteroid  organisms.  They  are 
used  in  the  form  of  solids  or  of  Hquids,  which  may  absorb  the  substances 

'  Army  Medical  Regulations,  1878,  part  5,  section  v.,  paras,  644-663. 


170  PRACTICAL    HTGIEXE. 

from  the  air,  or  of  gases  which  may  pass  into  the  air,  and  there  act  on  the 
gases  or  molecular  impurities. 

(a)  Solid  Air  Purijiers. — Dried  earth,  quicklime,  charcoal,  and  calcium 
and  magnesium  carbolates  (phenates),  a  mixture  of  lime  and  coal-tar,  are 
the  most  important. 

Of  these  charcoal  is  the  most  eflfectual.  It  presents  an  immense  sur- 
face, and  has  a  very  extraoxxlinary  power  of  separating  and  absorbing 
gases  and  vapors  from  the  atmosphere,'  and  oxidizes  rapidly  almost  every 
substance  capable  of  it.  Its  action  is  not  indiscriminate,  but  elective  (A. 
Smith) ;  when  charcoal  which  has  absorbed  oxygen  is  warmed,  it  gives  off 
CO3  (A.  Smith),  a  proof  of  its  great  oxidizing  power.  ExjDosed  to  the  air 
in  bags  or  shallow  pans,  its  action  is  raj^id  and  persistent ;  its  effect  is  es- 
pecially marked  with  sewage  gases,  and  with  the  organic  emanations  in 
disease.  It  also  absorbs  hydrogen  sulphide.  Its  power  of  pui'ifying  air 
from  organic  emanations  is  really  great,  and  can  be  employed  in  hospital 
wards  with  advantage. 

Of  the  different  kinds  of  charcoal,  the  animal  charcoal  has  the  highest 
reputation,  and  then  peat.  But  the  carbon  left  in  the  distillation  of  Bog- 
head coal  has  been  stated  to  be  even  better  than  animal  charcoal  If  vege- 
table charcoal  be  used,  it  should  be  rather  finely  powdered.  The  disin- 
fecting quahties  of  charcoal  on  air  scarcely  lessen  with  time  if  the  charcoal 
be  kept  dry.  Charcoal  filters  to  be  placed  before  the  mouth  have  been 
recommended  by  Stenhouse,  and  might  be  useful  in  cases  of  veiy  impure 
air.  Dried  marly  earth  is  much  inferior  to  charcoal,  but  still  can  be  em- 
ployed in  the  absence  of  the  latter. 

Quicklime  absorbs  CO,  and  perhaps  compounds  of  sulphur,  and  has 
been  employed  for  that  purpose. 

Calcium  and  viagnesium  carbolates  have  been  also  used  ;  as  they  give  off 
carbolic  acid,  their  action  is  probably  chiefly  in  that  way. 

(6)  Liquid  Air  Purifiers. — Solutions  of  potassium  i^rmanganate  (Condy's 
red  fluid),  zinc  chloride,  and  lead  nitrate  are  sometimes  used,  being  either 
exposed  in  flat  dishes,  or  cloths  are  dipped  in  the  solution  and  exposed  to 
the  air.  They  act  only  on  the  air  which  comes  in  contact  with  them,  but 
in  that  way  absorb  a  good  deal  of  impurity.  Condy's  fluid,  when  well  ex- 
posed to  the  air,  seems  to  have  a  good  purifying  effect,  and  to  lessen  the 
close  smell  of  ill-ventilated  rooms,  and  it  absorbs  hydrogen  suljDhide,  and 
so  will  also  solution  of  nitrate  of  lead. 

ic)  Gaseous  Air  Purifiers. — The  evolution  of  gases  into  the  air  is  the 
most  powerful  means  of  purifying  it  independent  of  ventilation.  The 
principal  gases  are  ozone,  chlorine,  fumes  of  iodine  and  hrovnne,  nitrous, 
sidphurous,  and  hydrochloric  acid,  carbolic  acid,  tar  fumes,  acetic  acid, 
ammonia. 

Ozone. — It  has  been  proposed  to  disengage  ozone  constantly  into  the 
air  of  a  room,  by  heating  a  platinum  wire  by  a  Bunsen  cell ;  by  half  im- 
mersing a  stick  of  phosphorus  in  tepid  water  in  a  wide-mouthed  bottle  ; 
or  by  mixing  very  gradually  3  parts  of  strong  sulphuric  acid  and  2  parts  of 
permanganate  of  jDotassium.  This  Inst  method  is  that  used  by  Dr.  Fox.^ 
The  amount  of  ozone  can  be  measured  by  the  common  ozone  paper,  and 
the  stopper  put  in  if  the  tint  is  too  deep.  It  is  presumed  it  will  then 
act  as  a  powerful  oxidizing  agency,  and  destroy  organic  matter,  as  it 
certainly  removes  the  putrid  effluvia  of  decomposing  blood  ("Wood  and 

'  Sennebier,  quoted  by  Chevallier,  Traite  des  Desinfect.,  p.  146,  and  A.  Smith. 
'  Ozone  and  Antozone,  p.  25. 


DISINFECTION    AND    DEODOEIZATION.  17 1 

Ricliardson).  It  was  much  used  by  Dr.  Moffat  in  cholera  and  cattle 
plague. 

Chlorine. — Given  off  from  chloride  of  lime,  moistened  with  water,  or 
with  dilute  sulphuric  acid,  and  placed  in  shallow  vessels,  or  from  chloride 
of  soda,  or  evolved  at  once.  Four  parts  by  weight  of  strong  hydrochloric 
acid  are  poured  on  one  part  of  powdered  manganese  dioxide,  or  four  parts 
of  common  salt  and  one  part  of  manganese  dioxide  are  mixed  with  two 
parts  by  weight  of  sulphuric  acid  and  two  of  water,  and  heated  gently. 
According  to  the  size  of  the  room,  the  actual  weight  of  the  substances 
taken  must  vary.  Or  two  tablespoonfuls  of  common  salt,  two  teaspoonfuls 
of  red  lead,  half  a  wiiieglassful  of  sulphuric  acid,  and  a  quart  of  water  are 
taken.  Mix  the  lead  and  salt  with  the  water,  stir  well,  and  add  the  sul- 
phuric acid  gradually.  Chlorine  is  evolved,  and  is  absorbed  by  the  water, 
from  which  it  is  slowly  driven  out.  It  may  be  kept  in  a  jar  or  stoppei'ed 
bottle,  left  open  as  occasion  may  require. ' 

Chlorine  decomposes  hydrogen  and  ammonium  sulphides  at  once,  and 
more  certainly  than  any  other  gas.  It  doubtless  destroys  organic  matter 
in  the  air,  as  it  bleaches  organic  pigments,  and  destroys  odors,  either  by 
abstracting  hydrogen,  or  by  indirectly  oxidizing.  Euchlorine,  a  mixture 
of  chlorous  acid  and  free  chlorine,  obtained  by  gentl}'-  heating  (by  placing 
the  saucer  in  warm  water)  a  mixture  of  strong  hydrochloric  acid  and  potas- 
sium chlorate,  has  been  also  used  instead  of  pure  chlorine.  It  has  been 
strongly  recommended  by  Professor  Stone,  of  Manchester,  who  has  de- 
vised a  special  apparatus  for  its  disengagement.  He  also  uses  it  by 
placing  fuming  hydrochloric  acid  in  a  wine-glass,  and  adding  a  few  grains 
of  chlorate  from  time  to  time.  In  that  way  there  is  no  danger  of  explo- 
sion, as  sometimes  is  the  case  if  a  large  quantity  of  chlorate  is  warmed 
with  hydrochloric  acid.  The  odor  of  euchlorine  is  more  pleasant  than 
that  of  chlorine  ;  it  acts  as  rapidly  on  iodide  of  potassium  and  starch 
paper,  and  appears  to  have  a  similar  action  on  organic  substances  ;  it  is 
probably  inferior  to  pure  chlorine,  but  the  ease  of  development  and  its 
pleasanter  smell  are  in  its  favor. 

Iodine  can  be  easily  diffused  through  the  atmosphere  by  placing  a 
small  quantity  on  a  hot  plate.  Dr.  Richardson  proposes  to  saturate  a 
solution  of  peroxide  of  hydrogen  with  iodine,  and  to  add  2^  per  cent,  of 
sea-salt ;  by  "  atomizing  "  or  "  pulverizing  "  the  fluid  by  the  little  instru- 
ment used  for  this  purpose,  the  air  can  be  charged  with  iodine  and  sea- 
salt  spray  very  readily.  Iodine  will  decompose  SH„,  and  destroys,  therefore, 
much  odor.  Its  action  was  investigated  by  Duroy  in  1854,^  who  showed 
that  it  is  a  powerful  arrester  of  putrefaction.  As  it  condenses  easily,  and 
does  not  diffuse  everywhere  like  chlorine,  it  might  be  expected  to  be  less 
useful  than  chlorine. 

Bromine. — In  the  American  civil  war  bromine  was  rather  largely  used 
as  an  aerial  disinfectant ;  a  solution  of  bromine  in  bromide  of  potassium 
is  placed  in  saucers  and  exposed  to  the  air  ;  the  vapor  is,  however,  very 
irritating,  and  should  not  be  disengaged  in  too  large  an  amount. 

Nitrous  Acid  or  Nitrogen  tetroxide  can  be  evolved  by  putting  a  bit  of 
copper  in  nitric  acid  and  a  little  water.  The  nitrogen  dioxide  which  is 
given  off  takes  oxygen  from  the  air,  and  red  fumes,  consisting  chiefly  of 
nitrogen  tetroxide  or  nitrous  acid  (NO,),  are  formed. 

The  oxidizing  action  of  nitrous  acid  is  very  great  on  organic  matter. 

1  Medlock's  Record  of  Pharmacy  and  Therapeutics,  1858,  p.  20. 
^  Chevallier,  Traiti  des  Desinfect.,  p.  19. 


172  PRACTICAL   HYGIENE. 

It  removes  the  smell  of  the  dead-house  sooner  than  any  other  gas.  It  is 
rather  imtating  to  the  lungs,  and,  in  some  persons,  large  quantities  of  it 
cause  vertigo,  nausea,  and  even  vomiting. 

The  action  of  nitrous  acid  results  from  the  ease  with  ■which  it  parts 
with  oxygen  to  any  oxidizable  substance,  being  converted  into  nitrogen 
dioxide,  which  again  at  once  combines  with  atmospheric  oxygen,  and 
so  on. 

Sulphurous  Acid  or  Sulphxir  dioxide. — Most  easily  evolved  by  burning 
sulphur.  It  decomposes  hydrogen  sulphide  (SO^  H-  2SH.,  =  3S  +  20H.J, 
and  also  combines  with  ammonia.  It  has  also  been  suj)posed  to  act  pow- 
erfully upon  organic  matter  (Graham),  and  probably  does  so  if  ammonia 
is  not  present.  Guyton-de-Morveau,  who  studied  the  action  of  this  acid, 
was  of  opinion  that  it  completely  disinfects  miasms,  and  gives  some  evi- 
dence on  this  point.     It  must  be  used  in  large  quantity. 

Hydrochloric  Acid. — The  fumes  of  this  acid  were  used  by  Guyton-de- 
Morveau,  and  at  one  time  they  were  much  employed,  but  the  action  of 
chlorine  is  so  much  more  powerful  that  they  are  now  seldom  used. 

Carbolic  Acid. — This  substance  is  given  off  when  solid  carbolic  acid  is 
placed  in  a  saucer,  or  when  the  liquid  acid  and  water  are  sprinkled  about, 
or,  still  better,  when  one  part  of  the  acid  and  two  of  ether  are  allowed  to 
evaporate.  It  is  difficult  to  measure  its  action,  as  it  decomposes  solu- 
tion of  potassium  permanganate,  which  cannot  therefore  be  used  as  a 
measure  of  the  organic  impurity  of  air  when  carbolic  acid  vajDors  are 
present. 

Dr.  Sansom '  has  shown  that  when  the  acid  evaporates,  1  grain  of  car- 
bolic acid  is  taken  up,  at  different  temperatures,  by  the  following  amounts 
of  ah',  viz.,  by  320.75  cubic  inches  at  50^  Fahr.,  by  159.44  cubic  inches  at 
60°  Fahr.,  and  by  93.75  cubic  inches  at  70°  Fahr.  Vaporizers  for  carbolic 
acid  fumes  have  been  made,  by  means  of  which  carbolic  acid  falls,  drop  by 
di'op,  on  a  hot  metal  plate. '^  Dr.  Langstafi"^  has  invented  a  trough,  con- 
taining flannel  wetted  with  water  and  carbolic  acid  (1  part  of  acid  and  20  of 
water),  which  is  placed  in  the  inlet  ventilating  tubes  ;  he  finds  that  at  a 
temperature  of  57°,  foiu-  ounces  of  water  are  taken  up  in  twenty-four 
hours,  and  this  will  keep  the  air  of  a  room,  22  feet  by  10  and  11  feet  high, 
thoroughly  impregnated  with  the  odor.  Carbolic  acid  conceals  all  odors, 
though  it  will  not  destroy  hydrogen  sulphide  if  it  exists  ;  it  lessens  the 
rapidity  of  putrefaction  of  animal  substances  suspended  in  a  room,  and 
they  also  dry  faster,  according  to  Lnngstaff.  It  also  rapidly  arrests  the 
growth  of  fungi,  though  it  will  not  completely  destroy  them  ;  for  example, 
some  fresh  fecal  matter,  free  from  urine,  was  put  in  a  bottle,  and  air . 
washed  in  strong  sulphuric  acid  drawn  over  it ;  fungi  appeared  rapidly  on 
the  fecal  matter.  Air  impregnated  with  carbolic  acid  was  then  passed 
over  the  fungi ;  they  became  discolored,  brownish,  and  apparently  died  ; 
but  on  again  substituting  washed  air,  they  revived.  The  rapid  desti-uc- 
tion,  and  the  as  rapid  recovery  and  regrowth,  could  be  repeated  many 
times,  and  showed  that  the  carboUc  acid  air  had  withered  without  actu- 
ally killing  the  fungi. 

The  small  growing  cells  suspended  in  the  air  are  also  stopped  in  theii* 
growth  (according  to  Ti'autman)  ;  and,  in  fact,  the  action  of  carbolic  acid 
may  be  said  to  be  restraint  of  putrefaction  and  hmitation  of  growth  of  low 

'  Tlie  Antiseptic  System,  by  A.  E.  Sansom,  M.D.,  1871,  p.  15. 

^  Savory  &  Moore's  vaporizer  is  figured  by  Sansom. 

3  Hospital  Hygiene,  by  Charles  Laugstaff,  M.D.,  1872,  p.  20. 

f 


DISINTECTION    AND   DEODORIZATIOX.  173 

forms  of  aerial  life/  The  exact  mode  in  which  it  acts  is  uncertain.  When 
in  some  quantity,  it  coagulates  albumen  ;  and  it  has  been  suj^posed  to  be  in 
this  way  that  it  restrains  putrefaction." 

A  mixture  of  1  part  of  carboHc  acid  and  9  of  yinegar,  and  a  little  cam- 
phor, has  been  used  as  a  disinfectant  in  cabins  on  board  shijD. 

Coal-tar  and  Bitumen  Fames. — This  is  an  old  plan  much  used  in  the 
last  century  ;  the  fmnes  contain  cai'bolic  and  cresylic  acids  with  other  sub- 
stances, and  it  is  presumed  have  the  same  effect  as  carbolic  acid.  The 
substance  employed  by  Siivern,  and  which  has  had  some  rejDutation  in 
Germany,  owes  its  success  as  an  aii'-jouriiier  to  the  fumes  of  coal-tar. 

Vinegar  and  Ammonia. — The  vapor  of  vinegar  is  an  old  remedy,  and 
was  much  employed  -by  Howard  in  the  purification  of  jails  ;  the  efficient 
agents  were  probably  heat  and  ventilation,  which  Howard  made  use  of  at 
the  same  time.  The  vinegar  would,  of  course,  neutralize  any  ammoniacal 
vaj3ors  which  might  be  in  the  aii' ;  whether  its  action  would  extend  beyond 
this  is  doubtful." 

The  vapor  of  ammonia  would  not  a  priryri  seem  hkely  to  be  a  purifier, 
though,  as  it  restrains  decomposition  in  solid  matters,  its  vapor  may  have 
an  effect  in  the  aii-. 

It  will  be  obseiwed  that  the  chief  gases  attacked  by  the  air-puiTfiers  are 
hydrogen  and  ammonium  sulphide,  which  ai-e  easily  destroyed  by  several 
agents,  especially  by  chlorine,  iodine,  and  sulphui-ous  acid  gas. 

The  opinion  that  the  floating  organic  vapors  or  molecules  of  whatever 
kind  in  the  air  are  destroyed  by  the  air-purifiers,  has  been  hitherto  derived 
not  fi'om  dii'ect  quantitative  detennmation  of  the  organic  matter  before  and 
after  the  action  of  the  purifiers,  but  fi'om  their  influence  on  odors  and  on 
other  organic  substances  where  theii'  action  is  more  easily  followed.  But 
the  analogical  evidence  is  so  sti'ong  that  we  can  have  httle  doubt  of  the 
reality  of  the  action.  Ton  Nageli,  however,  denies  the  p)ossibihty  of  effect- 
ing the  destiniction  of  disease-germs  by  fumigation  of  any  kind.'' 

The  mode  of  action  of  the  air-purifiers  may  be  conceived  to  vary. 
Ozone  and  niti'ous  acid  will  directly  oxidize  all  substances  which  can  be 
so  acted  upon.  Chlorine  may  act  by  substitution  for  hydrogen,  or  it  may 
take  hydrogen  and  oxidize  indirectly  by  hberating  oxygen  ;  bromine  and 
iodine  may  also  take  hydi'ogen  in  the  same  way.  Sulphui'ous  acid  more 
probably  deoxidizes  and  forms  sulphuric  acid.  In  other  cases,  it  seems 
probable  that  neither  substitution  nor  oxidation  nor  the  reverse  takes 
place,  but  that  the  action  is  one  of  restraint  of  putrefaction  and  of  limita- 
tion of  the  growth  of  cryptogamic  life.  At  least  this  may  be  infeiTed  from 
the  exjDeriments  of  Crookes,  Lemaii'e,  and  others  on  the  action  of  carbolic 
acid  on  low  forms  of  life  growing  in  lic^uids.  In  practically  carrying  out 
atrial  piuification,  great  care  is  necessaiw  to  ensure  that  the  gas  or  vapor 
is  diffused  everwhere  through  the  room,  and  that  it  is  constantly  present 

Purification  of  Booms  after  Infectious  Diseases. — In  addition  to  thorough 
cleansing  of  all  wood-work  with  soft  soap  and  water,  to  which  a  little  car- 
bolic acid  has  been  added  (1  jDint  of  the  common  lic[uid  to  3  or  4  gallons  of 
water),  and  to  removal  and  washing  of  all  fabrics  which  can  be  removed, 
and  brushing  of  the  walls,  the  room  should  be  fumigated  for  three  hours 
with  the  fumes  of  either  sulphurous  or  nitrous  acids.     Both  of  theise  are 

^  Lemaire,  Crookes,  Sansom,  and  otters. 

^  Tarioiis  other  hydrocarbons  probably  act  in  the  same  way,  as,  for  instance,  the 
terebene  proposed  by  Dr.  Bond,  of  Gloucester,  and  Jeyes'  Perfect  Purifier. 
'•"  It  may  perhaps  delav  putrefaction  and  the  growth  of  minute  orarani^ms. 
^  Die  Xiederen  Pilze,  pp.  154,  202,  203. 


174  PRACTICAL   HYGIENE. 

believed  to  be  superior  to  chlorine,  especiaUy  in  small-pox.  All  doors  and 
windows  and  the  chimney  being  closed,  and  curtains  taken  down,  sulphur 
is  put  in  a  metallic  dish,  a  little  alcohol  is  povu-ed  on  it,  and  it  is  hghted. 
The  proportions  should  be  1  lb  of  sulphvu-  for  every  1,000  cubic  feet  of 
space  ;  and  in  a  long  room,  it  is  best  to  have  the  sulphur  in  two  or  more 
places.  After  three  hours  the  doors  and  windows  should  be  opened,  and 
kept  open  for  twenty-four  or  thii'ty-six  hours. 

Letheby  gives  a  much  larger  j^roportion,  viz.,  ^  ounce  for  every  10 
cubic  feet.  Even  this  is  not  an  excessive  amount.  The  quantity  given 
above  yields  little  more  than  1  per  cent,  to  the  quantity  of  air.  Thus — 1  lb 
of  sulphiu'  produces  11.7  cubic  feet  of  sulphurous  acid  gas,  and  this  diluted 
with  1,000  cubic  feet  of  air  gives  only  1.17  per  cent.  Half  an  ounce  of  sul- 
phur yields  0.366  of  a  cubic  foot  of  the  gas,  and  this  for  10  cubic  feet  of  air 
gives  3.66  per  cent.  Baxter  found  that  0.194  to  1  per  cent,  destroyed  the 
reproductive  jjower  of  septic  microzymes  in  an  albuminous  or  aqueous 
medium,  but  with  0.58  per  cent,  the  poison  of  infective  i]iflammatiou  was 
still  active.  Vaccine  was  destroj-ed  after  10  minutes'  ex^^osure  to  an  atmos- 
phere saturated  with  S0„,  whilst  chlorine,  or  carbolic  acid,  took  30  mmutes' 
exposure.  He  concludes  that  for  aerial  disinfection  SO^  is  the  most  con- 
venient, but  that  the  aii*  should  be  saturated  "\rith  it. 

A  lamp  has  been  proposed  by  Messrs.  Price  &  Co.,  in  which  disulphide 
of  carbon  is  burned.  This  seems,  from  experiments  made  at  Netley  by 
Professor  Macdonald,  to  be  efficacious,  but  the  extreme  inflammability  of 
the  substance  may  be  a  source  of  danger.  An  ounce  burned  in  53  cubic 
feet  arrested  the  movements  of  putrefactive  Bacteria  in  a  meat  infusion  in 
a  saucer  ;  it  also  made  the  infusion  acid,  but  after  some  hours  Bacteria  were 
again  in  active  motion.  The  amount  of  SO^  evolved  in  the  aii'  was  1.16  per 
cent. 

In  whitewashed  rooms  the  walls  should  be  scraj^ed,  and  then  washed 
with  hot  lime  to  which  carbolic  acid  is  added. 

Mortuaries  and  dead-houses  are  best  purified  with  nitrous  acid  or 
chlorine. 

In  a  sick-room  the  vessel  from  which  it  is  disengaged  should  be  some 
little  distance  above  the  bed,  or,  in  some  cases,  underneath  it.  In  hospitals 
with  inlet  tubes,  it  should  be  in  the  inlet  tubes ;  whatever  be  the  agency, 
there  should  be  a  slight  odor  always  perceptible. 

It  ought  to  be  clearly  tmderstood  that  anything  like  effectual  disinfection 
is  only  possible  by  fumigation  when  the  air  is  rendered  in-espirable  for  the 
time.  Therefore  any  attempt  whilst  a  room  is  in  actual  occupation  can 
only  be  successful  in  deodorizing  ;  experiment  having  shown  that  minute 
organisms  are  not  destroyed  by  anything  short  of  jioisonous  doses  which 
would  prove  fatal  to  man  or  the  higher  animals.  If,  however,  the  germs  of 
disease  are  (as  is  suspected)  much  more  vulnerable  than  oixlinaiy  putre- 
factive Bacteria,  partial  fumigation,  such  as  may  be  employed  in  a  sick- 
room, may  do  some  good.  Even  the  deodorization  alone  will  be  an  advan- 
tage, but  it  is  weU  not  to  depend  too  much  upon  it  as  a  disinfectant,  and  so 
permit  it  to  engender  a  false  seciuity,  or  aUow  it  to  interfere  with  complete 
and  perfect  ventilation. 

AVith  regard  to  the  effect  of  chemical  reagents  on  low  forms  of  vege- 
table and  animal  life,  the  works  of  Sansom,'  of  Dr.  DougaU,''  and  the  papers 

'  The  Antiseptic  System,  by  A.  E.  Sansom,  M.D.,  1871. 

•■•'  On  the  Relative  Power  of  Various  Substances  in  Preventing  the  Germination  of 
Animalculte,  by  John  Doiigall,  1871. 


DISINFECTION    AND    DEODOKIZATION.  l75 

of  Calvert '  may  be  consulted  ;  it  need  only  be  mentioned  here  that,  accord- 
ing to  Dougall/  the  most  powerful  agents  in  destroying  "  animalculae  "  are 
the  following  substances: — Sulphate  of  copper,  chloride  of  aluminum, 
chromic  acid,  and  dichromate  of  potassium,  dichloride  of  mercury,  benzoic 
acid,  bromal  hydi'ate,  chloral  hydrate,  hydrocyanic  acid,  alum,  hydrochlorate 
of  strychnia,  ferrous  sulphate,  arsenious  acid,  picric  acid,  and  others  which 
are  less  efficacious. 

Picot'  has  stated  that  silicate  of  soda,  even  in  very  small  quantity, 
arrests  putrid  fermentation  and  retards  other  fermentations,  and  is  veiy 
useful  in  the  treatment  of  blennorrhagic  ui-ethi^al  discharge  in  women.  It 
also  opposes  the  transformation  of  glucose  and  of  the  gtycogenous  matters 
of  the  Hver.  If  silicate  of  soda  has  such  an  effect,  may  not  some  of  the 
other  sihcates  be  also  active  in  this  way,  and  may  not  the  antiputrescent 
power  of  some  soils  be  thus  produced  ?  Lex  found  the  movements'  of  Bacteria 
to  be  best  arrested  by  chloroform,  carbolic  acid,  prussic  acid,  and  strong 
solutions  of  quinine,  in  the  order  named.  Dr.  O'Nial,  C.B.  (Deputy  Sur- 
geon-General), made  many  experiments  on  the  time  of  appearance  of  Bacteria 
in  extract  of  meat  and  other  menstrua.^  He  found,  Hke  DougaU,  the 
potassium  dichromate  to  be  the  most  powerful  agent  in  preventing  the 
appearance  of  Bacteria,  and  after  it,  but  far  below,  is  carbolic  acid ;  yet 
neither  was  quite  efficacious.  The  sodium  disulphite  was  found  to  be  of 
no  value,  and  permanganate  of  potassium,  though  a  good  deodorant,  had 
scarcely  any  restraining  effect  on  the  formation  of  Bacteria.  Commercial 
chlor-alum  was  of  little  use,  but  a  strong  solution  of  chloride  of  aluminum 
was  fairly  effectual.  The  paper  must  be  consulted  for  many  details,  but  it 
shows  clearly  how  httle  Bacteria  can  be  influenced  by  oui'  present  modes 
of  using  these  "chemical  disinfectants."     See  also  Baxter's  Paper. ^ 

From  a  number  of  experiments  made  at  Netley  by  Drs.  Macdonald, 
Notter,  and  de  Chaumont,^  the  conclusions  aiiived  at  were  that  disin- 
fectants required  to  be  in  poisonous  quantity  before  they  affected  low  forms 
of  Kfe,  such  a?  Bacteria.  Similar  conclusions  have  been  arrived  at  by 
Lebon.'  At  the  same  time,  he  points  out  that  there  is  little  or  no  parallel- 
ism between  action  on  ordinary  Bacteria  and  disinfection.  Thus  potassium 
permanganate  is  a  disinfectant,  but  has  little  action  on  Bacteria  ;  alcohol, 
on  the  other  hand,  prevents  the  development  of  the  latter,  but  is  no  disia- 
fectant 

5.    DISINFECTION    IN   VARIOUS    DISEASES. 

Exanthemata,  Scarlet  Fever,  and  Rbtheln. — The  points  to  attack  are  the 
skin  and  the  throat.  The  skin  should  be  rubbed,  from  the  veiy  commence- 
ment of  the  rash  until  completed  desquamation,  with  camphorated  oil,  or 
oil  with  a  little  weak  carboUc  acid.  The  tkroat  should  be  washed  with 
Condy's  fluid,  or  weak  solution  of  sulphurous  acid.  Clothes  to  be  baked, 
or  to  be  placed  at  once  in  boiling  water,  to  every  gallon  of  which  2  ounces 
of  commercial  chloride  of  lime,  or  1  ounce  of  sulphate  of  zinc,  or  ^  fluid- 

'  Proceedings  of  the  Royal  Society,  vol.  xx. ,  p.  185. 
^  Op.  cit.,  table,  p.  6. 
^  Comptes  Rendus,  December,  1872. 

^  Army  Medical  Department  Report  for  1871,  vol.  xlii.  (1873). 

*  Reports  of  the  Medical  Officer  of  the  Privy  Council  and  Local  Government  Board, 
new  series,  No.  vi.,  p.  216. 

^  Report  on  Hygiene,  Army  Medical  Reports,  vol.  xx.,  1880. 
'  Comptes  Rendus,  Juillet  1882,  p.  259. 


176  PRACTICAL    HYGIENE. 

ounce  of  chloride  of  zinc,  is  added.     The  clothes  should  not  be  washed  at 
a  common  laundry. 

Chlorine  or  euchlorine  may  be  diffused  in  the  air,  the  saucer  being  put 
some  little  distance  above  the  head  of  the  patient.  Carbolic  acid  and  ether 
or  carbolic  acid  spray  may  be  used  instead. 

In  this,  as  in  all  cases,  there  can  be  no  use  in  using  aerial  disinfectants, 
unless  tliey  are  constantly  in  the  air,  so  as  to  act  on  any  particle  of  poison 
which  may  pass  into  the  atmosphere. 

Small-pox. — The  skin  and  the  discharges  from  the  mouth,  nose,  and 
eyes  are  to  be  attacked.  There  is  much  greater  difficulty  with  the  skin,  as 
inunction  cannot  be  so  well  performed.  But  smearing  with  oil  and  a  little 
carbolized  glycerine,  or  in  difficult  cases  applying  carbolized  glycerine  to 
the  papules  and  commencing  pustules,  might  be  tried.  The  permanganate 
and  sulphurous  acid  solutions  should  be  used  for  the  mouth,  nose,  and 
eyes.  The  clothing  should  always  be  baked  before  washing,  if  it  can  be 
done.  The  particles  which  j^ass  into  the  air  are  enclosed  in  small  dried 
pieces  of  pus  and  epitheUal  scales  ;  and  Bakewell,  who  has  examined  them, 
expresses  great  doubt  whether  any  air-purifier  would  touch  them. 

Measles. — Oily  applications  to  the  skin  and  air-purifiers,  and  chloride  of 
zinc  or  of  aluminum  in  the  vessels  receiving  the  expectoration,  appear  to 
be  the  proper  measures. 

Typhus  [exanthematicus). — Two  measures  seem  sufficient  to  prevent  the 
spread  of  typhus — viz.,  most  complete  ventilation  and  immediate  disinfec- 
tion and  cleansing  of  clothes.  But  there  is  also  more  evidence  of  use  from 
air-purifiers  than  in  the  exanthemata.  The  nitrous  acid  fumes  were  tried 
very  largely  toward  the  close  of  the  last  century  and  the  beginning  of  this, 
in  the  hulks  and  prisons  where  Spanish,  French,  and  Russian  prisoners  of 
war  were  confined.'  At  that  time,  so  rapidly  did  the  disease  spread  in  the 
confined  sj)aces  where  so  many  men  were  kept,  that  the  efficacy  even  of 
ventilation  was  doubted,  though  there  can  be  no  question  that  the  amount 
of  ventilation  which  was  necessary  was  very  much  unden-ated.  Both  at 
Winchester  and  Sheerness  the  circumstances  were  most  difficult ;  at  the 
latter  place  (in  1785),  in  the  hulk,  200  men,  150  of  whom  had  typhus,  were 
closely  crowded  together ;  10  attendants  and  24  men  of  the  crew  were 
attacked ;  3  medical  officers  had  died  when  the  experiments  commenced. 
After  the  fumigations,  one  attendant  only  was  attacked,  and  it  appeared  as 
if  the  disease  in  those  already  suffering  became  milder.  In  1797  it  was 
again  tried  with  success,  and  many  reports  were  made  on  the  subject  by 
army  and  naval  surgeons.  It  was  subsequently  largely  employed  on  the 
Continent,"  and  everywhere  seems  to  have  been  usefvd. 

These  facts  lead  to  the  inference  that  the  evolution  of  nitrous  acid 
should  be  practised  in  typhus  fever  Avards,  proper  precautions  being  taken 
to  diffuse  it  equally  through  the  room,  and  in  a  highly  dilute  form. 

Hydrochloric  acid  was  employed  for  the  same  pui-pose  by  Guyton-de- 
Morveau,  in  1773,  but  it  is  doubtless  much  inferior  to  nitrous  acid. 
Chlorine  has  been  also  employed,  and  apparently  with  good  results.' 

In  typhus  it  would  seem  probable  that  the  contagia  pass  off  constantly 
by  the  skin  ;  at  least,  the  effect  of  ventilation,  and  the  way  in  which  the 

'  It  was  used  at  Winchester  in  1780  by  Carmichael  Smith,  and  again  at  Sheerness  in 
3785.  Smith  published  several  accounts. — An  accoiint  of  the  Experiment  made  at  the 
iesire  of  the  Lords  Commissioners  of  the  Admiralty,  by  J.  C.  Smith,  1796. 

'•^  Chevallier,  Traita  des  Diisinfectants,  pp.  89,  40. 

»Ibid.,  pp.  14,  15. 


DISINFECTION    AND    DEODORIZATION.  177 

agent  adheres  to  body  linen,  seem  to  show  this.  The  agent  is  not  also  en- 
closed in  quantities  of  dried  discharges  and  epidermis,  as  in  the  exanthe- 
mata, and  is  therefore  less  persistent,  and  more  easily  destroyed,  than  in 
those  cases.  Hence  possibly  the  greater  benefit  of  fumigations,  and  the 
reason  of  the  arrest  by  ventilation.  The  clothes  should  be  baked,  steeped, 
and  washed,  as  in  the  exanthemata. 

Bubo  Plague. — The  measures  would  probably  be  the  same  as  for  ty- 
phus. 

Enteric  {Typhoid)  Fever. — The  bowel  discharges  are  believed  to  be  the 
chief,  if  not  the  sole,  agents  in  spreading  the  disease  ;  effluvia  from  them 
escape  into  the  air,  and  will  adhere  to  walls,  and  retain  power  for  some 
time,  or  the  discharges  themselves  may  get  into  drinking  water. 
Every  discharge  should  be  at  once  mixed  with  a  powerful  chemical  agent ; 
of  those,  chloride  and  sulphate  of  zinc  have  been  chiefly  used,  but  sul- 
•  phate  of  copper  (which  Dougall  found  so  useful  in  stopping  the  growth  of 
animalculse),  chloride  of  aluminum,'  nitrate  of  lead,  strong  solution  of 
ferrous  sulphate  (1  ounce  to  a  pint  of  water),  or  carbolic  acid.''  After  com- 
plete mixiug,  the  stools  must  be  thrown  into  sewers  in  towns  ;  but  this 
should  never  be  done  without  previous  complete  disinfection.  In  country 
places  they  should  be  deeply  buried  at  a  place  far  removed  from  any  water 
supply;  they  should  never  be.  thrown  on  manure  heaps  or  into  middens, 
nor  into  earth-closets,  if  it  can  possibly  be  avoided.  As  the  bed- 
clothes and  beds  are  eo  constantly  soiled  with  the  discharges,  they  should 
be  baked,  or  if  this  cannot  be  done,  boiled  immediately  after  removal 
with  sulphate  or  chloride  of  zinc.  It  would  be  less  necessary  to  employ 
air-purifiers  in  this  case  than  in  others. 

Cholera. — There  can  be  little  doubt  that  the  discharges  are  here  also 
the  active  media  of  conveyance  of  the  disease,  and  their  complete  disin- 
fection is  a  matter  of  the  highest  importance.  It  is,  however,  so  difficult 
to  do  this  with  the  immense  discharges  of  cholera,  especially  when  there 
are  many  patients,  that  the  evidence  of  the  use  of  the  plan  in  the  last 
European  epidemic  is  very  disappointing. 

The  ferrous  sulphate  (green  vitriol),  which  has  been  strongly  recom- 
mended by  Pettenkofer  as  an  addition  to  the  cholera  evacuations,  was 
fully  tried  in  1866  at  Frankfort,  Halle,  Leipzig,  in  Germany,  and  at  Pill, 
near  Bristol,'  and  in  those  cases  without  any  good  result.  In  other  places, 
as  at  Baden,  the  benefit  was  doubtful.  It  seemed  to  answer  better  with 
Dr.  Budd  and  Mr.  Davies  at  Bristol,  but  other  substances  were  also  used, 
viz.,  chlorine  gas  in  the  rooms,  and  chloride  of  Ume  and  Condy's  fluid 
for  the  linen.  On  the  whole,  it  seems  to  have  been  a  failure.''  Ferric  sul- 
phate, with  or  without  potassium  permanganate,  has  been  recommended 
by  Kiihne,  instead  of  ferrous  sulphate,  but  there  does  not  appear  to  be 
any  evidence  on  the  point.  Carbolic  acid  was  largely  used  in  England  in 
1866,  and  appeared  in  some  cases  to  be  of  use,  as  at  Pill,  near  Bristol,  and 

'  In  speaking  of  chloride  of  aluminum,  reference  is  always  made  to  the  strong  solu- 
tion, and  not  to  the  commercial  "  chor-alum,"  which,  though  useful  in  various  ways, 
is  yet  a  weak  solution. 

-  Or  a  mixture  of  two  or  more  (Budd).  Be  lavish  (says  Budd)  in  the  use  of  chemi- 
cals, rather  than  run  the  terrible  risk  of  failing  by  default. 

^  Tibbets,  Medical  Times  and  Gazette,  October,  1867. 

^  In   Dr.    Parkes'  experiments  on  sewage   putrefaction  (Army  Med.  Reports,  vol. 
viii.,  p.  318),  ferrous  sulphate  had  very  little  action  in  preventing  putrefaction,  and  the 
Committee  of  the  Berlin  Medical  Society  declined  to  recommend  it  for  cholera,  as  they 
found  it  did  not  prevent  fermentative  action. 
Vol.  II. -12 


178  PRACTICAL    HYGIENE. 

perhaps  in  Southampton.  It  failed  at  Erfurt,  but  as  it  is  beHevecl  the 
wells  were  contaminated  by  soakage,'  this  is  perhaps  no  certain  case. 
Chloride  of  lime  and  hme  were  used  at  Stettin  without  any  good  result, 
and,  on  the  whole,  it  may  be  said  tliat  the  so-called  disinfection  of  the  dis- 
charges of  cholera  does  not  seem  to  have  been  attended  with  veiy  marked 
results.  At  the  same  time,  it  cannot  be  for  a  moment  contended  that  the 
plan  has  had  a  fair  trial,  and  we  can  easily  believe  that  unless  there  is  a 
full  understanding  on  the  part  of  both  medical  men  and  the  public,  of 
what  is  to  be  accompHshed  by  this  system,  and  a  conscientious  caiTying 
out  of  the  plan  to  its  minutest  details,  no  safe  opinions  of  its  efficacy  or 
othei*wise  can  be  arrived  at.  It  would  be  desirable  to  try  the  effect  of 
ckromic  acid  or  potassium  dichromate. 

With  regard  to  air-purifiers,  little  evidence  exists.  Chlorine  gas, 
diffused  in  the  air,  was  tried  very  largely  in  Austria  and  Hungaiy  in  1832, 
but  without  any  good  results.  Nitrous  acid  gas  was  used  at  Malta  in  1865, 
but  apjDarently  did  not  have  any  decided  influence,  although  Ramon  de 
Luna  has  asserted  that  it  has  a  decided  preservative  effect,  and  that  no  one 
was  attacked  in  Madi-id  who  used  fvimigations  of  nitrous  acid.  But  nega* 
tive  evidence  of  this  kind  is  always  doubtful.  Charcoal  in  bulk  appears  to 
have  no  effect ;  Dr.  Sutherland  saw  a  shijj's  crew  severely  attacked,  al- 
though the  ship  was  loaded  with  charcoal. 

Carbolic  acid  vapor  diffused  in  the  atmosphere  was  largely  used  in 
1866  in  England ;  the  liquid  was  sprinkled  about  the  wards,  and  sawdust 
moistened  with  it  was  laid  on  the  floors  and  under  the  j^atients.  The  effect 
in  preventing  the  spread  of  the  disease  was  vei-y  uncertain.  The  lighting 
of  sulphur  fires  in  infected  districts  has  been  recommended  in  India. 

Yellow  Fever. — In  this  case  the  discharges,  especially  from  the  stomach, 
probably  spread  the  disease,  and  disinfectants  must  be  mixed  with  them. 
Fumigations  of  nitrous  acid  were  employed  by  Ramon  de  Luna,^  and  it  is 
asserted  that  no  agent  was  so  effectual  m  arresting  the  spread  of  the  disease. 

Dysentery. — It  is  well  known  that  dysentery,  and  especially  the  jDutrid 
dysentery,  may  spread  thi-ough  an  hospital  from  the  practice  of  the  same 
close  stools  or  latrines  being  used.  As  long  ago  as  1807  fumigations 
of  chlorine  were  used  by  Mojon,^  to  destroy  the  emanations  from  the  stools, 
and  with  the  best  effects.  The  chlorine  Avas  diffused  in  the  air,  and  the 
stools  were  not  disinfected  ;  but  this  ought  to  be  done,  as  in  enteric  fever, 
and  especially  in  the  sloughing  form.  It  is  probable  that  carbolic  acid  in 
large  quantity  would  be  efficacious. 

With  respect  to  Erysipelas^,  DiiAtheria,  Syphilis,  Gonorrhcea,  Glanders, 
and  Farcy,  local  applications  are  evidently  required,  and  carbolic  acid  in 
various  degrees  of  strength,  and  the  metallic  salts,  are  evidently  the  best 
measures.* 

'  Ninth  Report  of  the  Medical  OflBcer  to  the  Privy  Council. 

■  Ann.  d'Hygi^ne,  April,  18G1. 

^  His  words,  as  quoted  by  Chevallier,  are  interesting: — "  The  dysentery  became  con- 
tagious in  the  Hospital  at  Genoa  ;  almost  all  the  sick  in  my  division,  nearly  200,  were 
attacked) ;  and  as  we  know  that  this  disease,  when  contagious,  is  communicated  or- 
dinarily from  one  person  to  another  by  the  abuse  which  exists  in  all  hospitals  of  mak- 
ing the  same  latrines  serve  for  all  the  sick  of  a  ward,  I  wished  to  see  if  fumigations 
of  chlorine  liad  the  power  of  destroying  these  contagious  exhalations.  I  therefore 
caused  fumigations  to  be  used  twice  daily  in  the  latrines,  and,  in  a  few  days,  I  was 
able  to  destroy  that  terrible  scourge,  wbich  already  had  made  some  victims." 

■•  Davaine  finds  iodine  most  powerful  in  destroying  the  infection  of  malignant  pus- 
tule, -j-jNOTith  part  being  effectual.  It  may  be  injected  into  the  skin  without  injury 
(Comptes  Rendus,  September  and  October,  1873).  See  also  Report  on  Hygiene,  Army 
Med.  Reports,  vol.  xiv.,  in  which  its  use  in  snake  bite  is  suggested. 


DISINFECTION-    AND    DEODOEIZATION.  179 

Cattle  Plague. — The  experiments  made  by  jVIr.  Crookes  on  the  disinfect- 
ant treatment  of  cattle  plague  with  carbolic  acid  vapor  have  an  important 
bearing  on  human  disease.  Although  the  observations  fall  short  of  demon- 
stration, there  are  grounds  for  thinking  that  when  the  air  was  kept  con- 
stantly filled  with  carbolic  acid  vapor,  the  disease  did  not  spread.  So  also 
euchlorine  was  employed  in  Lancashire  by  professor  Stone,  of  Manchester, 
and  with  apparent  benefit.  Dr.  Mdftat  employed  ozone  (developed  from 
phosphorus  exposed  to  the  air),  and  he  believes  with  benefit.'  As  such  ex- 
periments are  very  much  more  easily  carried  out  on  the  diseases  of  animals 
than  on  those  of  men,  it  is  much  to  be  wished  that  the  precise  effect  of  the 
so-called  disinfectants  should  be  tested  by  continuing  the  experiments 
commenced  by  Mr;  Crookes,  not  only  in  cattle  jDlague  in  the  countries 
where  it  prevails,  but  in  epizootic  diseases  generally. 

Among  other  substances  which  may  be  used  are  Jeyes'  Perfect  Purijier 
and  Little's  Absolute  Phenol,  both  coal-tar  preparations  ;  Sporokton,  a  con- 
centrated solution  of  sulphurous  acid  ;  and  many  others. 

6.    DEODOPJZATION    OF    SEWAGE, 

A  very  great  number  of  substances  have  been  added  to  sewage  for  the 
purpose  of  preventing  decomposition  and  retaining  the  ammoniacal  com- 
pounds. 

1.  Charcoal,  which  soon,  however,  gets  clogged  and  loses  its  power  ;  it 
is  not  nearly  so  iaseful  when  used  in  this  way  as  in  the  j)urification  of  air. 
When  iu  relatively  large  quantity  it  decomposes  the  ammonia  and  sets  ni- 
trogen free,  and  so  diminishes  the  agricultural  value.  Sillar's  preparation 
(A,  B,  C  deodorant)  is  a  mixture  of  animal  charcoal,  blood,  clay,  and  alum 
refuse.  Under  the  name  of  native  guano,  the  resulting  product  seems  to 
be  of  value.     Messrs.  Weare  &  Co.  's  is  also  a  charcoal  process. 

2.  Dry  Earth,  especially  humus,  and  marly  and  clayey  soils  ;  the  effect 
is  similar  to  that  of  charcoal,  but  it  is  not  so  soon  clogged.  Bird's  prepa- 
ration is  ferruginous  clay,  moistened  with  sulphuric  acid,  and  then  dried 
and  pulverized. 

3.  Quicklime  is  sprinkled  over  the  solid  excreta,  or  quicklime  and  water 
added  to  sewer  water,  till  a  deposit  occurs,  leaving  a  clear  fluid  above. 
This  is  a  very  imperfect  method,  and  the  solid  deposit  has  little  or  no  value 
as  a  manure. 

From  15  to  16  grains  of  quicklime  are  enough  for  1  gallon  of  sewage, 
or  20  cwt.  per  million  gallons.  At  Leicester  580  tons  of  quicklime  were 
used  per  annum  for  4,700,000  tons  of  sewage.  The  process  has  now  been 
discontinued  there,  but  is  still  partially  employed  at  Birmingham  and 
elsewhere. 

Hanson's  process  consists  in  the  use  of  slaked  lime  and  black  ash  refuse, 
or  the  soda  and  tank  waste  from  the  alkali  works,  mixed  with  sulphuric 
acid. 

4.  Cheap  salts  of  ahimina,  and  then  lime,  or  alum  sludge,  lime,  and 
waste  animal  charcoal  (Manning),  or  zinc  and  charcoal  (Stothert's  process), 
A,  B,  C  (Sillar's  process),  chloride  of  aluminum  (chlor-alum). 

The  alumina  precipitated  by  the  lime  forms  a  very  bulky  precipitate, 
well  suited  to  the  entanglement  of  suspended  matters.  The  clearance  of 
the  sewage  is  more  perfect  than  with  Ume  alone,  but  otherwise  the  process 


'  On   Meteorology   in   Reference  to  Epidemic  and  Sporadic  Cholera,  by   F.  Moffat, 
M.D.,  Hawarden,  1868. 


180  PRACTICAL    HYGIENE. 

and  the  objections  are  the  same,  and  the  cost  is  greater.  The  whole  of  the 
phosjDhoric  acid  is  precipitated  as  ahiminum  phosphate.  To  a  gallon  of 
sewage  water  there  should  be  added  73|-  grains  of  aluminum  suli:)hate, 
3^  grains  of  sulphate  of  zinc,  73^  grains  of  charcoal,  and  16f  grains  of 
quicklime, 

Chlor-alum  is  a  weak  solution  of  chloride  of  aluminum  ;  it  is  not  a  veiy 
powerful  deodorizer,  and  must  be  used  in  large  quantity,  but  its  cheaj^ness 
and  want  of  poisonous  properties  '  ai"e  recommendations,  and  when  in  suf- 
ficient amount  it  is  effectual.  It  is  efficacious  against  ammonia,  but  not 
against  hydi'Ogen  sulphide  ;  it  acts  moderately  against  fecal  odor. 

5.  Magnesium  Superphosphate  and  Lime-water  (Blyth's  patent). — The 
idea  was  to  add  a  substance  which,  in  addition  to  deodorizing,  might  be 
useful  as  a  manure,  and  it  was  thought  that  a  double  phosphate  of  mag- 
nesium and  ammonium  would  be  thrown  down  ;  but  this  salt  is  sufficiently 
soluble  in  water,  especially  when  the  water  contains  chloride  of  sodium,  to 
render  this  expectation  incorrect.  This  method  has  been  practically  found 
to  be  useless,  and  to  be  more  costly  than  any  other  plan. 

6.  F.  Hille,''  whose  process  is  in  use  at  Wimbledon,  the  town  of  Al- 
dershot,  and  elsewhere,  uses  a  mixtui-e  of  lime,  tar,  and  salts  of  magnesium 
for  defecation  and  deodorizing  the  sewage.  The  effluent  water  is  then 
passed  through  artificial  filters,  or  used  for  iiTigation  purposes.  This  plan 
has  been  well  spoken  of  by  Captain  Flower'  and  others,  and  it  appears  to 
be  moderate  in  cost  compared  with  most  other  processes. 

7.  Iron  Perchloride. — When  this  salt  is  added  to  sewage,  a  precipitate 
of  ferric  oxide  is  caused  by  the  ammonium  carbonate  (which  lorms  so  rap- 
idly in  sewage),  and  cax'rieswith  it  all  the  suspended  matters  of  the  sewage. 
A  clear  fluid  remains  above.  The  hydrogen  sulphide  falls  in  the  precipi- 
tate as  ii'on  sulphide.  As  the  sulphide  of  iron  tends  to  fonn  ferric  oxide, 
sulphur  being  let  free,  it  has  been  conjectured  by  Hofmann  that  an  oxidiz- 
ing effect  from  the  oxide  may  follow  the  fu-st  action. 

Both  precipitate  and  suj^ernatant  Hquid  are  free  from  odor. 

This  substance  has  been  tried  at  Croydon  and  Coventiy.  From  14  to  29 
grains  per  gallon  of  sewage  are  necessary  for  London  sewage  ;  for  Croydon 
sewage  from  5  to  15  grains  were  necessary.  One  gallon  of  hquid  perchlo- 
ride was  sufficient  for  15,000  gallons  of  sewage  (Hofman  and  Frankland). 

The  perchlorides  of  iron  can  be  manufactured  by  dissolving  in  hydro- 
chloiic  acid  peroxide  of  u-on,  the  different  iron  ores,  refuse  oxide  of  iron  from 
sulphuric  acid  works,  iron  rust  in  foundries,  etc.  Another  plan  is  to  take 
equivalent  proportions  of  common  salt,  sulphuric  acid,  iron  rust,  and  water, 
so  that  chlorine,  when  disengaged,  shall  combine  with  the  ii'on.  A  hard 
yellowish,  not  very  deUquescent  substance,  containing  26  per  cent,  of  per- 
chloride of  iron,  is  formed,  which  can  be  ti-ansported  to  any  distance.  The 
price,  if  made  in  this  way,  is  £2  7s.  per  ton  (cost  of  labor  not  included) 
in  England. 

The  perchloride  acts  both  on  hydrogen  and  alkaline  sulphides,  in  both 
cases  setting  free  sulphur.  In  sewage  its  ordinary  action  is  on  ammonium 
sulphide. 

'  In  some  samples  I  have  found  a  considerable  amount  of  lead,  but  bj  improved 
manufacture  this  (it  is  said)  lias  since  been  remedied. — [F.  de  C] 

■^  System — F.  Hille,  Sewage  Disinfecting  and  Filtration  Process,  2d  edition,  1876. 

^  Sewage  Treatment,  more  especially  as  affecting  tlie  pollution  of  the  River  Lea,  a 
paper  contributed  to  the  Sewage  Conference  held  by  appointment  of  the  Council  of  the 
Society  of  Arts,  in  May,  1876,  by  Captain  L.  Flower,  Sanitary  Engineer,  Lea  Censer' 
vancy  Board,  etc. 


DISINFECTIOlSr    AISTD    DEODORIZATION".  181 

Objections  have  been  made  to  tbe  percbloride,  as  it  contains  arsenic; 
but  the  amount  of  this  is  small,  and  as  it  falls  with  the  deposit  it  is  never 
likely  to  be  dangerous. 

8.  Lueder  &  Leidloff's  Powder  consists  (according  to  Leuchtenberg's 
analysis)  of  ferric  sulphate,  36  per  cent. ;  ferrous  sulphate,  16  ;  free  sul- 
phuric acid,  4 ;  calciiun  sulphate  and  other  substances,  44  It  has  been 
highly  commended,  but,  from  experiments  made  at  Netley,  it  does  not  seem 
very  powerful. 

9.  Lead  Nitrate,  or  Ledoyen's  Fluid,  is  made  by  dissolving  1  pound  of 
litharge  in  about  7  ounces  of  strong  nitric  acid  and  2  gallons  of  water ;  a 
little  of  the  water  is  mixed  with  the  Htharge  ;  the  acid  is  gradually  added, 
and  then  the  rest  oi  the  water.  This  quantity  will  deodorize  a  moderate- 
sized  cesspool.  It  acts  rapidly  on  hydrogen  sulphide,  and  can  be  depended 
upon  for  this  purpose. 

10.  Zinc  Chloride. — Burnett's  fluid  contains  25  grains  to  every  fluid 
drachm  ;  1  pint  is  added  to  a  gallon  of  water  (1  to  8).  It  is  usually  said  to 
decompose  hydrogen  sulphide  until  the  solution  becomes  acid,  when  its 
action  ceases ;  but  Hofmann  finds  that  it  does  not  act  on  free  hydrogen 
sulphide,  but  on  ammonium  sulphide,  forming  zinc  sulphide  and  ammonium 
chloride.  It  destroys  ammoniacal  compounds  and  organic  matter.  The 
sulj)hates  of  zinc  and  copper  decompose  free  hydrogen  sulphide,  with  for- 
mation of  metallic  sulphide  and  water. 

Burnett's  fluid  delays  decomposition  in  sewage  for  some  time  ;  but  a 
very  peculiar  odor  is  given  out,  showing  that  some  change  is  going  on. 
A  good  effect  is  produced  on  hydrogen  sulphide  by  a  mixture  of  zinc  and 
ferrous  sulphates  (Lirnaudes'  mixture)  which  also  lessens  for  the  time  the 
peculiar  sewage  smell. 

11.  Zinc  SuljyJiate. — This  forms  part  of  the  Universal  Disinfecting 
Powder '  (Langston-Jones'  patent),  along  with  Cooper's  salts,  viz. ,  calcium 
and  sodium  chlorides.  This  powder  has  the  advantage  of  being  inodorous, 
but  it  is  not  a  strong  deodorant.  It,  however,  gets  rid  of  fecal  odor  to 
some  extent,  aijd  is  efficacious  against  H^S. 

12.  Potassium  permanganate  prevents  putrefaction  for  a  short  time,  and 
removes  the  odor  from  putrefying  sewage,  but  it  requires  to  be  used  in 
large  quantity. 

13.  Preparations  from  coal-tar ;  carbolic  acid  (phenol  or  phenic  acid,  or 
phenyl- alcohol  (C^H^O) )  ;  coal-tar  creosote,  and  cresyhc  acid  (cresol  or 
cresyl-alcohol  (C^H^O)  ),  in  various  admixtures.^  These  substances  are  all 
excellent  sewage  deodorants  and  arresters  of  putrefaction. 

The  last  few  years  have  seen  an  extraordinary  development  in  the 
manufacture  of  these  substances.  Phenol  or  carbohc  acid  is  now  obtained 
in  gTeat  purity,  and  is  sold  in  crystals,  and  also  in  a  hquid  form.     All  the 

'  Analysis  (de  Chaumont) : — 

Water 7.40 

Calcium  and  sodium  chlorides 73. 20 

Zinc  sulphate 14.26 

Insoluble 5. 20 

Total  100.06 

To  later  samples  some  calcium  borate  was  added.  Probably  the  addition  of  ferrous 
sulphate  might  improve  it. 

''  It  is  perhaps  unfortunate  that  phenol  and  cresol,  which  are  rather  alcohols  than 
acids,  should  have  been  termed  carbolic  and  cresylic  acids.  If  the  terms  phenol  and 
cresol  could  be  used  instead  it  would  be  better. 


182  PRACTICAL    HYGIENE. 

preparations  may  be  conveniently  classed  iinder  the  tlu-ee  divisions  of  crys- 
tals, liquids,  and  powders. 

(a)  Crystals. — Carbolic  acid,  more  or  less  pure,  is  the  only  substance 
under  this  head  ;  it  is  so  slightly  soluble  in  water  (only  in  the  proportion 
of  5  per  cent.)  that  it  is  not  so  useful  as  a  deodorant  as  the  impurer  kind. 
When  mixed  with  sewage  it  acts  slowly  and  not  so  perfectly  as  the  impurer 
kinds.  When  exposed  to  the  air  it  liquefies,  and  is  slowly  given  out  into 
the  au',  and  is  then  supposed  to  be  useful  as  an  air  jDiuifier. 

(6)  Liquids. — Carbolic  acid,  more  or  less  impui-e,  dissolved  in  water, 
simply,  or  with  a  Httle  alcohol  and  cresylic  acid  (cresol),  forms  the  hquid 
carbohc  acids.  In  the  market  they  ai'e  found  almost  colorless,  or  highly 
colored.  The  vaiious  lic{uids  contain  from  10  to  90  -per  cent,  of  phenol. 
Cresol,  though  crystalline  and  colorless  when  pure,  is  usuall}^  found  in  the 
market  as  a  dark  liquid.  Some  of  it,  no  doubt,  exists  in  most  samples  of 
cai'bolic  acid.  Owing  probably  to  the  way  they  mix  at  once  with  the 
sewage,  the  liquid  acids  are  more  deodorant  than  the  ciystallized  acid,  and 
resti-ain  putrefaction  for  a  long  time.  Carbolic  acid,  however,  does  not 
act  on  hydrogen  sulphide,  though  it  will  restrain  the  processes  which  pro- 
duce it. 

Samples  of  so-eaUed  carbolic  acid  are  sold,  which  are  only  impure  tar 
oils,  and  almost  destitute  of  deodorizing  power.  Sometimes  a  nauseous 
sulphiu*  compound  is  also  present. 

Mr.  Crookes'  gives  the  following  rules  in  order  to  determine  the  pre- 
sence of  the  tar  oils  : — 

"  Commercial  carbolic  acid  is  soluble  in  from  20  to  70  parts  of  water, 
or  in  twice  its  bulk  of  a  solution  of  caustic  soda,  while  oil  of  tar  is  nearly 
insoluble,  but  if  the  amount  of  cai'boUc  acid  be  increased,  some  remains 
undissolved, 

"  To  apply  the  tests — 1.  Put  a  teaspoonful  of  the  carbohc  acid  in  a  bot- 
tle, pour  on  it  half  a  pint  of  warm  water,  and  shake  the  bottle  at  intervals 
for  half  an  hour,  when  the  amount  of  oily  residue  vnH  show  the  impurity  ; 
or  dissolve  one  part  of  caustic  soda  in  10  parts  of  warm  water,  and  shake 
it  up  ^dth  5  parts  of  the  carbohc  acid.  As  before,  the  residue  will  show 
the  amoiint  of  impm-ity. 

"  These  tests  will  show  whether  tar  oils  have  been  used  as  adidterants, 
but  to  ascertain  whether  the  hquid  consists  of  a  mere  solution  of  carbohc 
acid  in  water  or  alkah,  or  whether  it  contains  sulpho-carbohc  or  sulpho- 
cresyHc  acids,  another  test  must  be  used  based  on  the  solubiUty  of  these, 
and  the  iusolubihty  of  carbolic  acid  in  a  small  quantity  of  water.  In  this 
case  proceed  as  follows  : — 2.  Put  a  wineglassful  of  the  hquid  to  be  tested 
in  a  bottle,  and  pour  on  it  half  a  pint  of  warm  water.  If  the  greater  part 
dissolves,  it  is  an  adulterated  article.  Test  the  liquid  in  the  bottle  with 
htmus  paper  ;  if  strongly  acid,  it  wiU  show  the  probable  presence  of  sulpho- 
acids  ;  whilst  if  alkahne,  it  will  show  that  caustic  soda  has  been  probably 
used  as  a  solvent," 

If  the  quantity  of  carbolic  acid  has  to  be  estimated  from  a  liquid,  it  must 
be  distilled  at  a  given  temperature.  Carbohc  acid  boils  at  184^  C.  (=  363° 
Fahr.),  cresol  at  203^  C.  {=  397.4°  Fahr.). 

In  using  the  liquid  acid,  1  part  is  mixed  with  50  or  100  of  water,  accord- 
ing to  the  strength  of  the  acid,  and  thrown  down  drains  or  into  cesspools, 
or  sprinkled  with  a  watering-can  over  dung-heaps. 

'  Third  Eeport — Cattle  Plague  Commission.  Carbolic  acid  can  be  distinguished 
from  crt'osote  by  its  solubility  in  glycerine  (Morson). 


DISINFECTIOJSr    AND    DEODOEIZATIO]^.  183 

(c)  Powders. — The  two  principal  carbolic  acid  powders  are  M'Dougall's 
and  Calvert's,  but  there  are  several  others  in  the  market  known  under  var- 
ious names. 

M'Dougall's  and  Calvert's  powders  are  widely  different  in  composition. 

The  former  is  strongly  alkaline  from  lime,  and  makes  the  sewage  alka- 
line. It  consists  of  about  33  per  cent,  of  carbolate  of  hme  and  59  per 
cent,  of  sulphite  of  magnesia,  the  rest  being  water. 

Calvert's  powder  is  carbolic  acid,  about  20  to  30  per  cent.,  mixed  with 
alumina  from  alum  works,  and  some  siHca. 

The  quantity  of  these  preparations  which  must  be  used  depends  on  the 
degree  and  duration  of  deodorization  wished  for.  For  the  daily  sohd  ex- 
creta (4  ounces)  of -an  adult  at  least  from  30  to  70  grains  of  the  ciystaUized 
acid,  60  drops  of  the  strong  liquid  (90  j)er  cent,  of  acid),  or  ^  ounce  of  the 
dilute  carbohc  acid,  sold  at  Is.  per  pint,  are  necessaiy,  if  the  sewage  is  to 
be  kept  in  an  unaltered  state  for  10  to  20  days,  but  a  smaller  amount  is 
sufficient  for  2  or  3  days.'  Dr.  Sansom,  who  does  not  rate  the  effect  of 
carbolic  acid  so  highly  as  a  deodorant,  also  finds  that  much  larger  quanti- 
ties must  be  used  than  is  usually  stated.^  Half  an  ounce  of  either  Calvert's 
or  M'Dougall's  powder  for  4  ounces  of  sewage  has  a  preservative  effect  for 
18  to  20  days  ;  ^  ounce  or  less  is  effectual  for  3  or  4  days,  but  if  the  stools 
contain  urine  much  more  is  necessary.^ 

Smaller  quantities  can,  however,  be  used,  if  diminution,  but  not  entire 
removal  of  smell  and  putrefaction  is  desired.  Quicklime  5  parts,  and  car- 
bolic acid  1  part,  make  a  good  deodorizing  mixture.  If  hydrochloric  acid 
is  added,  and  then  water,  the  lime  is  deposited,  and  the  carbolic  acid 
floats  on  the  surface,  and  its  amount  can  be  determined. 

14.  The  Silvern  Deodorant. — The  water  flowing  from  sugar  factories  has 
long  been  a  source  of  annoyance  and  ill-health  ;  it  contains  quantities  of 
vegetable  organisms  ( Oscillaria  alba  or  Beggiatoa),  which  act  hke  ferments, 
and  rapidly  decompose  the  sulphates  in  the  water,  and  liberate  hydrogen 
sulphide.  Herr  Silvern,  to  remedy  this,  proposed  a  preparation  of  coal-tar 
thus  prepared.''  A  bushel  and  a  half  of  good  quicklime  is  put  in  a  cask 
and  slaked  ;  it  is  well  stirred,  and  10  lb  of  coal-tar  are  thoroughly  mixed 
with  it,  so  that  the  coal-tar  may  be  thoroughly  divided.  Fifteen  pounds  of 
magnesium  chloride  dissolved  in  hot  water  are  then  thoroughly  mixed 
with  the  mass,  and  then  additional  hot  water  is  added,  enough  to  make  a 
mass  of  just  sufficient  liquidity  to  drop  slowly  from  a  stick  inserted  in  it 
and  then  pulled  out.  The  magnesium  chloride  forms  dehquescent  calcium 
chloride,  magnesia  being  hberated,  and  it  is  found  that  this  prevents  the 
caking  of  the  deodorant  and  the  adherence  to  pipes.  This  deodorant  has 
come  into  considerable  use  for  cesspools,  drains,  etc.  The  MuUer-Schurr 
deodorizer  has  been  already  noticed. 

15.  Dr.  F.  T.  Bond  (of  Gloucester)  has  introdiiced  a  new  deodorant  in 
the   form  of  powder  and  liquid,  consisting  essentially  of   metaUic  salts, 

'  See  Dr.  Parkes'  experiments  in  the  Army  Medical  Department  Report,  vol.  viii.,  p. 
318. 

'^  Op.  cit. ,  p.  203. 

^  Dr.  John  Day  (of  Geelong)  published  a  paper  in  the  Australian  Medical  Journal 
(June,  1874),  on  the  comparative  value  as  disinfectants  of  carbolic  acid  and  mineral 
oils,  such  as  gasolene  and  kerosene.  He  prefers  gasolene,  and  finds  it  may  be  iised  for 
papered  walls,  furniture,  clothing,  and  flooring.  It  must  be  used  with  caution  near 
lights,  as  it  is  very  inflammable.  Dr.  Day  attributes  its  action  to  its  strong  oxidizing 
properties  ;  paper  brushed  over  with  it  gave  the  reaction  of  peroxide  of  hydrogen  after 
more  than  a  year. 

*  Trautman,  Die  Zersetzungsgase,  1869,  p.  35. 


184  PRACTICAL    HYGIENE. 

alum,  and  ferehene  (a  hydrocarbon  deiived  from  tuipentine  by  treatment 
■with  sulphvu'ic  acid).  Terebene  has  a  pleasant  odor,  and  so  far  is  superior 
to  carboHc  acid  ;  its  deodorizing  powers  are  very  considerable.  The  pre- 
pai'ations  in  the  fonn  of  powder  are  various,  the  chief  being  ferrahan  and 
capralum,  the  latter  being  most  frequently  employed.  It  consists  of  copper 
sulphate,  aluminum  suljDhate,  a  httle  potassium  dichi'omate,  and  terebene. 
It  is  a  very  powei^ful  deodorant,  covmteracting  ammonia  and  hydrogen  sul- 
phide, and  at  least  masking  fecal  odor  as  much  as  carbolic  acid.  Some 
objections  were  formerly  made  to  it  on  accoiuit  of  a  tendency  to  dehque- 
scence,  due  to  the  presence  of  sodium  chloride.  This  has  now  been  reme- 
died, and  the  preparation  keeps  well. 

The  substance  advertised  as  Sanitas  is  a  hydi-ocarbon  derived  from  tur- 
pentine acted  upon  by  steam.  It  has  the  advantage  of  being  easily  mis- 
cible  with  water,  but  it  is  not  very  powerful. 

16.  The  remarkable  power  shown  by  salicylic  acid  in  arresting  fermen- 
tation, and  its  value  in  the  antiseptic  treatment  of  wounds,  would  seem  to 
indicate  it  as  a  good  agent,  but  it  is  at  present  too  expensive  for  use  on  a 
lai'ge  scale. 

General  Conclusion. — It  must  be  remembered  that  deodorization  is  only 
possible  within  certain  Hmits,  and  that  in  a  number  of  cases  only  partial 
results  can  be  obtained,  unless  very  large  cpiantities  of  the  deodorant  are 
used.'  The  most  effectual  appear  to  be  the  terebene  preparations,  esjoe- 
ciaUy  the  cupralum,  and  carbohc  acid  and  its  prepai'ations.  Of  these  the 
eupralum  has  the  advantage  of  destroying  hydrogen  sulj^hide  and  neutral- 
izing ammonia,  whicli  are  only  masked  by  the  others.  Chloride  of  Ume 
and  chloride  of  soda  are  also  powerful,  but  have  themselves  a  sickly  odor, 
very  disagreeable  to  many  persons.  The  Silvern  deodorant  is  probably  the 
next  best,  and  after  that  the  fenic  chloride  (FeClj). 

'  In  experimenting  with  the  very  offensive  infusion  of  linseed,  it  was  found  almost 
impossible  to  get  rid  of  odor  without  using  very  large  quantities  of  the  deodorants. — 
[F.  de  C] 


CHAPTER   XX. 
STATISTICS. 

An  accurate  basis  of  facts,  derived  from  a  sufficient  amount  of  experience, 
and  tabulated  with  the  proper  precision,  lies  at  the  very  foundation  of 
hygiene,  as  of  all  exact  sciences.  Army  surgeons  have  already  contributed 
much  important  statistical  evidence  as  to  the  amount  and  pi-evalence  of 
different  diseases,  and  it  is  evident  that  no  other  body  of  medical  prac- 
titioners possess  such  opportunities  of  collecting,  with  accuracy,  facts  of 
this  kind,  both  among  their  own  nations  and  others.  As  they  have  to  make 
many  statistical  returns,  it  seems  desirable  to  make  a  few  brief  remarks 
on  some  elementary  points  of  statistics,  which  are  necessary  to  secure  the 
requisite  accuracy  in  collecting  and  arranging  facts.  But  it  is,  of  course, 
impossible  to  enter  into  the  mathematical  consideration  of  this  subject ; 
for  a  separate  treatise  would  be  required  to  do  justice  to  it. 

SECTION  I 

A  FEW  ELEMENTARY   POINTS   CONNECTED   WITH  GENERAL  STATISTICS. 

1.  The  elements  of  statistical  inquiries  are  individual  facts,  or  so-called 
numerical  units,  which  having  to  be  put  together,  or  classed,  must  have 
precise;  definite,  and  constant  characters.  For  example,  if  a  number  of 
cases  of  a  certain  disease  are  to  be  assembled  in  one  group  with  a  definite 
signification,  it  is  indispensable  that  each  of  these  cases  should  be  what  it 
purports  to  be,  an  unit  not  only  of  a  definite  character,  but  of  the  same 
character  as  the  other  units.  In  other  words,  an  accurate  diagnosis  of  the 
disease  is  essential,  or  statistical  analysis  can  only  produce  error.  If  the 
numerical  units  are  not  precise  and  comparable,  it  is  better  not  to  use 
them.  A  great  responsibility  rests  on  those  who  send  in  inaccurate  statis- 
tical tables  of  diseases  ;  for  it  must  be  remembered  that  the  statist  does 
not  attempt  to  determine  if  his  units  are  correct ;  he  simply  accepts  them, 
and  it  is  only  if  the  results  he  brings  out  are  different  from  prior  results 
that  he  begins  to  suspect  inaccuracy.' 

'  It  is  in  vain  to  conceal  the  fact  that  many  persons  look  at  tables  of  diseases  col- 
lected indiscriminately  as  worse  than  useless,  from  errors  in  diagnosis.  Even  in  the 
army  returns,  which  are  all  furnished  by  qualified  practitioners,  there  is  reason  to 
doubt  the  correctness  of  the  earlier  tables  especially.  But  it  is  believed  that  the  army 
returns  of  diseases  are  now  gaining  in  accuracy,  and  it  cannot  be  too  strongly  urged  on 
medical  officers  that  perfect  accuracy  in  diagnosis  is  a  duty  of  the  highest  kind.  It  is 
much  better  to  have  a  large  heading  of  undetermined  diseases  than,  when  in  doubt,  to 
p^^t  a  case  of  disease  under  a  heading  to  which  it  has  no  unequivocal  pretensions.  It  is 
greatly  to  be  regretted  that,  from  the  abridged  form  in  which  they  are  now  published, 
much  valuable  information  is  now  no  longer  obtainable  from  the  Army  Medical  Reports- 


186  PKACTICAL    HYGIENE. 

2.  These  items  or  numerical  units  being  furnished  to  the  calculator, 
are  by  him  arranged  into  groups ;  that  is  to  say,  he  contemplates  the 
apparently  homogeneous  units  in  another  light,  by  selecting  some  charac- 
teristic which  is  not  common  to  all  of  them,  and  so  divides  them  into 
groups.  To  take  the  most  simple  case:  A  certain  number  of  children  are 
born  in  a  year  to  a  given  population.  The  children  are  the  numerical 
imits.  They  can  then  be  separated  into  groups  by  the  dividing  character 
of  sex,  and  then  into  other  groups  by  the  dividing  character  of  "  born 
alive,"  or  "  still-born,"  etc. 

Or,  a  number  of  cases  of  sickness  being  given,  these  numerical  units 
(all  agreeing  in  this  one  point,  that  health  is  lost)  are  divided  into  gi'oups 
by  diseases,  etc.  ;  these  groups,  again,  are  divided  into  others  by  the 
character  of  age,  etc.,  and  in  this  way  the  original  large  group  is  analyzed, 
and  separated  into  minor  parts. 

This  group-building  seems  simple,  but  to  j^roperly  group  complex 
facts,  so  as  to  analyze  them,  and  to  bring  out  all  the  possible  inferences,  can 
only  be  done  by  the  most  subtle  and  logical  minds.  The  dividing  charac- 
ter must  be  so  definite  as  to  leave  no  doubt  into  which  group  an  unit  shall 
faU  ;  it  must  be  precise  enough  to  prevent  the  possibiUty  of  an  unit  being 
in  two  gi'oups  at  the  same  time.  This  rule  is  of  the  greatest  importance, 
and  many  examples  could  be  pointed  out  of  error  from  inattention  to  it. 

Having  decided  on  the  groups,  their  numerical  relations  are  then  ex- 
pressed in  figures,  for  example  : — 

3.  In  order  to  express  the  relation  of  the  smaller  groups  to  the  gross 
number  of  individual  facts  or  units,  a  constant  numerical  standard  must 
be  selected,  else  comparison  between  groups  of  unequal  numbers  cannot 
be  made.  The  standard  universally  adopted  in  medical  statistics  is  to 
state  this  relation  as  a  percentage,  or  some  multiple  of  a  percentage.  So 
much  jDer  cent.,  or  per  1,000,  or  per  10,000,  is  the  standard.  This  is  got 
simply  by  multiplying  the  number  of  units  in  the  smaller  groups  by  100, 
and  dividing  by  the  total  number  of  units.  Thus,  let  us  say  there  occur 
362  cases  of  pneumonia  ;  this  is  divided  into  two  groups  of  recovered  or 
died,  say  343  recoveries  and  19  deaths  ;  and  their  relation  may  be  ex- 
pressed in  one  of  two  ways,  viz.,  either  by  the  relation  of  the  deaths  to  the 
total  number  of  cases,  which  will  be — 


19  X  100 

— o^s — =  •'5.25  per  cent. 


of  mortality  ;  or  by  the  relation  of  the  deaths  to  recoveries,  viz. — 

19  y  100 

— oTo — =  5.54  per  cent. 

4.  Having  established  that  in  a  certain  number  of  cases,  di\T[ded  into 
groups,  the  number  in  each  group  bears  a  certain  jDroportion  to  the  whole, 
how  far  are  we  justified  in  concluding  that  the  same  proportions  will  be 
repeated  in  future  cases  ?  This  will  chiefly  depend  on  the  number  of  the 
cases.  If  the  number  of  cases  from  which  one  proportion  has  been  taken 
is  small,  we  can  have  no  confidence  that  the  same  proportion  will  be 
repeated  in  future  cases.  If  the  number  is  large,  there  is  a  greater  prob- 
ability that  the  proportion  in  succeeding  numbers  of  equal  magnitude  will 
be  the  same.  The  result  obtained  even  from  a  very  large  number  is,  how- 
ever, only  an  approximation  to  the  truth,  and  the  degree  in  which  it 
approaches  the  truth  can  be  obtained  by  calculation.     The  following  rule 


STATISTICS.  187 

is  given  by  Poisson  for  calculating  fhe  limits  of  error,  or,  in  other  words, 
the  degree  of  approximation  to  the  truth  : — 

Let  jj.  be  the  total  number  of  cases  recorded, 
m  be  the  number  in  one  group, 
n  be  the  number  in  the  other, 
So  that  m  +  n  :=  [X. 

The  proportion  of  each  gToup  to  the  whole  will  be  respectively  —        — , 

but  these  proportions  will  vaiy  within  certain  limits  in  succeeding  instances. 
The  extent  of  variation  will  be  within  the  jDroportions  represented  by 

m 


+  2      /2.  m.  n 


\/ 


and'  '^  -  2,  A  "^-^^ 

It  will  be  obvious  that  the  larger  the  value  of  /x  the  less  will  be  the  value  of 
'      '    ,  and  consequently  the  less  will  be  the  limits  of  error  in  the 

simple  proportion  — 
/^ 
An  example  wiU  show  how  this  rule  is  worked.     The  following  is  given 
by  Gavarret : — ^ 

Louis,  in  his  work  on  "  Typhoid  Fever,"  endeavors  to  determine  the  effect 
of  remedies,  and  gives  140  cases,  with  52  deaths  and  88  recoveries.    What 
is  the  mortahty  per  cent.,  and  how  near  is  it  to  the  true  proportion  ? 
m  =    52  =  number  of  deaths, 
n  =    88  =  number  of  recoveries, 
ft  =  140  =  total  number  of  cases, 
i.e.,  37  deaths  in  100  cases,  or  more  precisely  37,143  deaths  in  100,000  cases. 
How  near  is  this  ratio  to  the  truth  ?     The  possible  error  is  as  follows — the 
second  half  of  the  formula,  viz. : — 


will  be 


V 

v 


2  .  771  .  n 
2  X  52  X  i 


0.11550  to  unity. 


(140)^ 
(Or  11,550  in  100,000.) 

The  mortahty  being  37.143  per  cent.,  or  37,143  deaths  in  100,000  cases. 
in  these  cases,  it  may  be  in  other  140  cases  either 

37,143  +  11,550  =  48.693  per  cent, 
or  37,143  -  11,550  =  25.593       " 

In  other  words,  in  successive  140  cases  the  mortahty  vdU  range  from  49  per 

'  This  is  sometimes  stated  tlius :  — 


^s^ 


Z  +  ,    /Sp{q-p) 


when  q  =  total  number  of  events, 

and    2^  =  total  number  of  events  in  anv  particular  direction. 
Statisque  Medicale,  1840,  p.  284. 


188  PK ACTIO AL    HYGIENE. 

cent,  (nearly)  to  26  per  cent,  (nearly),  so  that  Louis's  numbers  are  far  too 
few  to  give  even  an  approximation  to  the  time  mean. 

5.  There  being  a  number  of  facts,  each  of  which  can  be  expressed  by  a 
numerical  value,  an  average  or  mean  number  is  obtained  by  adding  all  the 
numerical  values,  and  dividing  by  the  number  of  facts.'  This  gives  the 
common  or  arithmetical  mean,  which  can  be  shown  mathematically  to  be 
the  nearest  to  the  truth  in  physical  inquiries.  Its  degi'ee  of  approxima- 
tion may  be  determined  by  working  out  the  probable  error  ;  ^  the  smaller 
the  latitude  of  error  the  more  tnistworthy  the  series  from  which  the  mean 
number  is  drawn.  To  compare  two  or  more  similar  groups  together,  the 
probable  error  of  each  may  be  ascertained,  the  relative  values  being  as  the 

reciprocals  of  the  squares  of   the  probable  erroi*s  ;  that  is  ,  where 

(pef 
(pe)  is  the  probable  eiTor.     Thus  if  we  have  two  gi'oups,  A  and  B,  A  haAang 
a  probable  error  of  10  per  cent,  and  B  one  of  2  per  cent.,  the  value  of  A 

will  be —  and  the  value  of  B  will  be  —_—__,  or  the  group  B  will 

10'  - 100'  2'       4  ^      ^ 

have  a  value  25  times  as  great  as  A. 

The  relative  values  of  two  or  more  series  are  also  as  the  square  roots  of 
the  numbers  of  units  of  observation.  So  also,  by  increasing  the  number 
of  observations  in  any  inquiry,  the  value  (or  accuracy)  increases  as  the 
squai-e  root  of  the  number. 

Thus  a  group  of  10  observations  is  to  a  gi'oup  of  100  as  y/  10  to  -/lOO, 
or  as  3.16  to  10 

In  many  cases  the  method  by  successive  means  is  very  useful.  This 
consists  in  taking  the  mean  of  the  mean  numbers  successively  derived  from 
a  constantly  repeated  series  of  events  (say  the  mortahty  to  a  given  popula- 
tion yearlv).  Supposing,  for  example,  the  annual  mortality  in  England  to 
be,  in  successive  years,  22,  23,  21,  26,  23,  21,  22,  28,  22,  21,  per  1,000 
hving,  the  successive  means  would  be — 

22  +  23        22  4-23  +  21        22  +  23  +  21  +  26 
2  3  4  ' 

and  so  on,  until  the  numbers  are  so  gi-eat  as  to  give  every  time  the  same 
result.     It  is  useful  to  calculate  the  successive  means  in  both  the  direct 

'  The  nnthmetiml  mean  is  used  in  medical  inquiries  ;  but  there  are,  in  addition, 
the  (jeometrical,  harmonic,  and  quadratic  means.  For  an  account  of  these,  and  for 
many  rules,  reference  may  be  made  to  Dr.  Bond's  translation  of  Professor  Radicke's 
Essay,  New  Sydenham  Society  Publ.,  vol.  xi. 

^  To  find  the  mean  error  : — 1.  Find  the  mean  of  the  series  of  observations ;  find  the 
mean  of  all  the  observations  above  the  mean,  and  subtract  the  mean  from  it,  this 
gives  the  mean  error  in  excess.  2.  Find  the  mean  of  all  the  observations  beloir  the 
mean,  and  subtract  the  latter  from  this  mean,  this  gives  the  mean  error  in  deficiency. 
Add  the  two  quantities,  and  take  the  half,  this  is  the  mean  error. 

To  find  the  error  of  mean  square: — Square  each  of  the  observations  and  add  them 
together,  subtract  from  this  sum  the  square  of  the  mean,  multiplied  by  the  number  of 
observations,  then,  calling  this  remainder  (S),  and  the  number  of  observations  (tz), 
we  have : — 


Error  of  mean  square, 


Of  a  single  measure, 
Of  the  result,       .     . 


The  probable  error  is  obtained  by  taking  two-thirds  (nearly)  of  the  mean  error  or 
error  of  mean  square,  the  actual  ratio  being  1  :  0.6745. 


STATISTICS.  189 

and  inverse  order,  viz.,  from  first  to  last,  and  then  from  last  to  first,  i.e., 
putting  the  two  last  together,  then  the  three  last,  etc.,  so  as  to  see  if  the 
variation  was  greater  at  the  end  of  a  series  than  at  the  beginning.  The 
degree  of  uncertainty  is  then  the  mean  variation  between  the  successive 
means. 

A  plan  almost  the  same  as  this  has  been  used  ;  a  certain  number  of 
facts  being  recorded,  the  sum  is  divided  into  two,  three,  or  more  parts, 
and  it  is  then  seen  whether  the  results  drawn  from  the  lesser  groups  agree 
with  that  drawn  from  the  larger  group  and  with  each  other.  If  there  is 
any  great  difference  of  results,  the  numbers  of  the  lesser  groups  are  not 
sufficient.  In  the  instance  given  above,  the  mean  of  the  ten  years  is  22.9  ; 
the  mean  of  the  first  three  years  is  22  ;  of  the  second  three  years  is  22.33  ; 
of  the  thii'd  three  years  is  24.  The  term  of  three  years  is  therefore  far  too 
short  to  aUow  a  safe  conclusion  to  be  drawn.  The  mean  of  five  years  again 
is  23,  and  of  eight  years  is  22.8,  numbers  which  are  much  nearer  each 
other  and  the  mean  of  the  whole  ten  years. 

The  application  of  averages  when  obtained  is  of  great  importance,  but 
there  is  one  usual  error.  The  results  obtained  from  an  average  (that  is, 
from  the  mean  result  obtained  from  a  number  of  units,  not  one  of  which 
perhaps  is  the  same  as  the  mean  result,  but  either  above  or  below  it)  can 
never  be  apphed  to  a  particular  case.  On  either  side  the  average  there  is 
always,  as  before  shown,  a  range  the  value  of  which  may  be  obtained  by 
Poisson's  rule,  or  by  the  determination  of  the  mean  error,  and  the  particu- 
lar case  may  be  at  either  end  of  the  range.  The  use  of  the  average  is  to 
apply  it  to  an  aggregate  of  facts.  Then,  supposing  it  to  be  founded  on  a 
sufficient  number  of  cases,  it  will  approximate  proportionately  to  exactitude. 

6.  In  addition  to  averages,  it  is  always  desirable  to  note  extreme  values, 
that  is,  the  two  ends  of  the  scale  of  which  the  average  is  the  middle.  To 
use  Dr.  Guy's  pointed  expression,  "averages  are  numerical  expressions  of 
probabilities  ;  extreme  values  are  expressions  of  possibilities."  '  In  taking 
too  great  note  of  mean  quantities,  we  may  forget  how  gTeat  a  range  there 
may  be  above  and  below  them,  and  it  is  by  reminding  us  constantly  of 
this  that  Poisson's  rule  and  the  rule  for  mean  error  are  so  useful.^ 

7.  Statistical  results  are  now  frequently  expressed  by  graphic  represen- 
tations, a  certain  space  drawn  to  scale  representing  a  number.  The  most 
simple  plan  is  that  of  intersecting  horizontal  and  vertical  lines. 

Two  lines,  one  horizontal  (axis  of  the  absciasce),  and  the  other  vertical 
(axis  of  the  ordinates),  form  two  sides  of  a  square,  and  are  then  divided 
into  segments,  drawn  to  scale — vertical  and  horizontal  lines  are  then  let 
fall  on  the  points  marked  ;  the  axis  of  the  ordinates  representing,  for  ex- 
ample, a  certain  time,  and  the  axis  of  the  abscissae  representing  the  num- 
ber of  events  occurring  at  any  time.  A  line  drawn  through  the  points  of 
intersection  of  these  two  quantities  forms  a  graphic  representation  of  their 
relation  to  each  other,  and  the  surface  thus  cut  can  be  also  measured  and 
expressed  in  area  if  required,  or  the  space  can  be  plotted  out  in  various 
ways,  in  columns,  pyramids,  etc.  In  the  same  way  circles  cutting  radii 
at  distances  from  the  centre  drawn  to  scale  are  very  useful ;  the  circles 

'  Cyclopaedia  of  Anatomy  and  Physiology,  art.  "  Statistics." 

■^  In  a  good  (that  is  a  trustworthy)  series,  the  extremes  on  the  two  sides  of  the  mean 
will  balance  each  other,  the  numbers  being  distributed  according  to  the  coefficients  of 
a  binomial,  whose  exponent  is  the  number  of  possible  events  in  the  series  (see  Quetelet, 
On  Probabilities ;  Airy,  On  the  Theory  of  Errors  of  Observation  ;  Merriman,  Theory  of 
Least  Squares ;  F.  de  Chaumont,  Lectures  on  State  Medicine).  See  table  in  Appen- 
dix E. 


190  PRACTICAL    HYGIENE. 

marking  time  (in  tlie  example  chosen),  and  the  radii  events,  or  the  reverse. 
Such  graphic  representations  are  most  useful,  and  allow  the  mind  to  seize 
more  easily  than  by  rows  of  figui'es  the  connection  between  two  conditions 
and  events. 

Generally  speaking,  it  may  be  said  that  the  amounts  of  sickness  and 
mortality  in  different  bodies  of  men  or  in  the  same  body  of  men  at  succes- 
sive periods,  show  such  wide  variations,  that  the  mean  error  is  always  very 
great,  and  it  requires  a  very  large  number  of  cases,  and  an  extended  pe- 
riod, to  deduce  a  probable  true  mean.  For  this  reason  it  is  necessary  to 
be  cautious  in  apj^ortioning  blame  or  credit  to  persons,  or  to  sj^ecial  modes 
of  treatment,  unless  the  numbers  are  very  lai*ge  and  accordant.  The  cir- 
cumstances influencing  the  result  are,  in  fact,  very  numerous,  and  the 
proper  estimation  of  a  numerical  result  is  only  possible  when  it  is  consid- 
ered in  reference  to  the  circumstances  under  which  it  occurs. 

The  most  important  statistical  inquiries  applied  to  health  are — 

1.  Births  to  Population. — To  obtain  all  these  elementary  facts,  an  ac- 
curate census  and  proper  registration  are  required.  It  is  only  within  re- 
cent years  that  the  most  civilized  nations  have  commenced  these  inquiries. 

2.  Eelative  Number  of  Live  and  Still-born,  of  Premature  andfull-Grown 
Children. 

3.  Number  of  Children  Dying  in  the  First  Year,  with  Sub-Groups  of  Sex 
and  Months. — There  are  two  great  periods  of  mortality  in  the  first  year, 
viz.,  in  the  first  week,  and  at  the  time  of  weaning,  about  the  seventh  month. 

4.  Amount  of  Sickness  to  Population. 

(a)  Number  constantly  sick,  grouped  according  to  sex,  age,  occu- 
pation, and  diseases. 
(&)  Average  duration  of  sickness,  etc. 

5.  Amount  of  Yearly  Mortality  in  a  Population,  or  Deaths  to  Popidation. 
— The  deaths  are  generally  expressed  as  so  many  deaths  to  1,000  or 
10,000  living  ;  but  the  deaths  can  be  calculated  in  relation  not  only  to  the 
number  living  at  the  end  of  the  time,  but  to  that  number  jjlus  a  certain 
addition  to  be  made  on  account  of  those  persons  who  lived  during  part  of 
the  time,  but  died  before  its  close.  But  the  difference  is  not  material. 
Grouped  according  to  sex,  age,  etc. 

6.  Mean  Age  at  Death  of  a  Popndation  is  the  Sum  of  the  Ages  at  Death 
divided  by  the  Deaths. — The  mean  age  at  death  expresses,  of  coui-se,  the  ex- 
pectation of  life  at  birth,  or  the  mean  lifetime.  It  is  no  very  good  test  of 
the  health  of  a  people,  as  a  great  infant  mortality  may  reduce  the  age, 
though  the  health  of  the  adults  may  be  extremely  good.  The  mean  age 
of  death  in  England  is  about  40  years.  Farr  has  shown  that  it  is  nearly 
equivalent  to  the  reciprocal  of  the  death-rate  minus  one-third  of  the  differ- 
ence between  the  reciprocal  of  the  death-rate  and  that  of  the  birth-rate  ; 
or  two-thirds  the  reciprocal  of  death-rate  plus  one-third  that  of  the  birth- 
rate. ' 

7.  Mean  Duration  of  Life  {vie  moyenne). — This  is  the  expectation  of  life 
at  birth  ;  at  any  other  age  than  birth,  it  is  the  expectation  of  life  at  that 
age  (as  taken  from  a  life-table)  added  to  the  age.  It  is  no  good  test  of 
sanitary  condition  or  health. 

8.  Probable  Duration  of  Life  {vie  probable  ;  probable  lifetime)  is  the  age 

'  Suppose  the  death-rate  to  be  1  in  46,  and  the  birth-rate  1  in  29  (about  the  existing 

rates  in  England),  we  have  t?_lA  -.  30.7  +  ^  =  9.7  =  40.4  =  mean   age  at   death  in 

3  o 

England. 


STATISTICS. 


191 


at  whicli  a  given  number  of  children  born  into  the  world  at  tbe  same  time 
■will  be  reduced  one-haK. 

9.  Expectation  of  Life,  or  Mean  Future  or  After  Lifetime. — This  is  the 
true  test  of  the  health  of  a  peojDle.  It  is  the  average  length  of  time  a  per- 
son of  any  age  may  be  expected  to  hve  ;  and  in  order  to  construct  it,  we 
must  know  the  number  of  the  living,  their  ages,  the  number  of  deaths  and 
the  ages,  and  the  other  changes  in  the  population  caused  by  bu'ths,  emi- 
gration, immigration,  etc.  It  does  not,  of  course,  follow  that  any  particu- 
lar person  will  hve  the  time  given  in  such  a  table  ;  he  may  die  before  or 
after  the  period,  but  taking  a  large  number  of  cases,  the  average  is  then 
found  to  apply.  Life-tables  show  at  a  glance  the  expectation  of  life  at 
any  age. 

England.^ 


Age. 

Males. 

Females. 

Age. 

Males. 

Females. 

Age. 

Males. 

Females. 

0 

39.91 

41.85 

10 

47.05 

47.67 

i    70 

8.45 

9.02 

1 

46.65 

47.31 

20 

39.48 

40.29 

80 

4.93 

5.26 

2 

48.83 

49.40 

30 

32.76 

33.81 

90 

2.84 

3.01 

3 

49.61 

50.20 

40 

26.06 

27.34 

95 

2.17 

2.29 

4 

49.81 

50.43 

50 

19.54 

20.75 

I  100 

1.68 

1.76 

0 

49.71 

50.33 

60 

13.53 

14.34 

1 

After  the  fii'st  year  the  chances  of  hving  increase  up  to  the  fourth  year  ; 
the  fifth  year  is  nearly  as  good,  and  then  the  chances  of  hfe  lessen,  but  at 
first  slowly,  and  then  more  rapidly;  from  5  to  40  years  of  age  the  expecta- 
tion of  hfe  lessens  in  the  ratio  of  from  2|-  to  3|-  or  3f  years  for  each  c^uin- 
quennial  period. 

SECTION  n. 


AEMT   STATISTICS.  2 

At  the  close  of  the  Peninsular  war  in  1814,  Sir  James  M'Grigor  com- 
menced the  collection  of  the  statistics  of  disease  and  moriahty  in  the  Eng- 
hsh  army,  and  during  the  course  of  the  next  twenty  years  a  gTeat  amount 
of  valuable  evidence  was  accumulated.  In  1835  Dr.  Henry  Marshall  (Dep- 
uty Inspector-General  of  Hospitals,  and  one  of  the  most  philosophical  sur- 
geons who  have  ever  served  in  the  Enghsh  amiy)  commenced  to  put  these 
returns  into  shape,  and  the  late  Major-General  Sir  Alexander  TuUoch, 
K.C.B.  (at  that  time  a  heutenant  in  the  45th  Regiment,  employed  in  the 
"War  Office),  was  associated  with  him.  In  the  foUovring  year,  on  the  retire- 
ment of  Dr.  Marshall,  Dr.  Balfour,  f onnerly  head  of  the  Statistical  Branch  of 
the  Army  Medical  Department,  was  appointed  as  his  successor,  and  in  con- 
junction with  Sir  A  Tulloch,  brought  out  the  series  of  reports  on  the  health 
of  the  aiTQT  which  have  had  such  influence,  not  merely  on  the  causes  of  the 
sickness  and  mortahty  among  soldiers,  but  indh'ectly  on  those  of  the  ciril 
population  also.  In  1838-41,  reports  were  issued  of  the  following  stations  : 
— United  Kingdom,  Mediterranean,  and  British  America,  West  Indies, 
Western  Africa,  St.  Helena,  Cape,  Mauritius,  Ceylon,  and  Tenasserim. 

^  Abridged  from  Dr.  Farr's  Life  Tables.  Some  interesting  information  will  be  found 
in  Statistics  of  Families,  by  C.  Ansell,  jun.,  1874. 

^  This  sbort  summary  of  the  history  of  the  Army  Statistical  Reports  is  chiefly  taken 
from  Dr.  Balfour's  account,  in  the  Army  Medical  Report  for  1860,  p.  131. 


192  PRACTICAL    HTGIEKE. 

These  returns  included  the  year  1817-1836.  In  1853  another  report, 
containing  the  stations  of  the  troops  in  the  United  Kingdom,  Mediterra- 
nean, and  British  America,  including  tlie  years  1836-1846,  was  prepared 
by  the  same  gentlemen. 

In  these  reports,  in  addition  to  the  statistical  analysis,  short  but  most 
graphic  and  comprehensive  topographical  and  climatic  accounts  of  the  dif- 
ferent stations  Avere  given. 

The  effect  of  these  several  reports,  and  especially  of  the  earlier  issues, 
was  to  direct  the  attention  of  the  Government,  both  to  the  fact  of  an  enor- 
mous sickness  and  mortality,  and  to  its  causes,  and  then  commenced  the 
gradual  series  of  improvements  which  at  a  later  period  were  urged  on  by 
Lord  Herbert  with  so  much  energy. 

The  Eussian  war  of  1854-1855  prevented  any  further  pubUcation  until 
1859,  when  yearly  reports  were  commenceTi  by  Dr.  Balfour,  and  have  been 
regularly  issued  since.  Li  the  report  for  1860  Dr.  Balfoixr  gave  a  summary 
of  the  earlier  and  later  mortality  of  the  different  stations  before  and  after 
1837,  which  showed  a  remarkable  difference  in  favor  of  the  later  periods 
as  regards  both  sickness  and  mortality. 

Sub-Section  I. 

With  respect  to  soldiers,  in  time  of  peace,  the  statistical  evidence  is  re- 
quired to  show  the  amount  of  benefit  the  State  receives  from  its  soldiers, 
and  the  amount  of  loss  it  suffers  yearly  from  disease.  Tables  should  there- 
fore show — 

1.  The  amount  of  loss  of  strength  a  definite  number  of  men  in  each 
arm  of  the  service  suffers  in  a  year — 

(a)  By  deaths,  or,  in  other  words,  the  mortality  to  strength. 

(b)  By  invaliding  from  disease,'  for  if  this  is  not  regarded,  different 
systems  and  modes  of  invaliding  may  entirely  vitiate  any  conclusions  drawn 
from  the  mortality. 

The  groups  thus  formed  must  be  again  subdivided,  so  as  to  show — 

(a)  The  causes  of  death  or  invahding. 

{b)  The  ages  of  those  who  die  or  who  are  invalided. 

(c)  Then-  length  of  service.  It  is  of  great  importance  to  determine  the 
influence  of  service  in  every  year,  and  these  groups  should  be  again  divided 
by  ages. 

2.  The  loss  of  effective  service  a  definite  number  of  men — say,  1,000  men 
in  each  arm — suffers  during  a  year.     This  is  best  expressed  as  follows  : — 

(a)  The  total  number  of  cases  of  disease  in  a  year,  i.e.,  the  number  of  ad- 
missions to  hospital  per  annum.  It  must  be  understood  that  this  does  not 
express  the  number  of  men  admitted,  as  one  man  may  be  admitted  two, 
three,  or  even  ten  times  with  the  same  disease  ;  each  admission  counts  as 
a  fresh  case.  It  is  important  to  have  another  table  showing  the  number  of 
men  admitted  for  different  diseases,  or,  in  other  words,  the  number  of 
cases  of  readmission  for  the  same  disease.  The  actual  number  of  cases 
treated  in  a  period  may  be  obtained  from  the  mean  of  the  admissions  and 
discharges. 

(6)  The  number  constantly  sick  on  an  average.     This  is  often  called  the 


^  Loss  by  purchase  of  discharge,  expiration  of  term  of  service,  imprisonments,  and 
dismissals  Irom  tlie  army,  must  also  be  put  under  separate  headings  ;  but  the  medical 
officer  has  nothing  to  do  with  this  point,  except  to  see  that  such  cases  are  not  confounded 
with  invaliding  from  disease. 


STATISTICS.  193 

sick  population,  and  is  obtained  most  easily  in  army  hospitals  by  dividin"* 
the  number  of  diets  issued  in  a  year  by  365,  or  adding  all  the  "  remaining- " 
on  the  daily  or  \\-eekly  states  together,  and  dividing  by  365  or  52,  as  the 
case  may  be. 

(c)  The  total  number  of  days  lost  in  a  year  to  the  service  by  illness  by 
each  1,000  men,  and  of  the  number  of  daj's  per  head.  The  number  of  the 
sick  population  (that  is,  the  number  constantly  sick  out  of,  say  1,000  men) 
multiplied  by  365  and  divided  by  1,000,  or  by  the  number  furnishing  the 
sick,  whatever  that  may  be,  gives  these  facts. 

{d)  The  mortality  in  relation  to  sickness. 

The  group  constituted  by  the  sick  must  then  be  subdivided  by  diseases, 
and  lesser  groups  must  be  made  by  distributing  the  causes  of  sickness  and 
deaths  under  ages  and  length  of  service. 

There  are  a  few  points  which  require  attention.  The  amount  of  sick- 
ness and  mortahty  is  calculated  on  the  mean  strength,  that  is,  the  number 
of  men  of  a  regiment  present  at  a  certain  station  on  the  muster  days  di- 
vided by  the  number  of  muster  days.  But  it  must  be  understood  that  this 
includes  the  sick  men  in  hospital  as  well  as  the  healthy  men,  and  therefore 
does  not  perfectly  express  the  amount  of  disease  among  the  healthy  men. 
Also  sometimes  the  muster  rolls  of  a  regiment  include  men  on  detachment 
at  some  distance,  whose  sickness  is  not  attributable  to  the  headquarter  station. 
The  French,  in  theii'  Army  Statistical  Returns,  make  two  headings,  one  of 
"mean  strength"  [effectif  moyen),  and  the  other  of  "present"  [presents), 
the  men  in  hospital  not  being  included  in  the  latter.  Moreover,  in  the 
French  army,  nearly  one-sixth  are  always  absent  on  leave  ;  and  the  deaths 
of  those  on  leave  are  included  among  the  army  deaths,  but  the  sickness  is 
not  so.  Consequently,  sickness  has  to  be  calculated  on  the  number  not  on 
leave ;  deaths,  on  the  total  strength.  In  the  French  army  officers  are  in- 
cluded with  the  men  ;  in  the  EngUsh,  separate  returns  are  made. 

It  is  often  difficult  to  get  the  mean  strength  if  there  are  many  changes 
of  troops,  and  instances  of  erroneous  calculations  fi'om  this  cause  are  not 
uncommon.' 

In  calculating  also  the  effect  of  age  and  length  of  service  upon  disease 
and  mortality,  it  is  necessary  to  know  not  only  the  ages  and  length  of  ser- 
vice of  the  sick  men,  but  of  the  healthy  men  also,  and  to  calculate  out  the 

'  The  following  is  one  which  Dr.  Balfour  has  given.  It  will  be  seen  that  an  nn- 
healthr  station  (Masulipatam)  in  India  is  credited  with  a  much  greater  degree  of  health 
than  it  reallj  was  entitled  to,  and  the  annexed  extract  from  Dr.  Balfour's  paper  (Edin. 
Med.  and  Surg.  Jour.,  Xo.  172)  shows  clearly  how  the  mistake  arose  :  — 

"  The  [Madras]  Medical  Board,  in  submitting  to  Government  the  table  from  which 
these  figures  are  computed,  stated  that  the  ratio  of  mortality  among  all  the  European  reg- 
iments in  the  Presidency,  from  January,  1813,  to  December,  1819,  was  5.690  per  cent.  ; 
whilst  that  of  the  regiments  at  Masulipatam,  from  1813  to  1832  inclusive,  was  5.100 
percent.  They  then  add— '  The  rate  of  mortalit}' having  been  somewhat  lower  than 
throughout  the  rest  of  the  Presidency  for  such  a  period,  gives  reason  to  conclude  that 
the  station  cannot  be  considered  under  ordinary  circumstances  as  unhealthy.'  Now, 
the  Board  appears  to  have  arrived  at  this  conclusion  from  an  error  in  the  mode  of  cal- 
culating the  ratio.  In  several  of  the  years  between  1813  and  1832  the  regiments  were 
quartered  at  Masulipatam  during  part  of  the  year  only.  It  must  be  obvious  to  any  one 
conversant  with  the  principles  of  statistics,  that  in  such  a  case  a  proportion  of  the  an- 
nual strength  only  should  be  taken  corresponding  with  the  period  for  which  the  regi- 
ment was  quartered  there.  Thus,  if  the  period  was  nine  months,  the  sickness  and  mor- 
tality should  be  calculated  on  three-fourths  of  the  strength  :  if  eight  months,  on  two- 
thirds,  and  so  forth.  The  Board,  however,  have  made  the  calculation  in  every  instance 
on  the  average  annual  strength  without  any  such  deduction.  Had  the  necessary  cor- 
rection been  made,  the  deaths  from  1813  to  1832  would  have  been  found  to  average 
6.394  per  cent,  annually,  instead  of  5.100  as  above  stated." 
Vol.  II.— 13 


194  PRACTICAL    HYGIENE. 

proportion  of  the  sick  to  the  healthy  at  that  particular  age  or  length  of 
service,  otherwise  very  erroneous  conclusions  might  be  drawn.  For  ex- 
ample, it  might  appear  that  sick  men  under  twenty  years  of  age  were  very 
numerous  in  proportion  to  other  years,  but  in  a  very  young  army  the 
greater  number  of  the  force  might  be  of  this  age.  Care  is  necessary  in  aU 
these  points  to  arrive  at  correct  conclusions. 

Sub-Section  II. — Statistics  in  Wab. 

In  time  of  loar  the  statistics  must  be  slightly  altered  in  form,  though 
the  same  in  principle.  The  object  is  to  show  as  completely  as  possible  to 
the  General  in  command  what  amount  of  loss  his  army  is  suffering  at  the 
moment,  and  to  what  extent  it  may  be  expected  to  suffer,  and  also  what  are 
the  causes  of  such  sickness. 

The  sickness  here  must  not  only  be  calculated  on  the  mean  strength 
(which  will  include  the  men  in  hospital),  but  also  on  the  healthy  men,  or 
those  actually  under  arms  and  effective.  If  the  sick  are  counted  in  the 
strength,  the  sickness  of  the  army  may  be  much  understated.  "WTiat  a 
General  wants  to  know  with  regard  to  sickness  will  be  these  jDoints — 

1.  How  many  men  am  I  losing  daily  from  the  rank  and  file  actually 
serving  with  the  colors  ? 

2.  How  many  are  replaced  by  discharge  from  hospital  ? 

3.  What  is  the  balance,  gain  or  loss  ? 

4.  If  my  effective  force  loses  daily,  when  this  balance  is  struck,  such  a 
percentage,  what  will  be  its  loss  of  strength  in  a  week,  in  four  weeks,  in 
six  weeks  ?  etc. 

5.  What  are  the  causes,  i.e.,  what  are  the  diseases  which  are  causing 
this  sickness,  and  how  are  they  affected  by  special  circumstances  of  age, 
particular  service  or  arms,  or  other  causes  ? 

The  mortality  in  war  should  be  calculated  on  the  mean  strength,  that 
is,  on  the  total  number  of  healthy  and  sick,  and  also  on  the  sick  alone,  so 
as  to  represent  both  the  loss  of  the  army  and  the  fatality  of  the  sickness. 


i00fe 


THE' SERVICE  OF  THE  SOLDIER/ 

It  is  now  necessary  to  consider  a  little  more  particularly  the  nature  of  the 
service  of  the  soldier,  and  the  influence  it  has  on  him,  A  recruit  entering 
the  army  from  civil  life  comes  under  new  conditions,  which  will  require  to 
be  shortlv  enumerated. 


CHAPTER   I. 
THE   RECRUIT. 


In  the  English  army,  young  men  are  now  enlisted  at  nineteen  years  of 
age,^  unless  they  are  intended  for  drummers.  They  must  be  of  a  certain 
height,  which  is  fixed  by  regulation  from  time  to  time,  according  to  the 
particular  arm,  and  to  the  demands  of  the  service.  There  must  also  be 
a  special  girth  of  the  chest,  which  is  in  proportion  to  the  age  and  height. 

In  time  of  war,  the  measurements  are  reduced  according  to  the  demand 
for  men  ;  and  even  in  time  of  peace,  the  necessary  height  of  the  infantry 
recruit  is  varied.  At  present  it  is  64  inches.^  Before  the  enlistment  is 
completed,  the  recruit  is  examined  by  a  medical  officer,  and  then  by  the 
surgeon-major  of  the  recruiting  district,  according  to  a  scheme  laid  down 
in  the  "  Medical  Kegulations."  '  The  scheme  is  a  very  good  one,  and  aims  at 
investigating,  as  far  as  can  be  done,  the  mental  condition  ;  the  senses  ;  the 
general  formation  of  the  body,  and  especially  of  the  chest ;  the  condition 
of  the  joints  ;  the  state  of  the  feet ;  the  absence  of  hernia,  varicocele,  piles, 
etc.  ;  and  the  condition  or  physical  examination  of  the  heart,  lungs,  and 
abdominal  organs  generally.^  A  certain  minimum  girth  of  chest  according 
to  the  height  is  required." 


^  Medical  officers  entering  the  army  will  find  a  great  deal  of  useful  sanitary  informa- 
tion and  details  of  duty  bearing  on  health  in  Sir  Garnet  Wolseley's  Soldiers'  Pocket 
Book  for  Field  Service. 

■■'  In  reality  they  sometimes  enlist  under  this  age. 

3  General  Order,  No.  81,  July,  1881. 

^  For  a  full  account  of  the  system  of  recruiting,  the  mode  of  examination,  and  much 
useful  information  on  disabilities,  see  a  paper  by  Dr.  Crawford,  in  the  Army  Medical 
Report  for  1862  ;  Blue  Book,  1864.     See  Medical  Regulations  (1878),  part  4,  section  ii. 

"  As  the  Medical  Regulations  are  in  the  hands  of  all  medical  officers,  it  is  unneces- 
sary to  go  into  more  detail  on  this  point.  Professor  Longmore  uses  in  the  Army  Medi- 
cal School  a  set  form  of  examination  (Instructions  on  the  Examination  of  Recruits, 
Southampton,  1882),  which  renders  it  almost  impossible  that  any  point  should  be  over- 
looked. 

^  At  present,  34  inches  for  64  to  70  in  height ;  35  inches  if  above  70  in  height. 


19G  PRACTICAL    HYGIENE, 

After  joining  liis  regiment  lie  is  again  examined,  and  may  be  rejected 
if  any  defect  is  discovered.  Rejections  may  take  place  then  either  at  the 
primary  or  secondary  inspection. 

The  trades  of  the  men  furnishing  recruits  vary  greatly  from  year  to  year. 

The  total  number  of  rejections,  either  at  once  or  after  re-examination 
by  a  second  medical  officer,  on  various  grounds,  of  men  brought  by  the 
recruiting  sergeant  to  the  medical  officer,  varies  somewhat  from  year  to 
year. 

About  two-fifths  of  the  rejections  arise  from  causes  connected  with 
general  bad  health  or  feeble  constitution,  and  one-fifth  from  causes  affect- 
ing the  marching  powers  of  the  men  (Balfour). 

In  the  French  army,  the  height  was  fixed  in  1860  at  69  inches  (1.76 
metre)  for  the  carabiniers,  and  61^  inches  (1.56  metre)  for  the  infantry  of 
the  line. 

In  1872  the  maximum  for  the  cuii'assiers  was  reduced  to  1'".70  (67 
inches)  without  any  fixed  maximum. 

In  1868  the  maximum  for  the  line  was  reduced  to  1™.55  (61  inches), 
and  stiU  further,  in  1872,  to  1"'.54  (60^  inches).' 

The  rejections  in  the  French  conscription  include  men  rejected  for  in- 
sufficient height,  as  well  as  reasons  of  health." 

After  the  recruit  has  been  enlisted  and  approved,  he  joins  his  depot  or 
his  regiment ;  receives  his  kit,  which  he  subsequently  in  part  keeps  up  at 
his  own  cost ;  and  is  put  on  the  soldier's  rations.  He  enters  at  once  on  his 
drill,  which  occupies  from  3^  to  4^^  hours  daily.  Wherever  gymnasia  are 
established,  he  goes  through  a  two-months'  course  of  gymnastic  training 
for  one  hour  every  day.  He  then  goes  to  rifle  drill,  which  lasts  about  six 
weeks,  and  then  joins  the  ranks.  After  the  rifle  drill,  he  has  another 
month's  gymnastic  training,  and  is  then  svipposed  to  be  a  finished  soldier. 

Such  being  the  system,  it  will  be  desirable  to  consider  certain  points. 

1.  The  Age  of  the  Recruit. — Strong  opinions  have  been  expressed  by 
Ballingall  (English  army).  Levy  (French  army),  Hammond  (American 
army),  and  other  army  surgeons,  that  the  age  of  17  or  18  is  too  low — that 
the  youngest  recruit  should  be  20  or  21  years  of  age. 

This  opinion  is  based  both  on  actual  experience  of  the  effect  produced 
on  boys  of  17  to  20  when  exposed  to  the  hardships  of  war,  or  even  to 
heavy  duty  in  time  of  peace,  and  on  a  physiological  consideration  of  the 
extreme  immaturity  of  the  body  at  18  years  of  age. 

With  regard  to  the  first  point,  there  is  no  doubt  that  to  send  young 
lads  of  18  to  20  into  the  field,  is  not  only  a  lamentable  waste  of  material, 
but  is  positive  cinielty.  At  that  age  such  soldiers,  as  Napoleon  said, 
merely  strew  the  roadside  and  fill  the  hospitals.  The  most  effective  armies 
have  been  those  in  which  the  youngest  soldiers  have  been  22  years  of  age. 

With  regard  to  the  second,  it  is  also  certain  that  at  18  the  muscles  and 
bones  are  very  immature,  and,  in  fact,  it  is  not  till  25  years  of  age,  or  even 
later,  that  epij^hyses  of  the  bones  have  united,  and  that  the  muscles  have 
attained  their  full  growth.^ 

The  epiphyses  of  the  transverse  and  spinous  processes  of  the  vertebrae 
hardly  commence  to  ossify  before  16  years  of  age,  and  it  is  not  till  after  20 
years  that  the  two  thin  circular  plates  form  on  the  body  of  the  vertebrae. 
The  whole  process  is  not  completed  till  close  on  the  30th  year.     The  con- 

'  Morache.  Traite  d'Hygiene  Militaire,  1874. 

^  Sistach,  Recueil  de  Mem.  Mil.,  November,  1861,  p.  353. 

^  See  Aitken's  Growth  of  the  Recruit  and  Young  Soldier,  1862: 


THE    EECEUIT.  197 

solidation  of  the  sacrum  only  commences  at  the  18th  year,  and  is  com- 
pleted from  the  25th  to  the  30th  year.  The  fourth  and  third  bones  of  the 
sternum  are  only  united  between  the  20th  and  25th  years,  and  the  second 
is  not  united  to  the  third  bone  before  the  35th  year.  The  epiphysis  of  the 
ribs  commence  to  grow  betweeen  the  16th  and  the  20th  years,  and  are  com- 
pleted by  the  25th  year.  The  epiphysis  of  the  scapula  join  between  the 
ages  of  22  and  25.  The  epiphysis  of  the  clavicle  begins  to  form  between 
the  18th  and  20th  years.  The  internal  condyle  of  the  humerus  unites  at 
18,  but  the  upper  epiphysis  does  not  join  till  the  20th  year.  The  epiphysis 
of  the  radius  and  ulna,  the  femur,  the  tibia,  and  fibula,  are  all  unjoined  at 
18  years,  and  are  not  completely  joined  till  25  years.  The  epiphysis  of  the 
pelvic  bones  (viz.,  crest  of  ilium,  spine,  and  tuberosity  of  the  ischium)  be- 
gin to  form  at  puberty,  and  are  completed  by  the  25th  year. ' 

That  the  muscles  are  equally  immature  is  just  as  certain  ;  they  grow  in ' 
size  and  strength  in  proportion  to  the  bones. 

These  facts  show  how  wrong  it  is  to  expect  any  great  and  long-con- 
tinued exercise  of  energy  from  men  so  young  as  18  and  20,  and  what  will 
be  the  inevitable  consequences  of  taxing  them  beyond  their  strength. 

Are  we,  then,  to  conclude  that  the  soldier  should  not  be  enlisted  be- 
fore 20  ? 

If  the  State  will  recognize  the  immaturity  of  the  recruit  of  19  years  of 
age,  and  will  proportion  his  training  and  his  work  to  his  growth,  and  will 
abstain  from  considering  him  fit  for  the  heavy  duties  of  peace  and  for  the 
emergencies  of  war  till  he  is  at  least  20  years  of  age,  then  it  would  seem 
that  there  is  not  only  no  loss,  but  a  great  gain,  by  enlisting  men  early. 
At  that  most  critical  period  of  life  the  recruits  can  be  brought  under  judi- 
cious training,  can  have  precisely  the  amount  of  exercise  and  the  kind  of 
diet  best  fitted  for  them,  and  thus  in  two  years  be  more  fully  developed, 
and  be  made  more  efficient,  than  if  they  had  been  left  in  civil  life. 

2.  The  Height  and  Weight  of  the  Recruit. — The  desire  of  almost  all  mili- 
tary officers  is  to  get  tall  men.  The  most  favored  regiments,  especially 
the  cavalry,  get  the  tallest  men.  It  has  been  recommended  both  that 
shorter  men  should  be  generally  taken,  and  that  the  infantry  should  have 
the  tallest  men.  The  last  point  is  one  for  military  men  to  determine,  and 
must  be  decided  by  considerations  of  the  respective  modes  of  action  of 
cavalry  and  infantry. 

The  first  point  is  entirely  physiological,  and  opens  a  difficult  question. 

What  is  the  height,  at  19  years  of  age,  which  is  attended  with  the 
greatest  amoutit  of  health,  strength,  and  endurance,  or  is  it  possible  to  fix 
such  a  standard? 

Tables  of  average  height  and  weight  have  been  compiled  by  Quetelet, 
and  much  used,  and  lately  somewhat  similar  tables  have  been  framed  by 
Danson,  Boyd,  and  Liharzik.^ 

With  regard  to  all  of  these  it  may  be  said  that  the  observations  (how- 
ever numerous)  are  yet  too  few  for  such  a  large  question,  and  that  the  in- 
fluence of  race  has  been  too  little  regarded. 

Boyd  gives  the  height  at  18  years  at  60.4  inches,  and  at  25  years  at  67 
inches,  and  Liharzik  at  the  same  ages  gives  64.17  and  68.9  inches.  The 
English  Army  Keturns  (1860-67)  give  the  heights  of  the  recruits,  but  it 

'  See  Aitken's  Growth  of  the  Recruit,  p.  37,  and  Quain's  Anatomy,  for  still  fuller 
details. 

^  Liharzik's  numbers  profess  to  be  based  on  a  law  induced  from  great  numbers  of 
measurements  in  different  animals. 


198  PRACTICAL    HYGEEKE. 

must  be  understood  that  we  cannot  deduce  the  mean  height  of  the  popu- 
lation from  these  figures,  as  the  shorter  men  are  not  taken  as  reciniits. 

Although  the  numbers  are  not  very  accordant,  we  may  perhaps  assume 
that  at  19  the  average  height  will  be  something  near  65  inches,  and  the 
average  weight  125  ft. 

The  best  rule  to  guide  us  is  that  given  by  Dr.  Aitken,  viz.,  to  take  into 
consideration  the  tlu'ee  points  of  age,  height,  and  weight,  and  if  either  in 
weight  or  height,  or  both  together,  there  is  any  great  divergence  fi-om  the 
mean,  then  something  wrong  will  probably  be  found.  But  as  long  as 
weiffht  and  height  ai-e  in  accord,  the  taller  and  hea^•ier  the  man  the  better, 
as  a  inile.  The  weight  in  poimds  ought  to  be  about  twice  the  height  in 
inches. 

One  point  is,  however,  quite  clear.  "UTien  the  height  is  much  below  the 
mean,  the  bodily  development  generally  is  bad.  Hammond  states  that  ia 
the  American  war,  men  of  less  than  5  feet  broke  down  by  a  few  weeks' 
campaigning,  whUe  men  of  5  feet  stood  the  work  well.  Probably  63  inches 
at  19  vears  of  age,  and  120  lb  weight,  should  be  a  minimum,  even  in  times 
of  the"  greatest  pressure.  So  also  a  very  great  height  at  19  years  of  age  is 
objectionable,  aud  anything  over  68  inches  at  that  age  should  be  looked  on 
with  great  suspicion.  As  a  rule,  also,  adult  men  of  middle  size  (67  to  69 
inches)  appear  to  bear  hard  work  better  than  taller  men.' 

3.  The  Physical  Training  of  the  Recruit. — A  great  improvement  has 
been  introduced  by  the  order  that  each  recruit  shall  have  three  months' 
gymnastic  training.  If  properly  done,  this  will  have  a  most  beneficial  ef- 
fect. The  medical  officer  will  have  power  to  continue  this  if  necessary,  and 
care  should  be  taken  to  use  this  poAver. 

4.  Tlie  Mental  Training.— Since  the  introduction  of  rifle  practice,  the 
trade  of  a  soldier  has  become  much  moi-e  interesting  to  him  ;  he  is  now 
taught  scientifically  how  to  manage  his  arm,  and  learns  to  take  interest  in 
his  shooting.  It  would  be  most  desirable  to  give  him  some  knowledge  of 
the  Mihtary  Art,  and  of  the  object  of  the  manoeuvres  he  goes  through.  A 
mihtaiy  hterature  fitted  for  the  private  soldier  is  still  wanting.  It  is  also 
very  important  to  train  him  for  the  field,  and  to  teach  him  to  perfoiTii  for 
himself  all  the  offices  which  in  time  of  war  he  will  have  to  do — not  merely 
trench  work,  but  hutting,  cooking,  washing  and  mending  his  clothes,  as  in 
time  of  war.  It  is  too  late,  at  the  commencement  of  a  campaign,  to  begin 
these  necessary  parts  of  a  soldier's  education  ;  they  should  form  part  of  his 
training  as  a  recruit  ;  and  if  he  is  excused  guard  and  other  duties  during 
his  first  year,  there  would  be  ample  time. 

Great  attention  is  now  being  directed  to  the  importance  of  soldiers 
keeping  up  their  trades,  or  learning  some  trade  if  they  have  none.  Such 
a  system  occupies  men,  makes  them  contented,  keeps  them  from  dissipa- 
tion, and  opens  a  career  for  them  when  they  leave  the  army.  Instead  of 
interfering  with  their  mihtary  training,  it  can  be  made  to  subserve  it,  and 
possibly  might  be  found  to  be  advantageous  to  the  State,  even  in  a  pecu- 
niarj'  point  of  view.  The  recruit  then  would  have  to  keep  up  or  learn  his 
trade. 

5.  The  Moral  Training. — The  recruit,  on  entering  the  army,  is  brought 
under  moral  influences  of  a  strong  kind.     A  disciphne  always  rigorous, 

'  For  some  usefiil  information  on  these  points,  see  Morache,  op.  cit.,  Roth  and  Lex, 
op.  cit.,  and  Aiigiiste  Jansen,  Etudes  sur  la  taille,  le  perimetre  dela  poitrine  et  le  poids 
des  recrues,  extrait  des  Archives  Medicales  Beiges,  1877;  also  Ltude  d'Anthropometrie 
Medicale  an  point  de  vue  de  i'Aptitude  au  service  militaire,  by  the  same  author,  Brux- 
elles,  1882. 


THE   EECEUIT.  199 

and  sometimes  severe,  produces  often  a  ready  obedience  and  a  submission 
of  character,  and,  when  not  carried  too  far,  greatly  improves  him.  At  the 
same  time,  independence  is  preserved  by  the  knowledge  which  the  soldier 
has  of  his  rights  and  privileges,  and  the  result  is  a  manly,  conscientious, 
and  fine  character.  But  occasionally,  a  too  sensitive  natui'e  on  the  part  of 
the  recruit,  or  a  discipline  too  harsh  or  capricious  on  the  part  of  his  offi- 
cers, produces  very  different  results,  and  the  soldier  becomes  cunning, 
artfiil,  and  false,  or  morose  and  malicious.  The  two  characters  are  often 
seen  well  marked  in  old  soldiers,  and  no  contrast  can  be  greater  than  be- 
tween the  two.  A  heavy  responsibihty  rests,  then,  with  the  officers  of  the 
army  who  have  power  thus  to  influence,  for  good  or  evil,  natures  like  their 
own. 

The  influence  of  companionship  is  also  brought  to  bear  on  the  recruit, 
and  is  fraught  with  both  good  and  evil.  The  latter  probably  predomi- 
nates, though  there  are  many  excellent,  high-minded,  and  religious  men 
in  the  army.  Indeed,  in  some  regiments  the  proportion  of  steady  reli- 
gious men  is  perhaps  beyond  the  number  in  the  analogous  class  in  civil 
Hfe.  But  if  the  influences  be  for  bad,  the  recruit  soon  learns  some  ques- 
tionable habits  and  some  "\ices. 

Thus  he  almost  invariably  leams  to  smoke,  if  he  has  not  acquired  this 
habit  before.  It  is  indeed  remarkable  what  a  habit  smoking  tobacco  is  in 
every  army  of  Eui'ope  ;  it  seems  to  have  become  a  necessity  with  the  men, 
and  arises  probably  from  the  amount  of  sjDare  time  the  soldier  has,  which 
he  does  not  know  what  to  do  with.  A  recruit,  on  joining,  finds  all  his 
comrades  smoking,  and  is  driven  into  the  habit. 

The  discussion  on  the  effects  of  tobacco  does  not  seem  to  have  led  to 
any  clear  conclusions.  The  immoderate  use  brings  many  evils,  to  di- 
gestion and  circulation  especially.  But  no  great  erils  appear  to  result 
from  the  moderate  use,  though  no  good  can  be  traced  to  it.  In  moder- 
ation it  has  not  been  proved  to  lessen  apjDetite,  to  encourage  drinking, 
or  to  destroy  procreative  power.  But,  on  the  other  hand,  it  probably  les- 
sens bodily,  and  perhaps  even  mental  activity.  It  is  certainly  remarkable 
how  uniformly  the  best  trainers  prohibit  its  use,  and  men  of  the  highest 
physical  vigor  are  seldom  great,  and  often  are  not  even  moderate  smokers. 
As  it  is  of  no  use,  and  indeed  injurious,  by  bringing  men  under  the  thral- 
dom of  a  habit,  it  seems  very  desii'able  to  discourage  it.  But  in  the  army 
it  seems  useless  to  fight  against  this  custom,  nor  is  it  indeed  one  which  is 
sufficiently  injurious  to  be  seriously  combated,  except  for  one  reason.  In 
time  of  war,  the  soldier  often  cannot  obtain  tobacco,  and  he  then  suffers 
seriously  from  the  deprivation.  The  soldier  should  have  no  habits  which 
he  may  be  compelled  to  lay  aside,  and  which  it  would  pain  him  to  omit. 

A  much  more  serious  matter  is  the  vice  of  drinking,  which  many  re- 
cruits are  almost  forced  into,  in  spite  of  themselves.  The  discipline  of  the 
army  represses  much  open  drunkenness,  though  there  is  enough  of  this,  but 
it  cannot  prevent,  it  even  aids,  covert  drinking  up  to  the  very  edge  of  the 
law.  Formerly,  a  most  lamentable  canteen  custom  made  almost  every  man 
a  drunkard,  and  a  young  boy  just  enlisted  soon  learned  to  take  his  morning 
dram,  a  habit,  which,  in  civil  life,  would  mark  only  the  matured  drunkard. 
Now,  happily,  spirits  are  not  sold  in  the  canteens,  and  no  regulation 
thrusts  raw  spirits  down  a  man's  throat.  Drinking  is,  however,  still  the 
worst  vice  in  the  army,  and  that  which  strikes  most  of  all  at  the  efficiency 
of  the  soldier.  Great  efforts  have  been,  however,  made  by  the  military 
authorities  to  check  this  vice,  and  there  is  little  doubt  that  the  army  is 
gradually  becoming  more  temperate. 


200  PRACTICAL    HYGIENE. 

Another  vice  is  almost  as  certainly  contracted  as  smoking  by  the  re- 
ci'uit.  Probably,  before  enlistment,  he  has  led  no  very  pure  life,  but  when 
he  enters  the  army,  he  is  almost  sure  to  find  his  moral  tone  higher  than 
that  of  some  of  his  new  associates.  A  regiment,  in  fact,  is  composed  of 
young  men  with  few  scruples  and  smaU  restraints.  Prevented  from  mar- 
riage, and  often  tempted  by  low  prostitutes,  it  is  no  wonder  if,  to  the  ex- 
tent of  his  means,  the  soldier  indulges  in  promiscuous  sexual  intercourse. 
He  does  this,  in  fact,  to  excess,  and  the  young  recruit  is  led  at  once  into 
similar  habits.  That  many  recruits  are  most  seriously  injured  by  this 
habit,  even  if  they  neither  contract  syphilis  nor  gonorrhoea,  is  certain. 

It  has  also  been  supposed  that  solitary  vice  is  particularly  rife  in 
armies.     There  does  not  seem  to  be  any  evidence  on  this  point. 

6.  TJie  Amount  of  Sickness  and  Mortality  suffered  by  the  Recruit  during 
the  First  Six  Months  and  Year  of  Service. — This  is  an  extremely  important 
matter,  but  at  jiresent  we  are  not  able  to  answer  the  question  for  the  Eng- 
lish army. 

In  the  French  army,'  the  amount  of  sickness  among  soldiers  under  one 
year  of  service  is  more  than  one-third  greater  than  among  the  army  gen- 
erally ;  this  is  partly  caused  by  slight  injuries,  though  not  solely,  for  the 
admissions  to  hospital  are  nearly  one-fourth  more  among  them  than  in  the 
army  at  large. 

'  Statistique  Medicale  de  rArmt-e. 


CHAPTER  II. 

THE   CONDITIONS   UNDER   WHICH  THE    SOLDIER  IS 

PLACED. 

These  conditions  are  extremely  various,  as  the  soldier  serves  in  so  many 
stations,  but  the  chief  points  common  to  all  can  be  passed  in  review. 

The  water  and  air  supplies  have  been  ah-eady  sufficiently  noticed,  and 
the  conditions  now  to  be  noticed  under  which  the  soldier  is  placed  are 
barracks,  huts,  tents,  and  encampments  ;  the  food,  clothing,  and  work. 


SECTION  I. 

BAREACKS. 

Barracks  have  been  in  our  army,  and  in  many  armies  of  Europe  still  are, 
a  fertile  source  of  illness  and  loss  of  service.  At  all  times  the  greatest  care 
is  necessary  to  counteract  the  injurious  effects  of  compressing  a  number  of 
persons  into  a  restricted  space.  In  the  case  of  soldiers,  the  compression 
has  been  extreme  ;  but  the  counteracting  care  has  been  wanting.  It  is  not 
more  than  sixty  years  since,  in  the  West  Indies,  the  men  slept  in  ham- 
mocks touching  each  other,  only  23  inches  of  lateral  space  being  allowed 
for  each  man.  At  the  same  time,  in  England,  the  men  slept  in  beds  with 
two  tiers,  like  the  berths  in  a  ship  ;  and  not  unfrequently,  each  bed  held 
four  men.  When  it  is  added,  that  neither  in  the  West  Indies,  nor  in  the 
home  service,  was  such  a  thing  as  an  opening  for  ventilation  ever  thought 
of,  the  state  of  the  air  can  be  imagined. 

The  means  of  removal  of  excreta  were,  even  in  our  own  days,  of  the 
rudest  description,  both  at  home  and  in  many  colonies ;  and  from  this 
cause  alone  there  is  no  doubt  that  the  great  military  nations  have  suffered 
a  loss  of  men  which,  if  expressed  in  money,  would  have  been  sufficient  to 
rebuild  and  purify  every  barrack  they  possess.' 

^  It  is  a  most  remarkable  circumstance,  that  the  two  diseases  which,  in  the  French, 
Prussian,  Hanoverian,  and  Belgian  armies,  and  probably  in  the  Austrian,  and,  till  lately, 
in  our  own  army,  caused  the  largest  share  of  mortality,  were  a  destructive  lung  dis- 
ease, terxaed  phthisis  in  the  returns,  and  typhoid  fever. 

The  production  of  disorganizing  lung  disease  (thoiigh  occurring  in  several  other 
ways;  is  intimately  connected  with  the  constant  breathing  of  an  atmosphere  vitiated  by 
respiration  ;  and  typhoid  fever  is  as  closely  related  with  bad  drainage.  Both  diseases 
are  therefore  diseases  of  habitations,  and  show,  in  the  case  of  the  soldier  (who  is  not 
subjected  to  other  causes  of  phthisis,  such  as  inaction,  constrained  position,  and  inhala- 
tion of  dust,  etc.),  that  the  air  of  his  dwelling  is  foul.  In  hot  climates  the  same  rule 
holds  good.  Is  it  not  a  remarkable  fact,  that  in  the  West  Indies,  those  islands  of  para- 
dise, where  no  cold  inclement  wind  ever  vexes  the  tender  lungs,  there  was,  forty  or  fifty 
years  ago,  an  extraordinary  mortality  from  consumption,  and  from  a  continued  fever, 
which  in  all  probability  was  typhoid  ?     Yet  who  can  wonder,  when  we  find,  in  tho 


202  PRA.CTICAL    HYGIENE. 


Sub-Section  L — Barracks  on  Home  Service.' 

The  imperfection  of  the  English  ban*acks  was  owing  to  two  causes — 
first,  a  great  disregard  or  ignorance  of  the  laws  of  health  ;  and,  secondly, 
an  indisposition  on  the  part  of  Parliament  to  vote  sums  of  money  for  a 
standing  army.  At  the  close  of  the  last,  and  at  the  commencement  of  the 
present  century,  the  Whig  party  especially  opposed  eveiw  grant  which  Mr. 
Pitt  brought  forward  for  this  purpose.^  After  the  gi'eat  war,  the  exhaus- 
tion of  the  nation  prevented  anything  being  done,  and  in  spite  of  the  rep- 
resentations of  many  military'  men,  comparatively  little  change  occurred 
till  the  Crimean  war.  In  1855,  a  committee,^  of  which  Lord  Monck  was 
chairman,  was  appointed  by  the  War  Office  to  consider  this  subject,  and 
presented  a  most  excellent  Eeport  on  Barracks,  the  suggestions  of  which 
have  been  since  gi'adually  cai'ried  out.  Immediately  after  this,  a  Barrack 
Improvement  Commission  ^  was  organized,  and  in  1861  this  Commission 
published  a  Blue  Book,  which  not  only  contained  plans  and  descriptions  of 
the  existing  barracks  and  hospitals,  but  laid  down  nales  for  their  constnic- 
tion,  ventilation,  and  sewerage,  for  future  guidance.  It  is  difficult  to  speak 
too  strong!}'  of  the  excellence  of  this  Eeport,  and  if  its  rules  are  attended 
to,  there  can  be  no  doubt  the  British  army  will,  as  far  as  habitations  are 
concerned,  be  lodged  in  healthier  dwellings  than  almost  any  class  of  the 
community.  °  Eef erence  must  be  made  to  this  report  for  a  fuller  account 
of  the  older  ban'acks  and  hospitals  than  can  be  given  here." 

Windward  and  Leeward  command,  the  very  best  barrack,  in  1827,  gave  only  this 
amount  of  accommodation :  the  men  slept  in  hammocks  touching  each  other  ;  the  av- 
erage space  allowed  to  each  man  measured  only  28  inches  in  breadth ;  and  the  total 
cuVjic  space  per  head,  in  this,  the  best  barrack  in  a  tropical  climate,  was  only  250  cubic 
feet.     The  air  was,  of  course,  putrid  in  the  highest  degree. 

So  also  in  India,  the  best  writer  on  the  means  of  preserving  the  health  of  troops  in 
India  (Dr.  Chevers)  did  not  hesitate  to  assert  that  faulty  barracks  w^e,  though  not-the 
only,  yet  a  great  cause  of  a  mortality  which,  in  a  term  of  years,  had  been  at  least  four- 
fold more  than  at  home.  Phthisis  and  typhoid  fever  hold  a  subordinate  place  (though 
it  is  not  unlikely  that  their  frequency  was  underrated)  ;  but  other  diseases  appear, 
which  are  in  part  connected  with  faulty  barrack  arrangements,  such  as  dyseiitery  and 
cholera. 

In  India,  as  in  England,  no  expense  has  of  late  years  been  spared  ;  but  yet  the  fact 
remains,  that  the  very  habitations  erected  for  their  shelter  and  comfort  proved  in  many 
cases  to  the  soldiers  a  source  of  suffering  and  death. 

'  Army  medical  officers  are  referred  to  an  admirable  paper  by  Surgeon-General  Dr. 
Massy,  C.B.,  on  the  Construction  and  Ventilation  of  Barracks  and  Hospitals  (Army 
Med.'Dep.  Report,  vol.  vi.,  p.  229). 

^  On  looking  through  the  Annual  Register,  it  will  be  found  that  Fox,  as  well  as  his 
followers,  spoke  strongly  against  the  grant  of  sums  of  money  for  improving  barracks. 
Their  motives  were  good,  and  their  jealousy  of  a  standing  army  justified  by  what  had 
gone  before,  but  the  result  has  been  most  unfortunate  for  the  soldier. 

^  Report  of  the  Official  Committee  on  Barrack  Accommodation  for  the  Army,  Blue 
Book,  1855. 

^  Mr.  Sydney  Herbert,  Drs.  Sutherland  and  Burrell,  and  Captain  Gallon,  were  the 
first  Barrack  and  Hospital  Improvement  Commissioners.  Lord  Herbert  did  not  sign  the 
first  Report,  as  he  became  Minister  of  War.  Dr.  Burrell  retired.  The  remaining  Com- 
missioners (Dr.  Siitherland  and  Captain  Gallon)  subsequently  published  the  Report  on 
the  Mediterranean  and  other  Barracks. 

*  General  Report  of  the  Commission  appointed  for  Improving  the  Sanitary  Condi- 
tion of  Barracks  and  Hospitals,  1861. 

*  For  the  duties  of  medical  officers  with  respect  to  barracks,  see  Queen's  Regula- 
tions. 1881,  Section  15  ;    and  the  Army  Medical  Regulations,  1878. 


CONDITIONS    OF    SEEVICE.  203 

Infantry  Barracks. 

Block  Plan. — Formerly  a  number  of  men,  even  a  whole  regiment,  were 
aggregated  in  one  large  house,  and  this  was  often  built  in  the  form  of  a 
square  (a  plan  originated  by  Vauban),  the  quarters  for  the  officers  forming 
one  side,  on  account  of  the  ease  of  surveillance.  Many  officers  still  prefer 
this  form.  But  it  is  always  objectionable  to  have  an  inclosed  mass  of  air, 
and  if  it  is  adopted  the  angles  should  be  left  open,  as  recommended  by 
Eobert  Jackson.  The  Barrack  Improvement  Commissioners  have  very 
justly  recommended  that  there  shall  be  division  of  the  men  among  numer- 
ous detached  buildings  ;  and  instead  of  the  square,  that  the  separate 
buildings  shall  be  arranged  in  lines,  each  building  being  so  placed  as  to 
impede  as  httle  as  possible  the  movement  of  air  on  the  other  buildings, 
and  the  incidence  of  the  sun's  rays. 

In  arranging  the  lines,  the  axis  of  the  buildings  should  be  if  possible 
north  and  south,  so  as  to  allow  the  sun's  rays  to  fall  on  both  sides.  One 
building  should  in  no  case  obstruct  air  and  hght  from  another,  and  each 
building  must  be  at  a  sufficient  distance  from  the  adjoining  house,  and 
this  distance  should  not  be  less  than  its  own  height,  and  if  possible  more. 

Parts  of  a  Barrack. — 1.  The  barrack  room,  with  non-commissioned 
officers'  rooms  screened  off.  2.  Quarters  of  the  married  privates — seven 
to  each  company.  (With  the  short  service  system  this  will  probably  be 
modified.)  3.  Quarters  of  the  staff-sergeants  and  sergeants'  mess.  4. 
Quarters  of  the  officers.  5.  Kitchens.  6.  Ablution  rooms.  7.  Latrines 
and  urinals.  8.  Orderly-room ;  guard-room.  9.  Cells.  10.  Tailors'  shop 
and  armory  ;  commissariat  stores  ;  canteen.  11.  Reading-room  (in  many 
barracks);  schools;  magazine. 

It  is  unnecessary  to  describe  all  these  buildings. 

The  old  barracks  are  of  all  conceivable  forms  and  kinds  of  construction, 
for  details  of  which  see  the  Commissioners'  Report. 

When  new  barracks  are  built,  the  plans  of  the  Commission  will  bfe 
followed. 

(a)  Barrack  Rooms. — The  size  and  shape  of  the  barrack  room  will  de- 
cide the  kind  of.  buildings.  The  Barrack  Committee  of  1855  recommended 
that  each  room  should  accommodate  twelve  men,  or  one  squad,  as  this  is 
most  comfortable  for  the  men  ;  but  small  rooms  of  this  size  are  more  diffi- 
cult to  arrange,  and  it  is  now  considered  best  to  put  twenty-four,  or  one 
section,  in  each  room. 

The  Barrack  Improvement  Commissioners'  recommendations  may  be 
condensed  as  follows  : — 

The  rooms  are  directed  to  be  narrow,  with  only  two  rows  of  beds,  and 
with  opposite  windows — one  window  to  every  two  beds.  As  each  man  is 
allowed  600  cubic  feet  of  space,  and  as  it  is  strongly  recommended  that  no 
room  shall  be  lower  than  12  feet,  the  size  of  a  room  for  24  men  will  be — 
length  60  feet,  breadth  20  feet,  height  12  feet.  This  size  of  room  will  give 
14,400  cubic  feet,  or  (600  x  24)  enough  for  24  men ;  but  as  the  men's  bodies 
and  furniture  take  up  space,  an  additional  2  feet  has  been  allowed  to  the 
length  in  some  of  the  new  barracks.  Assuming  the  length  to  be  62  feet, 
the  superficial  area  for  each  man  will  be  nearly  52  feet,  a  little  more  than 
5  feet  in  the  length  and  10  in  the  width  of  the  room.  At  one  end  of  the 
room  is  the  door,  and  a  room  for  the  sergeant  of  the  section,  which  is 
about  14  feet  long,  10  wide,  and  12  high.  At  the  other  end  is  a  nari'ow 
passage  leading  to  an  ablution  room,  one  basin  being  provided  for  4  men, 
and  a  urinal. 


204 


PRACTICAL    HYGIENE. 


Such  is  the  present 
difl&cult  to  conceive  a 


«!- 


8- 


Fia.  98.— Colchester  Camp 
Houses. 


arrangement  of  a  single  barrack  room,  and  it  is 
better  plan,  unless  it  might  be  suggested  that  an 
open  veranda,  never  to  be  made  into  a  corridor, 
should  be  placed  on  the  south  or  west  side.  It 
■would  be  a  lounging-place  for  the  men.  So  also 
B  cleaning-room  for  arms  and  accoutrements 
"would  be  a  very  useful  addition. 

The  room  thus  formed  may  constitute  a 
Bingle  hut,  but  if  space  is  a  consideration,  two 
such  rooms  are  directed  to  be  placed  in  a  line, 
the  lavatories  being  at  the  fi'ee  ends.  A  house 
of  this  kind  will  accommodate  half  a  company. 
The  several  houses  are  separated  by  an  interval 
of  not  less  than  25  feet.  For  the  sake  of  econo- 
my, however,  the  houses  will  in  future  be  fre- 
quently made  two-storied,  so  that  one  house 
will  contain  a  company  in  four  rooms,  and  ten 
will  suffice  for  a  regiment. 

The  three  following  plans  of  recently  erected 
barracks  show  the  arrangements  which  are 
adopted : — 

1st,  When  there  is  a  single  story,  as  at  Col- 
chester, and  no  staircase  is  required. 

2d,  When  there  are  two  stories,  and  a  stair- 
case must  be  introduced,  as  in  the  new  cavalry 
barracks  at  York. 

3d,  When  there  are  not  only  staircases,  but 
the  barracks  must  be  extended  in  one  long  line, 
including  many  rooms,  and  when,  therefore,  the 
ablution  rooms  cannot  be  put  at  the  ends  of  the 
rooms,  but  must  be  placed  on  the  landings,  as  at 
Chelsea. 

If  ten  houses  are  thus  formed,  and  arranged 
so  as  to  insure  for  each  the  greatest  amount  of 
light  and  air,  the  following  area  will  be  occupied 
by  these  houses  alone.  Each  house  (with  walls) 
would  measure  about  140  feet  long  and  22 
broad,  and  the  space  between  the  houses  may 
be  taken  at  64  feet,  or  twice  the  height  of  the 
house.  The  external  houses  would,  of  course, 
have  clear  spaces  on  both  sides  like  the  others. 
The  area  of  occupied  and  unoccupied  space 
would  be  very  nearly  12  square  yards  to  a  man. 

But  this  amount  of  compression,  which  would 
be  injurious  in  a  large  city,  will  do  no  harm  in 
these  well-planned  and  ventilated  barracks. 

(b)  Day-rooms. — Tlie  soldier  lives  and  sleeps 
in  his  barrack  room  ;  it  has  long  been  a  desider- 
atum to  introduce  day -rooms,'  but  at  present 
the  expense  is  too  heavy.  Still  it  is  very  im- 
portant that  the  men  should  take  their  meals 
elsewhere  than  in  their  ban-ack  room,  and  in 


'  See  Report  of  Committee  (1855),  p.  iv.     The  objections  to  day-rooms  are — 1st, 


CONDITIONS    OF    SERVICE. 


205 


some  barracks  a  room  is  provided  close 
a  few  verandas  to  the  rooms  vs^ould  be 


to  the  kitchen.     The  addition  of 
less  expensive;  and  if  reading- 


ir^^ 


TCJ:.'- 


€H 


<fl! 


tjH PT 

-S-a EL 


»J 


Fia.  99.— New  Cavalry  Barracks  at  York. 


Pig.  100. — New  Chelsea  Barracks. 


More  labor  to  keep  clean ;  2d,  Chance  of  men  being  debarred  from  their  barrack  room 
during  day  ;  3d,  Chance  of  day-room  being  appropriated  on  emergencies.  The  Com- 
mittee, therefore,  recommend  only  dining-rooms  for  the  men,  to  be  arranged  near  the 
kitchen,  if  possible. 


206  PEACTICAL    HYGIENE. 

rooms  were   provided,   some  of    tlae    purposes  of  day-rooms   would    be 
obtained. 

(c)  Xon- Commissioned  Officers'  Booms.  —  The  Sergeant-major  and 
Quartermaster-sergeant  are  entitled  to  two  rooms  and  a  kitcLen  ;  the  Pay- 
master-sergeant, Hospital-sergeant,  Schoolmaster-sergeant,  and  some  oth- 
ers, are  entitled  to  two  rooms.  The  company  sergeants  have  one  room 
each.  The  rooms  are  about  14  feet  by  12,  and  10  high,  and  contain  about 
1,680  cubic  feet  when  empty.  The  amount  of  space  is  small,  and  as  many 
of  these  non-commissioned  officers  are  married,  and  as  it  is  a  matter  of 
justice  no  less  than  of  poUcy  to  make  them  as  comfortable  as  possible,  it 
is  to  be  hoped  that  two  rooms  may  be  allowed  to  eveiy  mamed  man,  and 
three  in  the  case  of  all  the  senior  non-commissioned  officers.  The  non- 
commissioned officers  should  be  looked  on  in  the  hght  of  the  overlookers 
of  a  factory ;  they  are  even  more  essential  to  the  good  working  of  the  ai'my 
than  the  overlookers  are  in  a  mill ;  but  no  married  overlookers  would  ever 
conceive  the  possibiUty  of  living  in  two  rooms,  in  one  of  which  cooking 
must  be  done. 

(d)  Married  Soldiers'  Quarters. — Seven  privates  in  a  company  of  100  men 
are  allowed  to  be  maii-ied.  Formerly  they  were  placed  in  the  men's  bar- 
racks, a  space  being  screened  off,  but  now  they  are  entitled  to  separate 
quai'ters,  each  family  receiving  one  room  14  feet  by  12,  or  168  superficial 
and  1,680  cubic  space. 

There  is  no  doubt  that  this  allowance  of  space  will  be  increased  in  ac- 
cordance Avith  the  general  feeling  of  the  time,  which  is  strongly  against  the 
mixing  up  adults  and  children  of  all  ages  in  the  same  room.  The  amount 
of  space  also  is  really  much  too  small.  Certainly  two  such  rooms  ought  to 
be  given  to  each  married  private. 

Warming  of  Barrack  Booms. — The  rooms  are  waimed  by  Galton  grates 
in  two  ways — radiant  heat  from  an  open  fire,  and  wann  aii",  which  is  ob- 
tained from  an  au'-chamber  behind,  and  heated  by  the  fire.  The  external 
ail-  is  led  by  a  pipe  to  this  chamber,  and  then  ascending,  enters  the  room 
by  a  louvre.  The  grates  are  of  various  sizes,  according  to  the  size  of  the 
room.  Smallest — 1  foot  3  inches  of  fire  ojDening  for  rooms  of  3,6C0  cubic 
feet.  Middle — 1  foot  5  inches  for  rooms  of  3,600  and  9,800  cubic  feet. 
Lai'gest — 1  foot  9  inches  up  to  12,000  cubic  feet.  Lai'ge  rooms  have  two 
gi'ates.     One  grate  is  usually  provided  for  twelve  men. 

The  radiating  jjower  of  the  small  baiTack  gi'ate  is  aided  by  a  well- 
aiTanged  angle,  and  by  a  fire-clay  back  ;  as  the  fire  is  small,  however,  the 
radiating  power  is  not  great. 

In  the  wards  of  Foi-t  Pitt,  with  the  lai-gest  size  of  gi'ates,  the  mean 
rapidity  of  movement  of  wann  air  thi'ough  the  upper  shts  of  the  louvre, 
with  a  good  fii'e,  was  found  to  be  about  2^  feet  per  second,  and  the  total 
cubic  amount  of  warm  air  entering  per  hour  through  the  whole  louvre  was 
(approximately)  4,600  cubic  feet  j^er  hour,  with  a  mean  temperatiu-e  of  19° 
in  excess  of  the  external  air-temperatiu-e.  No  unusual  dryness  of  the  air 
is  produced  by  the  admission  of  this  c[uantity  of  wai'm  aii-,  the  relative 
humidity  of  the  air  being  about  70. 

The  movement  of  air  through  the  hot-air  louvi'es  is  not  regular  ;  open 
doors  and  windows,  which  increase  the  pressure  of  the  air  of  the  room  on 
the  louvi-e,  will  sometimes  delay  the  movement,  and,  if  the  aii'-chamber  is 
not  veiy  hot,  wiU  even  reverse  it  and  drive  the  air  down,  as  the  rapidity  of 
movement  in  those  hot-air  chambers  is  never  veiy  gi'eat  ;  but  in  cold 
weather,  when  the  doors  and  windows  are  shut,  the  action  is  tolerably 
regular. 


CONDITIONS    OF    SEEVICE.  207 

VeMilation  of  Barrack  Rooms. — (See  under  Venitlation.) 

Ablution  Booms. — Formerly  the  means  for  washing  were  of  a  very  rude 
kind,  but  now  in  the  new  barracks  regular  basins  with  clean  water  and 
discharge  dirty-water  pipes  are  provided  close  to  every  room,  in  the  pro- 
portion of  one  basin  to  four  men.  The  basins  are  of  slate  or  iron.  In 
several  cases  basins  on  the  floor  have  been  provided  for  feet-washing,  and 
in  some  instances  there  are  also  baths  for  each  regiment.  The  Barrack 
Improvement  Commissioners  recommend  one  bath  to  every  100  men.  It 
is  understood  to  be  the  desire  of  the  Government  to  provide  plunge-baths 
wherever  practicable,  and  this  would  not  only  aid  cleanliness,  but  might 
be  made  the  means  of  teaching  the  men  swimming,  as  suggested  by  Mr. 
M'Laren. 

If  water  be  scarce,  the  most  economical  kind  of  bath  is  a  shower-bath, 
so  aiTanged  as  to  permit  80  to  100  men  to  have  a  bath  at  once. 

Inspections  for  cleanliness  are  made  in  many  regiments.  They  should 
be  systematically  carried  on  under  the  direction  of  good  non-commissioned 
officers  ;  but,  if  means  are  provided,  soldiers  will  generally  be  cleanly. 

Kitchens. — Great  improvements  have  been  made  in  cooking  by  the  em- 
ployment of  better  ovens  and  boilers,  and  especially  by  making  use  of 
steam,  as  in  Warren's  cooking  stoves.  The  cost  of  fuel  per  head  has  been 
greatly  reduced. 

The  opinion  of  the  medical  officer  will  seldom  be  asked  on  the  question 
of  construction,  at  any  rate  on  home  service.  He  may,  however,  be  re- 
ferred to  on  the  question  of  consumption  of  fuel,  and  then  he  can  take  as 
the  standard  for  an  ordinary  good  apjDaratus  -^  lb  of  fuel  per  man  per  diem. 

More  often,  however,  he  will  have  to  examine  the  cooking,  to  which 
reference  is  made  under  the  different  sections  in  the  chapter  on  Food. 
The  chief  points  to  which  attention  should  be  paid,  are  the  temperature, 
the  rapidity  of  its  application,  and  the  ventilation  of  roasting  ovens.  Faulty 
cooking  will  generally  be  found  to  be  owing  to  one  or  other  of  these  con- 
ditions. 

Formerly  the  regimental  cooking  establishment  was  badly  arranged ; 
men  cooked  by  turns,  and  for  short  periods  only.  Now,  cooks  are  regularly 
trained  at  Aldershot. 

The  other  parts  of  a  barrack  are — officers'  quarters  ;  laundry  (in  some 
cases) ;  workshops  for  tailor,  shoemaker,  and  armorer ;  orderly-room  ; 
guard-room  ;  cells  ;  reading-room  (in  some  cases);  chapel  and  school,  which 
are  often  in  one  ;  magazine  ;  barrack-masters'  and  quarter-masters'  stores 
for  regimental  purposes,  bread,  and  meat. 

Guard-room. — The  guard-room  for  a  regiment  of  1,000  strong  has  a  size 
of  about  24  feet  by  18  ;  two  rooms  open  into  it — one  a  lock-up  for  pris- 
oners, the  other  a  room  where  prisoners  are  placed  who  are  not  put  in  the 
lock-up.  In  many  barracks,  however,  the  lock-up  is  placed  near  the  cells. 
The  guard-room  is  ventilated  like  the  other  rooms,  with  Sheringham  valves, 
shafts,  etc.  M'Kinnell's  ventilator  is  well  adapted  for  it.  It  should  be  fitted 
with  a  drying  closet  by  the  side  of  the  fire,  to  dry  the  men's  clothes  when 
they  come  in  wet  off  sentry. 

Cells. — The  cells  are  ranged  on  one  or  both  sides  of  a  corridor.  They 
are  10  feet  long,  6^  wide,  and  9  high  (=  605  cubic  feet),  with  one  window,  2 
feet  9  inches  wide  by  1  foot  3  inches  high,  placed  at  the  top  of  the  wall,  and 
guarded  by  iron  bars.  A  movable  ii-on  shutter  is  sometimes  added  for 
security,  and  to  make  the  cell  a  dark  one  if  needed.  Fresh  air  is  admitted 
through  a  grating  opening  from  the  corridor,  which  is  Avarmed.  The  air 
enters  below,  or  in  some  cases  above  ;  but  the  former  arrangement  is  the 


208  PRACTICAL    nYGIEISTE. 

best.  A  foul-air  shaft  inins  from  the  top  of  the  room.  Two  cells  are  pro- 
vided for  every  100  men.     A  medical  officer  inspects  the  cells  every  day. 

Latrines  and  Urinals. — Formerly,  urine  tubs  were  brought  into  barrack 
rooms  eveiy  night ;  and  indeed  this  is  still  done  in  some  barracks.  The 
tubs  are  charred  inside,  and  emptied  every  morning  and  filled  with  water 
during  the  day.  In  all  new  barracks  urinals  are  introduced  ;  they  are 
placed  at  the  end  of  the  passage  beyond  the  ablution  room.  It  is  found 
by  the  men  that  th's  is  inconvenient ;  the  passage  is  often  wet  and  cold. 
If  the  urinal  is  full  of  water,  it  splashes  ;  it  might  be  well  to  put  the  over- 
flow-pipe a  little  lower  down.  It  has  been  recommended  to  put  a  small 
pipe  and  stopcock  a  few  inches  above  the  urinal,  so  that  the  men  may 
cleanse  themselves,  and  in  this  way  possibly  lessen  the  chances  of  syphilitic 
infection. 

Cesspits  are  now  discontinued  in  most  baiTacks,  and  water  latrines  are 
used.  The  latrines  are  jilaced  at  some  little  distance  from  the  rooms,  and 
are  usually  connected  with  them  by  a  covered  way  ;  in  almost  all  barracks 
they  are  Jenning's  or  Ttlacfarlane's  patents.  TJiese  are  metal  or  earthen- 
ware troughs,  which  are  one-thii'd  full  of  watei'.  Twice  a  day  a  trap-door 
is  lifted,  the  latrine  is  flushed,  and  the  soil  flows  into  a  sewer  or  tank  at  a 
distance.  A  hydrant  is  now  frequently  placed  close  to  the  latrine  ;  an 
india-rubber  pipe  can  be  connected  with  it,  and  the  seats  and  floor  of  the 
latrine  are  thoroughly  washed  in  this  way  twice  daily.  Probably  it  would 
be  difficult  to  suggest  anything  better  than  this,  although  soldiers  can  be 
taught  to  use  water-closets  like  other  people,  and  not  to  damage  them.  If 
water-closets  are  used,  a  plan  suggested  by  jVIr.  Williams,  C.E.,  clerk  of  the 
works  at  Gravesend,  seems  a  very  good  one.  It  is  to  have  the  water- 
closets  at  the  top  of  a  two-storied  building,  to  the  central  part  of  which 
they  form  a  small  third  stoiy.  In  this  way  the  follo^\ing  advantages  are 
secured : — vicinity  to  the  men — under  the  same  roof,  yet  with  perfect  ven- 
tilation ;  impossibilit}'  of  effluvia  passing  down  ;  proximity  to  the  cistern  ; 
and  a  good  fall.  At  j)resent,  however,  it  seems  better  to  kee-p  to  the  water 
latrines  outside  the  barracks. 


Cavalry  Barracks. 

In  many  cases  the  men's  rooms  are  placed  over  the  stables,  and  there 
has  been  much  discussion  as  to  whether  this  arrangement  is  a  good  one. 
On  the  one  hand,  the  men  get  more  room,  as  the  horses  cannot  be  crowded, 
and  they  are  near  their  horses.  On  the  other  hand,  there  is  strong  evi- 
dence that  the  effluvia  from  the  stables  pass  into  the  men's  rooms  over- 
head ; '  and  although  I  have  been  able  to  find  no  statistical  proof  that  this 
has  produced  sickness  among  the  men,  we  may  safely  a  pi-ioi^i  conclude 
that  it  is  objectionable.  The  evidence  of  mews  in  London  is  not  in  point, 
as  they  are  often  close,  ill-ventilated  courts,  independent  of  the  stables  in 
them.     Besides,  this  e%ddence  is  as  yet  rather  contradictory. 

The  question  has,  however,  been  solved  by  a  "  Keport  on  the  Ventilation 
of  Cavalry  Stables"  (1863),"  by  the  Barrack  Improvement  Commissioners, 
who  have  shown"  that  the  ventilation  and  Hghting  of  stables  can  only  be 

'  See  especially  the  evidence  of  Mr.  Wilkinson,  Principal  Veterinary  Surgeon  to  the 
Armv  ;  Report  of  Barrack  Committee  (1855),  p.  136,  question  2262  ;  also  the  Report  on 
the  Ventilation  of  Cavalry  Stables  (1863). 

^  Report  of  Barrack  and  Hospital  Improvement  Commission,  signed  by  Sir  Richard 
Airey,  Captain  Galton,  Dr.  Sutherland,  Dr.  Logan,  and  Captain  Belfield. 


CONDITIONS    OF    SERVICE.  209 

satisfactorily  carried  out  in  one-storied  buildings,  and  who,  therefore,  rec- 
ommend that  the  men's  rooms  shall  not  be  placed  over  stables. 

Stables. — The  medical  officer  has  no  duties  connected  with  stables,  ex- 
cept to  see  that  they  are  in  no  way  injurious  to  the  health  of  the  men ;  but 
it  may  be  well  to  give  the  suggestions  lately  made  by  the  BaiTack  Improve- 
ment Commissioners. 

In  all  the  old  stables,  if  it  is  not  ah-eady  done,  ventilating  shafts  are  to 
be  carried  up,  au'-bricks  introduced,  and  more  window  space  to  be  given. 

"Whenever  stables  are  to  be  built  in  future,  it  is  recommended  that  the 
building  should  be  one-storied  ;  that  the  breadth  should  be  33  feet  ;  the 
height  of  the  side  waUs  to  the  spring,  12 ;  and  of  the  roof,  8^  feet  more. 
The  breadth  of  each  stall  is  to  be  o^  feet,  and  there  are  to  be  only  two  rows 
of  horses  in  each  stable.  Each  horse  is  to  have  100  superficial  feet,  and 
1,605  cubic  feet ;  the  ventilation  is  by  the  roof,  and  is  formed  by  a  louvre 
16  inches  wide  carried  fi'om  end  to  end,  and  giving  4  square  feet  of  venti- 
lating outlet  for  each  horse.  A  course  of  air-bricks  is  carried  I'ound  at  the 
eaves,  giving  1  square  foot  of  inlet  to  each  horse  ;  an  air-brick  is  introduced 
about  6  inches  from  the  gi'ound  in  every  two  stalls.  There  is  a  swing  "uin- 
dow  for  every  staU,  and  spaces  are  left  below  the  doors.  In  this  way,  and 
by  attention  to  surface  drainage  and  roof  hghting,  it  is  anticipated  that 
stables  will  become  perfectly  healthy.  Some  experiments  were  made  some 
years  ago  by  Dr.  de  Chaumont  on  the  air  of  some  artillery  stables  at  Hil- 
sea.  In  one  stable,  with  32  ventilators,  and  with  655  cubic  feet  per  horse, 
the  total  C0„  was  1.053  volume  per  1,000;  in  another,  with  1,000  cubic 
feet  per  horse,  and  -with  420  air-bricks,  25  windows,  and  a  ridge  opening, 
it  was  .573  volume  per  1,000.  The  last  experiment  shows  great  purity  of 
the  air. 

Reports  on  Barracks. 

The  Regulations  order  the  form  in  which  reports  on  barracks  shall  be 
sent  in.  The  arrangements  should  be  strictly  followed ;  it  comprehends 
site,  construction,  external  ventUation,  internal  ventilation,  basements,  and 
administration.  It  is  then  certain  that  no  point  will  be  overlooked  ;  and, 
if  nothing  can  be  made  out  after  going  thoroughly  through  all  the  headings, 
it  may  be  concluded  that  the  cause  of  any  prevailing  sickness  must  be 
sought  elsewhere.  The  site  and  basement  should  be  especially  looked  at ; 
every  cellar  should  be  entered,  and  the  drainage  thoroughly  investigated. 
Little  can  be  learned  by  merely  walking  through  a  barrack  room,  which  is 
nearly  sure  to  look  clean,  and  may  present  nothing  obviously  wrong.  "With 
respect  to  ventilation,  the  statements  of  soldiers  can  seldom  be  trusted ; 
they  are  accustomed  to  vitiated  air,  and  do  not  perceive  its  odoi'.  The 
proper  time  to  examine  the  air  of  a  room  is  about  12  to  3  a.m.,  and  the 
medical  officer  should,  accordingly,  visit  barrack  rooms  between  midnight 
and  3  a.m.  every  now  and  then.  The  cisterns  should  be  regularly  in- 
spected. 

The  walls  and  floors  of  the  rooms  should  be  carefully  looked  to.  "Walls 
are  porous,  and  often  become  impregnated  with  organic  matter.  If  there 
is  any  susj)icion  of  this,  they  should  be  scraped  and  then  well  washed  with 
quicklime.  The  medical  officer  should  see  that  the  lime  is  really  caustic  ; 
chalk  and  water  does  little  good.  Collections  of  dirt  form  under  the  floors 
sometimes,  and  a  board  might  be  taken  up  to  see  if  this  is  the  case. 
Vol.  II.— 14 


210  PRACTICAL    HYGIEKE. 


Sub-Section  II. — Bareacks  dt  Forts  xkd  Cit^u)els. 

In  fortified  places  it  is,  of  course,  often  impossible  to  follow  the  examples 
of  good  baiTacks  just  given.  Citadels  may  have  little  ground  space  ;  build- 
ings must  be  compressed,  guarded  from  shot,  made  -svith  thick  and  bomb- 
proof walls,  with  few  openings.  Buildings  are  sometimes  underground. 
Drainage  is  often  difficult,  or  impossible  ;  and  if  to  all  these  causes  of  con- 
tamination of  air  we  add  a  deficiency  of  water,  which  is  common  enough, 
it  will  not  sui-prise  us  that  the  sickness  and  mortahty  in  forts,  in  even 
healthy  localities,  are  gi-eater  than  should  be  the  case.  Both  at  Malta  and 
Gibraltar  there  has  for  years  been  too  large  a  mortality  from  typhoid  fever, 
and  from  the  destructive  lung  diseases,  which  apj^ear  in  the  retiu-ns  as 
phthisis.  The  special  difficulties  of  casemates  are  as  follows :  dampness, 
which  is  very  common  in  all  casemates,  so  that  the  moisture  often  stands 
in  drops  on  the  walls  ;  a  low  temperatiu-e  ;  a  want  of  ventilation  ;  and  a 
want  of  light 

How  these  difficulties  are  to  be  met  is  one  of  the  most  difficult  prob- 
lems the  military  engineer  has  before  him.  How,  without  weakening  his 
defences,  he  is  to  get  light  and  aii'  into  the  buildings,  and  an  efficient 
sewerage,  would  test  the  ingenuity  of  a  Biamel.  It  is  possible  that  the  best 
plan  would  be  by  the  emplojTuent  of  thick  movable  u'on  doors  and  shutters. 
In  time  of  peace  these  might  be  open  ;  in  time  of  wai*  easily  rej^laced.  But, 
in  addition,  means  of  ventilation  must  be  pro^•ided  when  such  defences 
close  the  usual  ojoenings ;  tubes  must  be  carried  up,  and,  if  necessarily 
winding,  an  enlarged  area  might,  perhaps,  compensate  for  this. 

It  must  be  said,  also,  that  it  is  quite  certain  that  in  our  foi'tified  places 
many  of  the  arrangements  are  much  worse  than  they  need  be,  and  that  the 
sanitary  rules  deducible  from  home  experience  should  be  aj^plied  in  every 
case  when  the  defensive  properties  ai'e  not  interfered  with. 

Sub-Section  HI. — Barracks  in  Hot  Cluviates. 

The  older  barracks  in  both  the  East  and  West  Lidies  were  often  merely 
copies  of  the  English  barrack  square.  In  some  cases,  also,  the  exigencies 
of  defence  led  to  a  cramped  and  ii-regular  plan,  and  owing  to  the  little 
attention  which  was  paid  either  to  the  health  or  comfort  of  the  soldier, 
overcrowding  and  deficient  ventilation  were  as  common  in  the  tropics  as  at 
home.  For  several  years  there  has  been  a  gradual  imjDrovement,  and  in 
India  esiDCcially  vast  and  extensive  palaces  have  been  reared  in  many  stations, 
which  testify  at  any  rate  to  the  anxiety  of  the  Government  to  house  their 
soldiers  properly. ' 

It  will  be  desirable  to  refer  here  chiefly  to  the  Indian  barracks,  but  the 
same  principles  apply  to  all  hot  countries. 

'  Some  of  these  great  barracks,  as  at  Allahabad,  have  not  given  satisfaction,  and 
have  been  found  as  hot  or  even  hotter  than  the  old  barracks.  But  this  appears  to  have 
been  from  not  attending  to  the  rule,  never  to  let  the  sun's  rays  fall  on  a  main  wall,  but 
to  shadow  the  wall  by  a  veranda.  The  double  roof  also  has  apparently  not  been 
sufficiently  double,  i.e.,  the  openings  above  and  below,  to  allow  the  air  to  circulate, 
have  not  been  large  enough  ;  ventilators  have  also  not  been  put  to  the  verandas,  so 
that  the  heated  mass  of  air  cannot  ascend.  Nothing  tends  to  cause  greater  heat  than 
stagnancy  of  the  air,  as  may  be  seen  by  the  ease  with  which  water  may  be  boiled  in  a 
close  vessel  by  the  rays  of  the  sun,  even  in  England.  The  objection  to  the  palaces 
which  have  been  built  in  India  since  the  mutiny  is  not  so  much  to  the  principle  of  tbe 
barracks,  but  to  some  faults  in  construction,  and  especially  to  their  localities,  viz.,  in 
the  plains  instead  of  in  the  hills  in  many  cases. 


CONDITIONS    OF    SEE  VICE.  211 

Tlie  Indian  Sanitary  Commission  have  recommended  that  each  man  in 
barracks  shall  have  100  superficial  feet,  and  1,500  cubic  feet.  The  Govern- 
ment of  India  recommended  in  1864  that  there  should  be  90  superficial  feet 
in  the  plains,  and  77  in  the  hills,  which,  with  a  width  of  24  and  22  feet,  and 
height  of  20  and  18  feet,  would  give  1,800  cubic  feet  in  the  plains  and  1,408 
in  the  hills.  ]Mi-.  Webb,^  who  has  paid  great  attention  to  the  subject  of 
overcrowding  in  Indian  barracks,  and  who  beheves  that  it  is  the  grand 
cause  of  insalubrity  in  India,  has  adduced  good  reasons  for  thinking  that 
this  amount  is  not  nearly  sufficient.  It  is  suggested,  indeed,  that  3,000 
cubic  feet  of  space  is  not  too  much. 

In  1857  and  1858  the  Bengal  Government  ordered  standard  plans  to  be 
prepared,  and  some  -barracks  have  been  built  in  accordance  with  them.  A 
description  and  figures  will  be  found  in  the  former  editions  of  this  work. 
In  1863  the  Governor-General  of  India  in  Council  ordered  a  renewed  in- 
quu-y  into  the  matter,  and  Colonel  Crommelin  submitted  altered  designs 
for  barracks,  which  were  subsequently  submitted  to  the  Bengal,  Madras, 
and  Bombay  Governments,  and  to  the  Army  Sanitary  Committee  at  home. 
The  plan  of  these  new  barracks  is  essentially  that  proposed  by  the  Indian 
Sanitary  Commission  ;  while  the  preparation  of  the  detailed  design  is  left 
to  the  local  officers,  certain  general  principles  are  strictly  laid  down,  and 
standard  plans  suitable  for  different  localities  are  furnished  for  diiierent 
guidance.  The  number  of  men  to  be  placed  imder  one  roof  is  fixed  at  40 
or  50  (half -company  barracks) ,  excej)t  under  exceptional  circumstances  ; 
the  number  of  men  in  one  room  is  to  be  16  to  20,  and  not  to  exceed  24  ; 
the  barracks  are  to  be  two-storied  in  the  plains,  and  one  or  two  storied 
in  the  hills,  both  floors  being  used  for  dormitories  ;  single  verandas  of  10 
or  12  feet  wide  surround  these  rooms.  There  are  to  be  only  two  rows  of 
beds  in  the  dormitories ;  the  beds  are  to  be  9  inches  fi'om  the  wall,  and 
only  two  beds  are  to  be  in  the  wall  space  between  two  contiguous  doors 
(or  windows) ;  in  the  plains  each  bed  is  to  have  7^  feet  of  running  wall 
space,  in  the  hills  7.  The  general  arrangements  of  the  buildiug  are  based 
on  the  suggestions  of  the  Royal  Indian  Sanitary  Commission.  At  each  end 
of  the  dormitory  are  closets  and  night  lu'inals  ;  and  what  appears  to  be  the 
best  plan  places  these  at  the  extreme  end  of  the  veranda,  leaving  a  space 
between  them  and  the  dormitory. 

The  lower  story  in  the  plains  was  intended  to  be  used  as  a  day-room, 
but  it  appears  that  this  has  not  been  comfortable  for  the  men,  and  both 
floors  are  now  used  as  dormitories. 

The  married  people's  quarters  are  to  be  grouped  in  small  one-storied 
blocks,  each  block  holding  the  married  people  of  a  company  or  troop.  Two 
rooms  (16  feet  x  14  feet  and  14  feet  x  10  feet)  are  provided  for  each 
family ;  verandas,  12  and  10  feet  wide,  are  provided. 

In  aU  these  arrangements  it  will  be  perceived  that  the  essential  prin- 
ciples of  the  home  barracks  are  preserved  ;  long,  thin,  narrow  lines  of 
buildings,  with  thorough  cross  ventilation,  with  the  sleeping-rooms  raised 
well  off  the  ground,  would  certainly  appear  to  be  as  good  an  arrangement 
as  could  be  devised.  A  few  more  remarks  on  some  of  the  points  have  to  be 
made. 

1.  Size  of  Houses. — ^If  there  are  no  strong  military  reasons  to  the  con- 
trary, it  seems  certain  that  it  is  even  more  important  in  India  than  in  Eng- 

^  Remarks  on  the  Health,  of  European  Soldiers  in  India,  p.  50.  By  H.  Webb. 
Bombay,  1864. 


212      .  PRACTICAL    HYGIENE. 

land  to  spread  the  men  over  the  widest  available  area,  and  not  to  place 
more  than  fifty  men  in  a  single  block,  and  twenty-five  men  in  a  single  room  ; 
and  therefore,  the  proposed  plan  is  most  desii-able.  There  has  been  an 
objection  raised,  that  small  detached  houses  in  the  hot  plains  of  India,  not 
having  any  large  space  in  shadow,  get  everjnvhere  heated  by  the  sun's 
rays,  and  become  veiy  hot.  The  objection  is  theoretical ;  it  is  the  im- 
mense blocks  of  masonry  used  in  the  constiniction  of  large  buildings 
which  are  to  be  avoided  as  much  as  possible,  since,  once  heated,  they  take 
hours  to  cool. 

2.  Anmngement  of  Houses. — Broadside  on  to  the  prevalent  wind,  and  dis- 
position en  echelon,  as  now  adopted  in  India,  is  ob\'iously  the  proper  plan. 
The  only  exception  will  be  when  there  are  marsh  or  guUy  winds  to  be 
avoided,  and  then  the  houses  should  be  placed  end  on  to  the  deleterious 
wind  ;  and  no  windows  should  open  on  that  side.  But  it  is  seldom  such  a 
site  would  be  selected  or  kept. 

If  a  barrack  is  built  on  a  slope,  and  the  ground  is  ten-aced,  the  Army 
Sanitary  Committee  have  recommended  that  the  barrack  should  be  jolaced 
end  on  to  the  side  of  the  hill,  and  not  nearer  the  sloj^e  than  20  to  30  feet. 
But  terracing  should  be  avoided  as  .much  as  possible. 

3.  Breadth  of  Houses. — As  in  England,  it  is  important  to  have  only  two 
rows  of  beds  in  each  house,  and  to  keep  the  houses  under  30  feet  in  width, 
so  as  to  peiTait  effective  perflation.  A  single  veranda  is  as  good  as  a 
double  one  in  keeping  ofit'  the  direct  rays  of  the  sun  from  the  walls  of  a 
house,  and  two  verandas  (one  inner  aiid  one  outer)  add  to  the  breadth 
to  be  ventilated.  The  width  of  the  verandas  must  be  10  to  12  feet ;  and 
on  the  sou.theni  and  western  sides  wooden  jalousies  may  have  to  be  placed 
so  as  to  occupy  3  or  4  feet  at  the  ui^per  j^art  of  the  veranda. 

Verandas  should  be  ventilated  by  openings  at  the  highest  part,  so  as 
to  have  a  free  movement  of  air  through  them  ;  this  is  veiy  important.  If 
there  are  two  stoi'ies,  the  roof  of  the  upper  veranda  should  be  doubled. 

Materials  of  Building. — On  this  point  there  is  little  choice,  for  the  risk 
of  fire  renders  the  use  of  wood  undesirable  for  walls  and  roofs.  And  yet, 
apart  from  this  risk,  loosely  joined  wood,  or  frames  of  bamboo,  have  the 
great  advantage  of  allowing  air  to  pass  throvigh  the  walls.  Brick  or  stone 
has  therefore  to  be  used.  In  India,  sun-dried  brick  {kutvha),  covered  with 
cement,  or  faced  with  burnt  brick,  is  often  used  ;  and  the  remains  of 
Babylon  or  Nineveh  show  how  imperishable  a  material  this  is  if  properly 
protected.  It  is  said  to  be  a  cooler  material  than  burnt  brick  (pucka), 
but  it  absorbs  a  great  deal  of  moistui-e. 

L'on  barracks  were  sent  out  from  England  during  the  mutiny,  but  were 
said  to  be  hot,  and  were  not  liked  ;  but  iron  frames  have  been  usefully 
employed,  the  intervals  being  filled  up  with  unburnt  bricks.  There  is, 
however,  a  very  general  feeling  against  unburnt  brick,  on  account  of  the 
moisture  it  absorbs  and  retains.  The  concrete  walls  now  coming  into  so 
much  use  in  England  would  be  particularly  adapted  for  India  ;  they  are 
cheap,  and  are  dry. 

Construction  of  the  Building. — The  three  points  to  be  aimed  at  ai'e — 
avoiding  the  malai-ia  and  dampness  of  the  ground,  should  there  be  any 
risk  of  this  ;  insuring  coolness  ;  providing  ventilation. 

(a)  Employment  of  Open  Arches  for  the  Basement. — The  extraordinary 
diminution  in  the  risk  of  malaria  by  elevating  the  building  only  a  few  feet 
above  the  ground,  and  allowing  a  free  cui'rent  of  air  under  the  house,  is 
illustrated  in  various  pai'ts  of  the  world  ;  along  the  banks  of  the  lower 
Danube,  in  the  plains  of  Burmah  and  Siam,  etc.    But  another  great  benefit 


CONDITIONS    OF    SEPwVICE.  213 

is  obtained  :  dryness  and  freedom  from  pent-up,  stagnant,  and  often  septic 
masses  of  air  are  insui'ed,  so  that,  even  when  the  soil  is  not  distinctly  ma- 
larious, buildings  should  be  raised.  In  a  malaiious  country  the  height  of 
the  ground-floor  above  the  ground  should  be  8  or  10  feet ;  in  non-mala- 
rious districts  3  or  4  feet  ai'e  sufficient,  but  it  should  always  be  high 
enough  to  allow  cleaning. 

If  high  enough,  these  open  spaces  afford  excellent  spaces  for  exercise 
dui'ing  the  heat  of  sun. 

(b)  Walls. — Very  thick  brick  walls  do  not  add  to  coolness  (Chevers),  but 
being  thoroughly  heated  during  the  day,  give  out  heat  all  night.  The 
direct  rays  of  the  sun  should  not  be  allowed  to  fall  on  any  part  of  the 
main  wall.  This  will  be  fotmd  one  of  the  most  Important  niles  for  in- 
suring coolness.  Double  main  walls,  with  a  wide  space  between,  and  free 
openings  above  and  below,  so  as  to  admit  a  constant  movement  of  air  be- 
tween, is  the  coolest  plan  known.  Consideiing  the  excellent  ventilation 
which  goes  on  .in  bamboo  and  wooden  houses,  it  may  be  a  question 
"whether,  in  the  warm  parts  of  India,  the  walls  might  not  be  made  as  far  as 
j)ossible  permeable  ;  at  any  rate,  above  the  heads  of  the  men.  Whitening 
the  outside  walls  reflects  the  heat,  but  is  dazzling  to  the  eyes  ;  almost  as 
good  reflection,  and  much  less  dazzling,  is  obtained  by  using  a  shght 
amount  of  yellow  or  hght  blue  color  in  the  cement  or  lime-wash. 

(c)  Floors. — The  materials  at  present  used  ai-e  flagstones  (in  Bengal), 
slates  (in  some  barracks  in  the  Punjab),  greenstone  (in  some  I\Iadi'as  bai'- 
racks),  tdes,  bricks  placed  on  end  and  covered  with  concrete,  pounded 
brick  and  lime  beaten  into  a  sohd  concrete  and  plastered  with  lime,  broken 
nodulaled  hmestone  or  kunkur  (in  places  where  the  masses  of  kunkiu'  are 
found,  as  in  Bengal),  asphalt,  pitch  and  sand,  wood  (Chevers).  Of  these 
various  materials,  the  asphalt  gets  soft  and  is  objectionable  ;  the  cements 
and  kunkur  wear  into  holes,  produce  dust,  and  have  been  supposed  to 
cause  ophthalmia  (Chevers)  ;  wood  is  liable  to  attacks  of  white  ants,  etc. 

On  the  whole,  it  would  seem  that  good  wood  (if  there  be  a  space  below 
the  barracks)  with  brick  supjDorts  is  the  best,  and  after  this  tiles. 

(d)  Roofs. — Double  roofs  are  now  usually  employed,  and  ai'e  made 
slanting,  and  not  terraced.  The  terraced  roofs,  if  made  single  {i.e.,  with 
battens  on  the  joists  covered  "^ith  kunkur),  conduct  heat  too  freely  ;  but  if 
nade  double,  v,ith  a  good  current  of  air,  there  is  an  advantage  in  giving  a 
promenade  to  the  men,  and  also,  at  some  seasons  of  the  year,  the  roof  may 
be  most  advantageously  used  as  a  sleeping-place. 

The  slojjing  roofs  are  better  adapted  for  ventilation.  The  coolest  roof 
is  made  of  thatch,  covered  %vith  tiles  ;  it  would  be  cooler  still  if  the  thatch 
were  outside  ;  but  thatch  is  dangerous  on  account  of  fire,  and  harbors 
vermin  and  insects.  If  there  is  a  good  space  between  the  two  roofs 
(2  feetj,  and  if  there  are  sufficient  openings  to  permit  a  good  current  of 
air,  perhaps  two  tile  roofs  would  be  as  cool  as  any. 

(e)  Doors  and  Windoios. — These  ai'e  now  always  made  very  numerous, 
and  opposite  each  other,  so  as  to  permit  perfect  pei'flation.  The  official 
"Suggestions"  order  one  window  for  eveiy  two  beds.  Five  doors  are  rec- 
ommended for  each  room  of  twenty-five  men  ;  and  Xorman  Chevers  gives 
a  good  rule  :  A  light  placed  in  the  centre  at  night  should  be  seen  on  all 
sides.  Upper  as  well  as  lower  windows — a  clerestory,  in  fact — are  useful ; 
the  lower  vvindows  shoidd  then  open  to  the  ground.  In  most  of  the 
stations  in  Xorthem  India  the  endows  must  be  glazed. 

The  Committee  appointed  to  caiTy  out  the  suggestions  of  the  Indian 
Sanitary  Commission  have  recommended  that  each  window  should  consist 


214  PRACTICAL    HYGIENE. 

of  two  i^arts — the  upper  portion,  about  2  feet  in  depth,  being  hinged  on 
its  lower  edge  to  fall  inward,  so  as  to  direct  the  currents  of  aii'  towai'd  the 
ceiling  of  the  room. 

Ventilation  of  Tropical  and  Subtropical  Barracks. 

If  barracks  are  not  made  too  broad,  and  are  properly  placed,  the  same 
principles  of  ventilation  may  be  applied  to  them  as  to  barracks  at  home. 
The  perflation  of  the  wind  should  be  obtained  as  fi'eely  as  possible.  The 
numei'ous  doors  and  windows,  however,  render  it  tmnecessary  to  provide 
special  inlets  ;  outlets  should,  as  at  home,  be  at  the  top  of  the  room,  either 
along  the  ridge,  or  if  of  shafts,  they  should  be  earned  up  some  distance  ; 
if  they  are  made  of  masonry,  and  painted  black,  the  sun's  rays  will  cause  a 
good  uj)-ciu"rent.  The  area  of  the  shafts  is  ordered '  to  be  1  square  inch 
to  every  15  or  20  cubic  feet,  with  lou^Tes  above  and  inverted  lou^Tes 
below.  In  the  lower  rooms  these  shafts  are  to  be  built  in  the  walls  ;  in 
the  upi^er  rooms  to  be  in  the  centre. 

In  many  parts  of  India,  however,  at  particular  times  of  the  year,  the  air 
is  both  hot  and  stagnant ;  in  such  stations  artificial  ventilation  must  be 
employed,  and  the  forcing  in  of  air  offers  greater  advantages  than  the 
method  by  asjjiration.  The  wheel  of  Desaguliers  was  introduced  into 
India  many  years  ago  by  Dr.  Kankine,  and,  under  the  name  of  "Thennan- 
tidote,"  is  frequently  used  in  private  houses  and  hospitals.  Wheels  may 
be  used  of  a  larger  kind,  and  driven  by  horses  and  bullocks,  or  steam  or 
water  joower.  The  great  advantages  are  that  the  air  is  put  in  motion  and 
can  be  cooled  by  evaporation. 

An  Amott's  pump,  made  as  large  as  a  man  can  easily  work,  will  be 
found  to  be  cheaper,  and  as  good  as  the  thermantidote. 

The  common  punkah  is  a  ventilator,  as  it  displaces  masses  of  aii- ;  the 
waves  pass  far  beyond  the  building,  and  are  replaced  by  fresh  au--waves 
entering  in.  An  improved  punkah,  worked  by  horse  or  bullock,  and  sujd- 
phed  with  water  for  evapoi-ation,  was  devised  by  the  late  ]Mi\  Moorsom,  of 
the  52d  Regiment ;  it  is  described  and  figured  in  the  "Rej^ort  of  the  In- 
dian Sanitaiy  Commission,"  and  woiild  seem  likely  to  be  a  very  useful 
modification  of  the  common  punkah. 

Ventilation  in  most  parts  of  India  must  be  combined  with  plans  for 
cooling,  and  often  for  moistening  the  air. 

Cooling  of  Air. — When  the  air  is  dry,  i.e.,  when  the  relative  humidity 
is  low,  there  is  no  difficulty  in  cooling  the  air  to  almost  any  extent.  If 
the  air  be  moving,  this  is  still  easier.  The  evaporation  of  water  is  the 
great  cooUng  agency.  A  drop  of  water  in  evaporating  absorbs  as  much 
heat  as  would  raise  967  equal  drojos  Y^  Fahr.,  or,  in  other  words,  the 
evaporation  of  a  gallon  of  water  absorbs  as  much  heat  fi'om  the  air  as 
would  raise  44-  gallons  of  water  from  zero  to  the  boiling-point.  As  the 
specific  heat  of  an  equal  weight  of  air  is  \  that  of  water,  it  toUows  that  the 
evaporation  of  1  gallon  or  10  it)  of  water  will  cool  (10  x  4  x  967)  38,680  lb 
of  air,  or  477,637  cubic  feet  of  air  1'  Fahr. ;  or,  to  put  it  in  another  way, 
the  evaporation  of  1  gallon  of  water  will  reduce  26,216  cubic  feet  of  air 
from  80^  to  60°  Fahr.  If  thoroughly  utilized,  1^  gallon  per  head  would 
be  the  allowance  for  twelve  hours,  but  as  the  full  work  is  never  got  out  of 
any  material,  this  quantity  ought  in  practice  to  be  doubled.  In  India  the 
temperature  of  a  hot  dry  wind  is  often  reduced  15°  to  20°  by  blowing 

'  Suggestions,  p.  22. 


CONDITIONS    OF    SERVICE.  215 

through  a  wet  kuskus  tattie  ;  but  merely  sprinkling  water  on  the  floors 
will  have  a  perceptible  effect  on  the  temperature. 

When  the  air  is  stagnant  cooling  is  less  easy.  In  India  it  is  often 
attempted,  in  a  still  atmosphere,  to  insm-e  coolness  by  creating  currents 
of  air  either  by  the  simple  punkah  or  by  thermantidotes ;  these  act  by 
increasing  evaporation  from  the  body,  and  they  certainly  do  away  with  the 
oppressiveness  of  a  still  atmosphere.  But  evaporation  of  water  must  be 
also  employed,  as  in  Captain  Moorsom's  punkah  just  referred  to,  or  in 
some  other  way. 

In  the  case  of  a  thermantidote,  or  Amott  pump,  thin  wet  cloths  sus- 
pended in  a  short  discharge-tube,  or  ice  suspended  in  it,  or  a  bottle  con- 
taining a  freezing  mixture,  and  with  a  wet  surface,  will  answer  equally 
weU. 

When  water  is  abundant  other  contrivances  may  be  employed.  A 
stream  of  water  issues  from  a  small  orifice  with  a  high  velocity,  and  im- 
pinging on  a  round  iron  plate  about  an  inch  or  two  from  the  orifice,  is 
beautifully  pulverized.  Or  the  beautiful  sheet-water  fountains  used  to 
wash  air  for  ventilation  might  be  employed.  In  the  old  Roman,  and  some 
Italian  houses  coolness  was  obtained  by  a  fountain  in  the  central  court ; 
and  where  it  can  be  done,  the  more  common  employment  of  fountains  in 
the  houses  in  the  hot  parts  of  India  may  be  suggested. 

Cooling  is  then  easy  when  the  air  is  dry,  or  is  not  moister  than  70  per 
cent,  of  saturation  ;  but  when  the  air  is  very  moist,  and  almost  saturated, 
as  is  often  the  case,  for  example,  in  Lower  Scinde,  and  is  at  the  same  time 
still,  evaporation  is  very  slow.  What  can  be  done  ?  Of  course,  the  air 
must  be  set  in  motion  by  mechanical  means.  But  how  is  it  to  be  cooled  ? 
Two  plans  suggest  themselves — taking  the  air  through  a  deep  tunnel,  and 
the  employment  of  ice. 

The  tunnel  plan  was  tried  some  years  ago  at  Agra,  and  was  not  well 
thought  of.  But  everything  depends  on  the  mode  of  making  the  tunnel. 
It  must  be  deep  enough  to  get  into  a  cold  stratum  of  earth. ' 

The  Chinese,  in  the  north  of  China,  suspend  lumps  of  ice  in  their  rooms 
during  the  summer  ;  but  this  seems  a  wasteful  plan.  Ice  in  tunnels  would 
have  a  much  greater  effect.  If  the  ice  cannot  be  obtained,  freezing  mix- 
tures might  possibly  be  used,  if  the  expense  is  not  a  bar. 

Ablution  Rooms. — In  India,  every  private  house,  and  almost  every  room 
in  a  house,  belonging  to  a  European,  has  its  bath-room.  And  not  only  the 
luxury,  but  the  benefit  is  so  great,  that  bath-rooms  should  be  considered 
essential  to  every  barrack.  For  the  usual  purposes  of  ablution  the  plan 
now  used  on  home  service  is  the  best ;  but  it  should  be  supplemented  by 
shower-baths.  In  order  that  these  shah  be  eflficiently  given,  the  old  plan 
of  carrying  water  by  hand  must  be  given  up  ;  shower-baths  for  a  regiment 
could  never  be  provided  in  this  way  ;  water  in  large  quantity  must  be  laid 
on  ill  pijjes,  and  cisterns  at  the  top  of  every  barrack  should  feed  the  ablu- 
tion rooms,  and  supply  water  for  the  urinals.  At  least  from  12  to  18  gallons 
daily  should  be  allowed  per  head  for  shower-baths  alone,  and,  if  possible, 
more  than  this,  as  general  baths  should  be  also  provided.  So  essential 
must  baths  be  considered  for  health,  that  a  large  supply  of  water  should 
be  considei'ed  a  necessary  condition  in  the  choice  of  site.  The  disposal 
of  the  water  after  use  is  a  question  for  the  engineer  ;  but  it  must  not  be 

'  The  recent  investigations  into  the  composition  of  the  ground  air  give  additional 
reasons  for  objecting  to  the  tunnel  plan,  unless  the  utmost  care  were  taken  to  prevent 
the  ground  air  being  delivered  into  the  dwellings. 


216  PRACTICAL    HYGIEJ^E. 

permitted  to  soak  into  the  ground  near  the  barracks  ;  it  might  seem  super- 
fluous to  notice  this,  if  the  custom  of  allowing  the  ablution  water  to  run 
under  the  hoiises  did  not  prevail  at  some  stations. 

Urinals.— J^rme  tubs  are  still  used  in  many  of  the  barracks  in  India, 
but  their  use  should  be  discontinued  as  soon  as  possible.  Evaporation  is 
rapid,  and  decomposition  soon  sets  in.  Several  army  surgeons  have 
pointed  out  that  the  atmosphere  is  greatly  contaminated  in  this  way,  and 
some  have  considered  that  affections  of  the  eyes  are  produced  by  the  am- 
moniacal  fumes.  Earthenware  or  slate  urinals  should  be  used,  with  water 
running  through  them  ;  and  if  there  are  no  drains  to  carry  off  the  urine,  a 
zinc  pipe  may  be  laid  inside  the  building,  and  open  into  a  tub  below, 
"which  should  be  emptied  daily. 

The  "War  Office  Committee  '  recommended  Mr.  Jennings  urmal,  which 
consists  of  a  basin,  valve,  and  siphon-trap,  suppHed  with  water.  It  is 
cleaned  and  filled  by  raising  the  handle.  As  already  noticed  in  the  Home 
Barracks,  the  suggestion  of  a  small  water-tap  above,  to  allow  the  means  of 
ablution,  seems  an  excellent  one. 

Sub-Section  IV. — Wooden  Huts. 

Of  late  years  the  use  of  wooden  huts,  both  in  peace  and  war,  has  greatly 
extended  in  several  of  the  Evu'opean  armies.  In  peace,  their  first  cost  is 
small,  and  they  are  very  healthy.  In  war,  they  afford  the  means  of  hous- 
ing an  army  expeditiously,  and  are  better  adapted  for  winter  quarters  than 
tents. 

The  healthiness  of  wooden  huts  doubtless  depends  on  the  free  ventila- 
tion ;  when  single-cased,  the  wind  blows  through  them  ;  and  even  when 
double-cased  there  is  generally  good  roof  and  gable  ventilation, 

Numerous  patterns  of  huts  have  been  used  in  our  own  and  other  armies, 
from  small  houses  holding  six  men  to  the  large  houses  designed  by  Mr. 
Bininel  for  Eenkioi  Hospital,  and  which  were  2.5  feet  high  in  the  centre,  12 
feet  at  the  eaves,  and  held  50  men.  In  the  Crimea  the  most  common  sizes 
were  for  12,  18,  and  24  men.  Lord  Wolseley  thinks  the  most  useful  size 
is  32  feet  long,  16  wide,  6  feet  to  eaves,  and  16  to  ridge,  to  hold  28  men  ; 
two  huts  are  put  end  to  end,  with  one  chimney  between  them.  If  jirotec- 
tion  has  to  be  obtained  against  wind,  make  a  wall  a  foot  away. 

In  arranging  lines  of  huts,  as  much  external  ventilation  and  sunlight 
must  be  secured  as  possible  for  every  hut.  According  to  circumstances, 
the  arrangements  in  lines,  or  en  echelon,  etc.,  must  be  adopted. 

In  time  of  peace  huts  are  sure  to  be  put  up  well ;  to  be  properly  tm- 
derpinned  ;  on  a  drained  site,  and  well  warmed. 

War  Huts. 

In  the  putting  up  of  huts  in  time  of  war,  when  everything  is  done  more 
roughly,  the  following  points  should  be  attended  to  : — 

Do  not  excavate  ground,  if  possible  ;  and  never  pile  earth  against  the 
sides.'' 

'  Suggestions,  p.  24. 

'  While  it  is  desirable  to  have  the  walls  as  clear  from  accumulations  outside  as  possi- 
ble, it  must  be  remembered  that  this  rule,  like  others,  has  its  exceptions.  Thus,  in  a 
very  cold  country,  like  Canada,  a  sufficient  degree  of  warmth  could  not  be  obtained  in 
a  wooden  hut  without  piling  snow  up  against  the  sides. 


CONDITIONS    OF    SEEVICE.  217 

(a)  Floor. — Whenever  practicable,  underpin  the  joists,  so  as  to  get  a 
current  of  air  under  the  floor.  Arrange  for  the  drainage  underneath,  so 
that  water  may  not  He,  but  may  be  carried  by  a  surface  drain  at  once  to  an 
outside  drain.  If  the  floor  is  entirely  of  wood,  have  it  screwed,  and  not 
nailed  down, '  so  that  the  boards  may  be  taken  up,  and  the  space  below 
cleaned.  If  the  sides  are  of  planks,  and  the  centre  of  earth,  pave  the  centre 
with  small  stones,  if  they  can  be  got,  so  that  it  may  be  swept.  If  this  can- 
not be  done,  remove  a  little  of  the  surface  earth  every  now  and  then,  and 
put  clean  sand  or  gravel  down. 

(b)  Sides. — If  the  sides  are  double,  leave  out  a  plank  at  the  bottom  of  the 
outside,  and  at  the  top  of  the  inner  lining.  If  the  sides  are  single,  make 
obhque  openings  for  ventilation  above  the  men's  heads,  with  wooden  flaps 
falling  inward,  and  capable  of  being  puUed  more  or  less  up,  and  inclosing 
the  opening.  Place  a  plank  obliquely  along  the  bottom  at  the  outside,  to 
throw  the  drip  from  the  roof  outward,  so  that  the  water  may  not  sink  under 
the  houses.     Whitewash  both  inside  and  outside  of  the  planks. 

(c)  Boof. — Arrange  for  ridge  ventilation.  If  felt  is  used,  let  the  strips 
run  along  the  sides,  and  not  over  the  ridge, 
and  beginning  at  the  bottom,  so  that  each  suc- 
cessive strip  may  imbricate  over  the  one  below 
it ;  use  no  nails,  but  place  thin  strips  of  board 
across  the  strips  from  the  ridge  downward,  to 
hold  the  felt  down.  Tarred  calico  is  as  good 
as  felt. 

Warming. — In  cold  countries,  if  stoves  are 
provided,  place  them  at  one  end,  and  let  the 
chimney  run  horizontally  along  above  the  tie- 
^^°-  ^"^'  beams,  to  the  other  end,  and  open  at  the  gable  ; 

in  this  way,  the  heat  is  economized  ;  or  put  a  casing  of  wood  round  the 
stove,  except  in  front,  and  allow  fresh  air  to  pass  between  the  stove  and 
casing.  If  -no  stoves  are  provided,  and  a  fire-place  is  made  with  stone,  it 
should  be  put  at  one  end,  and  a  wooden  trough  running  out  at  the  gable 
be  used  as  a  chimney.  If  a  good  broad  slab  of  stone  can  be  obtained  for  a 
hearthstone,  dig  a  trench  under  the  boards  and  lead  the  air  from  outside 
under  the  hearthstone,  and  provide  an  opening  at  the  other  side  of  the 
stone.     In  this  way  the  entering  air  is  warmed. 

Trenches  should  be  carried  round  huts  as  in  the  case  of  tents. 
Fig.  102  shows  a  plan  much   used  by  the  Germans  in  1870-71  for 
temporary  sheds  ;  the  crossing  of  the  rafters  permits  thorough  roof  ven- 
tilation, and  the   raising  from  the   ground  where  practicable  is  very  im- 
portant. 

Causes  of  Unhealthiness  of  Wooden  Huts. 

1.  Dampness  from  Ground,  Earth  against  Wall,  etc. — Drain  well.  Cut 
away  ground  from  outside ;  have  good  trenches  round,  with  a  good 
faU. 

2.  Substances  collecting  under  Floors. — Look  weU  to  this  as  a  common 
cause  of  unhealthiness. 

'  If  possible  the  screws  should  be  of  copper,  not  iron ;  if  of  iron,  each  screw  ought 
to  be  dipped  in  oil  before  being  put  in ;  this  greatly  increases  the  ease  with  which  they 
can  be  withdrawn,  and  also  saves  the  wood  to  some  degree. 


218 


PRACTICAL    HYGIENE. 


3.  Earth  round  Huts  saturated  with  Be/use,  Urine,  etc. — Every  now  and 
then  clear  away  the  surface  earth,  and  replace  it  with  clean  dry  earth. 

4.  Ventilation  bad  from  too  few  openings. 

5.  Cold. — Issue  extra  clothes,  if  additional  fuel  cannot  be  obtained.    See 


that  the  greatest  effect  is  obtained  from  the  fuel ;  but  do  not,  if  it  can 
possibly  be  helped,  close  the  ventilators. 


Sub-Section  V. — Tents  and  Camps. 
Tents. 

A  good  tent  should  be  Hghtj  so  that  it  may  be  easily  transported,  readily 
and  firmly  pitched,  and  easily  taken  down.  It  should  completely  protect 
from  weather,  be  well  ventilated,  and  durable. 

It  is  perfectly  easy  to  devise  a  tent  with  some  of  these  characteristics, 
but  not  to  combine  them  alL 

The  tents  used  in  our  army  are  as  follows  : — • 

Home  Service. 

The  Bell  Tent. — A  round  tent  with  sides  straight  to  1  or  2  feet  high, 
and  then  slanting  to  a  central  pole.  Diameter  of  base,  14  feet ;  height,  10 
feet ;  area  of  base,  154  square  feet  ;  cubic  space,  513  feet ;  weight,  when 
dry,^  about  65  to  70  lb.  The  canvas  of  the  new  pattern  is  made  of  cotton 
or  hnen.  The  ropes  extend  about  1^  foot  all  arormd.  It  holds  from  twelve 
to  sixteen  men  ;  and  in  war  time,  even  eighteen  have  been  in  one  tent. 
The  men  he  with  their  feet  toward  the  pole,  their  heads  to  the  canvas. 
With  eighteen  men,  the  men's  shoulders  touch.  Formerly,  tbere  was  no 
attempt  at  ventilation  ;  but  afterward  a  few  holes  were  made  in  the  canvas 
near  the  pole.  Ventilation,  however,  was  most  imperfect.^  Dr.  Fyffe 
(formerly  of  the  Army  Medical  School),  who  carefully  examined  this  point, 
found  the  holes  so  small  that  the  movement  of  air  was  almost  imperceptible. 
There  is  httle  ventilation  through  the  canvas,  and  none  at  all  when  it  is 
wet  with  dew.  The  new  circular  tent  is  somewhat  improved  as  regards 
ventilation. 


'  Complete  wetting  of  a  tent  adds  from  30  to  40  per  cent,  to  the  weight. 
^  Barrack  Improvement  Report,  p.  107. 


CONDITIONS    OF    SERVICE.  219 

The  Hospital  Marquee. — An  improved  liospital  marquee  was  issued  in 
1866.  It  is  in  principle  the  same  as  the  old  marquee,  but  with  improved 
ventilation.  This  tent  is  two-poled,  ■^ivith  double  canvas.  It  is  made  of  a 
lower,  almost  quadi-angular  part,  and  an  upper  part,  sloping  from  the  top 
of  the  straight  portion  to  the  ridge. 

A  new  pattern  measui-ed  in  1872  was  28  feet  long,  14  feet  in  width  in 
the  quadrangular  part,  5  feet  high  to  the  top  of  the  straight  part,  and  12 
feet  high  from  gi'ound  to  top  of  ridge  ;  the  ground  space  was  353. -4  feet, 
and  the  cubic  S23ace  2,766.6  feet.  This  is  rather  smaller  than  the  old  pat- 
tern. 

It  is  intended  for  sick,  and  can  accommodate  ten  men  well ;  eighteen  is 
the  regulation,  and  twenty-four  men  have  been  put  in  it ;  but  this  crowds 
it  extremely.  There  are  ventilators,  and  a  large  flap  at  the  top  can  also  be 
opened  for  ventilation,  and  the  fly  can  be  raised.  Its  weight  (including  the 
valise)  is  about  500  ib.  A  watei-proof  sheet  is  now  supphed,  to  put  on  the 
ground,  and  this  weighs  145  ib. 

It  is  a  good  tent  when  care  is  taken  with  ventilation  ;  but  there  should 
be  a  way  of  raising  one  whole  side,  so  as  to  expose  eveiy  part  of  the  tent ; 
and  if  the  height  of  the  uj)right  part  were  6  feet,  it  would  be  more  con- 
venient. 

Circular  Tent. — A  double  circular  tent,  weighing  about  100  ft,  has  been 
approved  of  for  hospital  purposes,  into  which  four  sick  or  wounded  men 
would  be  placed.     This  forms  part  of  the  new  field  equipment. 

Shelter  Tent. — There  is  no  official  shelter  tent  for  the  English  army  on 
home  service,  but  one  was  formerly  issued  for  ser\'ice  at  the  Cape.  Each 
man  carried  a  canvas  sheet,  made  up  of  a  quadrangular  (5  feet  9  inches  x 
5  feet  3  inches)  and  of  a  triangular  piece  (2  feet  8  inches  height  of  triangle 
X  5  feet  3  inches  base).  Buttons  and  button-holes  were  sewn  along  three 
sides,  and  a  stick  (4  feet  long,  and  divided  in  the  middle),  and  three  tent 
pegs  and  rope  also  were  prorided.  Two  or  four  of  these  sheets  could  be 
put  together,  the  triangles  forming  the  end  flaps.  A  very  roomy  and  com- 
fortable shelter  tent,  4  feet  in  height,  was  formed,  which  would,  with  a 
little  crowding,  accommodate  six  men,  so  that  two  sheets  could  go  on  the 
ground.  The  objection  to  this  tent  was  its  weight,  riz.,  6  ft  14  ounces 
per  man.  If  a  thinner  material  could  be  obtained,  and  if  the  size  could  be 
a  little  lessened  in  all  directions,  it  would  be  a  very  good  tent.  Dr.  Parkes 
attempted  to  arrange  a  cape  aad  waterjDroof  sheet  in  such  a  way  as  to  form 
a  tent  when  suspended  on  rifles.  ^  A  plan  for  making  a  shelter  tent  with 
blankets  is  given  in  the  "Instructions  for  Encampments,"  1877,  p.  19,  para- 
graph 14. 

Officers'  Tents. — Marquees  are  allowed,  one  for  each  field-officer  ;  each 
captain,  and  every  two  subalterns,  have  one  circular  tent.  The  officers' 
marquee  weighs  176  ft. 

On  Indian  Service. 

The  tents  for  Europeans  are  marquees,  with  two  poles  and  ridge,  double 
fly.  Length,  21  feet  ;  breadth,  15  ;  height  to  inner  fly,  10  feet  3  inches  ; 
and  outer  fly,  11  feet  9  inches.  Twenty-five  infantry  are  accommodated  with 
85  cubic  feet  per  man  ;  or  twenty  cavalry,  with  saddles,  with  100  cubic 
feet. 

The  tents  for  natives  have  a  single  fly.     Length,  22  feet ;  breadth,  12  ; 

1  Army  Med.  Depart.  Report  for  1870  ;  1872,  p.  260. 


220  PRACTICAL    HYGIENE. 

lieigLt  of  pole,   10  feet ;  to  accommodate  twenty'  cavalrj',  or  twenty-five 
infantry. 

French  Tents.— In  tlie  French  army  two  chief  kinds  of  soldiers' tents 
were  used. 

1.  The  tenie  cVabri,  or  shelter  tent  of  hempen  canvas,  which  was  in- 
tended for  three  or  foiu'  men.     This  is  now  given  up. 

2.  Tente  de  Troupe,  or  Tente  Taconnet. — This  is  a  two-poled  tent,  with  a 
connecting  ridge-pole.  It  is  19^  feet  long,  by  13  or  14  wide,  and  10  high  ; 
the  ground  area  is  213.5  squai-e  feet.  It  is  intended  for  sixteen  men. 
There  are  two  openings  in  the  centre,  which  can  be  held  out  by  poles, 
each  5  feet  in  length,  or  closed  at  pleasure.  Between  the  poles,  at  the 
height  of  6  feet,  there  is  a  perforated  wooden  plank,  on  which  articles  are 
placed,  or  from  which  they  hang.  The  total  weight  is  143.5  lb  avoir. 
This  tent  is  considered  cumbersome  and  unstable,  and  is  now  being 
abandoned. 

3.  Two  conical  tents  are  also  used,  like  the  English  bell  tent ;  one 
(tente  conique)  a  cone,  and  the  other  having  an  upright  wall  16  inches 
high,  and  then  being  conical  above  (tente  c&nique  d  muraille).  This  last 
tent  is  ventilated  at  the  top  ;  a  galvanized  iron  ring,  12  inches  in  diameter, 
receives  the  canvas,  which  is  sewed  round  it.  An  opening  is  thus  left  of 
113  square  inches,  which  can  be  closed  by  a  wooden  top  which  rests  on 
the  top  of  the  pole,  and  is  buckled  to  the  ring.  Each  tent  holds  twenty 
men.  The  tente  conique  is  the  one  now  chiefly  used.  Small  tents  called 
ientes  de  marche  are  now  issued  to  officers,  who  formerly  provided  their 
own  of  various  forms. 

Prussian  Tent. — This  is  a  conical  tent,  with  a  single  pole,  like  the  bell 
tent  of  the  English  army ;  it  is  nearly  15  feet  in  diameter,  the  pole  is  12 
feet  high  ;  it  holds  fifteen  men,  and  weighs  91  ib  avoir.  The  floor  space  is 
12  square  feet  and  the  cubic  space  70  cubic  feet  per  head. 

P7'ussian  Hospital  Tent. — The  ground-floor  of  the  tent  is  a  rectangle  62 
feet  long  and  24  broad  ;  the  tent  is  16  feet  high  ;  there  are  6  or  8  poles  ; 
the  area  is  1,488  square  feet.  It  is  divided  into  thi-ee  parts  :  a  central,  52 
feet  long  and  24  broad  (  =  1,248  square  feet),  for  the  sick,  and  two  rooms, 
each  5  feet  long  and  24  broad,  for  attendants,  utensils,  etc.  Some  of  the 
tents  are  made  with  hollow  iron  poles,  and  there  is  a  good  hood  for  ven- 
tilation. Each  tent  could  contain  20  to  22  beds,  but  only  twelve  patients 
are  placed  in  it.  It  stands  on  an  area  of  80  feet  by  40.  Smce  1862  tha 
Prussians  have  treated  many  of  the  worst  cases  under  such  tents  during 
the  summer.  The  same  practice  has  been  adopted  in  the  Austrian  army 
for  many  years. 

Itussian  Tent. — The  infantiy  tent  is  quadrangular,  14  feet  square  and  7 
feet  high  to  the  slope  ;  there  is  a  centre  pole  and  four  corner  j)oles  ;  it  is 
intended  for  fourteen  men,  but  only  twelve  are  usually  placed  in  it. 
Round  the  tent  is  a  bench  1^  foot  broad,  and  covered  with  straw  mat- 
tresses and  sheets  (in  the  summer  camps)  for  sleeping.  A  wooden  rack 
roimd  the  centre  pillar  receives  the  rifles.  The  canvas  can  be  partly  or 
entirely  lifted  up.     The  officers'  tents  have  double  canvas. ' 

Northern  American  Tents. — At  the  commencement  of  the  civil  war  the 
Sibley  tent  was  much  used.  It  is  conical,  18  feet  in  diameter,  and  13 
feet  high,  with  an  opening  for  ventilation,  and  gives  1,102  cubic  feet ;  often 
twenty  or  twenty-two  men  were  held  by  one  tent.  Bell-  and  wedge-shaped 
tents  were  also  used  ;  the  latter  was  6  feet  10  inches  long,  8  feet  4  inches 

'  From  Heyf elder's  Camp  of  Krasnoe-Selo,  18G8. 


CONDITIOlSrS    OF    SERVICE.  221 

broacl,  and  6  feet  10  inches  higli,  with  a  cubic  space  of  194  feet.  It  held 
sis  men. 

These  tents,  however,  did  not  answer  ;  the  ventilation  was  most  imper- 
fect, and  in  the  summer  of  1862  ponchos  and  shelter  tents  were  issued, 
which  in  the  army  of  the  Potomac  superseded  the  old  tents.'  The  poncho 
is  a  piece  of  oil-cloth  with  a  slit  in  the  centre,  through  which  the  head  is 
put  ;  two  ponchos  can  form  a  shelter  tent.  The  army  of  the  Potomac 
spent  the  winter  in  improvised  huts  of  logs  or  mud,  with  the  shelter  tent 
for  the  roof. 

The  larger  tents  are,  however,  still  used  for  stationary  commands,  and 
for  hospital  purposes. 

Other  Plans.  — A  -^ery  great  number  of  different  kinds  of  tents  are  em- 
ployed by  different  nations,  and  many  plans  have  been  proposed  of  late 
years.^  Of  these  Edgington's  square  military  tent,  and  Turner's  and 
Ehodes'  tents,  are  the  best.  The  first  is  a  single-poled  pj^amidal  tent, 
with  a  second  pole  to  sustain  the  entrance  flap ;  it  is  13  feet  square,  and 
will  hold  sixteen  men.  There  are  ventilating  holes  through  the  canvas  at 
the  top,  protected  by  canvas.     It  weighs  90  lb. 

Turner's  tents  are  conical  and  oblong  ;  the  pole  is  hollow  iron,  and  is 
supported  in  a  tripod,  below  which  a  stove  can  be  placed,  to  which  the 
pole  serves  as  a  chimney.  Instead  of  ropes,  galvanized  wire  and  ii-on  pegs 
are  used,  and  wire  ropes  running  from  the  pole  to  the  circumference  are 
used  to  sustain  hammocks,  and  so  raise  the  men  fi'om  the  ground.  A  tent 
for  eighteen  men  weighs  300  lb.  Turner's  hospital  tent, is  60  feet  long,  29 
wide,  and  18  high,  and  weighs  896  lb.'  A  great  advantage  of  these  and 
similar  tents  is  that  a  stove  can  be  easily  used,  and  there  is  pretty  good 
ventilation  through  the  hollow  pole.  The  raising  of  men  off  the  ground 
is  also  a  great  advantage. 

Major  Rhodes'  tent  is  a  curvilinear  octagon,  which  is  made  up  by  a 
frame  of  stout  ash  or  bamboo  ribs,  which  are  stuck  into  the  ground,  pass- 
ing through  a  double-twisted  rope  near  the  ground,  and  bent  into  the 
centre,  where  they  meet  in  a  wooden  head  fitted  with  iron  sockets,  to  re- 
ceive the  ends  of  the  ribs.  The  framework  is  not  unlike  an  open  um- 
brella. The  rope  through  which  the  ribs  pass  is  well  pegged  to  the 
ground,  and  there  are  also  outside  storm-ropes,  so  that,  both  from  the 
shape  of  the  tent  and  its  ties,  no  storm  can  blow  it  over.  There  is  a  good 
top  ventilation  through  an  opening  protected  by  a  leathern  cap,  and  the 
canvas  covering  which  contains  the  tent  (when  packed)  can  be  divided  into 
two  parts,  and  buttoned  inside  the  bottom  of  the  tent,  so  as  to  prevent  air 
from  blowing  in  under  the  canvas. 

A  smaU  tent  (guard  tent),  capable  of  holding  four  or  five  men,  is  also 
used. 

The  hospital  tent  is  made  of  two  of  these  tents  connected  by  a  por- 
tion of  tent  made  of  ribs  which  run  to  a  ridge  pole.  It  is  30  feet  long,  15 
feet  wide,  and  10  feet  high,  but  can  be  made  of  any  length.  The  field 
tent  weighs  100  lb  ;  the  hospital  tent,  395  lb.  Both  these  seem  excellent 
tents  ;  they  give  much  more  ground  area,  cubic  space,  and  standing  room, 
than  any  form  of  cone  tent,  and  are  more  convenient,  as  there  are  no  poles. 

'  Woodward,  Outlines  of  the  Chief  Camp  Diseases  of  the  United  States  Armv, 
1863,  p.  46. 

"^  A  very  good  description  will  be  found  in  Major  Rhodes'  Tent  Life  and  Encamp- 
ing, 1859. 

3  Rhodes,  p.  173. 


222  PRACTICAL    HYGIENE. 

General  Conclusions. 

The  history  of  all  wars  in  the  temperate  zone  proves  that  men  cannot 
war  without  protection  from  weather. '  Both  theory  and  experience  show 
that  the  best  aiTangement  for  a  soldier  is  that  he  should  carry  a  portion  of 
a  shelter  tent,  which  may  at  once  serve  him  for  a  cloak  on  the  march,  and 
a  cover  at  night,  if  he  is  obliged  to  lie  out  without  pitching  his  tent,  and 
which,  joined  to  two  or  three  other  similar  pieces,  may  make  a  tent  to 
hold  thi-ee  or  four.  The  French,  however,  have  abandoned  this  system, 
belie\dng  that  its  advantages  are  more  than  counterbalanced  by  the  extra 
weight  the  men  have  to  carry.  For  camps  of  position,  where  troops  are 
kept  for  months,  and  where  there  is  less  trouble  about  transport,  larger 
tents  can  be  used,  and  then  either  a  tent  like  that  of  Major  Ilhodes',  or  a 
two-  or  fovir-poled  tent  like  the  Prussian,  appears  to  be  the  best. 

The  French  system,  now  adopted  by  the  Americans,  is  in  reality  a  very 
old  one.  The  Macedonians  used  small  tents  which  held  two  men,^  and 
Rhodes  figures  a  little  shelter  tent  of  the  same  form  as  the  French,  and 
holding  apparently  five  men,  which  was  in  use  in  the  British  army  in 
1750. 

At  various  times  in  late  wars  the  English  army  have  extemporized  tents 
of  this  description,  by  susjDending  blankets  over  their  firelocks.  But  it 
would  be  much  better  to  have  a  good  shelter  tent,  which  would  make  the 
men  independent  of  their  bell  tents,  on  emergency,  and  thus  greatly  lessen 
the  baggage  of  the  army,  as  well  as  protect  the  men. 

An  army  could  then  encamp  and  house  itself  as  fast  as  it  could  take  up 
its  ground,  and  so  short  is  the  time  necessary  for  pitching  the  tent  that 
even  in  heavy  rain  the  men  would  not  get  wet.  The  men  He  much  more 
comfortably  than  in  the  bell  tent,'  and  there  is  scarcely  a  possibility  of  its 
being  blown  down. 

Camps. 

Several  regulations  have  been  issued  by  the  Quartermaster-General's 
Department, ''  and  the  "  Queen's  Regulations  "  *  contain  sevei^al  orders  which 
will  be  noticed  hereafter.  The  Barrack  Improvement  Commissioners "  also 
lay  down  certain  rules  which  must  be  attended  to. 

Encampments  are  divided  into  two  kinds — those  of  position,  which  are 
intended  to  stand  for  some  time,  and  incidental  camj)s.  The  camps  are 
ai*ranged  in  the  same  way  in  peace  and  war,  as  a  means  of  training  the 
men  ;  but,  of  course,  in  peace  the  war  arrangements  need  not  be  adhered 
to. 

In  the  "Regulations  and  Instructions"  issued  in  1877  by  the  Quarter- 
master-General's Department,  the  following  rules  are  laid  down  : — 

1.  That  the  means  of  passing  freely  through  the  camp  should  be  main- 
tained. 

'  The  Franco-German  war  of  1870-71,  does  not  negative  the  rule  that  shelter  must 
be  given  in  some  way ;  the  Germans  in  their  camps  hutted  themselves,  and  in  their 
marches  found  shelter  in  houses  in  the  greater  number  of  cases. 

'-'  Rhodes'  Tent  Life,  p.  18. 

^  In  some  of  the  last  China  expeditions  waterproof  sheets  were  issued,  of  which  the 
men  made  tents  as  well  as  cloaks.  Dr.  Parkes  was  told  by  a  private  soldier  who  carried 
one  of  these,  that  nothing  more  comfortable  was  ever  issued  to  the  men.  His  sheet  was 
the  last  thing  that  a  man  would  part  with. 

*  Regulations  and  Instructions  for  Encampments,  "  Horse  Guards,"  1877.  A  great 
deal  of  very  important  information  is  given  in  this  little  book. 

6  Pocket  edition,  Section  8.  «  Report,  18G1,  p.  168. 


CONDITIONS    OF    SERVICE.  223 

2.  That  the  tents,  bivouacs,  or  huts  should  be  'disposed  with  a  view  to 
the  greatest  amount  of  order,  cleanhness,  ventilation,  and  salubrity. 

3.  That  the  camp  be  as  compactly  arranged  as  possible,  consistently 
with  the  above  considerations. 

Troops  are  ordered  to  be  encamped  in  such  a  manner  that  they  can  be 
rapidly  formed  in  a  good  position  for  action.  This  does  not  involve  the 
necessity  of  encamping  on  the  very  position  itself.'  Although  purely 
strategical  or  tactical  considerations  are  of  the  first  importance  before  an 
enemy,  yet  sanitary  advantages  must  always  be  allowed  great  weight,  and 
will,  in  most  cases,  govern  the  choice  of  ground  if  military  reasons  permit. 
Cavalry  and  infantry  camps  are  directed  to  be  formed  with  such  intervals 
between  their  troops  or  companies  as  circumstances  may  require,  or  the 
general  commanding  may  direct.  Oj)en  column  is  usually  the  most  ex- 
tended order  used  ;  but  the  camp  may  be  so  compressed  as  to  give  only  8 
square  yards  per  head.' 

In  front  of  the  camp  is  the  battalion  parade,  the  quarter-guard  being  in 
front  of  all.  Behind  the  men's  tents  are  the  kitchens,  and  behind  these  the 
tents  of  the  officers  ;  then  come  the  wagons,  horses,  drivers,  and  batmen ; 
next  the  ashpit  and  latrines,  and  on  the  boundary  line  the  rear-guard.  In 
fixed  camps  the  latrines  and  kitchens  may  be  pitched  elsewhere,  if  found 
advisable. 

The  distances  between  different  corps  are,  as  a  rule,  to  be  30  paces. 

Cavalry  are  encamped  in  the  same  way,  in  columns  of  troops  or  squad- 
rons ;  4  feet  of  space  is  allowed  to  each  horse,  which  is  picketed. 

Artillery  encamp  with  the  guns  in  front,  the  wagons  in  two  hues  behind, 
and  the  horses  and  men  on  the  flanks,  the  men  being  outside,  the  officers' 
tents  being  in  rear.  A  battery  of  artillery,  with  192  of  all  ranks  and  154 
horses,  occupies  a  space  of  115^  yards  by  133  in  open  order,  and  85 
by  71|-  in  close  order.  Other  arrangements  are  given  in  the  "Regula- 
tions."' 

On  considering  these  arrangements,  it  is  evident  that  the  compression 
of  the  men  is  considerable.  As  in  war  it  is  not  always  easy  to  give  space, 
the  importance,  even  in  a  military  point  of  view,  of  thoroughly  ventilating 
the  tents  is  obvious. 

Compressed  Camps. — Occasionally  the  tents  have  been  placed  much 
closer  together.  It  is  to  be  presumed  that  no  military  officer  who  regards 
the  comfort  or  health  of  his  men  will  ever  do  so  without  an  imperative 
mihtary  necessity.  Yet  it  has  been  occasionally  done,  and  tents  have  been 
placed  almost  as  closely  as  they  could  be,  even  when  ground  was  available 
and  no  enemy  was  in  front.  Under  these  circumstances,  an  explanation  of 
the  reasons  for  not  crowding  the  men  together  will  undoubtedly  satisfy  the 
officer  in  command  that  he  is  sacrfficing  comfort,  convenience,  and  effi- 
ciency to  a  false  notion  of  order  and  neatness. 

In  the  Crimea,  many  officers  dug  out  the  interior  of  their  tents,  leaving 
a  small  pillar  of  earth  to  support  the  pole  ;  a  ledge  of  about  9  inches  in 
width  was  also  left  all  round  the  outside  to  serve  as  a  shelf  ;  a  great  deal  of 
comfort  and  shelter  was  thus  given  in  cold  winds,  but  it  would  be  well  to 
go  to  as  little  depth  as  possible  unless  the  soil  is  dry. 

*  Regulations  and  Instructions  for  Encampments,  p.  1,  Section  ii. 

^  Measurements  in  infantry  camps  are  usually  made  in  paces :  6  paces  =  5  yards  ; 
other  camps  are  measured  in  yards. 

^  For  numerous  plates  of  camps,  tents,  kitchens,  etc.,  the  reader  is  referred  to  the 
Instructions  and  Regulations  for  Encampments,  price  6d. ,  which  ought  to  be  in  the 
hands  of  every  officer. 


224  PRACTICAL   HYGIENE. 

Points  to  he  attended  to  in  the  Erection  and  Conservancy  of  Camps. 

Dig  a  trench  roiind  eacli  tent,  4  inches  deep,  and  the  width  of  the  spade, 
and  carry  it  into  a  good  surface  drain  running  in  front  of  the  tents,  ^vith  a 
proper  fall.  Place  the  tent  on  the  ground  and  do  not  excavate,  or  to  a 
sHght  extent  ;  in  a  camp  of  position,  the  tents  can  sometimes  be  raised  on 
a  wall  constructed  of  stones,  or  even  eailh,  if  this  can  be  plastered  over. 
"Whenever  possible,  let  the  floor  of  the  tent  be  boarded,  the  boai'ds  being 
loose,  and  able  to  be  removed.  K  there  are  materials,  make  a  framework 
elevated  a  few  inches  from  the  gi-ound  to  cany  the  boards.  If  boards  can- 
not be  obtained,  canvas  or  watei-jDroof  sheets  should  be  used  ;  whatever  is 
used,  take  care  that  nothing  collects  below,  and  move  both  boai'ds  and 
canvas  fi'equently  to  see  to  this,  and  scrape  the  earth  if  it  is  at  all  impreg- 
nated. If  straw  is  used  for  bedding,  get  the  men  to  use  it  carefully  ;  to 
place  pegs  of  wood  or  stones,  and  make  ropes  of  straw  running  from  peg 
to  peg,  so  that  each  man  may  keep  his  own  place  neat ;  or  to  make  mats  of 
straw  of  a  triangular  shape,  and  3  or  4  inches  thick.  Take  care  that  the 
straw  is  kept  diy,  and  never  allow  the  men  to  use  green  fohage  or  any 
damp  substance.  Have  the  sides  of  the  tent  thoroughly  raised  during  the 
day,  and  even  at  night,  to  leewai'd.  "WTienever  practicable  (twice  a  week  if 
it  can  be  done),  the  tents  should  be  struck,  the  boards  taken  up,  the  siu-face 
well  cleaned,  the  woi-st  part  of  the  sti'aw  removed  and  burnt. 

In  a  camp  of  position  dry  paths  should  be  constnicted  between  the 
different  roads ;  latrines  should  be  dug  in  rear  of  the  stables,  and  not 
too  near  the  kitchen,  and  en  echelon  with  the  camp  ;  for  a  standing  camp 
each  latrine  should  be  a  trench  20  to  50  feet  long,  according  to  the  size 
of  the  camp,  10  deep,  and  2  wide  at  the  top,  and  3  at  the  bottom.  The 
earth  thrown  out  should  be  arranged  on  three  sides.  It  should  be 
screened  by  branches  of  trees,  and  several  inches  of  earth  should  be 
thrown  in  every  day.'  "When  4  feet  from  the  surface,  it  should  be  filled 
in  and  another  dug,  the  earth  of  the  old  one  being  raised  like  a  mound 
to  mark  the  spot.  Close  to  it  an  urinal  should  be  constructed,  of  a  slop- 
ing channel,  paved  as  well  as  can  be,  and  leading  into  the  latrines,  or  of  a 
tub  which  can  be  emptied  into  it,  and,  as  fai'  as  possible,  men  should 
be  prevented  from  passing  urine  round  their  tents.  In  camps  for  a  few 
days  a, trench  12  paces  long,  2  feet  deep,  2  feet  wide  at  top  and  1  foot  at 
bottom,  is  sufficient. 

A  coi-ps  of  scavengers  should  be  immediately  organized  to  clean  away 
all  surface  filth,  and  to  attend  to  the  latrines  and  uiinals.  All  refuse 
must  be  completely  removed  ;  it  is  a  good  plan  to  bum  it.  Both  in  peace 
and  war,  encamping  gi-ound  should  be  often  changed,  and  an  old  camp 
should  never  be  re-occupied. 

In  addition  to  tents,  the  men  may  be  taught,  if  possible,  to  house 
themselves.  Huts  of  wattle  should  be  run  up,  or  wooden  sheds  of  some 
kind.  In  T^r,  men  soon  learn  to  house  themselves.  Luscombe  gives  the 
following  account  of  the  huts  in  the  Peninsula  : — 

"  A  cork  tree  or  evergreen  oak  with  wide-spreading  branches  was 
chosen,  a  lower  branch  was  neai'ly  cut  through,  so  as  to  allow  the  extreme 
points  to  drop  to  the  ground.  Other  branches  were  then  cut  from  ad- 
joining trees  and  fixed  in  a  circle  in  the  ground,  through  the  branch,  on 
which  their  upper  branches  rested.  Smaller  branches  were  then  inter- 
woven to  thicken  the  walls,  and  the  inside  was  lined  with  the  broom- 

'  The  Eegalations  direct  2  or  3  inctes  of  earth. 


CONDITIONS    OF   SERVICE. 


225 


plant,  which  was  thatched  in.  The  door  of  the  hut  was  put  due  east,  so 
that  the  sun  might  pass  over  it  before  it  reached  the  hoiizon." 

This  hut  was  very  cool  during  the  day,  but  i;ery  cold  at  night,  and  thus 
'"  very  prejudicial  to  health." 

Lord  Wolseley  states  that  many  English  officers  and  the  Sardinians 
generally,  in  the  Crimea,  made  comfortable  huts  in  the  following  way  : — A 
space  was  dug  out  2^  feet  deep,  and  the  size  of  the  hut ;  those  made  to 
contain  6  Sardinian  soldiers  were  14  feet  3  inches  long,  and  7  feet  1  inch 
wide  in  the  clear.  Gables  were  then  built  of  mud  or  stone,  or  made  of 
boards  or  wattle  and  daub  ;  the  gables  were  2  feet  wider  than  the  excava- 
tion, so  as  to  form  a  shelf  aU  round  ;  a  door  was  in  one  and  a  window  in 
the  other.  The  fireplace  was  made  of  brick  or  mud,  or  simply  cut  out  of 
the  face  of  the  earth  in  one  of  the  side  walls,  a  flue  being  bored  in  a  slant- 
ing directiou,  so  as  to  come  out  clear  of  the  roof,  and  being  provided  with 
a  chimney  2  feet  in  height.  The  pitch  of  the  roofs  should  be  at  an  angle 
of  45°.' 

Underground  huts  are  sometimes  used  in  camps  ;  they  are,  however, 
dangerous  ;  they  are  often  damp,  and  are  difficult  of  ventilation.  In  cold, 
dry  countries,  however,  they  are  warm,  and  the  Turks  have  constantly 
used  them  in  campaigns  in  winter  on  the  Danube.  They  have,  however, 
frequently  suifered  from  typhus.  If  used,  there  should  be  two  openings 
besides  the  chimney,  so  as  to  allow  a  current  of  air  ;  and  a  spot  should 
be  chosen  where  it  is  least  Hkely  water  will  gravitate.  But  underground 
huts  are  always  to  be  discouraged  if  any  substitutes  can  be  found.  Some- 
times the  side  of  a  hill  is  cut  into,  and  the  open  top  covered  with  boards 
and  earth.     This  is  as  bad  as  an  underground  hut. 


Hospital  Encampment  of  9  Marquees  and  14  Tents. 


1 :±-^ 


KTEW:  OFFICES,!  AND  STORES. 


ri"i"a"rT"i+!4.i 


8  I   8  I  8   I 


t 


^-1°- 


4- 


llTi  a"!4'4i"i"{'a"| 

-"OFFICERS 


!        e* 


Fig.  103. — Measurements  are  in  paces  to  centre  poles  of  marquees, 
depth,  116  paces.     Total  length  of  front,  116  paces. 


Total 


*  Drawings  of  various  kinds  of  huts  and  bivouacs  are  given  in  the  Regulations,  op. 


cit. 


Vol.  II.— 15 


226 


PRACTICAL    HYGIENE. 


Hospital  Encampment. 

When  marquees  are  available,  and  a  good  piece  of  ground  can  be  se- 
lected, the  best  plan  is  to  arrange  the  marquees  in  the  form  of  a  triangle. 
The^figure  shows  the  plan  proposed  by  the  late  Surgeon-Major  Moffitt, 
"who  paid  great  attention  to  this  point.  In  the  plan  9  marquees  are  ar- 
ranged, but  3,  5,  7,  or  a  larger  number  than  9,  may  be  equally  well  placed 
in  the  same  order.  There  is  good  exposure  to  air,  and  convenience  in  ad- 
ministration. The  Regulation  plan  '  is  rather  different,  groujDS  of  12  tents 
being  arranged  in  hues,  5,  4,  and  3,  so  as  to  alternate  in  position. 


SECTION  n. 

THE  FOOD  OF  THE  SOLDIER-ARMY  REGULATIONS. 

The  "  Ai-my  Medical  Eegulations"  place  the  food  both  of  the  healthy  and 
sick  soldier  under  the  control  of  the  medical  officer.  He  is  directed  to 
ascertain  that  the  rations  of  the  healthy  men  are  good,  and  that  the  cooking 
is  properly  performed  ;  the  amount  of  food  for  the  sick  is  exj^ressly  fixed. 
On  taking  the  field,  the  principal  medical  officer  is  ordered  to  advise  on 
the  subject  of  rations,  as  well  as  on  all  other  points  aftecting  the  health  of 
the  troops.  It  will  thus  be  seen  that  a  great  resjionsibility  has  been  thrown 
on  the  Medical  Department,  and  that  its  members  will  be  called  upon  to 
give  ojDinions  on  the  quantity  of  all  kinds  of  food  supplied  to  soldiers  ;  on 
the  composition  of  diet ;  on  the  quahty  and  adulteration  of  the  differeut 
articles  ;  and  on  their  cooking  and  preparation. 

In  the  case  of  soldiers  and  sailors,  definite  quantities  or  rations  of  food 
must  be  given.  It  is,  of  coui'se,  impossible  to  fix  a  ration  which  shall  suit 
all  persons.  Some  will  eat  more,  some  less,  but  certainly  every  scale  of 
rations  should  err  on  the  side  of  excess  rather  than  defect. 

The  following  are  the  rations  of  the  chief  European  armies : — 

English  Soldier  on  Home  Service. 
The  English  soldier  receives  from  Government  1  ft)  of  bread,  and  f  lb 
of  meat,  and  buys  additional  bread,  vegetables,  milk,  and  groceries.     The 
following  table  shows  his  usual  food  : — 


Nutritive 

Value  in  Ounces 

[avoir. 

)  and  Tenths 

of  Ounces. 

Articles. 

Quantity  taken  daily 
in  oz.  and  tenths 
of  oz. 

Water. 

Nitro- 
genous 
Sub- 

Fat. 

Carbo- 

hi'drates. 

Salts. 

Total 
Water- 
free 

stances. 

Food. 

1 

12          oz.    ) 

Meat 

(of  which  ith  V 

7.20 

1.44 

0.81 

.15 

2.40 

is  bone).        ) 

Bread 

24          oz. 

9.60 

1.92 

0.36 

11.81 

.31 

14.40 

Potatoes 

16           " 

11.84 

0.32 

0.02 

3.36 

.02 

3.72^ 

Other  Vegetables  ^. . . 

8           •' 

7.28 

0.14 

0.04 

0.46 

.06 

0.70« 

Milk 

3.25     " 

2.82 

0.13 

0.12 

0.16 

.02 

0.43 

Sugar 

1.33     " 

0.04 

1.29 

.00 

1.29 

Salt 

0.25     '« 



•    »  .   . 

.... 

.25 

0.25 

Coffee 

0.33     " 
0.16     " 

.... 

Tea 

.... 

Total  Quantity. . 

65.32    oz. 

38.78 

3.95 

1.35 

17.08 

.81 

23.19 

'  Army  Medical  Regulations,  1878,  Appendix,  p.  225. 
*  Some  indigestible  ceUulose  not  reckoned. 


2  Taken  as  cabbage. 


'COITDITIOlSrS    OF    SERVICE.  227 

Calculating  this  by  the  tables  given  at  pp.  214-215,  Yol.  I.,  it  avouIcI  give — 

Grains. 

Nitrogen  272 

Carbon  in  albuminates 837  ) 

Carbon  in  fats 454  [-  4,588 

Carbon  in  carbo-hydrates 3,297  ) 

Hydrogen  in  albuminates 51  ]  -,  -,  ^ 

Hydrogen  in  fats 65  j  ^^^ 

Sulphur  in  albuminates 32 

The  quantity  of  nitrogen  is  considerably  below  that  of  the  standard 
diet,  -while  the  amount  of  cai'bon  is  nearly  correct,  only  this  is  given  chiefly 
in  the  form  of  carbo-hydi-ates,  and  not  as  fat.  The  diet  would  be  improved 
by  the  addition  of  more  meat  or  of  cheese,  and  by  the  addition  of  butter  or 
of  oil.  So  also,  while  fi-esh  succulent  vegetables  are  sufficient,  the  use  of 
peas  and  beans,  as  in  the  French  army,  would  be  very  desii'able/ 

Using  the  table  at  p.  218,  Yol.  L,  and  taking  the  bread  -i-th  crust  and  |ths 
crumb  and  the  '•  other  vegetables '"'  as  cabbage,  the  total  energy  obtainable 
in  the  body  fi'om  the  soldier's  daily  diet  ajDpears  to  be  equal  to  hfting 
3,542  tons  one  foot.  The  amount  for  the  internal  and  external  mechanical 
work  of  the  body  being  taken  at  600  tons  lifted  a  foot,  there  remain  2,942 
tons  for  the  animal  heat  and  all  the  other  processes. 

The  accessory  foods  are  rather  deficient  in  the  soldier's  food,  and  vine- 
gar especially  should  be  used.  Robert  Jackson  veiy  justly  insisted  on  the 
importance  of  vinegar  as  a  digestive  agent  and  flavorer,  as  well,  no  doubt, 
as  an  antiscorbutic.  He  remai'ks  on  the  great  use  of  vinegar  made  by  the 
Eomans,  and  possibly  the  compai'ative  exemption  which  they  had  fi-om 
scmwy  was  due  to  this. 

The  diet  of  the  soldier  on  foreign  stations  is  stated  under  the  several 
headings  when  it  differs  materially  fi-om  that  of  home  seiwice,  and  the  al- 
terations in  the  diet  which  should  be  made  under  cux-imistances  of  great 
exertions  are  given  in  the  joroper  chap)ter. 

In  the  time  of  Edwai'd  \1.  the  English  soldier's  rations  duiing  war 
were^meat  2  flb,  bread  1  ib,  wine  1  pint  (Froude). 

No  scale  of  diet  is  laid  down  for  war,  and  probably  it  would  be  fixed  at 
the  time,  and  in  view  of  the  possible  character  of  the  campai.gn.  The  war 
Scale  should  be  veiy  hberal,  and  eveiy  ai'ticle  ought  to  be  issued  by  the 
supply  Department.  It  would  be  probably  a  good  plan  to  have  the  supply 
under  two  headings,  the  "  usual "  and  the  "  extra  "  articles,  the  latter  being 
intended  for  special  occasions,  such  as  forced  mai'ches,  rapid  movements 
far  from  the  base  of  supphes,  etc.  The  usual  ration  ought  not  to  contain 
less  than  375  to  400  grains  of  nitrogen.  The  following  is  suggested  as  a 
Hberal  and  varied  war  ration,  which  could  be  easily  suppHed  under  ordi- 
naiT  cases  : — Bread,  1^  ft  ;  fi-esh  meat  (without  bone),  1  ft  ;  peas  or  beans, 
3  ounces ;  potatoes  and  green  vegetables,  1  ft  ;  cheese,  2  ounces  ;  sugar,  2 

^  That  tlie  food  of  the  English,  soldier  is  deficient,  especially  for  the  younger  men, 
is  known  also  from  evidence.  The  late  Director-General  (Sir  James  B.  Gibson)  strong- 
ly iirged  on  the  authorities  the  desirability  of  increasing  the  ration  of  meat,  and  in  the 
report  on  the  recruiting  of  the  army  the  same  point  was  brought  forward.  Inquiries 
among  soldiers  showed  that  the  recruits  and  young  soldiers  could  eat  much  more ; 
though  the  old  soldiers,  many  of  whom  had  been  long  accustomed  to  take  spirits,  and 
who  had  injured  their  digestive  powers  by  so  doing,  took  less  food.  There  is  no  doubt 
that,  taking  the  army  through,  the  ration,  especially  of  meat,  is  not  enough.  For 
further  remarks,  see  ""The  Soldier's  Eation,"  bv  F. 'de  Chaumont,  Sanitary  Record, 
February  5,  1876. 


228  PRACTICAL    HYGIENE. 

ounces ;  salt,  ^  ouuce  ;  ■  pepi^er,  20  ounce ;  gTound  coffee,  1  ounce  ;  tea,  ^ 
ounce  ;  red  wine,  10  ounces,  or  beer,  20  ounces.  Xo  spiiit  ration  to  be 
given,  except  under  order  from  tlie  generals  of  divisions.  The  nutritive 
value  of  this  diet  is  about  380  grains  of  nitrogen  and  5,000  of  carbon.^ 

The  "  extra ''  articles  would  be  kept  in  readiness  by  the  Supply  Depart- 
ment for  occasional  issue,  \iz.,  salt  meat,  AustraUan  meat,  Chicago  meat, 
dried  meat  (such  as  Hassall's  or  M'Call's,  or  the  best  market  article  of  the 
kind),  Liebig's  extract  of  meat,  pea  and  beef  sausages,  biscuits,  flom-,  meat 
biscuits,  rice,  lime  juice,  preserved  vegetables,  brandy  or  rum,  and  vinegar. 

This  plan  sujDposes  that  the  "usual"  scale  of  diet  would  be  issued  to 
the  troops,  and  the  "  extra "  articles  under  certain  conditions,  and  under 
order  of  the  general  of  the  division. 

Bread  (which  shoidcl  be  well-baked)  should  be  issued  as  long  as  possi- 
ble ;  ^  and  if  biscuit  is  issued  for  more  than  a  week,  flour  or  rice  shovdd  be 
added  to  it,  ^Mien  salt  meat  is  issued  for  several  days  in  succession,  rine- 
gar  should  be  given  with  it.  If  no  vegetables  can  be  obtained,  lime  juice 
should  be  early  had  recoiu'se  to. 

The  usual  alcoholic  ration  of  the  ti'oops  should  be  beer  or  %vine,  instead 
of  si^irits.  As  all  the  continental  ai'mies  issue  wine  rations  in  war,  there 
can  be  no  difficulty  on  the  score  of  transjiort ;  and  even  "with  beer,  though 
twice  as  bulky  as  -uine,  it  is  beheved  that  it  could  be  in  most  cases  sujDpHed. 

But  the  issue  of  red  wine  instead  of  sjDii-its  is  strongly  ui'ged. 

For  rapid  expeditions,  when  transport  has  to  be  reduced  to  the  mini- 
mum, the  use  of  concentrated  and  cooked  foods  is  all-important.  The 
men  can  carry  enough  for  seven  or  eight  days,  and  ai'e  then  independent 
of  all  base  of  supply. 

Pea  and  flour  sausages,  meat  biscuits,  and  dried  meat,  are  the  best  to 
use  ;  and  the  issue  of  cheese  and  bacon  fat,  if  it  can  be  obtained  with  these, 
gives  a  diet  which  is  fairly  nutritious  and  not  disagreeable.  The  follow- 
ing would  be  the  weight  of  food  which  would  last  a  man  for  a  week,  and 
render  him  independent  of  the  Commissariat  during  that  time  : — Biscuit, 
2  ft) ;  pea  or  floui'  meat  sausage,  4  lb  ;  diied  meat,  2  ft) ;  sugar,  f  ft)  ; 
tea,  ^  ft) ;  cheese,  1  fti  ; — total,  10  ft).  That  is  to  say,  a  weight  of  10  ib, 
which  would  be  lessening  day  by  day,  would,  if  properly  used  by  the  men, 
carry  them  through  a  week's  labor,  and  although,  of  course,  a  meagre  diet, 
would  yet  enable  them  to  do  their  work. 

The  extract  of  meat,  as  an  extra  ration,  is  intended  for  another  purjDOse, 
It  has  a  great  restorative  power,  and  should  be  kept  for  special  cases,  such 
as  the  following  : — 

1,  It  is  expected  the  anny,  after  a  rajDid  march,  will  meet  the  enemy, 

'  It  may  be  suggested  that  chloride  and  phosphate  of  potassium,  and  perhaps  a  little 
citrate  of  iron,  might  be  added  to  the  common  salt. 

^  For  further  remarks  see  "  Military  Hygiene,"  a  lecture  by  F.  de  Chaumont,  Jour- 
nal of  the  United  Service  Institution,  1870. 

^  Steam  baking  ovens  have  been  used  in  the  Autumn  Manoeuvres,  and  have  been 
found  very  good.  Field  ovens  were  also  built  by  iron  hoops  fixed  in  the  ground.  Lord 
Wolseley  gives  the  following  plan : — Take  a  barrel  (with  iron  hoops,  if  possible),  knock 
out  the  head,  lay  it  on  its  side,  after  scraping  a  bed  for  it ;  cover  it  with  a  coating  of  6 
or  8  inches  of  thick  mud,  except  at  the  open  end ;  pile  up  sand  or  earth  to  a  thickness 
of  6  inches  over  the  mud ;  arrange  a  flue  at  the  end  distant  from  the  open  part,  through 
the  mud  and  earth,  of  3  inches  diameter,  to  increase  the  draught  wheu  the  fire  is  burn- 
ing. Form  an  even  surface  of  well-kneaded  mud  at  the  bottom  of  the  barrel ;  light  a 
fire  in  the  barrel,  and  keep  it  alight  until  all  the  wood  is  burnt ;  there  will  then  be 
a  good  oven  of  clay,  supported  by  the  iron  hoops.  When  heated  for  baking,  the  mouth 
is  closed  with  boards,  or  a  piece  of  iron  or  tin.  These  ovens  were  used  in  the  Red 
River  Expedition,  and  answered  admirably. 


CONDITIONS    OF    SERVICE.  229 

and  that  there  will  be  no  time  for  preparing  food.  A  small  quantity  of 
Liebig's  extract,  merely  mixed  with  3  or  4  ounces  of  red  wine,  will  restore 
strength  in  a  wonderful  way ;  no  cooking  is  required,  and  ten  minutes' 
time  will  supply  a  whole  regiment, 

2.  The  force  meets  heavy  weather,  and  every  man  is  drenched.  The 
issue  of  Liebig's  extract,  made  into  hot  soup,  and  with  wine  added,  will 
have  a  very  gi'eat  effect  in  preventing  bad  consequences. 

3.  A  forced  march  has  to  be  made  in  a  very  short  time,  and  no  fires 
can  be  lighted  for  cooking.  Liebig's  extract  in  small  tins  should  be  dis- 
tributed to  the  men,  who  should  spread  it  on  their  biscuits. 

4.  After  action  it  is  invaluable  for  wounded  men,  and  can  be  carried 
about  the  field  and  given  to  the  men  who  cannot  be  brought  into  the 
hospital. 

It  would  be  convenient  to  have  the  extract  carried  in  cases  holding 
small  quantities,  so  that  one  pot  may  be  issued  to  ten  or  twenty  men. 

The  strength  and  use  will  requii-e  to  be  explained. 

In  war  the  supply  of  food  is  often  difiicult,  but  as  an  army  "fights  on 
its  belly,"  the  importance  of  food  at  critical  movements  cannot  be  over- 
rated. The  uncertainty  of  the  time  of  supply,  and  the  difficulty  of  cook- 
ing, often  cause  the  men  to  be  v\n.thout  food  for  so  many  hours  as  to 
exhaust  them  greatly  ;  and  some  actions  have  been  lost,  others  have  re- 
mained without  good  result,  from  this  cause.  This  can  only  be  avoided 
by  regimental  transport  of  condensed  and  ready-cooked  food,  which  may 
be  used  on  such  emergencies,  and  given  in  addition  to  the  usual  rations 
issued  by  the  Supply  Departments.  The  colonel  of  a  regiment  would 
then  always  be  sure  that  he  had  the  means  of  keeping  up  the  strength 
and  vigor  of  his  men.  The  Germans  are  now  trying  a  plan  of  cooking, 
which  is  intended  to  obviate  one  difficulty  on  the  march. '  A  Viennese 
engineer  (Herr  Beuerle)  has  altered  Papin's  digester  in  such  a  way  as  to 
make  it  a  convenient  cooking  utensil,  and  it  is  now  in  use  in  the  Austrian 
ambulances.  It  is  a  doubly  conic  iron  pot  covered  with  a  lid,  and  capable 
of  standing  the  pressiu-e  of  five  atmospheres  ;  the  lid  is  fastened  by  screws, 
and  a  layer  of  felt  or  india-rubber  is  between  it  and  the  rim  of  the  pot,  so 
as  to  exclude  air  ;  in  the  hd  is  a  ventilating  opening,  weighted  to  2.5  lb 
(Austrian  =  3.1*  ft)  English),  so  that  it  opens  when  the  pressure  exceeds 
one  atmosphere.  The  meat,  salt,  vegetables,  etc.,  are  put  into  this  digester, 
and  it  is  filled  up  with  water  tiU  about  3  fingers'  breadth  from  the  top. 
The  amount  of  water  is  1  pint  (English)  to  1  Bb  of  meat  (English).  This 
makes  so  strong  a  soup  that  it  has  to  be  diluted.  The  pot  with  the  lid 
screwed  down  is  put  on  the  fire  (three  iron  supports  from  which  the  pot 
hangs,  like  a  gipsy's  kettle,  are  provided  for  the  field),  and  as  soon  as 
steam  is  developed,  which  is  known  by  opening  the  ventilator  a  httle,  the 
fire  is  moderated.  In  an  hour  and  a  half  the  soup  is  ready.  Pots  to  cook 
from  eight  to  twenty-five  rations  are  made,  and  special  arrangements  are 
made  for  cooking  potatoes,  etc.  The  plan  is,  in  fact,  in  principle  similar 
to  Warren's  compressed  steam  boilers,  now  used  in  the  army,  but  is  simpler. 

One  advantage  in  active  service  of  this  plan  is,  that  if  the  troops  are 
surprised,  and  have  to  move  off  their  ground  before  the  soup  is  ready,  the 
pot  is  simply  thrown  into  the  wagon,  and  at  the  end  of  the  march  the  soup 
is  usually  found  to  be  ready. '^ 

'  Der  Beuerle'sclie DampfkocMopf ,  Deutsclie  Militairarztliclie  Zeitsch.,  1872,  heft  v., 
p.  215. 

-'  In  the  Crimea,  Soyer  introduced  various  portable  cooking  stoves,  but  probably  the 
compressed  steam  cooking  will  supersede  all  others.     Soyer  also  gave  several  receipts 


230 


PRACTICAL    HYGIENE. 


Rations  of  the  French  Soldier.' 


In  Time  of  Peace. 

Under  the  Regulations  of  1873,  the  Government  furnishes  the  meat  for 
the  soldiers'  rations  at  about  35  per  cent,  under  market  price.  This  has 
proved  a  great  advantage  for  the  soldier.  The  State  also  furnishes  bread 
\pain  de  maintien)  and  fuel ;  the  v^^hite  bread  (^jam  de  aoupe),  as  well  as 
other  articles,  are  bought  from  the  funds  of  the  ordinaire,  or  common  fund 
of  the  company,  battery,  or  squadron.  To  this  the  soldier  i^ays  43  cen- 
times a  day,  out  of  48  that  he  receives,  except  in  Paris,  when  his  contri- 
bution is  61,  out  of  a  total  of  58.  The  remaining  5  or  7  centimes  he  re- 
ceives in  cash. 

Infantry  of  the  Line.  ^ 

Grammes.  Ounces  avoir. 

Munition  bread 750  26.4 

White  bread  for  soup 250  8.8 

Meat  {uncooked) 300  "  10.6 

Vegetables  (green) 100  3.5 

(dried).... 30  1.1 

Salt 15  0.5 

^^PP^^ 2  I  =^31  grains. 

Total 1,447  51.00 

If  biscuit  is  issued,  550  grammes  (or  19.4  ounces)  are  given  in  place  of 
bread.  If  salt  beef  is  used,  250  grammes  (8.8  ounces)  are  issued,  or  200 
(7  oz. )  of  salt  pork.  Haricot  beans  form  the  chief  part  of  the  dried  vege- 
tables. 

Analyzed  by  the  table  for  calculating  diets,  and  deducting  20  per  cent, 
from  the  meat  for  bone,  the  water-free  food  of  the  French  infantry  soldier 
is,  in  ounces  and  tenths — 


Water. 

Albumi- 
nates. 

Fats. 

Carbo- 
hydrates. 

Salts. 

Water- 
free 
Food. 

Meat 

6.30 

14.15 
3.19 
0.16 

1.26 

2.82 
0.01 
0.24 

0.70 
0.53 

0^62 

17.25 
0.21 
0.58 

0.13 
0.45 
0.02 
0.02 
0.50 

2.09 

Bread 

21.05 

Vegetables  (taken  as  cabbage) 

0.24 

Vegetables  dried  (as  peas)     

0  86 

Salt    

0.50 

Total 

23.80 

4.33 

1.25 

18.04 

1.12 

24.74 

In  Algiers  the  ration  of  bread  is  also  750  grammes,  or  26.5  ounces,  and 
8.8  ounces  for  soup,  or  biscuit  643  grammes.     The  meat  is  the  same  ;  60 

for  field  cooking,  which  were  found  to  be  very  useful.  A  number  of  these  receipts 
were  printed  in  1872  at  the  Royal  Artillery  Institution  at  Woolwich,  In  case  of  a  war, 
it  would  be  useful  to  print  some  receipts  of  the  same  kind,  adapted  to  the  particular 
sort  of  cooking-stove  then  in  use. 

'  Code  des  Officiers  de  Sante,  par  Didiot,  1862,  pp.  481  et  seq.  Alterations  have  been 
made  in  the  scale  of  diet  since  1874;  the  new  scale  is  given  in  the  text. 

■■*  As  given  by  Morache,  Trait  ■  d'Hygiene  Militaire,  1874. 

^  240  without  bone  =  8.4  ounces. 


CONDITIONS    OF    SEEVICE. 


231 


grammes  of  rice  and  15  of  salt  are  issued,  and  on  the  march,  sugar,  coffee, 
and  ^  litre  of  wine. 

In  Time  of  War  {Morache). 


Total. 

Water. 

Albumi- 
nates. 

Fats. 

Carbo- 
hydrates. 

Salts. 

Water- 
free 
Pood. 

Meat  (without  bone) 

8.40 
35.30 
(26.50) 
2.12 
0.50 
0.70 
0.60 

6.3 
14.1 

1.26 

2.82 

o'.so 

0.70 
0.53 

17.25 
1.50 
6.70 

0.13 
0.45 

6.05 
0.50 

2.09 

Bread 

21.05 

Or  Biscuit 

Dried  Vegetables 

2.05 

Salt 

0.50 

Sugar 

Coffee 

Total 

45.82 

20.4 

4.58 

1.23 

18.75 

1.13 

25.69 

The  sugar  and  coffee  are  sometimes  replaced  by  25  centilitres  (9  ounces) 
of  wine,  or  6^  centilitres  (2.2  ounces)  of  brandy. 


Geeman  Soldiee.' 

The  soldier  receives  his  pay  every  ten  days,  i.e.,  three  times  a  month  ; 
it  amounts  to  three  thalers  (or  9  shillings  EngHsh)  per  month,  ^  or  3  silber- 
groschen  (=  3i  pence  nearly)  a  day.  Out  of  this  he  has  to  defray  the 
cost  of  a  warm  dinner  (menage)  at  the  rate  of  1^  silbergroschen  (  —  1^ 
penny) ;  and  he  also  receives  a  mess  contribution,  varying  according  to  the 
market  prices  of  food.' 

The  rations  in  time  of  peace  are  divided  into  the  smaller  and  the 
larger  victualling  rations.^ 

Larger  Ration  for  Marches,  etc., 

as  supplied  from  the 
Military  Stores,  in  ounces  avoir. 

26.50 
8.82 
4.22 
5.28 
10.60 
70.5 
0.87 
0.468 


Bread 

Smaller  Ration, 
in  evinces  avoir. 

26.50 

Meat  (raw)  . 
Rice 

6.00 
3.20 

Or  unhusked  Barley  (Groats) 

Or  Peas  or  Beans 

Or  Potatoes' 

4.21 

8.22 
53.08 

Salt 

0.87 

Coffee 

0.468 

'  From  information  furnisbed  by  Dr.  Rotb,  of  the  Prussian  Army  (now  Surgeon- 
General,  Saxon  Army). 

'^  Lance-corporals  and  privates  which  have  engaged  themselves  to  serve  a  longer 
term  of  years  receive  additional  pay  —  1  thaler  (3  shillings)  per  month. 

^  In  the  new  currency  —  1  thaler  —  3  marks  ;  1  mark  =  100  pfennings  ;  1  silber- 
groschen =  10  pfennings. 

^  The  Prussian  weights  are  now  assimilated  to  the  French  ;  the  Prussian  pound  is 
=  i  kilogramme  or  500  grammes;  the  loth  =  16.66  grammes  or  .5870  oz.  avoir. 

^  25  per  cent,  is  lost  in  boiling  and  peeling ;  besides  smaller  potatoes  than  the  Eng. 
lish  kind  are  served  out,  occasioning  still  more  waste. 


232 


PRACTICAL    HYGIENE. 


These   would   furnish   in   their  best   form  about   the   following  (oz. 
avoir.) : — 


Kind  of  Ration. 

Albumi- 
nates. 

Fat. 

Carbo- 
hydrates. 

Salts. 

Total 
Water- 
free. 

Smaller  Ration  .... 
Larger  Ration 

4.8 
5.7 

1.1 
1.4 

17.4 

18.6 

1.5 
1.6 

24.8 
27.3 

Troops,  when  travelling  on  railway  or  on  steamers,  receive  an  additional 
pay  of  24  silbergroschen  (=3  pence)  per  man  for  refreshments.  Should 
the  travelling  last  longer  than  16  hours,  the  additional  pay  is  doubled. 

In  Time  of  War. — The  supply  of  rations  for  the  Germans  during  the 
Franco-Gei-man  war  was  thus  conducted  : — 

1.  During  the  marches  in  Germany  the  men  were  billeted,  and  money 
was  paid  for  their  food. 

2.  Supplies  were  di-awn  from  the  magazines. 

3.  Sui:)plies  were  obtained  by  requisition  when  the  troops  entered 
France.  This  last  plan  was  a  bad  one,  as  was  especially  shown  in  the 
march  to  Sedan,  where  the  Germans  passed  over  a  country  previously 
nearly  exhausted  by  the  French.  The  principal  defect  was  the  great  un- 
certainty and  irregularity  of  the  sujoplies  ;  some  corps  received  too  much, 
others  too  little,  and  the  hospitals  especially,  which  had  not  men  to  send 
out  to  get  supplies,  were  particularly  badly  off.  The  quahty  of  the  food 
was  also  often  bad  ;  so  that,  as  far  as  the  health  of  the  troops  is  concerned, 
the  system  of  supplies  by  requisition  should  be  as  little  used  as  possible. 
It  must  be  noted,  however,  here,  that  the  Germans  did  not  pay  ready 
money,  which  might,  perhaps,  have  attracted  better  supplies  than  the 
system  of  wi'itten  vouchers.  The  magazine  supplies  were  excellent,  but 
occasionally  failed  in  certain  articles,  as  fresh  meat,  as  a  substitute  for 
which  the  celebrated  pea-sausage  was  issued.  But  it  was  found  that  if 
the  pea-sausage  was  used  too  exclusively,  the  men  disliked  it.  In  fact, 
one  of  the  greatest  difficulties  was  the  too  great  iiniformity  of  the  food. 
To  do  away  with  this,  bacon,  preserved  and  smoked  meats,  peas,  and  white 
beans,  and  potatoes,  when  possible,  were  issued  as  a  change  of  diet.  In- 
dependent of  these  extra  issues,  the  daily  German  ration  was  as  foUows, 
in  EngHsh  weights  : — 

Bread 26|-  ounces,  or  biscuit,  17     ounces. 

One    i  Fresh  or  salt  meat 13  " 

of      <  Salted  beef  or  mutton 9     ounces,  or 

these    ( Bacon 5f 

Rice 4.4 

One    i  Barley  or  groats 4.4 

of      •<  Peas  or  beans 8.8 

these   (  Flour 8.8 

Potatoes 3.3  ft 

Salt 0.7  ounce. 

Coffee 0.7  ounce  of  unroasted,  or 

1  ounce  of  roasted. 

The  want  of  knowledge  of  cooking  was  very  great,  and  also  the  addition 
of  articles  to  give  flavor,  as  vinegar  and  spices,  would  have  been  much 


CONDITION'S    OP    SEEVICE. 


233 


piized.     Eoth  strongly  recommends  the  establishment  of  a  school  for  cook- 
ing, like  that  at  Aldershot. 

The  bread,  ovdng  to  the  long  time  it  was  on  transport,  was  sometimes 
moxddy. 

AUSTEIA>J    SoLDIEPu" 

In  Time  of  Peace,  receives — bread,  31  oz.  avoir.  ;  meat  (without  bone), 
Q.&  ;  suet,  0.6;  flour  (or  vegetables  in  heui,  2.5;  salt,  0.6.  To  this  are 
added  a  httle  garhc,  onions,  and  vinegar.     These  give  about — 


Albumi- 
nates. 

Fat. 

Carbo- 
hydrates. 

Salts. 

VTater-free 
Food. 

In  time  of  peace 

In  time  of  vrar "  (mean) .... 

3.7 
4.5 

1.6 
3.2 

17.0 

22.8 

1.0 
1.0 

23.3 
31.5 

The  amount  of  the  peace  ration  is  much  the  same  as  our  own  ;  there  is 
too  great  a  preponderance  of  bread,  and  there  is  too  great  sameness.  The 
fat  is  in  too  small  a  quantity  ;  the  nitrogenous  substances  are  too  small. 

In  Time  of  War. — It  is  difficult  to  calculate  the  daily  ration,  as  there  is 
a  weekly  issue  of  many  substances  ;  the  above  figui'es  are  a  mean  taken 
from  those  cited  by  Meinert.  On  four  days,  fresh  pork  is  issued  ;  the  total 
amount  being  26  oz.,  or  6-i-  oz.  daily.  On  one  day,  6  oz.  of  salt  jDork ;  on 
one  day,  6  oz.  of  beef  ;  and  on  one  day,  6  oz.  of  smoked  bacon  ;  altogether 
in  the  week,  44  oz.  of  meat  ai-e  issued ;  and  in  addition,  1  oz.  of  butter 
or  fat. 

There  are  also  issued  per  week  : — 24^  oz.  of  biscuit,  147  oz.  of  flour  for 
bread,  29^-  oz.  of  flour  for  cooking,  54-  oz.  of  pickled  cabbage  (soui'  kraut), 
9  oz.  of  potatoes,  5^  oz.  of  peas,  and  5  oz.  of  barley. 

Wine,  brandy,  and  beer  are  also  given. 

KUSSIAN    SOLDIEE.^ 

There  are  196  meat  days  and  169  fast  days  in  the  year.  On  the  meat 
days  meat  is  given  -wdih.  schtschi  (cabbage  soup)  and  buckwheat  gTuel ;  on 
the  fad  days  the  meat  is  replaced  by  peas  and  (occasionally)  fish.  42  oz. 
avoir,  of  rye  bread  ai'e  issued  daily.  This  is  large,  but  it  is  probably  watery. 
Meinert  *  calculates  the  nutrition  value  as  follows,  oz.  avoir.  : — 


Albnminates. 

Fat.                     Carbo-hydrates. 

Salts. 

Water-free  Food. 

5.8 

1.0 

25.0 

2.5 

34.3 

On  the  march,  If  ft)  of  biscuit  (244-  Enghsh  oz.)  instead  of  bread. 
Brandy  only  on  rare  occasions,  calculated  at  135  fluid  ounces  per  year  (in 
5  oz.  rations). 

'  Kraus,  quoted  by  Rotli. 

^  Meinert,  Annee  mid  Volks-Ernaliniug,  Berlin,  1880. 

^  For  details  of  tMs  diet,  see  Dr.  Oscar  Hevfelder's  The  Russian  Camp  at  Krasnoe 
Selo,  German  edition,  1868,  or  former  editions  of  the  present  work,  or  Roth,  and  Lex, 
op.  cit.  ■*  Op.  cit. 


234 


PRACTICAL    HYGIENE. 


Sepoy  Diet. — Dr.  Goodwin  has  calculated  the  diet  of  a  Hindu,  such  as 
a  Sepoy  servant,  to  consist  of  4.387  oz.  of  albuminates;  1.278  oz.  of  fat; 
18.584  oz.  of  cai'bo-hydrates  ;  and  .64  oz.  of  salts — total  water-free  food, 
25.113  oz.  It  is  thus  a  really  better  diet  than  that  of  the  Eui'opean  soldier. 
The  principal  ai'ticles  were  24  oz.  of  attar  (ground  wheat),  4  oz.  of  dhoLl 
(pea),  and  1  oz.  of  ghee  (butter).  In  other  cases  rice  is  more  or  less  sub- 
stituted for  wheat.  The  Hindu  diet  consists  of  wheat,  or  of  some  of  the 
millets  (cholum,  ragee,  cumboo — see  Millets),  rice,  leguminosse  {Cajanus 
indicus),  with  green  vegetables,  oil,  and  spices.  If  any  kind  of  diet  of  this 
soi-t  has  to  be  calculated,  it  can  be  readily  done  by  means  of  the  analysis 
of  the  usual  foods  previously  given.  For  examjDle,  a  Hindu  prisoner  at 
labor  in  Bengal  receives,  under  Dr.  Mouat's  dietaiy/  the  following  diet 
during  his  working  days : — 


Total 
oz. 

Water, 
oz. 

Album, 
oz. 

Fat. 
oz. 

starches, 
oz. 

Salt, 
oz. 

Water- 
free 
Food. 

Rice 

DhoU  (a  pea,  Cajanus  indtrus). . . 
Vegetables  (reckoned  as  cabbage). . 
Oil 

20 
4.25 
6.0 
0.33 
0.33 
0.33 

2 

0.6 

5.3 

1 

0.9 
0.1 

0.16 
0.08 
0.03 
0.33 

16.64 
2.75 
0.34 

0.10 
0.12 
0.04 

0.33 

17.9 
3.3 
0.5 
0.3 

Salt 

0.3 

Spices 

Total 

31.24 

7.9 

2.0 

0.60 

19.83 

0.59 

22  4 

In  some  Bengal  prisons,  2  ounces  of  fish  or  flesh  appear  to  be  also 
given. 

In  the  Looshai  expedition  the  Sepoys  received — rice,  1  ft  ;  flour,  1  ft  ; 
ghee,  2  oz.  ;  salt,  1.5  oz."  The  nutritive  vahie,  if  the  ghee  is  calculated  as 
butter,  is  178  gi-ains  of  nitrogen  and  6,080  of  carbon,  Avhich,  though  deficient 
in  nitrogen,  would  appear  to  be  a  good  diet  in  respect  of  carbon.  Probably 
some  peas  were  added. 

SECTION  m. 


THE  CLOTHING  OF  THE  SOLDIER. 

The  structure  and  examination  of  fabrics  have  been  ah'eady  given. 

Regulations. — No  specific  instinictions  ai-e  laid  down  in  the  "Medical 
Regulations  "  respecting  clothing,  but  the  spii-it  of  the  general  sanitary-  iniles 
necessarily  includes  this  subject  also.  "When  an  ai-my  takes  the  field,  the 
Du'ector-General  is  dii-ected  to  issue  a  code  for  the  giiidance  of  medical 
officers,  in  which  clothing  is  specially  mentioned  ;  and  the  sanitaiy  officer 
with  the  force  is  ordered  to  give  advice  in  wTiting  to  the  commander  of  the 
forces,  on  the  subject  of  clothing  among  other  things. 

'  See  Mouat's  elaborate  report  On  the  Diet  of  Bengal  Prisoners,  Government  Return, 
1860,  p.  49.  Tbe  cliittack  is  reckoned  as  the  bazaar  chittack,  viz.,  =  .1283  Iti,  or  about 
2  ounces  avoir.  Some  useful  information  on  prison  and  coolie  diets  will  be  found  in  a 
memorandum  prepared  by  Surg. -Major  I.  B.  Lyon,  F.C.S.,  Chemical  Examiner  to  the 
Government  at  Bombay,  May,  1877. 

*  Indian  Med.  Gazette,  March  1,  1872. 


COTSTDITIONS    OF   SERVICE.  235 

Formerly  a  certain  sum,  intended  to  pay  for  the  clothing  of  the  men, 
was  allotted  by  Government  to  the  colonels  of  regiments.  This  was  a  relic 
of  the  old  system  by  which  regiments  were  raised,  viz.,  by  permitting  cer- 
tain persons  to  enhst  men,  and  assigning  to  them  a  sum  of  money  for  all 
expenses.  The  colonel  employed  a  contractor  to  find  the  clothes,  and  re- 
ceived from  him  the  surplus  of  the  money  after  all  paym'ents  had  been 
made.  A  discretionary  power  rested  with  the  service  officers  of  the  regi- 
ment, who  could  reject  improper  and  insufficient  clothing,  and  thus  the  in- 
terests of  the  soldier  were  in  part  protected. '  The  system  was  evidently 
radically  bad  in  principle,  and  since  the  Crimean  war,  the  Government  has 
gradually  taken  this  department  into  its  own  hands,  and  a  large  establish- 
ment has  been  formed  at  Pimlico,  where  the  clothing  for  the  army  is  now 
prepared.  This  system  has  worked  extremely  well ;  the  materials  have  been 
both  better  and  cheaj)er,  and  important  improvements  have  been  and  are 
still  being  introduced  into  the  make  of  the  garments,  which  cannot  fail  to 
increase  the  comfort  and  efficiency  of  the  soldier. 

At  the  Pimhco  depot  the  gTeatest  care  is  taken  to  test  all  the  materials 
and  the  making  up  of  the  articles  ;  the  viewers  are  skilled  persons,  who  are 
beheved  to  be  in  no  way  under  the  influence  of  contractors. 

In  Januarj^,  1865,  a  warrant  was  issued  containing  the  regulations  for  the 
clothing  of  the  army,  and  several  other  warrants  and  circulars  have  since 
been  promulgated.  They  are  now  consolidated  in  the  "  Regulations  for 
the  Supply  of  Clothing  and  Necessaries  to  the  Regular  Forces,"  1881  (vol. 
ii.,  "  Revised  Army  Regulations  "). 

When  a  soldier  enters  the  army  he  is  suppHed  with  his  kit ;  some  arti- 
cles are  subsequently  supphed  by  Government,  others  he  makes  good  him- 
self. In  the  infantry  of  the  line  a  careful  soldier  can  keep  his  kit  in  good 
order  at  a  cost  of  about  £1  per  annum.  The  following  are  the  articles  of 
the  kit  suppUed  to  the  infantry  recruit : — 


Clothing. 

2  Frocks. 

2  Pairs  ankleboots  (one  each  half 

2  Pairs  of  trousers. 

year). 

1  Forage  ca 

p  and 

badge. 

Necessaries. 

2  Flannel  shirts.' 

1  Sponge,  pipeclay. 

3  Pairs  socks  (worsted). 

1  Razor  and  case. 

1  Pair  braces. 

1  Hold-aU. 

1  Pair  mitts. 

1  Tin  of  blacking. 

1  Hair  comb. 

1  Blacking  brush. 

1  Knife  (table). 

1  Brass  brush. 

1  Fork. 

1  Cloth  brush. 

1  Spoon. 

1  PoHshing  brush. 

1  Mess  tin  and  cover. 

1  Shaving  brush. 

2  Towels. 

1  Button  brass. 

1  Piece  of  soap. 

1  Kit  bag. 

'  But  this  safeguard  was  not  sufficient.  Officers  are  not  judges  of  excellence  of  cloth  ; 
for  this  it  requires  special  training.  As  Eobert  Jackson  said  sixty  years  ago  :  "  Soldiers' 
clothing  is  inspected  and  approved  by  less  competent  judges  than  those  who  purchase 
for  themselves." 

^  By  a  Circular,  November,  1865,  flannel  shirts  only  are  ordered  to  be  supplied  to 
the  recruit. 


236 


PRACTICAL    HYGIENE. 


The  kit  is  divided '  into  the  svirplus  and  the  service  kit.  The  former, 
consisting  of  1  frock,  1  pair  of  socks,  1  shirt,  1  towel,  2  brushes,  and 
such  articles  for  the  hold-all  as  are  not  wanted,  is  carried  for  the  men.  The 
service  kit  is  supposed  to  be  can*ied  by  the  man,  either  on  his  person  or  in 
his  knapsack. 

Certain  articles  are  also  issued  fi-ee  of  expense  at  stated  inteis-als.  For 
the  particulars  of  these  reference  must  be  made  to  the  "  Regulations,"  1881, 
•where  they  are  stated  in  detail.  The  following  are  the  ax'ticles  issued  to 
the  line  infantry  soldier  at  home  :—r- 

One  helmet  and  bag Quadrennially. 

One  tunic Biennially. 

One  frock Annually. 

One  pair  tweed  trousers Annually. 

One  pair  tweed  trousers Biennially. 

Two  pairs  of  boots,  one  on  1st  April  and  one  on  )   .  ,, 

1st  October j  ^^^^^^^^y- 

One  forage  cap Annually. 

One  silk  sash  for  sergeants Biennially. 

One  worsted  sash  for  sergeants Biennially. 

One  great-coat Everj'  five  years. 

In  India  and  the  West  Indies,  and  other  Tropical  Stations,  light  clothing 
of  different  kinds  is  used — diill  trousers  and  caHco  jackets,  or  in  India 
complete  suits  of  the  khakee,  a  native  gray  or  dust-colored  cloth,  or  tunica 
of  red  serge,  and  very  light  cloth.  The  khakee  is  said  not  to  wash  well, 
and  white  drill  is  superseding  it.  The  English  dress  is  worn  on  certain 
occasions,  or  in  certain  stations.  Formerly  the  home  equipment  was  worn 
even  in  the  south  of  India  ;  but  now  the  dress  is  much  better  arranged, 
and  also  differences  of  costume  for  different  places  and  different  times  of 
the  year  are  being  introduced. 

During  Campaigns  extra  clothing  is  issued  according  to  circumstances. 
In  the  Crimea  the  extra  clothing  was  as  follows  for  each  man  : — 


2  Jersey  frocks. 

2  Woollen  drawers. 

2  Pairs  woollen  socks. 

2  Fail's  woollen  mitts. 


1  Cholera  belt. 
1  Fur  cap. 
1  Tweed  luied  coat. 
1  Comforter. 


To  each  regiment  also  a  number  of  sheepskin  coats  was  allowed  for 
sentries. 

The  "  Regulations  "  of  1881  order  the  following  articles  of  clothing  to 
be  issued  to  each  man  proceeding  on  active  service  in  cold,  temperate,  or 
hot  climates  : — - 


1.  In  Cold  Climates. 


Sheepskin  coats  (for  100  men) . . 
Fui*  caps                    (per  man) . . 
Woollen  comforters,       " 
Jerseys,  blue                   " 
Boots,  knee,  brown  leather,  pair 
Stockings,  woollen,  pau's 


8  !  Drawers,  flannel  (per  man)  pairs . .  2 

1  Cholera  belts,  flannel,  pairs 2 

1  IVIittens,   hned   with  lambskin  or 

1  ftu",  pair 1 

1  Pilot  coat,  each  mounted  man ....  1 
2 


Queen's  Regulations,  1881,  section  13,  par.  47. 


CONDITIONS    OF    SEEVICE.  237 


2.  In  temperate  climates. 

Cholera  belts,  vrhen  not  included       Waterproof  capes  (for  100  men) . .  10 

in  the  voyage  kit 2  ^  Watch  coats                   "             . .  3 

3.  In  tropical  climaies. 

White  helmet  (per  man) 1 

Frock  coat,  of  serge  or  tartan,  when  not  supplied  as  ordinary  clothing 

of  these  climates 1 

Cholera  belts,  of  flannel,  when  not  part  of  the  sea  kit 2 

Capes,  waterproof  (for  100  men) 10 

For  India,  a  drill  frock,  drill  trousers,  and  a  white  cap  cover  are  issued. 


SECTION  IV. 

AETIGLES  OF  CLOTHIXG. 

1.   Underclothing,  viz.,  vests,  drawers,  shirts,  stockings,  flannel  belts,  etc. 

The  soldier,  as  a  rule,  weai's  as  underclothing  only  a  shii't  and  socks. 
He  is  obhged  to  have  in  his  kit  two  shirts.  There  has  been  much  discus- 
sion as  to  the  resjDective  merits  of  cotton  and  flannel.  Almost  all  medi- 
cal ofiicers  prefer  the  latter,  but  its  cost,  weight,  difficulty  of  clean- 
ing, and  shiinking  in  washing,  have  been  objections  to  its  general  adoption. 
General  vSir  A.  Herbert  solved  the  diificulty  by  issuing  a  shiii:  which  is  partly 
wool,  partly  cotton  ;  it  is  hghter  and  cheaper  than  wool,  as  durable  as  cot- 
ton, and  does  not  shrink  in  washing.  It  is  of  soft  even  texture,  and  weighs 
19  ounces.  Under  the  microscope,  Dr.  Parkes  counted  from  45  to  47  per 
cent,  of  wool 

In  time  of  war,  shirts  may  be  partially  cleaned  in  this  way :  The  soldier 
should  wear  one  and  carry  one  ;  every  night  he  should  change  ;  hang  up 
the  one  he  takes  off  to  dry,  and  in  the  morning  beat  it  out  and  shake 
it  thoroughly.  In  this  way  much  dirt  is  got  rid  of.  He  should  then 
carry  this  shii't  in  his  pack  during  the  day,  and  substitute  it  for  the  other 
at  night.  If  in  addition  gi'eat  cai'e  is  taken  to  have  washing  pai'ades  as 
often  as  possible,  the  difficulty  of  cleaning  would  be  avoided. 

For  hot  countries,  the  common  Enghsh  flannels  are  much  too  thick  and 
irritating ;  flannel  must  be  exceedingly  fine,  or  what  is  perhaps  better, 
merino  hosiery,  which  contains  from  20  to  50  per  cent,  of  cotton,  could  be 
used.  The  best  writers  on  the  hygiene  of  the  tropics  (Chevers,  Jeffi-eys, 
Moore)  have  all  recommended  flannel. 

The  soldier  wears  no  drawers,  but  in  reahty  it  is  just  as  imjoortant  to 
cover  the  legs,  thighs,  and  hips  with  flannel  as  the  upper  pai't  of  the  body. 
Drawers  folding  well  over  the  abdomen  fonn,  vrith  the  long  shirt,  a  double 
fold  of  flannel  over  that  important  pai't,  and  the  necessity  of  cholera  belts 
or  kummerbunds  is  avoided.  Cholera  belts  are  made  of  flannel,  and  fold 
twice  over  the  abdomen. 

The  soldiers'  socks  are  of  worsted  ;  they  should  be  well  shrunken  before 
being  fitted  on.  It  has  been  proposed  to  divide  the  toes,  but  this  seems  an 
unnecessai'y  refinement.  It  has  been  also  proposed  to  do  away  with  stock- 
ings altogether,  but  with  the  system  of  weaiiug  shoes,  it  is  ditficult  to  keejD 
the  feet  perfectly  clean.  The  boots  get  impregnated  -^ith  persjm'ation. 
Some  of  the  German  ti'oops,  instead  of  stockings,  fold  pieces  of  caheo  across 


238  PEACTICAL   HYGIENE. 

the  foot  when  marching  ;  when  carefully  done,  this  is  comfortable,  but  not 
really  better  than  a  good  sock  kept  clean. 

2.  Outer  Garments. — The  clothes  worn  by  the  different  arms  of  the  ser- 
vice and  by  different  regiments  in  the  same  branch,  are  so  numerous  and 
diverse,  that  it  is  impossible  to  describe  them.  In  many  cases  taste,  or 
parade,  or  fantasy  simj^ly,  has  dictated  the  shajDe  or  the  material.  And 
diversities  of  this  kind  are  especially  noticeable  in  times  of  jDcace.  When 
war  comes  with  its  rude  touch,  everything  which  is  not  useful  disappears. 
What  can  be  easiest  borne,  what  gives  the  most  comfort  and  the  greatest 
protection,  is  soon  found  out.  The  arts  of  the  tailor  and  the  orders  of  the 
martinet  are  alike  disregarded,  and  men  instinctively  return  to  what  is  at 
the  same  time  most  simple  and  most  useful.  It  will  be  admitted  that  the 
soldier  intended  for  war  should  be  always  dressed  as  if  he  were  to  be  called 
upon  the  next  moment  to  take  the  field.  Everj'thing  should  be  as  simple 
and  effective  as  possible  ;  utility,  comfort,  durability,  and  facihty  of  repair, 
are  the  principles  which  should  reg-ulate  all  else.  The  di'ess  should  never 
be  encumbered  by  a  single  ornament,  or  embarrassed  by  a  single  contriv- 
ance which  has  not  its  use.  Elegant  it  may  be,  and  should  be,  for  the  use- 
ful does  not  exclude,  indeed  often  implies,  the  beautiful,  but  to  the  eye  of 
the  soldier  it  can  be  beautiful  only  when  it  is  effective. ' 

Head-Dress. — The  head-dress  is  used  for  protection  against  cold,  wet, 
heat,  and  hght.  It  must  be  comfortable  ;  as  light  as  is  consistent  with 
durabihty  ;  not  press  on  the  head,  and  not  to  be  too  close  to  the  hair  ;  it 
should  permit  some  movement  of  aii'  over  the  head,  and  therefore  openings, 
not  admitting  rain,  must  be  made  ;  it  should  present  as  little  surface  as 
possible  to  the  wind,  so  that  in  rapid  movements  it  may  meet  the  least 
amount  of  resistance.  In  some  cases  it  must  be  rendered  strong  for  de- 
fence ;  but  the  conditions  of  modern  war  are  rendeiing  this  less  necessary. 

As  it  is  of  great  importance  to  reduce  aU  the  dress  of  the  soldier  to  the 
smallest  weight  and  bulk,  it  seems  desirable  to  give  only  one  head-dress, 
instead  of  two,  as  at  present.  Remembering  the  conditions  of  his  Hfe,  his 
exposure  and  his  night-work,  the  soldier's  head-dress  should  be  adaj^ted  for 
sleeping  in  as  well  as  for  common  day-work.  Another  point  was  brought 
into  notice  by  the  Crimean  war  ;  in  all  articles  of  clothing,  it  much  facili- 
tates production,  lessens  expense,  and  aids  distribution,  if  the  different 
articles  of  clothing  for  an  army  ai'e  as  much  alike  as  possible  ;  even  for  the 
infantry,  it  was  found  difficult  to  keep  up  the  proper  distribution  of  the 
different  insignia  of  regiments. 

Head-Dress  of  the  Infantry. — Tlie  present  head-dresses  are  the  bear-skin 
caps  for  the  Guards,  a  smaller  and  rather  lower  kind  of  seal-skin  for  Fusi- 
liers, the  Highland  bonnets  and  shakoes  for  the  Highland  Eegiments,  and 
helmets  for  the  Artillery,  Engineers,  and  Line,  and  forage  caps  for  aU.  The 
bear-skin  weighs  37  ounces  ;  the  Lifantry  helmet,  made  of  cork  and  cloth, 
14^  ounces.  It  is  for  the  professional  soldier  to  decide  if  the  rapid  move- 
ments and  the  necessity  of  cover  in  modern  war  are  compatible  with  the 
retention  of  the  bear-skin.  If  not,  no  one  would  wish  to  retain  it  on  san- 
itaiy  grounds  ;  it  is  heavy,  hot,  gives  little  shelter  from  rain,  and  opposes 
a  large  surface  to  the  wind. 

The  Glengarry  Scotch  cap,  now  adopted  as  the  forage  cap  of  the  army, 
is  very  soft  and  comfortable,  presses  nowhere  on  the  head,  has  sufficient 
height  above  the  hair,  and  can  be  ventilated  by  openings  if  desired  ;  it 

'  La  tenue,  dans  laquelle  le  militaire  est  pret  a  marcher  a  Tennemi,  est  toujours 
belle. — Vaidy. 


C0XDITI0X3    OF    SERVICE.  239 

cannot  be  blown,  off ;  it  can  be  canied  at  the  top  of  the  head  when  desired 
in  hot  weather,  or  pulled  down  completely  over  the  forehead  and  ears  in 
cold.  Unfortunately,  either  to  save  cloth  or  from  some  idea  of  smartness, 
it  is  now  being  made  so  small  that  its  advantages  are  imperilled,  as  it  can- 
not be  drawn  do^vn  over  the  head. 

Head-Dress  of  the  Cavalry. — The  Horse  Artillery  and  Cayalry  carry  hel- 
mets and  caps  of  different  kinds. 

The  shape  of  the  helmet  in  the  Guards  and  heavy  dragoons  is  excellent. 
It  is  not  top-heavy ;  offers  httle  surface  to  the  wind  ;  and  has  sufficient 
but  not  excessive  height  above  the  head.  The  material,  however,  is  objec- 
tionable. The  metal  intended  for  defence  makes  the  helmet  veiw  hot  and 
heavy ;  and  the  helmet  of  the  Cavalry  of  the  Guard  weighs  55  ounces 
avou'.  ;  that  of  the  Dragoon  Guards,  39  ounces  (in  1868).  But  as  every 
ounce  of  unnecessary  weight  is  additional  unnecessary  work  thi-own  on  the 
man  and  his  horse,  it  is  very  questionable  whether  more  is  not  lost  than  is 
gained  by  the  great  weight  caused  by  the  metal  Leather  is  now  often  sub- 
stituted in  some  armies,  where  the  cavahy  helmets  are  being  made  ex- 
tremely Ught 

The  Lancer  cap  weighs  34^  ounces ;  the  Hussar,  29f  ounces.  Both 
are  dresses  of  fantasy.  The  Lancer  cap,  except  for  its  weight,  is  the  better 
of  the  two  ;  is  more  comfortable  ;  shades  the  eyes  ;  throws  off'  the  rain  bet- 
ter ;  and  offers  less  resistance  to  moving  air  than  the  Hussar  cap. 

In  Canada,  a  fur  cap  is  used,  with  flaps  for  the  ears  and  sides  of  the 
face  and  neck. 

In  India,  many  contrivances  have  been  used.  Up  to  the  year  1842  lit- 
tle attention  seems  to  have  been  paid  to  the  head-dress  of  the  infantry, 
and  the  men  commonly  wore  their  Eui'opean  forage  caps.  In  1842  Lord 
Hardinge  issued  an  order,  that  white  cotton  covers  shoiild  be  worn  over  all 
cap)S  ;  subsequently,  a  flap  to  fall  down  over  the  back  of  the  neck  was 
added.  The  effect  of  the  cotton  cover  is  to  reduce  the  temperatiu'e  of  the 
air  in  the  cap  about  4'  to  7°  Fahr.  Although  a  great  improvement,  it  is 
not  sufficient. 

Bamboo  wicker  helmets,  covered  with  cotton  and  provided  with  pugger- 
ies,  are  now  used  ;  they  are  light  (13  oz,),  durable,  not  easily  put  out  of 
shape,  and  cheap.  The  rim  is  inchned,  so  as  to  protect  from  the  level 
rays  of  the  sun.  The  pith,  or  "Sola"  hats,  appear  to  be  decidedly  inferior 
to  the  wicker  helmets  ;  and  men  have  had  sunstroke  while  wearing  them. 

In  the  French  infantry  the  shako  is  now  made  of  leather  and  paste- 
board, and  is  divested  of  all  unnecessary  ornament,  so  as  to  be  as  light  as 
it  can  be.  It  comes  well  back  on  the  head,  being  prolonged,  as  it  were, 
over  the  occipital  protuberance. 

In  Algeria,  the  Zouaves,  Spahis,  and  Tirailleui's  wear  the  red  fez,  covered 
with  a  turban  of  cotton.  In  Cochin-China,  the  French  have  adopted  the 
bamboo  wicker  helmet  of  the  English. 

The  natui-al  hair  of  the  head  is  a  very  gi'eat  protection  against  heat. 
Various  customs  prevail  in  the  East.  Some  nations  shave  the  head,  and 
wear  a  large  turban  ;  others,  like  the  Burmese,  wear  the  hah*  long,  twist  it 
into  a  knot  at  the  top  of  the  head,  and  face  the  sun  with  scarcely  any  tur- 
ban. The  Chinaman's  tail  is  a  mere  mark  of  conc[uest.  The  European  in 
India  generally  has  the  hair  cut  short,  on  account  of  cleanliness  and  dust. 
A  small  wet  handkerchief,  or  piece  of  calico,  caiTied  in  a  cap  with  good 
ventilation,  may  be  used  with  advantage  ;  and  especially  in  a  hot  land-wind 
cools  the  head  greatly. 

Coat,   Tunic,  Shell-Jacket,  etc. — The  varieties  of   the  coat  are  numer- 


240  PRACTICAL    HYGIEXE. 

ous  in  the  army  ;  and  there  are  undress  and  stable  suits  of  different 
kinds.  The  infantiy  now  wear  the  tunic,  which  is  a  great  improvement 
over  the  old  cutaway  coatee.  It  is  still,  however,  too  tight,  and  made  too 
scanty  over  the  hips  and  across  the  abdomen.  A  good  tunic  should  have  a 
low  collar-,  and  be  loose  round  the  neck.  The  stock  is  now  abolished,  a 
tongue  of  leather  being  substituted  where  the  collar  of  the  tunic  is  hooked 
in  front.  The  tunic  should  also  be  loose  over  the  shoulders  (so  as  to  allow 
the  deltoid  and  latissimus  the  most  unrestricted  play),'  and  across  the  chest. 
It  should  come  well  across  the  abdomen,  so  as  to  guard  it  completely  from 
cold  and  rain  ;  descending  loosely  over  the  hips,  it  should  fall  as  low  over 
the  thighs  as  is  consistent  with  kneeling  in  rifle  practice,  i.e.,  as  low  as  it 
can  fall  without  touching  the  ground.  Looking  not  only  to  the  comfort  of 
the  soldier,  but  to  the  work  and  force  requii-ed  of  him,  it  is  a  great  mis- 
take to  have  the  tunic  otherwise  than  exceedingly  loose.  A  loose  tunic,  a 
blouse  in  fact,  is  in  reality  a  more  soldier-like  dress  than  the  tight  gar- 
ment, which  every  one  sees  must  press  upon  and  hinder  the  rajDid  action  of 
muscles.  The  tunic  should  be  well  provided  with  pockets,  not  only  behind, 
but  on  the  sides  and  in  front ;  the  pockets  being  internal,  and  made  of  a 
very  strong  lining.  In  time  of  war,  a  soldier  has  many  things  to  caiTy  ; 
food,  extra  ammunition  sometimes,  all  sorts  of  little  comforts,  which  pack 
away  easily  in  pockets.  If  the  appearance  is  objected  to,  they  need  not  be 
used  in  time  of  peace  ;  but  -^ith  a  loose  dress,  they  would  not  be  seen. 

A  great  improvement  was  made  by  General  Herbert.  The  old  shell- 
jacket  was  done  away  with,  and  a  loose  frock  substituted. 

In  India  the  tunic  is  made  loose,  and  of  thin  material 

Waistcoats. — No  waistcoats  are  worn  in  the  British  army,  but  they  ought 
to  be  introduced.^  A  long  waistcoat  v\"ith  a»-ms  is  one  of  the  most  useful  of 
garments ;  it  can  be  used  ^rithout  the  tunic  when  the  men  are  in  ban*acks 
or  on  common  drill.  Put  on  under  the  tunic,  it  is  one  of  the  best  protec- 
tions against  cold.  At  j^resent  the  men  are  obliged  to  wear  tight  coats,  and 
having  nothing  under  them,  line  them  with  flannel  and  wadding.  In  win- 
ter and  summer  they  often  wear  the  same  dress,  although  the  oppression 
in  the  summer  is  very  gTeat.  If  the  tunic  were  made  very  loose  of  some 
light  material,  and  if  a  good  short  Jersey  or  Guernsey  frock  were  allowed 
to  be  worn  at  the  option  of  the  men,  the  men  would  have  cool  dresses  in 
summer,  warm  in  winter,  and  the  thin  tunic  would  be  more  comfortable  in 
the  MediteiTanean  and  subtropical  stations. 

Trousers. — Formerly  the  army  wore  breeches  and  leggings  ;  but  shorily 
before  or  during  the  Peninsular  war  trousers  were  introduced.  The  in- 
creased comfort  to  the  soldier  is  said  to  have  been  remarkable  ;  the  trou- 
ser,  indeed,  protecting  the  leg  quite  down  to  the  ankle,  seems  to  be  as  good 
a  dress  as  can  be  derised,  if  it  is  made  on  pi'oper  principles,  viz.,  very  loose 
over  the  hips  and  knees,  and  gathered  in  at  the  ankle,  so  that  merely  suf- 
ficient opening  is  left  to  pass  the  foot  through.  The  much-laughed-at  peg- 
top  trousers  seem  to  be,  in  fact,  the  proper  shape.  In  this  way  the  whole 
leg  is  protected,  and  the  increased  weight  given  by  the  part  of  the  trousers 
below  the  knee  is  a  matter  of  no  consequence. 

The  trousers  are  supported  either  by  braces  or  a  belt.  If  the  latter  be 
used,  it  should  be  part  of  the  trousers,  should  fit  just  over  the  hip,  and 

'  This  cannot  occnr  if  epanlets  are  worn  ;  and  it  is  to  be  hoped  nothing  will  ever 
occur  to  bring  in  again  the  use  of  the  so-called  ornaments. 

■•'  A  waistcoat  was  introduced  some  time  ago,  but  has  since  been  unfortunately  with- 
drawn aaain. 


CO^'DITIOXS    OF    SERVICE.  241 

not  go  rouBcl  tlie  vraist.  It  must  be  tiglit,  and  lias  one  disadvantage,  vrhich. 
is  that  in  great  exertion  the  perspiration  flowing  do'wn  from  above  collects 
there,  as  the  tight  belt  hinders  its  descent ;  also,  if  heavy  articles  are  car- 
ried in  the  pocket,  the  weight  may  be  too  great  for  the  belt.  Braces  seem, 
on  the  whole,  the  best. 

Trousers  should  be  made  with  large  pockets,  on  the  principle  of  giving 
the  men  as  much  convenience  as  possible  of  carrying  articles  in  time  of 
war. 

In  India,  trousers  are  made  in  the  same  fashion  as  at  home,  but  of  drill 
or  khakee  cloth,  or  thin  serge — an  excellent  material,  especially  for  the 
northern  stations. 

Leggings  and  Gedters. — Formerly  long  leggings  reaching  over  the  knees, 
and  made  of  half -tanned  leather,  were  used.  They  appear  not  to  have  been 
considered  comfortable,  and  were  discarded  about  sixty  yeai's  ago.  Short 
gaiters  were  subsequently  used  for  some  time,  but  were  iiually  given  up, 
and  for  several  years  nothing  of  the  kind  was  worn.  After  the  Crimean 
war  Lord  Herbert  introduced  for  the  infantr\^  short  leather  leggings,  6 
inches  in  height,  and  buttoning  on  the  outside.  These  were  not  of  good 
length  or  shape,  and  have  now  been  superseded  by  leggings  which  come 
more  up  to  the  knee,  and  are  much  more  serviceable. 

In  some  of  the  French  regiments  a  gaiter  of  half-dressed  hide  comes  up 
to  just  below  the  knee  ;  short  calico  or  linen  gaiters  are  worn  by  other 
corps  ;  a  flap  comes  forward  over  the  instep.  The  calico  gaiters  have  been 
much  praised,  but  they  soon  get  saturated  with  perspu'ation,  thickened  in 
ridges,  and  sometimes  irritate  the  skin.  On  the  other  hand,  leather 
gaiters,  if  not  made  of  good  leather,  lose  their  suppleness,  and  press  on  the 
ankles  and  instep. 

A  great  advantage  of  gaiters  and  leggings  is,  that  at  the  end  of  a  march 
they  can  be  at  once  removed  and  cleaned  ;  but,  on  the  whole,  if  suitable 
leather  could  be  fixed  at  the  bottom  of  trousers,  they  might  perhaps  be 
abandoned. 

Shoes  and  Boots. — In  the  action  of  walking  the  foot  expands  in  length 
and  breadth ;  in  length  often  as  much  as  ^th,  in  breadth  even  more.  In 
choosing  shoes  this  must  be  attended  to.  The  shoemaker  measures  when 
the  person  is  sitting,  and  as  a  rale  allows  only  g^^th  increase  for  walking. 
Ankle  boots,  weighing  40  to  42  ounces,  are  now  worn  by  the  infantry  :  the 
cavahy  have  Wellingtons  and  jackboots.  The  jackboots  of  the  Life  Guards 
weigh  (with  spurs)  100  ounces  avoir.  Shoes  cannot  be  worn  without 
gaiters.  Ankle  boots  are  preferable  ;  in  the  Enghsh  army  they  are  now 
made  to  lace,  and  are  fitted  with  a  good  tongue.  Great  attention  is  now 
paid  at  Pimlico  to  the  shape  and  make  of  the  boot,  and  the  principles  laid 
down  by  Camper,  Meyer,  and  others,  are  carefully  attended  to.  There  are 
eight  sizes  of  length  and  four  of  breadth,  making  thirty-two  sizes  in  all.  The 
boots  are  made  right  and  left.  The  heel  is  made  very  low  and  broad,  so 
that  the  weight  is  not  thrown  on  the  toes,  the  gastrocnemii  and  solei  can 
act,  which  they  cannot  do  well  with  a  high  heel,  and  there  is  a  good  base 
for  the  column  which  forms  the  line  from  the  centre  of  gravity,  and  the 
centre  of  gravity  is  kept  low  ;  the  inner  hne  of  the  boot  is  made  straight,  so 
as  not  to  push  outwai'd  the  great  toe  in  the  least  degree,  and  there  is  a 
bulging  over  the  root  of  the  great  toe  to  allow  easy  play  for  the  large 
joint.  Across  the  tread  and  toes  the  foot  is  made  very  broad,  so  that  the 
lateral  expansion  may  not  be  impeded  ;  the  toes  are  broad.  Great  care 
is  taken  in  the  inspection  of  the  boots,  the  order  of  inspection  being — 1st, 
The  proof  of  the  size,  which  is  done  by  standard  measui^e  ;  2d,  The  excel- 
YoL.  II.— 16 


242  PRACTICAL    HYGIENE. 

lence  of  the  leather,  which  is  judged  of  by  inspection  of  each  l)Oot,  and  by 
selecting  a  certain  number  from  each  lot  furnished  by  a  conti-actor,  and 
cutting  them  up  ;  if  anything  wrong  is  found,  the  whole  lot  is  rejected ; 
3d,  The  goodness  of  the  sewing  ;  there  must  be  a  certain  number  of 
stitches  per  inch  (not  less  than  eight  for  the  upper  leathers),  a  certain 
thickness  of  thread,  and  the  thread  must  be  well  waxed.  The  giving  uj:)  of 
boots  is  generally  owing  to  the  shoemaker  using  a  large  awl,  and  thin  un- 
waxed  thread,  with  as  few  stitches  as  possible  ;  the  work  is  thus  easier  to 
him,  but  the  thread  soon  rots. 

The  Germans  are  now  introducing  a  long  boot,  with  a  sht  down  the 
centre  ;  it  can  be  worn  under  the  trousers,  or  at  pleasure  outside,  as  the 
slit  opens,  and  can  then  be  laced.  A  someAvhat  similar  boot  was  invented 
by  the  late  Major  Sir  W.  Palliser. 

Considering  the  great  injury  inflicted  on  the  foot  by  tight  and  ill-made 
boots,  by  which  the  toes  are  often  distorted  and  made  to  override,  and  the 
great  toe  is  even  dislocated  and  ankylosed,  it  is  plain  that  the  increased 
attention  lately  excited  on  this  point  is  not  unnecessary.  The  compression 
of  children's  feet  by  the  tight  leather  shoes  now  made  is  extremely  cruel 
and  injurious.  It  may,  indeed,  be  asserted  that  the  child's  foot  would  be 
better  if  left  altogether  unclothed,  and  certainly  we  see  no  feet  so  well 
modelled  as  the  children  of  the  poor,  who  run  about  shoeless.  In  the  case 
of  the  soldier,  too,  who  has  in  many  campaigns  been  left  shoeless,  and  has 
greatly  suffered  therefrom,  it  is  a  question  whether  he  should  not  be  trained 
to  go  barefooted.  The  feet  soon  get  hard  and  callous  to  blows,  and  clean- 
liness is  really  promoted  by  having  the  feet  uncovered,  and  by  the  frequent 
washings  the  practice  renders  necessary.  After  being  unworn  for  some 
time,  shoes  that  previously  fitted  will  be  found  too  small,  on  account  of  the 
greater  expansion  of  the  foot,  and  this  is  itself  an  argument  against  the 
shoe  as  commonly  worn. 

The  sandal  in  all  hot  countries  is  much  better  than  the  shoe,  and  there 
is  no  reason  why  it  should  not  be  used  in  India  for  the  English  soldiers  as 
it  is  by  the  native  ;  the  foot  is  cooler,  and  will  be  more  frequently  washed. 
For  all  native  troops,  negroes,  etc.,  the  sandal  should  be  used,  and  the  boot 
altogether  avoided.  In  campaigns  it  is  most  important  to  have  large  stores 
of  boots  at  various  points,  so  that  fresh  boots  may  be  frequently  issued, 
and  worn  ones  sent  back  for  repair.  Soldiers  ought  to  be  trained  to  rejjair 
their  owa  boots. ' 

Great-coat  and  Cloak. — In  the  cavalry,  cloaks,  with  capes  which  can  be 
detached,  are  carried.  They  are  large,  so  as  to  cover  a  good  deal  of  the 
horse,  and  are  made  of  good  cloth  ;  the  weight  is  about  5  lb  to  6  lb  for  the 
cloak,  and  2^  lb  to  3  ft  for  the  cape.  The  infantry  wear  great-coats  weigh- 
ing from  5  ft  to  6  ft."  They  are  now  made  of  extremely  good  cloth, 
are  double-breasted,  and  are  as  long  as  can  be  managed.  They  are  not 
provided  with  pockets  at  the  back,  which  is  a  serious  omission,  and  they 
also  should  have  loops,  so  that  the  flaps  may  be  turned  back  if  desired. 

'  It  may  be  worth  while  to  give  a  receipt  for  making  boots  impermeable  to  wet. 
Dr.Parkes  tried  the  following,  and  foiind  it  effectual :  Take  half  a  pound  of  shoemaker's 
dubbing,  half  a  pint  of  linseed  oil,  half  a  pint  of  solution  of  india-rubber  (price  8s.  per 
gallon).  Dissolve  with  gentle  heat  (it  is  very  inflammable),  and  rub  on  the  boots. 
This  will  last  for  five  or  six  months  ;  but  it  is  well  to  renew  it  every  three  months. 
At  a  small  expense  the  boots  of  a  whole  regiment  could  be  thus  made  impermeable  to 
wet.  Army  Circular,  clause  66,  1875,  directs— (1)  That  boots  are  to  be  blackened 
with  three  coats  of  ordinary  blacking,  instead  of  other  substances. 

■  The  following  are  the  exact  weights  of  three— one  large  size,  one  medium,  and 
one  small ;  the  weights  were  6  ft  3  ounces,  5  ft  9  ounces,  and  5  ft  8  ounces. 


CONDITIONS    OE    SEKVICE.  243 

They  are  too  heavy,  aud  absorb  a  great  deal  of  wet,  so  that  they  dry  slowly. 
General  Eyre's  Committee  on  Equipments  recommended  a  lighter  great- 
coat, and  in  addition  a  good  waterproof  cape.  The  suggestion  seems  to 
be  a  very  good  one. '  A  hood  might  also  be  added  with  advantage.  In 
countries  with  cold  winds  they  are  a  great  comfort.  Or  the  Russian  bash- 
lik  might  be  introduced  ;  it  is  a  most  useful  covering  for  cold  and  windy 
countries. 

The  great-coat  is  perhaps  the  most  important  article  of  dress  for  the 
soldier.  With  a  good  great-coat,  Robert  Jackson  thought  it  might  be 
possible  to  do  away  with  the  blanket  in  war,  and  if  india-rubber  sheets 
were  used  this  is  perhaps  possible.  In  the  Italian  war  of  1859,  the  French 
troops  left  their  tunics  at  home,  and  campaigned  in  their  great-coats,  which 
were  w^orn  open  on  the  march.  ^ 

In  countries  hable  to  great  vicissitudes  of  temperature,  and  to  sudden 
cold  winds,  as  the  hilly  parts  of  Greece,  Turkey,  Afghanistan,  etc.,  a 
loose,  warm  cloak,  which  can  be  worn  open  or  folded,  is  used  by  the  in- 
habitants, and  should  be  imitated  in  campaigns.  It  is  worthy  of  remark, 
that  in  most  of  these  countries,  though  the  sun  may  be  extremely  hot,  the 
clothes  are  very  warm. 

In  very  cold  countries,  sheep-skin  and  buffalo-hide  coats,  especially  the 
former,  are  very  useful.  No  wind  can  blow  through  them  ;  in  the  coldest 
night  of  their  rigorous  winter  the  Anatolian  shepherds  lie  out  in  their 
sheepskin  coat  and  hood  without  injury,  though  unprotected  men  are 
frozen  to  death.  In  Bulgaria,  the  Crimea,  and  other  countries  exposed  to 
the  pitiless  winds  from  Siberia,  and  the  steppes  of  Tartary,  nothing  can  be 
better  than  coats  like  these.  ^ 


SECTION  V. 

WEIGHTS   OF  THE   ARTICLES   OF  DRESS   AND  OF  THE   ACCOUTREMENTS, 
AND   ON   THE   MODES   OF   CARRYING  THE  WEIGHTS. 

The  following  tables  give  the  weights  of  all  the  articles  used  by  a 
Heavy  Cavalry  Regiment,  an  Hussar  Regiment,  and  the  Infantry  of  the 
Line.  The  weights  canied  by  the  Artillery  are  much  the  same  as  those 
of  the  Cavalry.  The  weights  of  the  helmets  and  jackboots  of  the  Life  and 
Horse  Guards  have  been  already  mentioned.  The  cuirass  weighs  10  ib 
12  oz.  ;  it  rests  a  little  on  the  sacrum  and  hip,  and  in  that  way  is  more 
easily  borne  by  the  man.  With  these  exceptions,  the  weights  may  be  con- 
sidered nearly  the  same  as  those  of  the  heavy  dragoons.  The  uniform  and 
equipment  of  the  Guards  and  Cavalry  are  at  present  under  consideration, 
and  may  be  changed. 

'  Para.  47,  sect,  viii.,  Regulations  for  Clothing,  directs  the  issue  of  a  waterproof 
coat,  leggings,  wrappers,  sou'wester  caps,  etc.,  for  certain  duties. 

^ Cloth  may  be  made  waterproof  by  the  following  simple  plan: — Make  a  weak  solu- 
tion of  glue,  and  while  it  is  hot  add  alum  in  the  proportion  of  one  ounce  to  two  quarts; 
as  soon  as  the  alum  is  dissolved,  and  while  the  solution  is  hot,  brush  it  well  over  the 
surface  of  the  cloth,  and  then  dry.  It  is  said  that  the  addition  of  two  drachms  of  sul- 
phate of  copper  is  an  improvement. 

^  Sheep-skin  bags  with  the  wool  inside  were  much  used  by  the  French,  troops  dur- 
ing the  defence  of  Paris,  in  the  winter  of  1870-71. 


244 


PRACTICAL    HYGIE:NE. 


Cavalry. 

The  weight  of  the  accoutrements  and  equipment  is  in  great  part  car- 
ried by  the  horse.  The  cloak,  when  not  worn,  is  carried  in  a  roll  over  the 
shoulder,  or  sometimes  round  the  neck,  or  in  front  on  the  horse. 

Private  in  Qth  Dragoon  Guards. —  Weights  in  Marching  Order  {January,  1872). 

Articles.  lb.     oz. 

Carbine   6       8 

Sword-belt  and  sword 5       8 

Pouch-belt  and  pouch 1       8 

Cloak  and  cajDe 10       8 

Valise  comj^letely  packed  ...   15       0 

Saddle  complete 47       8 

Sheepskin,  corn-sack,  and  [      q       q 

nose-bag \ 

Man's  clothing  (which  in-^ 

eludes  a  complete  set  of 

underclothing,      helmet 

without   plume,   tunics,  )■    VI       0 

pants,  haversack,  gaunt- 
lets,   knee-boots,     and 

sj^urs) 


Articles.  lb. 

Blanket 4 

Heel  Eopes 1 

"    Pegs 2 

Shackles 0 

Collar  Shank 0 

Wellington  boots  and  spurs .  2 


oz. 

4 

8 

2 

10 

13 

10 


123     15 
Average   weight    of    man)  ^n-i       r> 
(naked) f 


Total....  284     15 
Or  20  stone  and  5  fib  (nearly). 


Weights  of  Mens  Clothes, 
No.  Articles. 

1  Tunic 

1  Busby,  plume,  and  lines. 
1  Pair  leather  overalls  and  \ 

straps f 

1  Pair  cloth     do.     do 

1  Stable-jacket 

1  Forage-cap 

1  Valise 

1  Cloak,  5  lb  8|  oz. ;  cape,  ) 

2  lb  6  oz \ 

1  Pair  boots 

1     "     sjDurs 

1     "     highlows 

1  Stable-bag 

1  Pair  braces 

1  Batton-brush 

1  Cloth         " 

1  Hair  "      

1  Brass         "      

1  Lace  "      

1  Shaving     "      

2  Shoe  brushes 

1  Tin  blacking 

1  Hair-comb    


Necessaries,  etc.,  IQth  Royal  Hussars  (1869).' 


R). 

oz. 

3 

0 

1 

13f 

3 

6 

2 

^ 

1 

l^ 

0 

5 

2 

7 

7 

14i 

3 

Oi 

0 

5i 

3 

8 

0 

6 

0 

3f 

0 

H 

0 

3^ 

0 

2f 

0 

2f 

0 

1 

0 

H 

0 

7^ 

0 

^ 

0 

Oi 

0 


No.  Articles.  lb. 

2  Pau's  drawers,  each  13f  oz.  1 

2  Pairs  gloves,  each  7^  oz. .  0 
Or,  2  Pairs  cotton  socks,  ) 
each  sock  1\  oz.  .  \ 

4  Brass  paste 0 

IHold-aU 0 

1  Horse-rubber 0. 

1  Knife,  fork,  and  spoon  0 

1  Pipeclay  and  sponge  0 

1  Razor 0 

8  Shii-ts,  each  14^  oz.  .  2 

1  Button  brass 0 

1  Stock 0 

2  Towels,  7f  oz.  each  .  0 

1  Stable  trousers 1 

2  Flannel       jackets, 

each  11  oz 

1  Oil  tin 0 

1  Pair  foot -straps  ....  0 

1  Mess-tin  and  strap . .  1 

1  Account-book 0 


oz. 
144- 


4 
11 

^ 

2 

^ 

Hi 

If 

H 

15i 
5 

6 

2i 
Oi 

H 


45      3^ 


*  Since  this  date,  the  only  change  is  the  substitution  of  long  hoots  for  booted  over- 
alls ;  but  it  is  uncertain  if  this  change  will  be  permanent. 


CONDITIONS    OF    SERVICE. 


245 


Weights  of  Saddlery,  10th  Royal  Hussars. 


Articles.  Tb. 

Saddle-tree 6 

"     seat 1 

Pair  flaps 2 

"   panels 4 

Gii-tb-tub 0 

Girth-leathers 1 

Stirrup-irons - 1 

"      leathers 1 

Crupper 0 

Breastplate 1 

Surcingle 0 

Set  of  baggage-straps ....  0 

"      cloak-straps 0 

Pair  waUets 1 

Pair  shoe-cases  and  straps .  1 

4  horse-shoes  and  nails ...  4 

New  carbine  bucket 2 

Bridle-bit  and  head-stall . .  2 

Bridoon-bit  and  reins ....  1 

Curb-chain 0 

Bit-reins 0 

Head-collar 1 

Collar-chain •.  1 

Sheepskin 4 

Shabraque 4 

Numnah 2 


5i 

Hi 

^ 

4i 
15 
9i 

14i 
4 

9 

m 

2 
2 
3f 

4 

^ 

lU 


Articles.  ft. 

Corn-sack 1 

Nose-bag 1 

Horse-brush 0 

Curry-comb 0 

Sponge 0 

Hoof-picker 0 

Scissors 0 

Horse-log 1 

Haversack 0 

Carbine 6 

Pouch-belt,  11^  oz 

Pouch  11^  oz 

20  rounds  ammunition, 

32J  oz 

Wrist-belt,  etc.,  1  Sb  1  oz. 
Sabretash  and  slings,  1  lb 

5^  oz 

Sword,  4  ft)  10  oz 


76 


IH 

H 
11 
11 

2 
If 

9 
9 


7# 


Weight  of  equipments,    121       11^ 


Total  weight  of  Hussar'  ]  259         6^ 
with  aU  his  equipments. ,  f  or  18|^  st. 


Infantry. 

The  articles  of  the  infantry  soldiers'  kit  have  been  already  noted.  The 
kit  is  divided  into  the  service  and  the  surplus  kit,  the  latter  being  always 
carried  for,  and  not  by,  the  man.  The  service  kit  consists  of  the  clothes 
he  wears,  and  of  some  dupHcate  articles  and  other  necessaries. 

These  articles  consist  of  one  flannel  shirt  (19  ounces),  pair  of  socks  (5 
oz.),  pair  of  trousers  (23  or  32  oz.,  according  to  kind),  pair  of  boots  (42 
oz.),  towel  (8  oz.),  hold-all,  and  knife,  fork,  and  spoon  (2|-  oz.),  2  brushes 
(6  oz.),  tin  of  blacking  (6^  oz.),  forage  cap  (4  oz.). 

The  following  table  gives  a  fairly  correct  statement  of  the  weights  of 
the  kit  and  equipment : — 


'  Average  weight  and  height  of  the  men  in  these  two  cavalry  regiments — 

Height.  Weight  (naked). 

ft.       in.  lb.  oz. 

6th  Dragoon  Guards 5      9^  161        0 

lOthHussars  , 5      7i  137      11 


246  PRACTICAL    HYGIENE. 

Average  weight. 

It).  oz. 
Weight  of  clothes  on  person,  including  helmet,  -winter  trousers, 

and  leggings '. 10  0 

Personal  necessaries,  viz.,  service  kit  in  valise 7  3 

Great-coat 5  8 

Valise  equipment  for  carrying  necessaiies,  great-coat,  and  arma- 
ment, viz.,  valise,  two  pouches,  ball-bag,  suspenders,  waist- 
belt,  frog,  coat-sti-aps 5  10 

Havei"sack 0  8 

Canteen 1  9 

Armament,  viz.,  rifle  and  sling  (91b  8  oz.),  bayonet  (1  ft),  ammu- 
nition (60  rounds,  6  ft  weight  =  1  ft  for  10  rounds  neaiiy) . .  16  8 
Water-bottle  (new  pattern)  and  water 2  9 


49         7 

In  war,  food  and  a  blanket  would  be  also  carried,  adding  from  6  to  8  ft 
to  the  weight.  By  omitting  40  rovmds  of  ammunition  and  one  pouch,  the 
weight  of  the  peace  equipment  is  lessened  to  40  ft ;  and  if  the  canteen 
were  only  canned  when  it  ■w-ns  wanted,  the  weight  would  be  under  39  ft. 
If  the  great-coat  with  the  cape  could  be  reduced  to  5  ft,  and  the  summer 
trousers  and  the  boots  were  left  out  of  the  valise,  the  weight  would  be 
reduced  below  35  ft,  and  stiU  the  soldier  would  have  really  everything 
necessary  for  his  comfori. 

Some- experienced  officera,  however,  consider  it  essential  that  the  second 
pail*  of  boots  should  be  always  cai'ried  by  the  soldier.  No  doubt  a  man 
should  have  a  second  pair  of  boots,  and  there  may  be  circumstances  in 
periods  of  peace  when  he  might  desire  to  have  them  with  him  ;  but  surely 
there  is  no  necessity  for  him  to  caiTy,  as  he  does  now,  even  if  he  only  goes 
on  guard  on  a  fine  day,  a  pair  of  boots  which  he  never  puts  on.  It  might 
be  left  to  his  discretion  to  carry  his  extra  boots,  and  it  is  pretty  certain  he 
will  take  them  when  they  add  to  liis  comfort.  So  also  with  the  second  pair 
of  trousei-s  ;  why  should  they  be  constantly  caii-ied  when  they  are  scai'cely 
ever  wanted  ? 

In  time  of  war,  it  is  most  important  to  have  the  soldier  as  little  weighted 
as  possible.  The  long  and  rapid  marches  which  have  so  often  decided  wars 
have  never  been  made  by  heavily  laden  men.  The  health  also  suffers.  It 
is  of  national  importance  that  the  soldier  should  be  as  healthy  and  as  effi- 
cient as  possible,  as  the  fate  of  a  nation  may  be  staked  on  the  prowess  of 
its  army. 

The  hne  which  the  weight  of  his  necessaries  should  not  exceed  should 
be  drawn  with  the  utmost  care  ;  if  his  health  suffers  more  by  carrying  some 
extra  pounds  of  weight  than  it  benefits  by  the  comfort  the  articles  give, 
why  load  him  to  his  certain  loss  ?  The  overdoing  the  necessaiies  of  the 
soldier  has  always  been  a  fault  in  our  ai-my  ;  Robert  Jackson  noticed  it 
seventy  yeai*s  ago.  "It  is  a  mistake,"  he  says,  "  to  multiply  the  ecjuip- 
ment  of  the  soldier  with  a  view  of  adding  to  his  comfort." 

There  are  certain  articles  of  material  comfort  to  a  man  on  service  in  a 
cold  or  wet  countiw,  and  some  altei-ation  in  the  present  arrangement  would 
be  desu-able.  Dr.  Parkes  jji-oposed  some  slight  changes.  The  gi'eat-coat, 
blanket,  and  a  watei-jDroof  sheet  (or  portion  of  a  shelter  tent),  to  keep  both 
the  coat  and  blanks  and  the  man  himself  dry,  are  articles  of  the  utmost 
imjDortance  ;  there  is  scarcely  anything  that  a  soldier  might  not  dispense 
with  cooner  than  these.     But  theu-  weight  is  considerable,  and  it  is  neces- 


CONDITIONS    OF    SEE  VICE.  247 

sary  to  sacrifice  some  thing  else  to  secure  them.  The  second  paii-  of  trou- 
sers is  clearly  unnecessary,  and  if  he  started  with  a  thoroughly  good  pair 
of  boots  made  waterproof,  as  can  be  easily  done,  and  had  a  cheap  loose 
shoe  which  he  might  put  on  after  a  fatiguing  march,  and  if  proper  trans- 
port were  provided  for  due  renewal,  the  second  joair  of  boots  might  be  left 
out.  A  spare  shirt,  towel,  socks,  comb,  a  small  hold-aU,  and  a  clasp-knife 
and  spoon,  would  comprise  all  that  would  be  necessary,  in  addition  to  his 
haversack,  water-bottle,  and  provisions.  The  forage  cap  with  waterproof 
cover  should  be  substituted  for  the  shako. 

If  such  a  plan  were  followed  the  weight  of  such  a  war  equipment  would 
be  as  follows  : — ' 

R).  avoir,   oz. 

Clothes  on  person 10  0 

Service  kit  in  vahse,  viz.,  shirt  (19  oz.),  towel  (8  oz.),  soap  (2  oz.), 

1  comb  (|-  oz.),  hold-all  (3  oz.),  socks  (5  oz.),  shoes  (16  oz.)  .  3  1 

Great-coat 4  0 

Waterproof  sheet  (with  appliances  for  tentage)  4  0 

Blanket 4  0 

Haversack  and  three  days'  provisions 6  0 

.  Water-bottle  and  20  fl.  oz.  of  water 2  2 

Canteen 1  9 

Valise  equipment 5  10 

Armament  (with  sixty  rounds) 16  8 

56       14 

On  ordinary  occasions  in  war,  as  he  would  only  carry  one  day's  provisions 
and  40  rounds  of  ammunition,  the  weight  would  only  be  52  ft).  While  he 
would  be  more  comfortably  provided,  he  would  be  less  weighted  than  with 
the  present  system,  and  would  be  able,  if  it  were  required,  to  carry  en- 
trenching tools. 

The  vahse  equipment  proposed  by  General  Eyre's  Committee,  and  now 
adopted  for  the  army,  possesses  gTeat  facihties  for  carrying  these  articles, 
as  wiU  be  presently  noticed. 

This  committee  also  recommended  that,  instead  of  the  squad-bag  for 
25  men,  each  man  shall  have  a  separate  canvas  bag  for  his  sui-plus  kit,  as  is 
now  provided  on  board  ship.  In  time  of  joeace  this  would  be  carried  for 
him,  as  the  squad-bag  is  at  present ;  in  time  of  war  it  would  be  left  at  home. 

It  is  of  great  moment  to  give  each  man  a  bag  for  surplus  kit  to  himseh. 
It  encourages  the  men  to  take  care  of  then-  things,  and  enables  them  to 
pack  them  comfortably.     Each  man  is  now  supphed  with  a  kit-bag. 

It  may  be  interesting  to  give  the  weights  of  the  various  articles  carried 
by  the  infantry  soldier  of  the  French,  Prussian,  and  Kussian  armies. 

'  The  weight  of  the  clothing,  equipment,  and  kit  of  the  Army  Hospital  Corps  is  as 
follows: — 

B).  oz. 

Clothes  on  the  person,  including  helmet  and  leggings 10  9 

Great-coat  and  cape 5  18 

Extra  kit  and  small  articles 8  2 

Valise  with  straps,  belt,  mess-tin,  haversack,  and  black  bag 8  1 

Water-bottle  (new  pattern)  with  water 2  9 

Field  companion,  complete. ...    , 9  13 

Water-bottle  for  ditto,  with  water. .  - 5  12 

Total 50        11 


248 


PEACTICAL   KYGIENE. 


Equipment  of  the  French  Infantry  Soldier  {3forache,  1874). 


A-  Clothixg,  etc. 

Articles. 


Shako 

Great-coat 

Epavilettes 

Shii't 

Neckcloth 

Braces 

Trousei-s 

Drawers 

Shoes 

Leather  gaiters 

Pocket  handkerchief . 

Knife 

Spoon  


Weight 
ill  ft      oz. 
avoir. 

0     15i 


6i 
6-1 
Of 

2i 
2^ 
8f 


0  10 

1  15^ 
0  llf 

0  2A 


Total  clothing,  etc . 


1 


12      4f 


n.  In  pack  : — 

2  Shii'ts 

Pair  drawers 

Pau's  linen  gaiters  .  . 

Night-cap 

Pocket  handkerchief. 

Pah-  shoes 

Pail"  trousers 

Hold-all  complete 

2  Pairs  gloves 

8  Packets  cartridges  . . 

Small  book 

Jersey  

Tunic 

Forage-cap 

Small  bag 


Weipht 
in  ft 
avoir. 


2      U 

0     10 

0      5i 


B.  Equipment  axd  Aema^ient. 

Eifle  (pattern  of  1866) ' . . .  8 

Strap  for  do 0 

Cartridge  pouch,         ) 

Belt  and  accessories,  >•....  4 

Sword-bayonet,  ) 

2  Loose  cartridges 0 

2  Packets  of  cartridges  in 

pouch 1 


12f 

H 
iif 


TTT.  Camp-equipage  : — 
Tent  (now  omitted) . 

Accessories 

Blanket 

Cooking-pot 

Mess-tin 

Water-bottle,  empty 


Total  equipment 15       3-^ 


C.  Pack. 


5  [  rV.  Four  days'  provisions, 
but  only  two  days'  of 
salt  meat  or  bacon' . . 


Total. 


L  Knapsack,  empty 5       7  Grand  total 72 

The  German  infantry  soldier  carries  the  following  weights  : — ^ 

Clothing  on  the  person  (with  gloves),  not  including  helmet ...  10 
Ai-mament   and    equipment    (including    helmet,  water-bottle 

(fuU),  coffee-miU,  and  trenching  tools) 31 

Pack,  with  extra  kit,  etc.,  and  reserve  ammunition 19 

Great-coat  and  straps 5 

Rations  7 


Total 


74 


IS. 

-■■4 

91 
^T 

lof 

8f 
10^ 

3 

1 

li 

H 

15^ 

4 

5f 


2  12^ 
1  3f 

3  8^ 
3  3 
0  14 
0  13f 


n 


45       Oi 


5 

11 

H 

134r 


Some  of  the  articles  are  not  always  carried  by  the  same  man,  such  as 
the  hatchet,  spade,  and  cofifee-mill,  so  that  the  weight  may  be  lessened  to 

'  This  has  been  recently  altered  to  the  Gras  rifle,  but  apparently  without  change  of 
weight. 

''  To  this  must  be  added  for  water  in  the  water-bottle,  2  ft  3J  oz.  and  at  least  1  lb  2 
oz.  if  the  tent  be  damp,  making  a  total  of  nearly  76  lb,  but  the  t<int  is  now  omitted. 

3  Roth  and  Lex,  op.  cit.,  Bd.  iii.  (1877),  p.  110. 


CONDITIOITS    OF    SERVICE.  249 

66  fb — average  weiglit  carried,  66  tb  to  71  ib.  The  shako  of  the  riflemen 
and  sharpshooters  is  about  3^  oz.  Ughter  than  the  infantry  helmet.  The 
Mauser  rifle  weighs  10  ft),  and  the  bayonet  1  ft)  8|-  oz. 

The  Russian  soldier  carries  70^ft),  the  Austrian  60  ft),  and  the  Italian 
75  ib  ;  the  mean  of  European  armies  being  66  ft). 

The  mean  weight  of  the  rifles  carried  by  European  infantry  is  9  ft)  6  oz. ; 
of  the  bayonet,  1  ft)  2^  oz. ;  and  of  each  cartridge,  1^  oz. 


SECTION  VI. 
CARRIAGE-  OF   THE   NECESSARIES  AND   ARMAMENT. 

The  equipment  of  the  cavalry  soldier  is  in  great  part  carried  by  the 
horse  ;  but  apparently  the  mode  in  which  the  cavah-y  valise  is  arranged  is 
not  comfortable  to  the  men.  The  total  weight  carried  by  the  horse  appears 
also  to  be  large.  A  soldier  has  personal  and  horse  equipments  equal  to 
nearly  his  own  weight.  Without  pronouncing  on  the  necessity  of  this,  it 
is  a  fact  that  in  Ught-cavalry  regiments  the  horse  now  carries  nearly  19 
stone  weight,  although  the  rider  is  on  average  under  10  stone. 

In  the  case  of  the  infantry  soldier,  who  carries  the  weights  himself,  the 
greatest  care  is  necessary  to  place  them  in  the  manner  least  likely  to  detract 
from  his  efficiency  or  to  injure  his  health.  If  it  were  possible  to  let  a  man, 
in  European  countries,  carry  nothing  but  his  armament  and  water-bottle, 
as  in  India,  much  more  work  would  be  got  out  of  him,  longer  marches  would 
be  made,  and  he  would  show  greater  endurance  on  the  day  of  action.  But 
such  an  arrangement  is  impossible,  as  transport  could  not  be  provided,  and 
the  alternative  of  leaving  a  man  without  his  necessaries  is  not  to  be  thought 
of.  But  it  cannot  be  too  strongly  imj)ressed  on  all  commanding  officers, 
that  every  ounce  of  weight  saved  is  a  gain  in  efficiency.  The  Prussians,  in 
the  war  of  1866,  obtained  wagons,  whenever  they  could,  to  carry  the  knap- 
sacks, and  the  comparison  between  the  condition  of  the  men  thus  relieved 
and  those  who  could  not  be  so,  was  striking.'  A  change  of  opinion  also 
must  be  brought  about  in  the  army  on  a  very  material  point.  Some  offi- 
cers believe  that,  as  the  men  must  carry  weights  in  war,  they  ought  to  carry 
them  on  all  occasions  during  peace,  so  that  the  men  may  be  accustomed 
to  them  ;  and  they  attempt  to  strengthen  their  position  by  referring  to  the 
custom  of  the  Romans,  who  exercised  their  men  in  peace  with  heavier 
weapons  than  those  used  in  war.  But  this  example  is  not  applicable.  A 
man  should  be  exercised  in  the  highest  degree  in  any  way  which  may  de- 
velop his  muscles  and  improve  the  circulation  through  his  lungs  and  heart. 
Any  amount  of  muscular  exertion  (within,  of  course,  reasonable  limits), 
any  degree  of  practice  with  weapons,  must  be  good  as  long  as  his  body  is 
unshackled  ;  but  if  he  is  loaded  with  weights,  and  especially  if  the  carriage 
of  the  weights  at  all  impedes  the  action  of  the  lungs  and  heart,  then  the 
very  exertion  which  in  other  circumstances  would  benefit  him  must  do  him 

'  See  Mr.  Bostock's  able  Report  in  the  Army  Medical  Reports,  vol.  vii.,  p.  359. 

Dr.  Parkes  quotes  a  letter  from  a  Prussian  officer,  high  in  rank,  and  certain  to  know 
the  fact,  stating  that  the  difference  in  the  health  of  the  Prussian  soldiers  who  carried 
the  knapsacks  in  the  Bohemian  marches  in  186(5,  and  those  who  did  not,  was  remark- 
able. The  men  who  had  not  carried  their  packs,  though  they  had  not  had  the  comfort 
of  their  necessaries,  were  fresh  and  vigorous  and  in  high  spirits  ;  those  who  had  carried 
them,  on  the  other  hand,  were  comparatively  worn  and  exhausted'.  And  this  was  with 
the  best  military  knapsack  then  known. 


250  PRACTICAL    HYGIENE. 

harm.  The  soldier  must  cany  weights  sometimes,  but  it  should  be  a  i^de 
not  to  cariT  them  wbeu  he  has  no  immediate  need  of  the  various  articles. 
The  aim  should  be  the  cultivation  of  the  breathing  j^ower  of  his  lungs  and 
the  power  of  his  muscles  to  an  extent  which  "v\ill  enable  him  to  beai*  his 
weights,  at  those  times  Avhen  he  must  caiiy  them,  more  easily  than  if,  on 
a  false  notion  of  accustoming  him  to  them,  he  had  been  obhged  to  wear 
them  on  all  jjossible  occasions. 

Sufficient  practice  with  the  weights  to  enable  a  man  to  dispose  them 
comfortably,  and  to  make  him  familiar  with  them,  should  of  coiu'se  be 
given  ;  but  a  very  short  teaching  will  suffice  for  this. 

The  weights  which  an  infantry  soldier  has  to  carry  have  akeady  been 
stated  ;  the  mode  of  disposing  of  them  has  now  to  be  considered. 

Weights  are  most  easily  borne  when  the  foUowing  points  are  attended 
to:— 

1.  They  must  lie  as  near  the  centre  of  gravity  as  possible.  In  the 
upright  position  the  centre  of  gravity  is  between  the  j^elvis  and  the  centre 
of  the  body,  usually  midway  between  the  umbihcus  and  pubis,  but  vary- 
ing of  course  -with  the  position  of  the  body  ;  a  line  prolonged  to  the 
gi'ound  passes  through  the  astragalus  just  in  the  front  of  the  os  calcis. 
Hence  weights  carried  on  the  head  or  top  of  the  shoulder,  or  which  can  be 
thrown  toward  the  centre  of  the  hij)  bones,  are  carried  most  easily,  being 
directly  over  the  line  of  the  centre  of  gravity.  When  a  weight  is  carried 
away  from  this  hne  the  centre  of  gravity  is  displaced,  and,  in  proportion 
to  the  added  weight,  occupies  a  point  more  or  less  distant  from  the  usual 
site  ;  untn,  perhajDS,  it  is  so  far  removed  from  this  that  a  hne  prolonged 
dowuwai'd  falls  beyond  the  feet  ;  the  man  then  falls,  unless,  by  bending 
his  body  and  bringing  the  added  weight  nearer  the  centre,  he  keep  the 
line  well  within  the  space  which  his  feet  cover. 

In  the  distribution  of  weights,  then,  the  first  rule  is  to  keep  the  weight 
nearer  to  the  centre  ;  hence  the  old  mode  of  carrying  the  soldier's  great- 
coat, viz.,  on  the  back  of  the  knapsack,  is  a  mistake,  as  it  puts  on  weight 
at  the  greatest  possible  distance  from  the  centre  of  gi'avity. 

2.  The  weights  must  in  no  case  compress  the  lungs,  or  in  any  way  in- 
terfere A\ith  the  resjDiratory  movements,  or  the  elimination  of  carbonic 
acid,  or  hinder  the  transmission  of  blood  through  the  lungs,  or  render 
difficult  the  action  of  the  heart. 

3.  No  important  muscles,  vessels,  or  nerves  should  be  pressed  upon. 
This  is  self-evident ;  an  example  may  be  taken  from  the  old  Regulation 
l^ack,  the  arm-strajDS  of  which  so  pressed  on  the  axHlaiy  nerves  and  veins 
as  to  cause  numbness,  and  often  swelling  of  the  hands,  which  has  been 
known  to  last  for  twenty-five  houi's. 

4.  The  weights  should  be  distributed  as  much  as  possible  over  several 
parts  of  the  body. 

If  we  consider  the  means  made  use  of  by  those  who  carry  great  weight, 
we  find  the  following  points  selected  for  bearing  them  : — 

1.  The  top  of  the  head.  The  cause  of  this  is  obvious  ;  the  weight  is 
comi^letely  in  the  line  of  centre  of  gravity,  and  in  movement  is  kept  bal- 
anced over  it.  Of  course,  however,  veiy  great  weights  cannot  be  canied 
in  this  way. 

2.  The  tops  of  the  scapulae,  just  over  the  supra-spiuous  fossa  and 
ridge.  At  this  point  the  weight  is  well  over  the  centre  of  gravity,  and  it 
is  also  difiused  over  a  large  surface  of  the  ribs  by  the  pressure  on  the 
scapula. 

3.  The  hip  bones  and  sacrum.     Here,  also,  the  weight  is  near  the 


COXDITIOXS    OF    SERVICE,  251 

centre  of  gi-aYitr,  and  is  iDorne  by  the  strong  bony  arch  of  tlie  liips,  the 
strongest  part  of  tlie  body. ' 

In  addition,  great  use  is  always  made  by  those  wlio  carry  great  weigbts 
of  the  system  of  balance.  The  packman  of  England  used  to  carry  fi'om  40 
to  even  60  ft  easily  thii'ty  miles  a  day  by  taking  the  top  of  the  scapula  for 
the  fixed  point,  and  having  half  the  weight  in  front  of  the  chest  and  half 
behind.  In  this  way  he  still  brought  the  weight  over  the  centre  of  gi'avity. 
The  same  point,  and  an  analogous  system  of  balance,  is  used  by  the  milk- 
maid, who  can  carry  more  weight  for  a  gTcater  distance  than  the  strongest 
guai'dsman  equipped  with  the  old  mihtars^  accoutrements  and  pack. 

These  points  must  guide  us  in  arranging  the  weights  carried  by  the 
soldier.  The  weight  on  the  head  is,  of  course,  out  of  the  question.  We 
have,  then,  the  scapulee,  the  hip,  and  the  principle  of  balance,  to  take  into 
consideration. 

In  our  army  the  caiTiage  of  the  kit  and  ammunition  has  always  been 
felt  to  be  a  difficulty,  and  many  have  been  the  changes  in  the  infantry 
knapsacks  since  the  close  of  the  Peninsular  war.  The  method  of  carriage 
which  was  formerly  in  use,  though  better  than  some  of  the  older  j)lans, 
had  grave  defects,  and  it  has  now  been  superseded  by  the  new  equipment." 

The  new  infantry  equipment,  proposed  by  a  War  Office  Committee, 
appointed  by  Lord  de  Grey  in  1864,  and  of  which  General  Hemy  Eyre  was 
the  president,  was  devised  for  the  purpose  of  enabling  the  infantiy  soldier 
to  carry  his  weights  with  gi'eater  comfort  (and,  therefore,  to  enable  him 
to  march  farther),  and  especially  to  do  away  with  any  chance  of  injuiing 
his  heart  and  lungs.  ^  This  committee  presented  four  reports  to  the  War 
Office.^ 

Considerable  difficulty  was  found  in  fixing  on  the  best  equipment ;  in 
addition  to  all  the  points  akeady  noted,  simplicity  and  durabihty,  and  as 
much  freedom  from  accidental  breakage  as  could  be  insured,  were  essen- 
tial ;  facihty  of  removal  and  readjustment  for  emergencies,  adaptation  for 
various  conditions  of  seiwice,  and  suitableness  for  military  exercises,  had  all 
to  be  considered.  After  passing  in  reriew  all  the  known  plans,  and  experi- 
menting on  a  large  scale,  the  committee  at  last  recommended  a  plan  which, 
after  an  extended  trial  in  many  regiments,  and  being  submitted  to  the 
oj)inions  of  many  officers,  was  finally  authorized  and  issued  in  place  of  the 
old  pattern. 

'  The  girls  engaged  in  some  of  the  works  in  Cornwall  carry  immense  bags  or  tam- 
pers of  sand  np  steep  liills  bv  resting  the  lower  part  of  the  sack  on  the  hip  and  sacrum, 
and  the  upper  part  on  the  scapula.  It  is  the  same  position  as  that  taken  bv  the  Turk- 
ish porters,  who  will  carry  600  and  800  lb  some  distance ;  they  also  sometimes  have  a 
band  round  the  forehead  fastened  to  the  top  of  the  weight. 

-  In  the  former  editions  descriptions  were  given  of*  the  obsolete  Regulation  equip- 
ment, and  of  various  other  plans.     But  it  has  been  thought  unnecessary  to  repeat  these. 

^  In  the  chapter  on  Home  Service  are  given  the  facts  about  the  amount  of  heart 
and  vessel  disease  in  the  army.  It  appears  to  be  very  large,  and  to  be  attributable,  in 
part  at  any  rate,  to  exercise  under  unfavorable  conditions.  It  h  not  confined  to  the 
infantry,  but  is  common  to  all  branches,  and  perhaps  the  disease  of  the  vessels  is  even 
greater  in  degree  in  the  cavalry  and  artillery.  Professor  Maclean,  C.B.,  called  the  at- 
tention of  the  authorities  to  this  matter  in  a  striking  lecture  delivered  at  the  Royal 
United  Service  Institution,  and  published  in  the  Journal  of  the  Institution,  vol.  viii., 
and  from  which  extracts  were  given  in  former  editions.  The  army  is  greatly  indebted 
to  Dr.  Maclean  for  his  clear  exposition  on  this  point.  The  first  Report  of  the  Com- 
mittee on  Knapsacks  contains  the  evidence  to  that  date. 

■*  Reports  of  the  Committee  appointed  to  Inquire  into  the  Effect  on  Health  of  the 
present  System  of  carrying  the  Accoutrements,  Ammunition,  and  Kit  of  Infantry 
Soldiers  : 'First  Report,  "1865  ;  Second  Report,  1867  ;  Third  and  Fourth  Reports,  1868. 


"252  PRACTICAL    HYGIENE. 

Tlie  new  equipment  is  essentially  based  on  the  yoke  valise  plan  of  the 
late  Colonel  Sir  Thomas  Troubridge,  C.B.,  who  had  been  for  many  years 
experimenting  on  this  subject ;'  but  it  is  greatly  altered  in  details  in  order 
to  avoid  the  use  of  copper  or  iron  rods.  The  two  great  principles  are  to 
use  the  scapulse  and  the  sacrum  in  about  equal  proportion  as  carriers  of 
the  weight,  and  to  place  the  weights  as  near  to  the  body  as  possible,  and, 
as  far  as  could  be  done,  in  front  as  well  as  behind,  so  as  to  avoid  the  dis- 
placement of  the  centre  of  gravity.  The  great  advantage  of  using  the  sa- 
crum as  one  of  the  points  of  support  has  been  very  apparent  in  the  trials  of 
the  valise  plan.  In  that  way  only  can  the  chest  be  tlioroughly  relieved  ;  a 
very  great  weight  can  be  carried  without  injury  if  it  is  necessary,  and  apart 
from  that  a  mechanical  advantage  of  no  small  moment  has  been  obtained. 
For  the  effect  of  placing  the  kit  and  ammmiition  low  down  is  to  free  the 
large  muscles  of  the  shoulder  and  back  from  the  impediment  which  hinders 
their  action  when  a  knapsack  of  any  kind  is  carried  in  its  usual  place  ;  the 
bayonet  exercise  can  therefoi-e  be  much  better  performed  ;  but  more  than 
this,  the  soldier  engaged  in  a  personal  struggle  is  in  far  better  position 
than  with  a  knapsack  on  the  upper  part  of  the  back  ;  for  in  the  latter  case, 
the  centre  of  gravity  being  displaced  (raised  and  carried  backwards),  the 
man  has  already  a  tendency  to  fall  back  which  tells  seriously  against  him. 
In  the  new  equij^ment,  on  the  contrary,  the  great  weights  being  all  below 
the  centre  of  gravity,  rather  tend  to  keep  a  man  steadier  and  firmer  on  his 
legs  than  otherwise. 

In  order  to  gain  these  advantages,  and  also  to  lessen  the  weight  of  the 
equipment,  the  framed  knajDsack  was  abandoned,  and  a  bag  or  valise  sub- 
stituted, which  is  large  enough  to  carry  the  service  kit  and  some  provisions. 
The  total  weight  of  the  whole  equipment,  as  intended  for  active  service,  is 
5  lb  8  oz. 

In  the  peace  equipment  there  is  a  single  pouch  in  front,  which  can  be 
shifted  to  one  side  so  as  to  allow  the  waist-belt  to  be  opened.  The  straps 
running  up  over  the  shoulder  from  the  rings  are  made  broad  on  the  scap- 
ulse,  they  cross  on  the  back  like  a  common  pair  of  braces,  and  then  catch- 
ing the  toj^  of  the  valise  on  the  other  side  by  a  buckle,  run  under  the  arm 
to  the  ring  on  the  opposite  side  from  which  they  started.  From  this  ring 
a  strap  runs  to  the  bottom  of  the  valise  which  is  placed  resting  on  the  sa- 
crum ;  by  this  arrangement  the  weight  of  the  valise  is  thrown  partly  on  the 
shoulder,  partly  on  the  sacrum,  and  is  also  thrown  forward  in  a  line  with 
the  centre  of  gravity.  From  the  ring  another  strap  runs  to  the  waist- 
belt  and  supports  the  ammunition,  which  thus  balances  in  part  the  weight 
behind. 

In  full  seiwice  order  two  2:)0uches  are  carried  in  front,  each  holding  20 
rounds  ;  there  is  also  a  ball-bag,  intended  to  hold  loose  cartridges  for  rapid 
firing,  in  which,  if  there  be  necessity,  20  or  even  30  cartridges  can  be  put. 
There  is  provision  in  the  valise  for  twenty  more. 

The  greatcoat  is  placed  above  the  valise,  and  being  soft,  gives  no  ob- 
struction to  the  action  of  the  muscles  of  the  shoulder.  " 

The  canteen  can  be  carried  over  the  greatcoat ;  biit  many  officers  prefer 
carrying  it  on  the  valise,  where  there  are  two  loops  intended  for  it. 

This  equipment  is  very  easy,  and  leaves  the  chest  perfectly  free  ;  it  is 
simple  both  in  principle  and  construction,  and  affords  many  facilities  for 
carriage  of  articles,  such  as  the  haversack,  the  water-bottle,  blanket,  etc., 

'  Sir  T.  Tronbridge's  equipment  will  be  found  described  and  figured  in  the  2d  edi- 
tion of  this  -work.     He  had  made  experiments  on  thissubject  for  more  than  fifteen  years. 


CONDITIOlSrS    OF    SERVICE.  253 

which  prove  useful  on  service.  It  is  of  more  importance  to  note  here,  that 
it  certainly  answers  all  medical  requirements  ;  and  as  it  leaves  the  man  very 
free  and  unencumbered  in  his  movements,  it  does  away  entirely  with  the 
stiff  unmilitary  appearance  produced  by  tlie  old  plan. 

There  seems  only  one  sanitary  point  which  has  been  urged  against  this 
equipment,  and  that  is,  that  a  good  deal  of  the  back  is  covered,  and  that 
perspiration  collects  under  the  valise.  Whatever  equipment  be  used,  there 
must  be  retention  of  perspiration  under  the  covered  parts  ;  this  is  inevita- 
ble, and  is  produced  by  any  knapsack.  The  valise  equipment  is  no  excep- 
tion to  the  rule,  but  it  is  singular  how  little  perspiration  really  collects 
under  the  valise  if  the  man  knows  how  to  manage  it.  By  allowing  the  top 
of  the  valise  to  fall  back  half  an  inch,  a  space  is  left  between  the  greater 
part  of  the  vahse  and  back,  which  allows  evaporation,  and  the  loins  are 
kept  cool.  On  the  march  also,  when  the  waist-belt  is  unbuckled,  both  the 
valise  and  great-coat  hang  loosely  and  away  from  the  body,  and  evaporation 
goes  on.' 

The  principle  of  the  valise  equipment  will  jDrobably  always  be  main- 
tained, although  some  details  may  be  altered.  The  "  magazine  accoutre- 
ments," invented  by  Brigade- Surgeon  W.  S.  Oliver,  A.M.D.,  have  been 
under  trial  some  time,  and  have  been  very  favorably  reported  upon.  They 
appear  to  be  even  easier  than  the  vaHse  equipment,  and  are  less  compli- 
cated in  their  fittings  ;  they  provide  for  the  carriage  of  more  ammunition, 
and  leave  the  back  freer  for  transpiration.  There  is  also  a  light  water- 
proof cape,  which  can  be  used  as  a  sheet  or  portion  of  a  shelter  tent. 

SECTION  vn. 

WORK  OF  THE  SOLDIER. 

The  kind  and  amount  of  work  in  the  different  arms  of  the  service  is  so 
different  that  it  is  impossible  to  bring  it  under  one  general  description. 
In  the  artillery,  cleaning  horses,  guns,  carriages,  and  accoutrements,  and 
gun  drill ;  in  the  cavalry,  cleaning  of  horses,  accoutrements,  and  drill  with 
the  special  arm  ;  in  the  infantry,  drill,  and  barrack  and  fatigue  duties, 
and  the  cleaning  of  arms  and  accoutrements,  are  all' kinds  of  work,  the 
amount  of  which  is  not  easy  to  estimate. 

Much  of  the  work  of  the  artillery  and  cavalry  is  highly  beneficial  to 
them,  and  the  fine  weU-developed  muscles  show  that  all  parts  of  the  body 
are  properly  exercised.  Some  of  the  work  (such  as  gun  driU  or  sword 
exercise)  is  hard,  and  even  violent,  and  the  great  amount  of  aneurism  in 
both  bodies  of  men,  as  well  as  in  the  infantry,  has  led  to  the  idea  that  the 
exercise  is  either  too  severe,  or  is  performed  under  unfavorable  conditions, 
such  as  heavy  equipments  or  too  tight-fitting  clothes.  Although  violent 
while  it  lasts,  it  seems  questionable  whether  the  work  is  so  severe  as  that 
which  man 3^  mechanics  undergo  without  injury  ;  it  may,  however,  be  more 
sudden  and  rapid,  and  the  heart  may  be  brought  into  more  violent  action. 
The  conditions  under  which  the  work  is  done  are  certainly  less  favorable 
than  in  the  case  of  the  mechanic,  who  is  never  embarrassed  by  weights  or 
tight  clothes. 


'  Reference  may  be  made  to  the  2d  edition  of  this  work  for  figures  and  descriptions 
of  the  continental  plans,  and  to  the  Reports  of  the  War  Office  Committee  on  Knapsacks 
and  Accoutrements,  for  fuller  details  than  can  be  given  here.  For  the  present  system, 
see  Valise  Equipment  for  Infantry  Regiments,  Instructions  for  Fitting  the,  1878. 


254  PRACTICAL    nrGIENE. 

In  the  infanti-y  the  amount  of  aneurism  is  slightly  below  that  of  the 
other  arms,  but  not  much  so.  The  hard  work  in  the  infantry  is  the  run- 
ning drill  when  the  weights  are  carried,  bayonet  e'xercise,  and  long 
mai'ches  ;  but  though  severe,  it  is  not  so  excessive  as  to  lead  us  to  think 
it  would  do  injury  to  strong  men  if  all  circumstances  were  favorable. 

During  war  the  amount  of  labor  undergone  is  sometimes  excessive,  as 
will  be  clear  from  what  is  said  in  the  next  section,  and  in  the  rapid  cam- 
paigns of  modern  times,  very  young  and  weakly  men  are  soon  exhausted. 

A  soldier  req\iires  to  be  trained  for  the  ordeal  of  active  ser^dce,  and 
this  is  now  done  in  our  army  by  a  series  of  gymnastic  exercises  and  sys- 
tematic marches,  intended  to  develop  every  muscle,  to  make  the  artillery 
or  the  cavalry  man  able  to  vault  on  his  horse,  and  the  foot  soldier  to  run 
and  to  escalade,  and  to  march  great  distances  without  fatigue. 

Gxjmnadic  Exercises. — All  military  nations  have  used  in  their  armies  a 
system  of  athletic  exercises.  The  Greeks  commenced  such  exercises  when 
the  increase  of  cities  had  given  rise  to  a  certain  amount  of  sedentary  Ufe. 
The  Romans  began  to  xise  athletic  training  in  the  early  days  of  the  Re- 
public, enth'ely  with  a  view  to  military  efficiency.  The  exercises  were  con- 
tinuous, and  were  not  alternated  with  periods  of  complete  idleness. 

The  officers  exercised  with  the  men.  At  a  later  day,  we  are  told  that 
Marius  never  missed  a  single  day  at  the  Camj^us  Martins  ;  and  Pompey  is 
said  by  Sallust  to  have  been  able  at  fifty-eight  years  of  age  to  run,  jump, 
and  carry  a  load  as  well  as  the  most  robust  soldier  in  his  army. 

Swimming  was  especially  taught  by  the  Romans,  and  so  essential  were 
the  gymnastic  exercises  deemed  that,  to  express  that  a  man  was  completely 
ignorant,  it  was  said  "  he  knew  neither  how  to  read  nor  swim."  The  gym- 
nastic exercises  were  the  last  of  the  old  customs  which  disappeared  before 
the  increasing  luxury  of  the  latter  empire. 

In  the  feudal  times  the  practice  of  the  weapons  was  the  best  gymnastic 
exercise  ;  every  peasant  in  England  was  obliged  to  practise  Avith  the  bow  ; 
the  noblemen  underwent  an  enormous  amount  of  exercise,  both  with  and 
Avithout  arms,  and  on  foot  and  horseback. 

After  the  invention  of  gunpowder  the  qualities  of  strength  and  agility 
became  of  less  importance  for  the  soldiei-,  and  athletic  ti-aining  was  dis- 
continued everywhere.  But  within  the  last  few  years  the  changing  con- 
ditions of  modern  warfare  have  again  demanded  from  the  soldier  a  degree 
of  endurance  and  of  rapidity  of  movement  which  the  wars  of  the  eighteenth 
century  did  not  require.  And  the  poiDulation  generally  of  this  country 
have  of  late  years  become  alive  to  the  necessity  of  compensating,  by  some 
artificial  system  of  muscular  exercise,  the  sedentary  life  which  so  many 
lead. 

In  our  own  time,  the  first  regular  gymnasium  appears  to  have  been 
established  at  Schwefental,  in  Saxony,  by  Saltzmann,  with  a  view  of  giving 
health  to  the  body,  strengthening  certain  muscles,  and  remedying  deform- 
ities. About  sixty  years  ago  Ling  also  commenced  in  Sweden  the  system 
of  movements  which  have  made  his  name  so  celebrated.  Switzerland, 
Spain,  and  France  followed,  and  of  late  years  in  Germany  many  gymnastic 
societies  (Tmnaer-Verein)  have  been  founded  in  almost  all  the  great  cities, 
and  the  literatm-e  of  gymnasticism  is  now  a  large  one.  In  our  oaati  country, 
the  outdoor  and  vigorous  life  led  h\  the  richer  classes,  and  by  many  work- 
ing men,  rendered  this  movement  less  necessary,  but  of  late  {-ears  societies 
have  been  formed,  gymnasia  established,  and  athletic  sports  encouraged 
in  many  places. 

Among  armies,  the  Swedish  and  Prussian  were  the  first  to  attempt  the 


CONDITIONS    OP    SERVICE.  255 

pbysical  training  of  their  soldiei'S.  France  followed  in  1845,  and  ever 
since  a  complete  system  of  gymnastic  instruction  has  been  carried  on  in 
the  French  army,  and  a  military  gymnastic-sehool  exists  at  Vincennes, 
where  instructors  for  the  army  are  taught. 

In  the  English  army  this  matter  attracted  less  attention  until  after  the  ' 
Ci'imean  war,  when  the  estabhsbment  of  gymnasia  as  a  means  of  training 
and  recreation  were  among  some  of  the  many  reforms  projected  by  Lord 
Herbert.  In  1859  General  Hamilton  and  Sir  G.  Logan,  lately  Director- 
General  of  the  Army  Medical  Department,  were  sent  over  to  inspect  the 
systems  in  use  on  the  Continent,  and  presented  a  very  interesting  Report, 
which  was  subsequently  published.  A  grant  of  money  was  immediately 
taken  for  a  gymnasium  at  Aldershot,  and  this  has  now  been  in  operation 
for  several  years,  under  the  direction  of  Colonel  Hammersley,  wth  most 
satisfactory  results.  Gymnasia  are  now  ordered  to  be  built  at  all  the 
large  stations,  and  a  complete  code  of  instructions,  drawn  up  by  Mr. 
Maclaren  of  Oxford,  is  published  by  authority.' 

The  instructions  have  two  great  objects — Isf,  To  assist  the  physical 
development  of  the  recruit;  2d,  To  strengthen  and  render  supple  the 
frame  of  the  trained  soldier.  Every  recruit  is  now  ordered  to  have  three 
months'  gymnastic  training  dui'ing  (or,  if  judged  expedient  by  a  medical 
officer,  in  lieu  of  part  of)  his  ordinary  drill.  Two  months  are  given  be- 
fore he  commences  rifle  practice,  and  one  month  afterward.  This  train- 
ing is  superintended  by  a  medical  officer,  who  will  be  responsible  that  it 
is  done  proj)erly,  and  who  will  have  the  power  to  continue  the  exercises 
beyond  the  prescribed  time,  if  he  deems  it  necessary.  The  exercise  for 
the  recruit  is  to  last  only  one  hour  a  day,  and  in  addition  he  will  have  from 
two  to  three  hours  of  ordinary  drill. 

The  trained  infantry  soldier  is  ordered  to  go  through  a  gymnastic  course 
of  three  months'  duration  every  year,  one  hour  being  given  every  other  day. 
The  cavalry  soldier  is  to  be  taught  fencing  and  sword  exercise  in  lieu  of 
gymnastics. 

The  "  Code  of  Instructions  "  drawn  up  by  Mr.  Maclaren  consists  of  two 
parts,  elementary  and  advanced  exercises.  The  exercises  have  been  ar- 
ranged with  very  great  care,  and  present  a  progressive  course  of  the  most 
useful  kind.  The  early  exercise  commences  with  walking  and  running ; 
leaping,  with  and  without  the  pole,  follows  ;  and  then  the  exercises  with 
apparatus  commence,  the  order  being  the  horizontal  beam,  the  vaulting 
bar,  and  the  vaulting  horse.  AU  these  are  called  exercises  of  jDrogression, 
The  elementary  exercises  follow,  viz.,  with  the  parallel  bars,  the  pair  of  rings, 
the  row  of  rings,  the  elastic  ladder,  the  horizontal  bar,  the  bridge  ladder, 
and  the  ladder  plank.  Then  follow  the  advanced  exercises  of  climbing  on 
the  slanting  and  vertical  pole,  the  slanting  and  vertical  rope,  and  the 
knotted  rope. 

Finally,  the  most  advanced  exercises  consist  of  escalading,  first  against 
a  wall,  and  then  against  a  prepared  building. 

In  the  French  army  swimming  and  singjng  are  also  taught.  Both  are 
very  useful ;  the  singing  is  encouraged,  not  as  a  matter  of  amusement 
(though  it  is  very  useful  in  this  way),  but  as  a  means  of  impro^ving  the 
lungs. 

Swimming  should  be  considered  an  essential  part  of  the  soldier's  edu- 

'  Gymnastic  Exercises,  etc.,  1877.  Mr.  Maclaren  lias  also  published  two  otlier  works 
of  great  utility  ;  a  System  of  Training  and  Physical  Education.  This  last  work  should 
be  in  the  hands  of  every  one. 


256  PRACTICAL    HYGIENE, 

cation,  and  it  is  probable  that  it  will  be  systematically  taugbt  in  the  Eng- 
lish arm}'. 

Robert  Jackson  very  strongly  recommended  that  dancing  should  be 
taught  and  encouraged.  There  is  sound  sense  in  this  ;  a  spirited  dance 
•brings  into  play  many  muscles,  and  in  a  well-aired  room  is  as  good  an  ex- 
ercise as  can  be  taken.     It  would  also  be  an  amusement  for  the  men. 

Duties  of  the  Officer  in  the  Gymnasium. 

The  "  Medical  Eegulations  "  order  the  inspecting  medical  officer  and  sur- 
geon to  visit,  and  adrise  on  the  kind  and  amount  of  gymnastic  exercises. 
The  "  Queen's  Eegulations "  (section  10,  para.  8)  order  a  strict  medical 
examination  of  each  man  before  the  instniction  is  commenced.  During 
the  course  further  inspections  are  to  be  made — of  the  recruits  once  a  fort- 
night, of  trained  soldiers  monthly.  The  measurements  of  the  reciiiit  are 
also  to  be  taken  under  the  direction  of  the  medical  officer.  The  following 
points  should  be  attended  in  regard  to — 

1.  Recruits. — The  recniit  is  inspected  from  time  to  time,  to  see  if  the 
system  agi'ees  with  him. 

(a)  Weight. — The  weight  of  the  body  should  be  ascertained  at  the  be- 
ginning and  end  of  the  course,  and  during  it,  if  the  recruit  in  any  way 
complains.  With  sufficient  food  recruits  almost  always  gain  in  weight, 
therefore  any  loss  of  weight  should  at  once  call  for  strict  inquiry.  It  may 
be  the  recruit  is  being  overdone,  and  more  rest  may  be  necessary.  But  in 
order  to  avoid  the  greatest  error,  the  weights  must  be  carefully  taken  ;  if 
they  are  taken  at  all  times  of  the  day,  without  regard  to  food,  exercise, 
etc.,  accuracy  is  impossible  ;  there  may  be  2  lb  or  3  lb  variation.  The  phy- 
siological practice  during  experiments  is  to  take  the  weight  the  first  thing 
in  the  morning  before  breakfast,  and  after  emptying  the  bladder.  If  it 
cannot  be  done  at  this  time,  scarcely  any  reliance  can  be  placed  on  the  re- 
sult. Food  alone  may  raise  the  weight  2  lb  or  3  lb,  and  we  cannot  be  sure 
that  the  same  quantity  of  food  is  taken  daily.  The  clothes,  also,  must  be 
remembered ;  men  should  be  weighed  naked  if  possible,  if  not,  in  their 
trousers  only,  and  always  in  the  same  dress. 

(6)  Height. — This  is  usually  taken  in  the  erect  position.     Dr.  Aitken  ' 
recommends  it  to  be  taken  Avhen  the  bodj'  is  stretched  on  a  horizontal, 
plane.     A  series  of  experiments  on  both  plans  would  be  very  desirable. 

(c)  Girth  of  Chest. — The  chest  is  measured  to  ascertain  its  absolute 
size,  and  its  amount  of  exjDansion. 

It  is  best  measured  when  the  man  stands  at  attention,  with  the  arms 
hanging  ;  and  the  tape  should  pass  round  the  nipple  line.  The  double 
tape  (the  junction  being  placed  on  the  spine)  is  a  gi-eat  improvement  over 
the  single  tape,  as  it  measures  the  sides  separately,  and  with  practice  can 
be  done  as  quickly. 

The  chest  should  be  measured  in  the  fullest  expiration  and  fullest  in- 
spiration. If  the  chest  is  measured  with  the  arms  extended,  or  over  the 
head,  the  scapulae  may  throw  out  the  tape  from  the  side  of  the  chest. 

(d)  The  Inspiratory  Power,  as  expressed  by  the  spirometer,  may  also  be 
employed. 

(e)  Growth  of  Muscles. — Tins  is  known  by  feeling  the  muscles  when 
telaxed  and  in  action,  and  by  measurements.  The  measurement  of  the 
upper  arm  should  be  taken  either  when  the  arm  is  bent  over  the  most 

'  On  the  Growth  of  the  Recruit,  p.  68. 


CONDITIONS    OF    SERVICE.  2o  ^ 

prominent  part  of  the  biceps,  or  over  the  thickest  part  when  the  arm  is 
extended. 

-  (/)  General  Condition  of  Health. — Digestion,  sleep,  complexion,  etc. 
The  recruit  should  also  be  inspected  during  the  time  of  exercise,  to  watch 
the  effect  on  his  heart,  lungs,  and  muscles.  In  commencing  training  the 
great  point  is  to  educate,  so  to  speak,  the  heart  and  lungs  to  perform  sud- 
denly, without  injm-y,  a  great  amount  of  work.  To  do  this  there  is  nothing 
better  than  practice  in  running  and  jumping.  It  is  astonishing  what  effect 
this  soon  has.  If  possible,  the  increase  in  the  number  of  respirations  after 
running  200  or  300  yards  should  be  noted  on  the  first  day,  as  this  gives  a 
standard  by  which  to  judge  of  the  subsequent  improvement.  But  as  it 
would  be  impossible  and  a  waste  of  time  to  do  this  with  all  the  men,  di- 
rectly the  run  is  ended  the  men  should  range  in  hne,  and  the  medical  offi- 
cer should  pass  rapidly  down  and  pick  out  the  men  whose  respiration  is 
most  hurried.  In  all  the  exercises  the  least  difficulty  of  respiration  should 
cause  the  exercise  to  be  suspended  for  four  or  five  minutes. '  The  heart 
should  be  watched ;  the  characters  indicating  the  necessity  for  rest  or 
easier  work  are  excessive  rapidity  (130-160),  smallness,  inequality,  and 
irregularity. 

Soreness  of  muscles  after  the  exercise,  or  great  weariness,  should  be  in- 
quired into.  It  would  be  well  every  now  and  then  to  try  the  inguinal  and 
femoral  rings  during  exertion  and  coughing. 

One  very  important  part  in  gymnastic  training  depends  on  the  in- 
structor. A  good  instructor  varies  the  work  constantly,  and  never  urges  a 
man  to  undue  or  repeated  exertion.  If  the  particular  exercise  cannot  be 
done  by  any  man  it  should  be  left  for  the  time.  Anything  like  urging  or 
jeering  by  the  i-est  of  the  men  should  be  strictly  discountenanced.  The 
instructor  should  pass  rapidly  from  exercise  to  exercise,  so  that  a  great 
variety  of  muscles  may  be  brought  into  play  for  a  short  time  each,  and  as 
the  men  work  in  classes,  and  all  cannot  be  acting  at  once,  there  is  neces- 
sarily a  good  deal  of  rest. 

The  grand  rule  for  an  instructor  is,  then,  change  of  work  and  sufficient 
rest. 

In  the  case  of  a  recruit  who  has  not  been  used  to  much  physical  exer- 
tion, the  greatest  care  must  be  taken  to  give  plenty  of  rest  during  the  ex- 
ercises. There  may  even  seem  to  be  an  undue  proportion  of  rest  for  the 
first  fortnight,  but  it  is  really  not  lost  time.  The  medical  officer  is  only 
directed  to  visit  the  gymnasium  once  a  fortnight,  but  during  the  first 
fortnight  of  the  training  of  a  batch  of  recruits  he  should  visit  it  every 
day. 

With  proper  care  men  are  very  seldom  injured  in  gymnasia.  Dr. 
Parkes  was  informed  at  Vincennes  that,  though  they  did  not  take  men  un- 
less they  were  certified,  as  fit  by  a  medical  officer,  they  occasionally  got  men 
with  "  delicate  chests,"  though  not  absolutely  diseased.  These  men  always 
improved  marvellously  during  the  six  months  they  remained  at  Vincennes. 
In  fact,  a  regulated  course  of  gymnastics  is  well  known  to  be  an  important 
remedial  measure  in  threatened  phthisis.  Hernia  is  never  caused  at  Vin- 
cennes.    Nor  does  it  appear  that  any  age  is  too  great  to  be  benefited  by 

'  In  the  training  of  horses  the  points  always  attended  to  are — the  very  gradual  in- 
crease of  the  exercise ;  gentle  walking  is  persevered  in  for  a  long  time,  then  slow  gal- 
lops ;  then,  as  the  horse  gains  wind  and  strength,  quicker  gallops ;  but  the  horse  is 
never  distressed,  and  a  boy  would  be  dismissed  from  a  stable  if  it  were  known  that  the 
horse  he  was  riding  showed,  by  sighing,  or  in  any  other  way,  that  the  speed  was  too 
great  for  him. 

Vol.  n.-17 


258  PRACTICAL    HYGIENE. 

gymnastics,  though  in  old  men  the  condition  of  the  heart  and  vessels  (as  to 
rigidity)  should  be  looked  to. 

Trained  Soldiers. — There  is  less  occasion  for  care  with  these  men  ;  they 
should,  however,  be  examined  from  time  to  time,  and  any  great  hurry  of 
respiration  noted.  The  man  should  be  called  out  from  the  class,  his  heart 
examined,  and  some  relaxation  advised  if  necessary. 


Drills  and  3Iarches. 

In  drill,  and  during  marches,  the  movements  of  the  soldiers  are  to  a 
certain  extent  constrained.  In  the  attitude  of  "  attention  "  the  heels  are 
close  together,  the  toes  turned  out  at  an  angle  of  60°,  the  a;rms  hang  close 
by  the  sides,  the  thumbs  close  to  the  forej&ngers,  and  on  a  line  with  the 
seam  of  the  trousers.  The  position  is  not  a  secure  one,  as  the  basis  of  sup- 
port is  small,  and  in  the  manual  and  platoon  exercise  the  constant  shifting 
of  the  weight  changes  the  centre  of  gi-avity  every  moment,  so  that  constant 
muscular  action  is  necessary  to  maintain  the  equilibrium.  Men  are  there- 
fore seldom  kept  long  under  attention,  but  are  told  to  "  stand  at  ease  "  and 
"stand  easy,"  in  which  cases,  and  especially  in  the  latter,  the  feet  are 
farther  apart  and  the  muscles  are  less  constrained. 

In  marching  the  attitude  is  still  stiff— it  is  the  position  of  attention,  as 
it  were,  put  into  motion.  The  slight  lateral  movement  which  the  easy 
walker  makes  when  he  brings  the  centre  of  gravity  alternately  over  each 
foot,  and  the  slight  rotatory  motion  which  the  trunk  makes  on  the  hip- 
joint,  is  restrained  as  far  as  it  can  be,  though  it  cannot  be  altogether 
avoided,  as  is  proved  by  observing  the  light  swaying  motion  of  a  line  of 
even  very  steady  men  marching  at  qu,ick  time.  Marching  is  certainly  much 
more  fatiguing  than  free  walking  ;  and  in  the  French  army,  and  by  many 
commanding  officers  in  our  own,  the  men  are  allowed  to  walk  easily  and 
disconnectedly,  except  when  closed  up  for  any  sjDccial  purpose.  This  may 
not  look  so  striking  to  the  eye  of  a  novice,  but  to  the  real  soldier,  whose 
object  is  at  the  end  of  a  long  march  to  have  his  men  so  fresh  that,  if 
necessary,  they  could  go  at  once  into  action,  such  easy  marching  is  seen  to 
be  really  more  soldier-like  than  the  constrained  attitudes  which  lead  so 
much  sooner  to  the  loss  of  the  soldier's  strength  and  activity. 

In  walking,  the  heel  touches  the  ground  first,  and  then  rapidly  the  rest 
of  the  foot,  and  the  great  toe  leaves  the  ground  last.  The  soldier,  in  some 
countries,  is  taught  to  place  the  foot  almost  flat  on  the  ground,  but  this  is 
a  mistake,  as  the  body  loses  in  part  the  advantage  of  the  buffer-like  mechan- 
ism of  the  heel.  The  toes  are  turned  out  at  an  angle  of  about  30°  to 
45°,  and  at  each  step  the  leg  advances  forward  and  a  little  outward  ;  the 
centre  of  gravity,  which  is  between  the  navel  and  the  pubis,  about  in  a  line 
with  the  promontory  of  the  sacrum  (Weber),  is  constantly  shifting.  It  has 
been  supposed  that  it  would  be  of  advantage  to  keejD  the  foot  quite  sti-aight, 
or  to  turn  the  toes  a  little  in,  and  to  let  the  feet  advance  almost  in  a  line 
with  each  other.  But  the  advantage  of  keeping  the  feet  apart  and  the  toes 
tiu-ned  out,  is  that,  first,  the  feet  can  advance  in  a  straight  line,  which  is 
obviously  the  action  of  the  great  vasti  muscles  in  front  of  the  thigh  ;  and, 
second,  when  the  body  is  brought  over  the  foot,  the  turned-out  toes  give  a 
much  broader  base  of  support  than  when  the  foot  is  straight.  .  The  spring 
from  the  great  toe  may  perhaps  be  a  little  greater  when  the  foot  is  straight 
(although  this  is  doubtful,  and  there  seems  no  reason  Avhy  the  gastrocnemii 
and  solei  should  contract  better  in  this  position),  but  there  is  a  loss  of 


CONDITIONS    OF    SERVICE. 


259 


spring  from  tlie  other  toes.  Besides  this,  it  has  been  shown  by  Weber 
that  when  the  leg  is  at  its  greatest  length,  i.e.,  when  it  has  just  urged  the 
body  forward,  and  is  lifted  from  the  ground,  it  falls  forward  like  a  pendu- 
lum from  its  own  weight,  not  from  muscular  action,  and  this  advance  is 
from  within  and  behind  to  without  and  before,  so  that  this  action  alone 
carries  the  leg  outward. 

The  foot  should  be  raised  from  the  ground  only  so  far  as  is  necessary 
to  clear  obstacles.  Formerly,  in  the  Russian  Imperial  Guard,  the  men 
were  taught  to  march  with  a  peculiar  high  step,  the  knee  being  lifted  al- 
most to  a  level  with  the  acetabulum.  The  effect  was  striking,  but  the  waste 
of  power  was  so  great  that  long  marches  were  impossible,  and  this  kind  of 
marching  is  now  given  up.  The  foot  should  never  be  advanced  beyond  the 
place  where  it  is  to  be  put  down  ;  to  do  so  is  a  waste  of  labor. 

In  the  English  army  the  order  is  as  follows  : — 


Length  and  Number  of  Steps  in  Marching. 


Kind  of  Step. 

Length. 

No.  per  Minute. 

Ground  Traversed 
per  Minute. 

Ground  Traversed 

per  hour  without 

Halts. 

Slow  time  

Inches. 
30 
30 
33 
33 
21 
13 

24 
30 

75 
116 
110 
165 

Feet. 

1871 
290 
303  J 
4531 

Miles. 
2.1 

Quick  time   

3.3 

Stepping  out 

3.4 

Double          

5.157 

Stepping  short 

Side  step 

or  when 

Forming  four  deep 

Stepping  back 

The  "  double  "  is  never  continued  very  long  ;  it  is  stopped  at  the  option 
of  the  commanding  officer.  In  the  French  army  it  is  ordered  not  to  be 
continued  longer  than  twenty  minutes.  At  the  double  (if  without  arms), 
the  forearms  are  held  horizontally,  the  elbows  close  to  the  side ;  if  the  rifle 
is  carried,  one  arm  is  so  held.  There  is  an  advantage  in  this  attitude,  as 
the  arms  are  brought  into  the  position  of  least  resistance ;  more  fixed  points 
are  given  for  the  muscles  of  respiration,  and  the  movement  of  the  arms 
and  shoulders  facilitates  the  rapid  shifting  of  the  centre  of  gravity. 

Quick  time  is  always  used  in  drills  and  marching.  The  ground  got 
over  per  hour  is  generally  reduced  by  halts  to  2.8  miles. 

Running  drill  has  been  introduced  of  late  years  ;  it  is  not  carried  be- 
yond 1,000  yards,  and  the  men  are  gradually  brought  up  to  this  amount. 
The  pace  is  not  to  exceed  6  miles  an  hour.  Weakly  men  (if  considered  un- 
fit by  the  medical  officers)  are  to  be  excused.' 

In  the  French  army  the  length  of  the  step  is  rather  different. 


'  Queen's  Reg. ,  section  10,  para.  25a. 


260 


PEACTICAL    HYGIENE. 


French  Steps  in  English  Measures  {Morache,  1874). 


Length  of  Step 
in  inches. 

steps  per  Minute. 

Ground  Traversed 

per  Minute  in 

Feet. 

Ground  Traversed 
per  Hour  in  Miles. 

Pas        ordinaire ) 

(now     seldom  V 

26 

76 

164 

1.86 

used) 1 

Pas  de  route 

26 

90 

195 

2.22 

Pas  accelere 

26 

110 

238 

2.70 

Pas  de  charge 

29.5 

120 

295 

3.35 

Pas     maximum    ) 
(gymnastique).  ) 

32.5 

165 

449 

5.10 

The  Frencli  step  is  therefore  4  inches  shorter  than  the  Enghsh  ;  this  is 
perhaps  because  the  men  are,  as  a  rule,  shorter.  The  Prussian  and  the 
Bavarian  step  is  31|^  inches  long,  and  112  steps  are  taken  per  minute. 

The  exact  length  of  the  step,  and  the  number  per  minute,  are  very  im- 
jDortant  questions.  The  object  of  the  soldier  is  to  get  the  step  as  long,  and 
the  number  per  minute  as  gTeat,  as  possible,  without  undue  fatigue,  so  as 
to  get  over  the  gi-eatest  amount  of  ground. 

The  quickest  movement  of  the  leg  forward  in  walking  has  been  shown 
by  Weber  to  con-espond  very  closely  with  half  a  pendulum  vibration  of  the 
leg,  and  to  occupy,  on  an  average,  0.357  seconds  ;  this  would  give  168  steps 
per  minute,  supposing  the  one  foot  left  the  ground  when  the  other  touched 
it.  This  is  much  quicker  than  the  army  walking  step  (the  double  is  a  inin), 
and  no  doubt  much  quicker  than  could  long  be  borne,  since,  with  a  step 
of  only  30  inches,  it  wovild  give  nearly  5  miles  per  hour  ;  bvit  it  may  be  a 
question  whether,  with  men  in  good  condition,  the  pace  might  not  be 
increased  to  130  per  minute.  Practical  trials,  however,  with  soldiers  carry- 
ing arms  and  accoutrements,  can  alone  decide  this  jDoint. 

The  length  of  the  step  of  an  average  man  has  been  fixed  by  the  Brothers 
Weber  at  about  28  inches.  In  individual  cases,  it  depends  entirely  on  the 
length  of  the  legs.  Robei't  Jackson  considered  30  inches  as  too  long  a  step 
for  the  average  soldier,  and  suggested  27  inches.  It  is  of  great  importance 
not  to  lessen  the  length  too  much,  and  it  would  be  very  desirable  to  have 
some  well-conducted  experiments  on  this  point.  The  steps  must  be  shorter 
if  weights  are  carried  than  without  them  ;  a  httle  consideration  shows  how 
this  is :  When  a  man  walks,  he  hfts  his  whole  body  and  propels  it  forward, 
and  in  doing  so  the  point  of  centre  of  gravity  describes  a  circular  motion, 
in  the  form  of  an  arc  about  the  foot.  The  less  the  body  is  raised,  or,  in 
other  words,  the  shorter  the  versed  sine  of  the  arc,  the  less  of  course  the 
labor.  In  long  steps  the  arc,  and  of  course  the  versed  sine,  or  height  to 
which  the  body  is  raised,  are  greater  ;  in  short  steps,  less.'  It  is  probable, 
with  the  weight  the  soldier  carries  (60  lb),  the  step  of  30  inches  is  quite 
long  enough,  perhaps  even  too  long  ;  and  it  wovild  be  desmible  to  know  if, 
after  a  march  of  six  or  eight  miles,  the  steps  do  not  get  shorter. 

In  the  French  army  the  march  is  commenced  at  the  pas  de  route  (90 
steps  per  minute) ;  then  accelerated  to  110  steps  ;  during  the  last  half-hour 

'  The  Brothers  Weber,  however,  have  shown  that  the  angle  at  which  the  body  is 
bent  and,  consequently,  the  coefficient  of  resistance  are  not  affected  by  the  length  of 
step,  provided  the  velocity  remains  the  same. 


CONDITIOlSrS    OF   SEE  VICE.  261 

100  steps  are  returned  to.  But  the  soldiers  themselves  often  set  the  step  ; 
the  grenadiers  and  the  voltigeurs  alternately  leading.  Four  kilometres 
(=  2|-  miles)  per  hour  is  considered  a  good  general  average  (Moi'ache). 

The  soldier,  in  this  country,  when  he  marches  in  time  of  peace  in  heavy 
order,  carries  his  pack,  kit,  haversack,  water-bottle,  great-coat,  rifle,  and 
ammunition  (probably  twenty  roimds).  In  India  he  does  not  carry  his 
pack  or  great-coat. 

There  is  a  very  general  impression  that  the  best  marchers  are  men  of 
middle  size,  and  that  very  tall  men  do  not  march  so  well. 

Length  of  the  March. — In  "marching  out"  in  time  of  peace,  which  is 
done  once  or  twice  a  week  in  the  winter,  the  distance  is  8  or  10  miles.  ^  In 
marching  on  the  route  or  in  war,  the  distance  is  from  10  or  12  miles  to 
occasionally  18  or  20,  but  that  is  a  long  march.  A  forced  march  is  any 
distance — 25  to  30,  and  occasionally  even  40  miles  being  got  over  in  twenty- 
four  hours.  In  the  French  army  the  length  of  march  is  from  20  to  25 
kilometres  (12^  to  15  miles).  In  the  Prussian  army  the  usual  march  is 
14  miles  (English) ;  if  the  march  is  continuous,  there  is  a  halt  every  foiu:th 
day. 

Conditions  rendering  Marches  Slower. — The  larger  the  body  of  men  the 
slower  the  march ;  14  miles  will  be  done  in  six  or  seven  houi's  by  two  or 
three  regiments,  but  not  under  eight  or  nine  hours  by  8,000  or  10,000 
men.  A  large  army  will  not  go  over  14  miles  under  ten  hours  usually.  A 
single  regiment  can  do  20  miles  in  eight  hours,  but  a  large  army  will  take 
twelve  or  fourteen,  including  halts.  Head  winds  greatly  delay  marches  ;  a 
very  stroDg  wind  acting  on  a  body  of  men  will  cause  a  difference  of  20  to 
25  per  cent.,  or  only  4  miles  will  be  got  over  instead  of  5. 

Snow  and  rain,  without  head  wind,  delay  about  10  to  15  per  cent.,  or  4^ 
miles  are  done  instead  of  5. 

Of  course,  bad  or  slipj)ery  roads,  deep  sands,  heavy  snows,  jungle  and 
brushwood,  are  often  acting  against  the  soldier,  and  in  hiUy  and  jungly 
countries  only  5  or  6  miles  may  be  got  over  in  a  day. 

Conditions  adding  to  the  Fatigue  of  3Iarching. — Heat — dust — thirst — 
constant  halts  from  obstructions — ^.want  of  food — bad  weather,  especially 
head  winds  with  rain.  In  order  to  avoid  heat  and  dust,  it  is  desirable, 
when  it  can  be  done,  to  separate  the  cavalry  and  artillery  from  the  infantry  ; 
to  let  the  latter  march  in  open  oi-der,  and  with  as  large  a  fi'ont  as  possible. 

Instances  of  Marches  during  War. — Itis  most  important  for  a  soldier  to 
know  what  has  been  done  and  what  can  be  done  with  a  large  body  of  foot 
soldiers,  and  it  is  scarcely  less  interesting  to  the  physiologist.  In  compar- 
ing the  marches  of  infantry,  it  must  always  be  remembered  how  great  an 
effect  increasing  the  number  of  men  has  in  lessening  the  I'apidity  and  length 
of  a  march,  and  in  increasing  the  fatigue.  No  large  army  has  ever  made 
the  marches  small  bodies  of  troops  have  done. 

At  times  the  fatigue  undergone  by  trained  men  has  been  something 
almost  incredible.  Wolfe  mentions  in  one  of  his  letters  that  in  1-743,  just 
before  the  battle  of  Dettingen,  his  regiment  marched  from  Frankfort  "two 
days  and  two  nights  with  only  nine  or  ten  hours'  halt."  This  would  be  a 
march  of  thirty-eight  hoiu's  out  of  forty-eight.  He  gives  the  distance 
at  about  40  miles,  but  it  was  probably  more.  The  43d,  52d,  and  95th 
Regiments  of  Foot,  forming  the  Light  Division  under  Crawfurd,  made  a 
forced  march  in  July,  1809,  in  Spain,  in  order  to  reinforce  Su'  Arthur 
Wellesley  at  the  battle  of  Talavera.     About  fifty  weakly  men  were  left 

'  Queen's  Regulations  (1881,  section  16,  para.  30).     See  also  Field  Exercise  (1877).-  • 


2G2  PRACTICAL    HYGIENE. 

behiad,  and  the  brigade  then  marched  G2  miles  in  twenty-six  hours,  carry- 
ing arms,  ammunition,  and  pack — in  all,  a  weight  of  between  50  lb  and  60 
ft). '  There  were  only  seventeen  stragglers.  The  men  had  been  weU  ti'ained 
in  marching  duiing  the  previous  month. 

One  of  these  regiments — the  52d — made  in  India,  in  1857,  a  march 
neai'ly  as  extraordinary.  In  the  height  of  the  mutiny,  intelligence  reached 
them  of  the  locality  of  the  rebels  from  Sealkote.  The  52d,  and  some 
ai'tillery,  started  at  night  on  the  10th  of  July,  1857,  from  Umritzui-,  and 
reached  Goodasepore.  42  miles  ofi",  in  twenty  hours,  some  part  of  the  march 
being  in  the  sun.  On  the  following  morning  they  mai'ched  10  miles,  and 
engaged  the  mutineers.  They  were  for  the  first  time  clad  in  the  com- 
fortable gray  or  dust-colored  native  khakee  cloth. 

A  march  of  a  small  j^ai-ty  of  French  was  nan-ated  by  an  officer  of  the 
party,  who  was  afterward  wounded  at  Sedan,  to  Dr.  Frank.  A  company 
of  a  regiment  of  Chasseurs  of  !NLacMahon's  army,  after  being  on  grand 
guard,  without  shelter  or  fire,  duiing  the  rainy  night  of  the  5th- 6th 
August,  1870,  started  at  three  in  the  morning  to  rejoin  its  regiment  in 
retreat  on  Xiederbronn,  after  the  battle  of  "Weissenburg.  It  arrived  at 
this  tillage  at  3.30  in  the  afternoon,  and  stai-ted  again  for  Phalsbourg  at 
six  o'clock.  The  road  was  across  the  hills,  and  along  forest  tracts,  which 
were  very  difficult  for  troops.  It  arrived  at  Phalsboui-g  at  8.30  o'clock  in 
the  evening  of  the  next  day.  The  men  had,  therefore,  marched  part  of 
the  night  of  the  5th-6th  August,  the  day  of  the  6th,  the  night  of  the 
6th-7th,  and  day  of  the  7th  till  8.30  p.m.  The  halts  were  eight  minutes 
every  hour,  fi'om  3.30  to  6,  one  hour  in  the  night  of  the  6th-7th,  and 
2^  hours  on  the  7th.  Altogether,  including  the  halts,  the  mai'ch  lasted 
41^  houi's,  and  the  men  must  have  been  actually  on  theii*  feet  about  thirty 
hours,  in  addition  to  the  guard  duty  on  the  night  before  the  march. 

An  officer  of  a  Saxon  Fusiher  regiment  gave  the  following  statement 
of  a  forced  march  in  one  of  the  actions  at  Metz,  in  1870.  The  regiment 
was  alarmed  at  midnight  and  marched  at  one  .\.m.  ;  and  continued  march- 
ing with  halts  until  7  p.m.  ;  they  bivouacked  for  the  night,  marched  at 
7  the  next  morning,  came  into  action  at  1.30,  and  in  the  evening  found 
themselves  15  kilometres  beyond  the  field  of  battle.  The  total  distance 
■was  534  miles  in  about  forty-two  hours,  with  probably  fifteen  hours' 
halt. 

Eoth  mentions  that  the  18th  division  of  the  Saxon  army,  in  the  various 
manoeuvres  about  Orleans,  mai'ched,  on  the  16th  and  17th  December,  1870, 
54  English  miles. 

Yon  der  Tann's  Bavarian  ai'my,  in  retreat  on  Orleans,  marched  42  miles 
in  twenty- six  hours. 

These  were  all  forced  marches  for  the  pm-pose  of  coming  into  action 
or  retuing  after  discomfitui-e.  Apart  from  the  Peninsulai-  Light  Division 
march,  they  show  that  in  two  days  and  one  night  a  small  body  of  men 
may  cover  54  Enghsh  miles,  and  that  is  probably  near  the  limit  of  endui- 
ance.     The  Light  Division  march  is  so  excessive  (62  miles  in  twenty-six 

'  Xapier's  War  in  the  Peninsula,  3d  edit.,  vol.  ii.,  p.  400  ;  Moorsom's  Record  of  the 
r)2d  Regiment,  p.  115.  Both  authors  state  that  the  men. carried  between  hO  lb  and  60 
lb  on  this  extraordinary  march,  but  there  seems  a  little  doubt  of  this.  During  the 
Peninsular  war  the  men  carried  bags,  weighing  about  2  It),  and  not  framed  packs,  and 
their  kits  were  very  scanty.  Lord  Clyde,  in  talking  of  this  march  to  Surgeon-General 
Loiigmore,  told  him  the  men  only  carried  a  shirt  and  a  spare  pair  of  either  boots  or 
soles.  He  saw  the  men  march  iu.  In  all  probability  also  they  would  not  carry  their 
full  ammunition. 


CONDITIONS    OF   SERVICE.  263 

hours,  or  2.38  miles  every  hour,  without  reckoning  halts),  that  it  may  be 
doubted  if  the  distance  was  properly  reckoned/ 

When  a  large  army  moves  it  has  never  accompKshed  such  distances. 

In  1806  the  French  army  marched  on  one  occasion  49  kilometres, 
or  30|-  miles.  On  June  15,  1815,  Napoleon  made  a  forced  march  to 
svirprise  the  Prussians  and  English,  but  only  accomplished  30  kilometres 
or  18|-  miles. 

In  Sherman's  celebrated  march  across  the  Southern  States  the  daily 
distance  was  about  14  miles.  When  the  Prussians  advanced  on  Vienna, 
after  the  battle  of  Kciniggratz,  in  1866,  they  accomphshed  almost  the  same, 
and  had  also  outpost  duty  every  other  night. 

The  Russians  marched  in  the  expedition  to  Khiva,  in  1873,  468. 7  miles 
(English)  in  89  days,  but  as  actual  marching  was  done  only  on  44  days, 
the  average  daily  march  was  (468.7-^44)  10.65  miles;  the  longest  march 
was  26^  miles." 

MacMahon's  army,  in  its  march  to  reUeve  Bazaine  at  Metz,  could  only 
accomplish  about  10  miles  daily,  while  the  Crown  Prince  of  Prussia  in 
pursuit  was  far  more  rapid. 

After  Sedan,  the  Prussian  and  Saxon  troops  pushed  on  to  Paris  by 
forced  marches,  and  accomphshed  on  an  average  35  kilometres,  or  21|- 
miles,  daily,  and  they  marched  on  some  days  42  to  45  kilometres  (26  to 
28  miles) ;  they  started  at  five  or  six,  and  were  on  their  ground  from 
four  to  eight  o'clock,  the  average  pace  being  5  kilometres  (3. 1  miles)  per 
hour. 

In  the  Indian  mutiny  several  regiments  marched  30  miles  a  day  for 
several  days. 

When  marches  are  continued  day  after  day,  an  average  of  about  20 
miles  may  be  expected  from  men  for  two  or  three  weeks,  after  which, 
probably,  the  amount  would  lessen. 

It  is  difficult  to  estimate  the  labor  of  such  marches,  as  besides  the  actual 
march  there  is  often  work  in  fetching  water,  cooking,  pitching  tents,  sen- 
try, outpost,  and  picket  duty,  etc.  As  20  miles  a  day  with  60  ib  weight  is 
equivalent  to  lifting  495  tons  one  foot,  and  there  is  always  additional  work 
to  be  done,  it  is  clear  that  the  labor  is  excessive,  and  must  be  prepared 
for,  and  that  during  the  time  the  men  must  be  well  fed. 

'  Sir  William  Cope,  who  was  one  of  the  officers  of  the  95th,  says  (in  his  History  of 
the  Rifle  Brigade,  formerly  the  95th)  that  the  distance  was  only  40  miles. 

^  In  1709,  on  the  3d  September,  in  order  to  secure  the  passage  of  the  Haine,  the 
Prince  of  Hesse-Cassel  made  a  march  of  49  English  miles  in  56  successive  hours,  with 
4,000  foot  and  60  squadrons  (Coxe's  Life  of  Marlborough,  v.  10-21). 

Alison  (History  of  Marlborough,  vol.  ii.,  p.  27)  says  that  "this  rapidity  of  advance 
for  such  a  distance  had  never  been  previously  surpassed,  though  it  has  been  outdone 
in  later  times."  He  refers  in  a  footnote  to  Mackenzie's  march  to  join  Wellington  at 
Talavera,  which  he  gives  as  62  English  miles  in  26  hours ;  also  the  Russian  foot  guards 
advancing  to  Paris  in  1814,  after  the  combat  at  Fere-Champenoise,  marched  48  miles 
in  26  hours. 

In  the  Times  of  1873,  a  writer  gives  the  following  statement ;  he  quotes  from  a  des- 
patch published  in  the  London  Gazette  of  1859 :—"  During  the  day  the  troops  from 
Khulkhulla  marched  35  miles,  and  those  from  the  camp  48  miles,  and  much  of  this 
under  a  more  than  usually  hot  sun."  He  also  says  that  at  the  end  of  1858,  General 
Whitlock  marched  86  miles  in  37  hours  to  relieve  Kirwee. 

In  April,  1859,  Colonel  De  Salis  (London  Gazette,  1859)  reported  a  march  of  not  less 
than  40  miles.  Captain  Rennie's  force  also  marched  40  miles  in  24  hours.  In  the 
same  number  of  the  Times  Captain  Carleton  states  that  Daly's  Guide  Corps  marched 
from  near  Peshawur  to  Delhi,  580  miles,  in  22  days.  Sir  Hope  Grant  says  750  miles 
in  28  days.  He  also  says  that  the  1st  Bengal  Fusiliers  (European)  marched  68  miles 
in  38  hours. 


2(>4  PRACTICAL    HYGIENE. 

In  marching  long  distances,  the  extent  of  the  marches,  the  halting 
grounds,  etc.,  are  fixed  by  the  Quartermaster-General's  department. 

Occasionally  the  march  has  been  divided,  one  part  being  done  in  the 
early  morning,  and  the  remainder  late  in  the  afternoon.  It  is,  however, 
better  to  make  the  march  continuous,  and,  if  necessary,  to  lengthen  the 
mid-day  halt. 

Order  of  March. — Whenever  possible,  it  seems  desirable  to  march  in 
open  order.  Inspector-General  J.  R.  Taylor  has  given  evidence  to  show 
that  a  close  order  of  ranks  is  a  cause  of  uuhealthiness  in  marching,  similar 
to  that  of  overcrowding  in  barracks  ;  and  the  Medical  Board  of  Bengal,  in 
accordance  with  this  ojDinion,  recommended  that  military  movements  in 
close  order  should  be  as  little  practised  as  possible.  There  should  also  be 
as  much  interval  as  can  be  allowed  between  bodies  of  ti'oops. 

Effects  of  Marches. — Under  ordinary  conditions,  both  in  cold  and  hot 
countries,  men  are  healthy  on  the  march. 

But  marches  are  sometimes  hurtful — 

1st.  When  a  single  long  and  heavy  march  is  undertaken  when  the  men 
are  overloaded,  without  food,  and  joerhaps  without  water.  The  men  fall 
out,  and  the  road  becomes  strewed  with  stragglers.  Sometimes  the  loss  of 
life  has  been  great. 

The  prevention  of  these  catastrophes  is  easy.  Place  the  soldier  as 
much  as  possible  in  the  position  of  the  professional  pedestrian  ;  let  his 
clothes  and  accoutrements  be  adapted  to  his  work  ;  supply  him  with  water 
and  proper  food,  and  exclude  spirits  ;  if  unusual  or  rapid  exertion  is  de- 
manded, the  weights  must  be  still  more  hghtened. 

When  a  soldier  falls  out  on  the  march  he  will  be  found  partially  faint- 
ing, with  cold  moist  extremities,  a  profuse  sweat  everywhere  ;  the  jjulse  is 
very  quick  and  weak — often  irregular  ;  the  respiration  often  sighing.  The 
weights  should  be  removed,  clothes  loosened,  the  man  laid  on  the  ground, 
cold  Avater  dashed  on  the  face,  and  water  given  to  drink  in  small  quantities. 
If  the  syncope  is  very  alarming,  brandy  must  be  used  as  the  only  way  of 
keeping  the  heart  acting,  but  a  large  quantity  is  dangerous.  If  it  can  be 
obtained,  weak  hot  brandy  and  water  is  the  best  under  these  circumstan- 
ces. When  he  has  recovered,  the  man  must  not  march — he  should  be 
carried  in  a  wagon,  and  in  a  few  minutes  have  something  to  eat,  but  not 
much  at  a  time.  Concentrated  beef-tea  mixed  with  wine  is  a  powerful 
restorative,  just  as  it  is  to  wounded  men  on  the  field. 

2d.  When  the  marches  which  singly  are  not  too  long,  are  prolonged 
over  many  days  or  weeks  without  due  rest. 

With  proper  halts  men  will  march  easily  from  500  to  1,000  miles,  or 
even  farthei*,  or  from  12  to  16  miles  per  diem,  and  be  all  the  better  for  it ; 
but  after  the  second  or  third  week,  there  must  be  one  halt  in  the  week 
besides  Sunday.  If  not,  the  work  begins  to  tell  on  the  men ;  they  get  out 
of  condition,  the  muscles  get  soft,  appetite  declines,  and  there  may  be  even 
a  little  anaemia.  The  same  effects  are  produced  with  a  much  less  quantity 
of  work,  if  the  food  is  insufficient.  Bad  food  and  insufficient  rest  are  then 
the  great  causes  of  this  condition  of  body. 

In  such  a  state  of  body  malarious  fevers  are  intensified,  and  in  India 
attacks'of  cholera  are  more  frequent.  It  has  been  supposed  that  the  body 
is  overladen  with  the  products  of  metamorphosis,  which  cannot  be  oxidized 
fast  enough  to  be  removed. 

Directly  the  least  trace  of  loss  of  condition  begins  to  be  perceived  in 
the  more  weakly  men  (who  are  the  tests  in  tliis  case),  the  surgeon  should 
advise  the  additional  halt,  if  military  exigencies  permit.     On  the  halt  day 


CONDITIONS    OF    SERVICE.  265 

the  men  should  Trash  themselves  and  their  clothes,  and  parade,  but  should 
not  di'ill. 

3d.  "When  special  circumstances  produce  diseases. 
Exposure  to  -^et  and  cold  in  temperate  climates  is  the  great  foe  of  the 
soldier.  As  long  as  he  is  marching,  no  gxeat  harm  results  ;  and  if  at  night 
he  can  have  diy  and  warm  lodgings,  he  can  bear,  when  seasoned,  gTeat 
exposure.  But  if  he  is  exposed  at  night  as  well  as  day,  and  in  war  he 
often  is  so,  and  never  gets  dry,  the  hardiest  men  will  suffer.  Affections 
arising  from  cold,  such  as  catarrhs,  rheumatism,  pulmonaiy  inflammation, 
and  dysentery  ai'e  caused. 

These  are  incidental  to  the  soldier's  life,  and  can  never  be  altogether 
avoided.  But  one  gT.eat  boon  can  be  given  to  him ;  a  wateiin'oof  sheet, 
which  can  cover  him  both  day  and  night,  has  been  found  the  greatest  com- 
fort by  those  who  have  tried  it. 

The  soldier  may  have  to  march  thi'OiTgh  malarious  regions.  The  march 
should  then  be  at  mid-day  in  cold  regions,  in  the  afternoon  in  hot.  The 
early  morning  marches  of  the  tropics  should  be  given  up  for  the  time  ; 
the  deadhest  time  for  the  malaria  is  at  and  soon  after  sumise.  If  a  special- 
ly deadly  narrow  district  has  to  be  got  thi'ough,  such  as  a  Terai,  at  the  foot 
of  hills,  a  single  long  march  should  be  ordered  ;  a  thoroughly  good  meal, 
-uith  wine,  should  be  taken  before  starting,  and  if  it  can  be  done,  a  dose 
of  c^uinine.  If  the  troops  must  halt  a  night  in  such  a  district,  every  man 
should  take  five  grains  of  quinine.  Tents  should  be  pitched  in  accordance 
with  the  rules  laid  down  in  the  chapter  on  Ca3j:ps,  and  the  men  should  not 
leave  them  till  the  sun  is  well  up  in  the  heavens. 

Yellow  fever  or  cholera  may  break  out.  The  rules  in  both  cases  are 
the  same.  At  once  leave  the  line  of  march  ;  take  a  short  march  at  right 
angles  to  the  wind  ;  separate  the  sick  men,  and  place  the  hospital  tent  to 
leewai-d  ;  let  every  evacuation  and  vomited  matter  be  at  once  buiied  and 
covered  with  earth,  or  burnt,  if  possible,  and  employ  natives  (if  in  India) 
to  do  this  constantly,  with  a  sergeant  to  superintend.  Let  eveiy  duty-man 
who  goes  twice  to  the  rear  in  six  houi's  report  himseK,  and,  if  the  disease 
be  cholera,  distribute  piUs  of  acetate  of  lead  and  opium  to  aU  the  non- 
commissioned officers.  Du'ectly  a  man  who  becomes  choleraic  has  used  a 
latrine,  either  abandon  it,  or  cover  it  with  earth  and  lime  if  it  can  be  pro- 
cured. If  there  is  carbolic  acid  or  chloride  of  zinc,  or  lime  or  sulphate  of 
iron  or  zinc  at  hand,  add  some  to  every  stool  or  vomit. 

In  two  days,  whether  the  cholera  has  stopped  or  not,  move  two  miles  ; 
take  care  in  the  old  camp  to  cover  or  bum  everything,  so  that  it  may  not 
prove  a  focus  of  disease  for  others.  The  diinking  water  should  be  con- 
stantly looked  to.  A  regiment  should  never  follow  one  which  carries 
cholera ;  it  should  avoid  to\\-ns  where  cholera  prevails ;  if  it  itself  carries 
cholera,  the  men  should  not  be  allowed  to  enter  tovras.  Many  instances 
are  known  in  India  where  cholera  was  in  this  way  introduced  into  a  town. 
The  men  may  suffer  from  insolation.  This  will  generally  be  imder 
three  conditions.  Excessive  solar  heat  in  men  unaccustomed  to  it  and 
wrongly  di'essed,  as  in  the  case  of  the  98th  in  the  first  China  war,  when 
the  men  having  first  landed  from  a  six  months'  voyage,  and  being  buttoned 
up  and  wearing  stocks,  fell  in  numbers  duiing  the  first  short  march.  A 
friend  who  followed  with  the  rearguard  informed  Dr.  Parkes  that  the  nien 
feU  on  their  faces  as  if  struck  by  lightning  ;  on  running  up  and  turning 
them  over,  he  found  many  of  them  already  dead.  They  had,  no  doubt, 
struggled  on  to  the  last  moment.  This  seems  to  be  intense  asphyxia,  with 
sudden  failure  of  the  heart-action,  and  is  the  "cardiac  variety"  of  Morehead. 


266  PRACTICAL    HYGIENE. 

A  dress  to  allow  perfectly  free  respiration  (freedom  from  pressure  on 
chest  and  neck),  and  protection  of  the  head  and  spine  from  the  sun,  -will 
generally  prevent  this  form.  The  head-dress  may  be  wetted  from  time  to 
time  ;  a  piece  of  wet  paper  in  the  crown  of  the  cap  is  useful.  When  the 
attack  has  occurred,  cold  affusion,  artificial  respiration,  ammonia,  and  hot 
bi-andy  and  water  to  act  on  the  heart,  seem  the  best  measm-es.  Bleeding 
is  hiu'tful  ;  perhaps  fatal.     Cold  affusion  must  not  be  pushed  to  excess. 

In  a  second  form  the  men  are  exposed  to  continued  heat,'  both  in  the 
sun  and  out  of  it,  day  and  night,  and  the  atmosphere  is  still,  and  perhaps 
moist,  so  that  evaporation  is  lessened,  or  the  air  is  vitiated.  If  much  exer- 
tion is  taken,  the  freest  perspiration  is  then  necessary  to  keep  down  the 
heat  of  the  body  ;  if  any  thing  checks  this,  and  the  skin  gets  diy,  a  certain 
amount  of  pyrexia  occurs ;  the  pulse  rises ;  the  head  aches ;  the  eyes  get 
congested ;  there  is  a  frequent  desire  to  micturate  (Longmore),  and  gradu- 
al or  sudden  coma,  with  perhaps  convulsions  and  stertor,  comes  on,  even 
sometimes  when  a  man  is  l3'ing  quiet  in  his  tent.  The  causes  of  the  inter- 
ruption to  perspu-ation  are  not  known  ;  it  may  be  that  the  skin  is  acted 
upon  in  some  way  by  the  heat,  and  from  being  over-stimvilated,  at  last  be- 
comes inactive. 

Li  this  form  cold  affusion,  ice  to  the  head,  and  ice  taken  by  the  mouth, 
are  the  best  remedies  ;  perhaps  even  ice  water  by  the  rectum  might  be 
tried.  Stimulants  are  hurtful.  The  exact  pathology  of  this  form  of  inso- 
lation is  uncertain.     It  is  the  cerebro-sj)inal  variety  of  Morehead. 

In  a  third  form  a  man  is  exposed  to  a  hot  land-wind  ;  perhaps,  as  many 
have  been,  from  Ijiug  drunk  without  cover.  "When  brought  in,  there  is 
generally  complete  coma  with  dilated  pupDs,  and  a  very  darkly  flushed  face. 
After  death  the  most  striking  point  is  the  enormous  congestion  of  the  lungs, 
which  is  also  marked,  though  less  so,  in  the  other  varieties.  Dr.  Parkes 
stated  that  he  had  never  seen  anything  like  the  enormous  congestion  he 
had  observed  in  two  or  three  cases  of  this  kind. 

As  prevention  of  all  forms,  the  following  points  should  be  attended  to  : — 
Suitable  clothing ;  plenty  of  cold  drinking  water  (Crawford)  ;  ventilation  ; 
production  in  buildings  of  currents  of  air  ;  bathing  ;  avoidance  of  spirits  ; 
lessening  of  exertion  demanded  from  the  men. 

Duty  of  Medical  Officers  during  Marches. 

General  Duties  on  Marches  in  India  or  the  Colonies. — Before  commencing 
the  mai'ch,  order  all  men  with  sore  feet  to  report  themselves.  See  that  all 
the  men  have  their  proper  kits,  neither  more  nor  less.  Every  man  should 
be  provided  with  a  water-bottle  to  hold  not  less  than  a  pint.  Inspect  halt- 
ing-grounds, if  possible  ;  see  that  they  are  perfectly  clean,  and  that  every- 
thing is  ready  for  the  men.  In  India,  on  some  of  the  trunk  roads  there  are 
regular  halting-grounds  set  apari.  The  conservancy  of  these  shoidd  be 
very  carefully  looked  to,  else  they  become  nothing  but  foci  for  disseminat- 
ing disease.  If  there  are  no  such  places,  halting-grounds  are  selected.  It 
should  be  a  rule  never  to  occupy  an  encamping  ground  previously  used  by 
another  coi-ps  if  it  can  be  avoided  ;  this  applies  to  all  cases.  Select  a  posi- 
tion to  windward  of  such  an  old  camp,  and  keep  as  far  as  possible  from  it. 
The  encampments  of  the  transport  department,  elephants,  camels,  bullock 

I  The  heat  of  sandy  plains  is  the  worst,  probably,  from  the  great  absorption  of  heat 
and  the  continued  radiation.  The  heat  of  the  san,  per  se,  is  not  so  bad  ;  on  board  ship 
sun-stroke  is  uncommon. 


CONDITIONS    OF    SERVICE.  267 

carts,  etc.,  must  be  looked,  to, — they  often  are  very  dirty ;  keep  tliem  to 
leeward  of  the  camp,  Bot  too  near,  and  see  especially  that  there  is  no  chance 
of  their  contaminating  streams  supplying  drinking  water.  If  the  encamp- 
ment is  on  the  banks  of  the  stream,  the  proper  place  for  the  native  camp 
and  bazaar  will  always  be  lower  down  the  stream.  The  junior  medical 
officer,  if  he  can  be  spared,  should  be  sent  forward  for  this  purpose  with  a 
combatant  officer.  Advise  on  length  of  marches,  halts,  etc.,  and  draw  up 
a  set  of  plain  rules  to  be  promulgated  by  the  commanding  officer,  directing 
the  men  how  to  manage  on  the  march  if  exposed  to  great  heat  or  cold,  or 
to  long-continued  exertion,  how  to  purify  water,  clean  their  clothes,  etc. 
If  the  march  is  to  last  some  time,  and  if  halts  are  made  for  two  or  three 
days  at  a  time,  write  a  set  of  instructions  for  ventilating  and  cleaning  tents, 
regulation  of  latrines,  etc. 

Special  Duties  for  the  March  itself. — Inspect  the  breakfast  or  morning 
refreshment ;  see  that  the  men  get  their  coffee,  etc.  On  no  account  allow 
a  morning  di'am,  either  in  malarious  regions  or  elsewhere.  Inspect  the 
water-casks,  and  see  them  properly  placed,  so  that  the  men  may  be  sup- 
plied ;  inspect  some  of  the  men,  to  see  that  the  water-bottles  are  full. 
March  in  rear  of  the  regiment  so  as  to  pick  up  all  the  men  that  fall  out,  and 
order  men  who  cannot  march  to  be  earned  in  wagons,  dhoohes,  etc.,  or  to 
be  relieved  of  their  j)acks,  etc.  If  there  are  two  medical  officers,  the  senior 
should  be  in  rear  ;  if  a  regiment  marches  indirisions,  the  senior  is  ordered 
to  be  with  the  last.  When  men  are  ordered  either  to  be  carried  or  to  have 
their  packs  carried,  tickets  should  be  given  specifying  the  length  of  time 
they  are  to  be  carried.  These  tickets  should  be  prepared  before  the  march, 
so  that  nothing  has  to  be  done  but  to  fill  in  the  man's  name,  and  the  length 
he  is  to  be  carried. 

Special  orders  should  be  given  that,  at  the  halt,  or  at  the  end  of  the 
day's  march,  the  heated  men  should  not  uncover  themselves.  They  should 
take  off  their  pack  and  belts,  but  keep  on  the  clothes,  and,  if  very  hot, 
should  put  on  then*  great-coats.  The  reason  of  this  (viz.,  the  great  danger 
of  chill  after  exertion)  should  be  explained  to  them.  In  an  hour  after  the 
end  of  the  march  the  men  should  change  their  underclothing,  and  hang  the 
wet  things  up  to  dry  ;  when  dry  they  should  be  shaken  well,  and  put  by 
for  the  following  day.  Some  officers,  however,  prefer  that  their  men  should 
at  once  change  their  clothes  and  put  on  dry  things.  This  is  certainly  more 
comfortable.     But,  at  any  rate,  exposure  must  be  prevented. 

At  the  end  of  the  march  inspect  the  footsore  men.  Footsoreness  is 
generally  a  great  trouble,  and  frequently  arises  from  faulty  boots,  undue 
pressui-e,  chafing,  riding  of  the  toes  from  narrow  soles,  etc.  Rubbing  the 
feet  with  tallow,  or  oil  or  fat  of  any  kind,  before  marching,  is  a  common 
remedy.  In  the  late  war  the  Germans  found  tannin  veiy  useful, — they  used 
an  ointment  of  one  part  of  tannin  to  twenty  parts  of  zinc  ointment.  A 
good  plan  is  to  dip  the  feet  in  very  hot  water,  before  starting,  for  a  minute  or 
two  ;  wipe  them  quite  dry,  then  rub  them  with  soap  (soft  soap  is  the  best), 
till  there  is  a  lather  ;  then  put  on  the  stocking.  At  the  end  of  the  day, 
if  the  feet  are  sore,  they  should  be  wiped  \nih.  a  wet  cloth,  and  rubbed  with 
tallow  and  spirits  mixed  in  the  palm  of  the  hand  (Galton).  Pedestrians 
frequently  use  hot  salt  and  water  at  night,  and  add  a  little  alum.  Some- 
times the  soreness  is  owing  simply  to  a  bad  stocking  ;  this  is  easily  remedied. 
Stockings  should  be  frequently  washed  ;  then  greased.  Some  of  the  Ger- 
man troops  use  no  stockings,  but  rags  folded  smooth  over  the  feet.  The 
French  use  no  stockings.  Very  often  soreness  is  owing  to  neglected  corns, 
bunions,  or  in-growing  nails,  and  the  surgeon  must  not  despise  the  little 


268  PRACTICAL    HYGIENE. 

surgery  necessary  to  remedy  these  things  ;  nothing,  in  fact,  can  be  called 
little  if  it  conduces  to  efficiency.  As  shoes  are  often  to  blame  for  sore  feet, 
it  becomes  a  question  whether  it  might  not  be  well  to  accustom  the  soldier 
to  do  without  shoes. 

Frequently  men  fall  out  on  the  march  to  empty  the  bowels  ;  the  fre- 
quency with  which  men  thus  lagging  behind  the  column  were  cut  off  by. 
Ai-abs,  led  the  French  in  Algeria  to  introduce  the  slit  in  the  Zouave  trous- 
ers, which  require  no  unbuckling  at  the  waist,  and  take  no  time  for  adjust- 
ment. 

At  a  long  halt,  if  there  is  plenty  of  water,  the  shoes  and  stockings 
should  be  taken  off,  and  the  feet  well  washed ;  even  wiping  with  a  wet 
towel  is  veiy  refreshing.  The  feet  should  always  be  washed  at  the  end  of 
the  march. 

Occasionally  men  are  much  annoyed  with  chafing  between  the  nates,  or 
inside  of  the  thighs.  Sometimes  this  is  simply  owing  to  the  clothes,  but 
sometimes  to  the  actual  chafing  of  the  parts.  Powders  are  said  to  be  the 
best — floxrr,  oxide  of  zinc,  and  above  all,  it  is  said,  fuller's  earth. 

If  blisters  form  on  the  feet,  the  men  should  be  directed  not  to  oj^en 
them  during  the  march,  but  at  the  end  of  the  time  to  draw  a  needle  and 
thread  through  ;  the  fluid  gradually  oozes  out. 

All  footsore  men  should  be  ordered  to  report  themselves  at  once. 

Sprains  are  best  treated  with  rags  dipped  in  cold  water,  or  cold  spirit 
and  water  with  nitre,  and  bound  tolerably  tight  round  the  part.  Eest  is 
often  impossible.     Hot  fomentations,  when  procurable,  will  reheve  pain.' 

Marches,  especially  if  hurried,  sometimes  lead  men  to  neglect  their 
bowels,  and  some  trouble  occui's  in  this  way.  As  a  rule,  it  is  desirable  to 
avoid  purgative  medicines  on  the  line  of  march,  but  this  cannot  always  be 
done  ;  they  should,  however,  be  as  mild  as  possible. 

Kobert  Jackson  strongly  advised  the  use  of  vinegar  and  water  as  a  re- 
freshing beverage,  having  probably  taken  this  idea  from  the  Komans,  who 
made  vinegar  one  of  the  necessaries  of  the  soldier.  It  was  probably  used 
by  them  as  an  anti-scorbutic ;  whether  it  is  very  refreshing  to  a  fatigued 
man  seems  uncertain. 

There  is  only  one  occasion  when  spirits  should  be  issued  on  a  march  : 
this  is  on  forced  marches,  near  the  end  of  the  time,  when  the  exhaustion  is 
great.  A  little  spirit,  in  a  large  quantity  of  hot  water,  may  then  be  useful, 
but  it  should  only  be  used  on  great  emergency.  Warm  beer  or  tea  is  also 
good  ;  the  warmth  seems  an  important  point.  Eanald  Martin  and  Parkes 
tell  us  that  in  the  most  severe  work  in  Burmah,  in  the  hot  mouths  of  April 
and  May,  and  in  the  hot  hours  of  the  day,  warm  tea  w-as  the  most  refresh- 
ing beverage.  Travellers  in  India,  and  in  bush  travelUug  in  Australia,  have 
said  there  was  nothing  so  reviving  as  warm  tea.  Chevers  mentions  that  the 
juice  of  the  country  onion  is  useful  in  lessening  thirst  during  marches  in 
India,  and  that,  in  cases  of  sun-stroke,  the  natives  use  the  juice  of  the  un- 
ripe mangoe  mixed  with  salt. 

Music  on  the  march  is  very  invigorating  to  tired  men.  Singing  should 
also  be  encouraged  as  much  as  possible. 

Marching  in  India. — Marches  take  place  in  the  cool  season  (November  to 
February),  and  not  in  the  hot  or  rainy  seasons,  except  on  emergency  ;  yet 
marches  have  been  made  in  hot  weather  without  harm,  when  care  is  taken. 
They  are  conducted  much  in  the  same  way  as  in  cold  countries,  except  that 

'  The  following  is  a  very  good  lotion  for  sprains :  sal-ammoniac,  20  grains,  vinegar 
and  spirit,  an  ounce  of  each. 


CONDITIONS    OF    SERVICE.  269 

the  very  early  morning  is  usually  chosen.  The  men  are  roused  at  half-past 
two  or  three,  and  parade  half  an  hour  later  ;  the  tents  are  strack,  and  car- 
ried on  by  the  tent-bearers  ;  coffee  is  served  out,  and  the  men  march  off  by 
half-past  three  or  four,  and  end  at  half-past  seven.  Everything  is  ready  at 
the  halting-ground,  tents  are  pitched,  and  breakfast  is  prepared. 

These  very  early  marches  are  strongly  advocated  by  many,  and  are  op- 
posed almost  as  strongly  by  some.  In  the  West  Indies,  marching  in  the  sun 
has  always  been  more  common  than  in  the  East.  Much  must  depend  on 
the  locality,  and  the  prevalence  and  time  of  hot  land  winds.  Both  in  India 
and  Algeria  marches  have  been  made  at  night ;  the  evidence  of  the  effects 
of  this  is  discordant.  The  French  have  generally  found  it  did  not  answer ; 
men  bear  fatigue  less  well  at  night  ;  and  it  is  stated  that  the  admissions 
into  hospital  have  alsvays  increased  among  the  French  after  night  march- 
ing. Annesley's  authority  is  also  against  night  marching  in  India.  On  the 
other  hand,  it  is  stated  by  some  that  in  India  the  march  through  the  cool 
moonhght  night  has  been  found  both  pleasant  and  healthy. 

Afternoon  marches  (commencing  about  two  hours  before  sunset)  have 
been  tried  in  India,  and  often  apparently  with  very  good  results. 

Marching  in  Canada. — In  1814,  during  the  war  v^^th  America  ;  in  1837, 
during  the  rebellion ;  and,  in  1861-62,  dm-ing  the  Trent  excitement, 
winter  marches  were  made  by  the  troops,  in  aU  cases  without  loss.  The 
following  winter  clothing  was  issued  at  home  : — A  sealskin  cap  with  ear 
lappets  ;  a  wooUen  comforter  ;  two  woollen  jerseys ;  two  pairs  of  woollen 
drawers  ;  a  chamois  leathern  vest  with  arms  ;  two  pairs  long  woollen  stock- 
ings to  draw  over  the  boots  ;  sealskin  mits  ;  and  a  pair  of  jackboots.  In 
Canada  a  pair  of  blankets  and  mocassins  were  added,'  and,  at  the  long 
halts,  weak  hot  nim  and  water  was  served  out.  A  quarter  of  a  pound  of 
meat  was  added  to  the  ration.  A  hot  meal  was  given  before  starting, 
another  at  mid-day,  and  another  at  night.  The  troops  were  extremely 
healthy.  During  exposure  to  cold,  spirits  must  be  avoided  ;  hot  coffee,  tea, 
ginger  tea,  or  hot  weak  wine  and  water,  are  the  best ;  it  is  a  good  plan  to 
i-ub  the  hands,  feet,  face,  and  neck  with  oil ;  it  appears  to  lessen  the  radia- 
tion of  heat  and  the  cooling  effect  of  winds. 

1  See  Inspector-General  Muir's  Report,  Army  Medical  Reports,  vol,  iv.,  p.  378. 


CHAPTER  III. 

THE  EFFECTS  OF  MILITARY  SERVICE. 

The  influence  of  the  various  conditions  of  military  life  is  shown  by  the 
records  of  sickness  and  mortality,  and  this  must  be  noted  in  the  various 
stations. 

The  recruit  having  entered  the  ranks,  begins  his  service  at  home,  and 
he  is  kept  at  his  depot  for  some  time.  He  does  not  go  on  foreign  service 
until  he  has  completed  his  twentieth  year.  We  should  suppose  his  hfe 
would  be  a  healthy  one.  It  is  a  muscular,  and,  to  a  certain  extent,  an 
open-air  life,  yet  without  great  exposure  or  excessive  labor  ;  the  food  is 
good  (though  there  might  be  some  improvement),  the  lodging  is  now  be- 
coming excellent,  and  the  principles  of  sanitation  of  dwellings  are  care- 
fully practised.  Although  the  mode  of  clothing  might  be  improved  as  re- 
gards pressure,  still  the  material  is  very  good.  There  is  a  freedom  from 
the  pecuniary  anxiety  which  often  presses  so  hardly  on  the  civil  artisan, 
and  in  illness  the  soldier  receives  more  immediate  and  greater  care  than 
is  usual  in  the  class  from  which  he  comes. 

There  are  some  counterbalancing  considerations.  In  a  barrack,  there 
is  great  compression  of  the  population,  and  beyond  a  doubt  the  soldier  has 
greatl}^  suffered,  and  even  now  suifers,  from  the  foul  air  of  barrack  rooms. 
But  this  danger  is  greatly  lessening,  owing  to  the  exertions  of  the  Barrack 
Improvement  Commissioners,  and,  as  is  proved  by  the  experience  of  some 
convict  jails,  can  be  altogether  avoided. 

Among  the  duties  of  the  soldier  is  some  amount  of  night-work  ;  it  is 
certain  that  this  is  a  serious  strain,  and  the  Sanitary  Commissioners,  there- 
fore, inserted  in  the  "Medical  Regulations"  an  order  that  the  number  of 
nights  in  bed  should  be  carefully  reported  by  medical  officers.  Major-Gen- 
eral  Sir  Fredei'ick  Roberts,  G.C.B.,  has  lately  called  marked  attention  to  the 
injurious  effects  of  night  duty  and  "  sentry-go.'"  Commanding  officers 
should  be  informed  how  seriously  the  guard  and  sentry  duties,  conducted 
as  they  are  in  full  dress,  tell  on  the  men  if  they  are  too  frequent ;  one 
guard-day  in  five  is  quite  often  enough,  and  four  nights  in  bed  should  be 
secured  to  the  men.  Exposure  during  guard  and  transition  of  temper- 
atui'e  on  passing  from  the  liot  air  of  the  guard-room  to  the  outside  air 
are  also  causes  of  disease.  The  weights  and  accoutrements  are  heavj',  but 
the  valise  equipment  introduced  by  General  Eyre's  Committee  has  removed 
the  eril  of  the  old  knapsack. 

The  habits  of  the  soldier  are  unfavorable  to  health  ;  in  the  infantry, 
especially,  he  has  much  spare  time  on  his  hands,  and  ennui  j^resses  on  him. 
Ennui  is,  in  fact,  the  great  bane  of  armies  ;  though  it  is  less  in  our  own 
than  in  many  others.  It  is  said  to  weigh  heavily  on  the  German,  the  Rus- 
sian, and  even  on  the  French  army.     Hence,  indeed,  part  of  the  restlessness 

'  Nineteenth  Century,  November,  1882. 


THE    EFFECTS    OF    MILITARY    SERVICE.  271 

and  one  of  the  dangers  of  large  standing  armies.  The  Romans  appear  to 
have  avoided  this  danger  by  making  their  distant  legions  stationary,  and 
permitting  maniage  and  settlement — in  fact,  by  converting  them  into  mili- 
tary colonies.  We  avoid  it  in  part  by  our  fi-equent  changes  of  place,  and 
our  colonia]  and  Indian  ser^'ice  ;  but  not  the  less,  both  at  home  and  abroad, 
do  idleness  and  ennui,  the  parents  of  all  evils,  lead  the  soldier  into  habits 
which  sap  his  health.  Not  merely  excessive  smoking,  drinking,  and  de- 
bauchery, but  in  the  tropics  mere  laziness  and  inertia,  have  to  be  combated. 
Much  is  now  being  done  by  establishing  reading-rooms,  trades,  industrial 
exhibitions,  etc.,  and  by  the  encouragement  of  athletic  sports  to  occupy 
spare  time,  and  akeady  good  results  have  been  produced. 

The  establishment  of  trades,  especially,  which  wih  not  only  interest  the 
soldier,  but  benefit  him  pecuniarily,  is  a-  matter  of  gi-eat  importance.  It 
has  long  been  asked  why  an  army  should  not  do  all  its  own  work  ;  give 
the  men  the  hope  and  opportunity  of  benefiting  themselves,  and  ennui 
would  no  longer  exist.  In  India,  Lord  Strathnaim  did  most  essential 
service  by  the  establishment  of  trades  ;  and  the  system,  after  long  discus- 
sion and  many  reports,  is  now  being  tried  in  England. 

One  of  the  proofs  of  abOity  for  command  and  administration  is  the 
power  of  occupying  men,  not  in  routine,  but  in  interesting  and  pleasant 
work,  to  such  an  extent  that  rest  and  idleness  may  be  welcomed  as  a 
change,  not  felt  as  a  burden.  Constant  mental  and  much  bodily  move- 
ment is  a  necessity  for  all  men  ;  it  is  for  the  officers  to  give  to  theu'  men 
an  impulse  in  the  proper  du-ection. 

The  last  point  which,  probably,  makes  the  soldier's  life  less  healthy  than 
it  would  otherwise  be,  is  the  depressing  moral  effect  of  severe  and  haras- 
sing discipline.  In  our  own  army  in  former  years,  it  is  impossible  to 
doubt  that  discipline  was  not  merely  unnecessarily  severe,  but  was  ab- 
solutely savage.  An  enhghtened  pubhc  opinion  has  gradually  altered 
this,  and  with  good  commanding  officers,  the  diseiphne  of  some  regiments 
is  probably  nearly  perfect  ;  that  is  to  say,  regular,  systematic,  and  unfail- 
ing ;  but  from  its  very  justice  and  regularity,  and  from  its  judiciousness, 
not  felt  as  irksome  and  oppressive  by  the  men. 

The  general  result  of  the  hfe  at  home  on  soldiers  must  now  be  con- 
sidered. 

It  is  by  no  means  easy  to  say  whether  soldiers  enjoy  as  vigorous  health 
as  the  classes  from  which  they  are  drawn  ;  the  comparison  of  the  number 
of  sick,  or  of  days'  work  lost  by  illness  by  artisans  cannot  be  made,  as 
soldiers  often  go  into  hospital  for  sHght  ailments  which  will  not  cause  an 
ariisan  to  give  up  work.  The  comparative  amount  of  mortahty  seems  the 
only  available  test,  though  it  cannot  be  considered  a  very  good  one. 

Following  the  order  laid  down  in  the  chapter  on  Statistics,  we  have  to 
consider — 

SECTION  L 

THE  LOSS  OF  STRENGTH  BY  DEATH  AND  INVALIDING,  PER  1,000, 

PER  ANNUIVL 

A.  By  Death. 

It  is  to  be  understood  that  the  mortahty  is  here  reckoned  on  the 
strength,  that  is,  on  the  total  number  of  healthy  and  sick  persons  actu- 
ally serving  during  the  time.  The  mortality  on  the  sick  alone  is  another 
matter. 


272  PRACTICAL   HYGIENE. 

From  the  Parliamentary  Statistical  Keturns  of  the  Army  (1840  and 
1853,  which  include  the  years  1826-1846),  we  find  that  the  mortality  among 
the  cavalry  of  the  line  was  at  that  time  about  one-thu-d  more  than  among 
the  civil  male  population  at  the  same  age  (nearly  as  15  to  10  '  jDcr  1,000)  ; 
among  the  Foot  Guards  it  was  more  than  double  (very  nearly  20^  per 
1,000  as  against  10) ;  among  the  infantry  of  the  line  it  was  three-fom*th& 
more  (or  18  per  1,000  as  against  10). 

The  State  was  thus  losing  a  large  body  of  men  annually  in  excess  of 
what  would  have  been  the  case  had  there  been  no  army,  and  was  therefore 
not  only  suffering  a  loss,  but  incurring  a  heavy  responsibility. 

In  the  splendid  men  of  the  Household  Brigade,  diseases  of  the  lungs 
(including  phthisis)  accounted  for  no  less  that  67.7  per  cent,  of  the  deaths, 
in  the  cavalry  of  the  line  for  nearly  50  per  cent.,  and  in  the  infantry  of  the 
line  for  57  per  cent.  ;  while  among  the  civil  population  of  the  soldiers'  age, 
the  proportion  in  all  England  and  Wales  was  only  44.5  per  cent,  of  the 
total  deaths.  The  next  chief  causes  of  deaths  were  fevers,  wliich  accounted 
in  the  difierent  arms  of  the  service  for  from  7  to  14  per  cent,  of  the  total 
deaths.  The  remainder  of  the  causes  of  deaths  were  made  up  of  smaller 
items. 

These  remarkable  results  were  not  peculiar  to  the  English  Army. 
Most  armies  did,  some  still  do,  lose  more  than  the  male  civil  population  at 
the  same  age.     The  following  are  the  most  rehable  statistics : — ' 

Army  Loss 
per  1,000. 

France  (1823) 28.3 

France  (Paixhans,  1846) 19.9 

France,  mean  of  7  years  (1862-68) 10.0 

France  (1869) 9.55 

France  (1872) 9.49 

French  in  Algeria  (1846) 64 

French  in  Algeria  (1862-66) 14.98 

Prussian'  (1846-1863,  including  officers) 9.49 

Prussian  (1869) 6.10 

Prussian  army  (including  the  Saxon  and  Wiirtemberg  corps  (1876).     4.96 

Prussian*  (1867) 6.54 

Kussian^  (series  of  years) 39 

Russian  (1857-1866) 18.7 

Austrian 28 

Austrian  (1869) 11.58 

Piedmontese  (1859) 16 

ItaUan  (1870) 8.40 

United  States  (before  the  war) 18.8 

Portuguese  (1851-53) 16.5 

Danish 9.5 

'  In  reality  the  deaths  from  the  civil  male  population  of  the  soldiers'  ages  (20  to  40) 
were  below  ten,  and  in  the  healthy  districts  much  below ;  the  case  against  the  soldier 
is,  therefore,  even  worse  than  it  reads  in  the  text. 

'^  Meyne  (Elements  de  Stat.  Med.  Militaire,  1859)  gives  some  of  these  figures  ;  others 
are  taken  from  the  reports  of  the  different  armies. 

3  Dr.  Engel,  in  Zt.  des  Kiinigl.  Preussich.  Stat.  Bureaus,  Aug.-Sept.,  1865,  p.  214. 

*  Stat.  Sanitats-bericht  iiber  die  Kon.  Pr.  Armee,  for  1867,  Berlin,  1870.  Without 
deaths  of  invalids  the  mortality  was  only  6. 19G.  The  men  were  all  under  thirty  years 
of  age,  which  must  be  taken  into  account. 

*  The  Russian  mortality  has  lately  been  greatly  reduced. 


THE    EFFECTS    OF    3nLITAEY    SERVICE.  273 

The  old  HanoTerian  airmy  was  vei'r  healthT,  losing  only  5.3  per  1,000  as 
against  9.5  among  the  ci^il  poj)iilation  of  the  same  ages. 

In  these  foreign  armies  the  same  nole  holds  good  ;  fevers  (chiefly  typhoid 
in  all  probabihty )  and  phthisis  were  the  gi-eat  caiises  of  mortality.  In 
Prussia  phthisis  formerly  caused  27  per  cent,  of  the  total  mortality,  but  in 
that  army  phthisical  men  are  sent  home,  and  after  a  certain  time  are  struck 
off  the  rolls,  so  that  the  anny  deaths  are  thus  fewer  than  they  would  be  if 
the  men  died  at  their  regiments.  In  Austria  phthisis  caused  25  deaths  out 
of  every  100  ;  in  France,  22.9  ;'  while  in  1859,  the  proportion  among  the 
civil  population  was  17.76  ;  in  Hanover,  39.4  ;  and  in  Belgium,  30  ;  though 
in  the  latter  country  the  propoi-tion  among  the  civil  population  was  only 
18.97  deaths  from  phthisis  per  100  of  all  deaths.  In  Portugal  the  mortality 
from  phthisis  consti^:uted  22  per  cent,  of  the  deaths,"  while  in  the  civil 
population  the  deaths  are  12  per  cent,  of  the  total  deaths.  In  the  Prassian 
army  in  1876  only  16  per  cent,  were  from  phthisis.  In  these  aiTuies,  also, 
fevers  caused  a  gi'eater  number  of  the  deaths  than  in  the  EngHsh  army,  even 
in  the  period  referred  to.  In  Prussia,  36  (reduced  in  1876  to  20j  ;  in  France, 
26  f  in  Belgium,  16.6  ;  and  in  Hanover,  23.68  per  cent,  of  all  deaths  were 
from  fever  (t\-phoid  ?) .  In  Portugal  only  3.9  deaths  are  from  t\-phoid  out 
of  every  100  deaths ;  this  is  owing  to  its  rarity  in  the  country  districts  ;  it 
is  common  in  Lisbon. 

Nothing  can  prove  more  clearly  that  in  all  these  armies  the  same  causes 
were  in  action.  And  from  what  has  been  said  in  previous  chapters,  it  may 
be  concluded  that  the  reason  of  the  predominance  of  these  two  classes, 
lung  diseases  and  typhoid  fever,  must  be  sought  in  the  imi^ure  ban-ack  aii', 
and  in  the  defective  removal  of  excreta. 

The  Crimean  war  commenced  in  1854,  and  ended  in  1856.  A  large  pai't 
of  the  army  was  destroyed,  and  a  fi'esh  force  of  younger  men  took  its  place. 
Soon  afterward,  the  great  sanitaiy  reforms  of  Lord  Herbert  commenced. 
In  1859  yearly  statistical  returns  began  to  be  pubhshed. 

The  mortahty  of  all  arms  has  undergone  an  extraordinary  decrease  from 
that  of  the  former  period. 

Mortality  per  1,000,  per  Annum,  in  Tnited  Kingdom. 

From  all      From  Disease  alone  'i.e., 
Causes.       excluding  violent  deaths). 

Mean  of  ten  years,  1861-70 9.45  8,534 

Mean  of  ten  rears,  1870-79 8.18 

1880 ] 6.83  5.876 

The  diminution  over  the  years  previously  noted  (1826-46)  is  extra- 
ordinaiw.  Three  causes  only  can  be  assigned  for  it — the  youth  of  the  army, 
and  a  better  selection  of  men  ;  or  a  j^artial  removal  of  the  causes  of  dis- 
eases ;  or  earher  invaliding,  and  the  action  of  the  Limited  Enlistment  Act, 
so  as  to  throw  the  fatal  cases  on  the  civil  population. 

'  This  was  in  1860  :  calculated  from  Laveran"s  returns  from  eleven  of  the  great 
garrisons. 

-  3Iarques,  reviewed  in  an  excellent  article  in  the  British  and  Foreign  liledico-Chir. 
Eeview  for  April,  1863. 

"  Laveran.  in  1860,  made  the  number  25.9  in  the  deaths  from  eleven  garrisons.     In 
1863  the  mortalitj  from  typhoid  in  the  French  army  was  1.87  per  1,000  of  effectives  in 
France,  1.63  in  Algeria,  and  3.55  in  Italy.     In  1S66  the  mortality  was  1.45  in  France, 
1.39  in  Algeria,  and  2.26  in  Italy. 
Vol,  IL-18 


274 


PRACTICAL    HYGIENE. 


The  question  of  age  has  been  examined  and  disposed  of  by  Dr.  Balfour,' 
■v\ho  has  shown  that  the  youth  of  the  army  does  not  account  for  the  lessening. 
Selection  has  always  been  made  with  equal  care,  and  invaliding,  though 
it  certainly  has  been  greater  of  late  years,  does  not  appear  to  have  been  in 
excess  sufficient  to  account  for  the  lessening.  There  can  be  no  doubt,  then, 
that  the  great  result  of  hahing  the  yearly  loss  of  the  army  by  disease  has 
been  the  work  of  Lord  Herbei-t  and  the  Royal  Sanitary  Commission. 

It  will  be  observed  that  the  amount  of  the  mortality  in  the  French  anny 
was  also  siugiilarl}^  lessened  from  1846  to  1862  and  1863,  and  this  is,  no 
doubt,  owing  to  the  great  sanitary  pi*ecautions  now  taken  in  that  army. 

Of  the  different  arms  of  the  service,  the  cavah-y  and  artillery  are  rather 
healthier  than  the  infantiy  ;  the  engineers  than  either ;  the  oihcers  always 
show  less  mortahty  than  the  non-commissioned  officers  and  privates,  and 
the  non-commissioned  olEcers  less  than  the  privates.  In  different  regiments 
there  is  often  a  singulai-  ditierence  in  the  mortality  in  a  given  year,  but 
this  is  usually  easily  accounted  for,  and  in  a  term  of  years  the  difl'erences 
disappear. 

Comparison  loith  Civil  Population. 

This  gross  mortahty  must  now  be  compared  Avith  that  of  the  civil  popu- 
lation.    In  England  the  gross  male  ci^il  mortahty  at  the  soldier's  age  is — 

Mortality  per  1 ,000 
of  Population. 

From  20  to  25  years  of  age 8.83 

"      25  to  35  "  9.57 

"     35  to  45  "  12.48 

The  soldier's  mortahty,  taken  as  a  whole,  is  therefore  under  that  of  the 
civil  population,  but  then  there  is  invaliding,  and  some  uncertain  addition 
should  be  made  to  the  mortahty  on  this  account. 

Comparing  the  soldier's  mortality  (for  a  ten  yeai's'  period,  and  invalid- 
ing being  disregarded)  with  trades,  he  is  more  imhealthy  than  cai-penters 
(7.77),  laborers  (7.92),  bakers  (7.94),  and  blacksmiths  (8.36).  But  he  is 
healthier  than  grocers  (8.4),  farmers  (8,56),  weavers  and  cotton -spinners 
(9.1),  shoemakers  (9.33),  butchers  (9.62),  miners  (9.96),  tailors  (11.62),  and 
publicans  (13.02).^ 

Influence  of  Age  on  the  Mortality. 

The  following  table  gives  the  results  : — ^ 


Per  1,000  of  Strength. 

Under  20. 

20  and 
under  25. 

26  and 
under  30. 

30  and 
under  35. 

35  and 

under  40. 

40  and 
upward. 

1870-79  (10  years) 

1880 

3.11 
3.00 

6.89 
5.83 

5.08 
4.80 

8.67 
7.3 

6.18 
5.75 

9.55 
7.93 

11.64 
10.23 

10.37 
8.36 

17.28 
15.99 

11.96 
8.96 

24.09 
21.92 

Civil    male    population     in 

England  and  Wales 

Healthy  districts 

18.96 
9.86 

'  Army  Medical  Report  for  1859,  p.  6. 

-  Dr.  Farr's  numbers,  in  the  Supplement  to  the  25th  Report  of  the  Registrar-Gen- 
eral, p.  16. 

^  Army  Medical  Reports,  vol.  xxii.,  1882,  p.  30. 


THE   EFFECTS    OF   MILITARY    SEEVICE. 


275 


The  number  of  soldiers  under  20  years  of  age  is  so  small  that  no  con- 
clusions can  be  drawn ;  but  it  would  appear  that  from  20  to  30  the  mortahty 
is  favorable  to  the  soldier,  but  after  that  the  proportion  is  reversed,  and 
the  soldier  dies  more  rapidly  than  the  civilian.  And  if  to  this  we  call  to 
mind  the  invaliding  from  the  army,  it  seems  clear  that  a  prolonged  military 
career  is  decidedly  injurious,  either  from  causes  proper  to  the  career,  or  to 
personal  habits  engendered  in  it. 

Causes  of  Mortality. 

In  order  to  see  the  principal  causes  of  the  eight  or  nine  deaths  which 
occur  annually  among  1,000  men,  the  following  table  has  been  calculated 
from  the  "  Army  Medical  Keports"  : — 

Causes  of  Mortality.^ 


PMliisis  and  tu- 
bercular haemop- 
tysis   

Diseases  of  heart 
and  vessels  . . . . 

Pneumonia 

Violent  deaths .... 

Diseases  of  ner- 
vous system. . . . 

Continued  fevers, 
chiefly  enteric . . 

Suicides 

Bronchitis 

Delirium  tremens. . 

All  other  causes . . 


Mortality  per 

annum  per  1,OOU  of 

Strength  (1867-71, 

5  years). 


2.648 

1.463 

.777 
.598 

.576 

.405 
.288 
.167 
.069 
1.756 


Deaths  in  100 

Deaths  (1867-71, 

6  years). 


30.26 

16.71 

8.88 
6.84 

6.58 

4.63 
3.30 
1.91 

.80 
20.07 


Mortality  per 

annum  per  1,000  of 

Strength  (1872-80, 

9  years). 


2.29 

1.17 

1.34- 

.61 

.54 

.30 
.21 


1.42 


Deaths  in  100 

Deaths  (1872-«0, 

9  years). 


29.0 

14.8 
17.0  5 

7.7 

6.8 

3.8 
2.7 


18.2 


This  table  must  now  be  analyzed  more  particularly. 

1.    TUBEECUIiAR    DISEASES. 

The  deaths  from  phthisis  and  haemoptysis  in  the  eight  years  ending 
1866  averaged  3.1  annually  per  1,000  of  strength,  the  highest  annual  ratio 
being  8.86,  and  the  lowest  1.95.  In  1867-71  the  mean  mortality  was  2.648 
per  1,000,  in  1872-80,  2.29.  In  addition  to  this  there  was  invaliding  for 
phthisis,  and  thus  a  certain  number  of  deaths  were  transferred  from  the 
army  to  the  civil  population.  The  following  table  shows  the  exact  number 
in  four  branches  of  the  service  (two  cavah-y  and  two  infantry)  in  seven 
years : — 


'  This  table  has  been  calculated  from  the  numbers  in  the  Army.  Med.  Department 
Blue  Books  (1867-80). 

'■*  The  abridged  and  incomplete  form  in  which  the  statistics  have  been  published 
since  1874  render  it  impossible  to  give  these  numbers  in  detail.  The  niambers  opposite 
pneitmonia  for  the  later  period  include  all  disease  of  the  Respiratory  System — and  the 
deaths  from  delirmm  tremens  are  included  under  the  head  of  Poisons. 


276 


PRACTICAL    HTGIEITE. 


Table  to  shoiv  the  Deaths  mid  Invaliding  per  annum  from  Phthisis  and 
ffcemojitysis  in  Household  Cavalry,  Gaoalry  of  the  Line,  the  Foot 
Guards,  and  Infantry  of  the  Line  {mean  of  seven  years,  1864-70). 


Phthisis  and  hsemoptysis, 

taken  from  Abstract  in 

Appendix  to  Dr.  Balfour's 

Eeport. 

Household 
Cavalry. 

Cavalry  of 
Line. 

Foot 
Guards. 

Infantry  of 
Line. 

Died  per  1,000 

Invalided  per  1.000. .. 
Total  died   and   inva- 
lided per  1,000 

3.763 
8  234 

11.997 

1.416 
4.025 

5.441 

2.300 
9.491 

11.791 

2.120 
5.510 

7.630 

This  table  shows  a  considerable  difference  between  the  branches  of  the 
service  ;  the  mortality  and  invaliding  of  the  household  troops  ai'e  much  the 
highest.  The  mortality  from  tuberculosis  of  the  infantry  of  the  hne  is 
below  the  mean  mortality  of  the  army  at  large  ;  the  mortahty  of  the  cavalry 
of  the  hne  below  that  of  the  infantry. 

It  is  quite  clear  (and  the  same  thing  is  seen  in  the  earliest  records)  that 
there  has  been  an  excessive  rate  of  mortality  and  invahding  from  phthisis 
in  regiments  ser\'ing  in  London,  which  points  to  some  influences  acting 
very  injuriously  upon  them.  During  the  later  years,  however,  the  invahd- 
ing in  the  foot  guards  has  decreased,  although  the  mortahty  has  not 
diminished.  It  is  remarkable  that  a  similar  excessive  mortality  has  been 
obsen-ed  in  the  guard  regiments  of  both  France  and  Prussia,  located  re- 
spectively in  Paris  and  Berlin.'  The  following  table  shows  the  average  of 
our  own  army  up  to  1876  : — 


Table  similar  to  the  one  above,  for  6  years,  1871-76. 


Phthisis,  etc. 

Household 
Cavalry. 

Cavalry  of 
Line. 

Foot  Guards. 

Infantry  of 
Line. 

Depots. 
1873-76. 

Died  per  1,000 

3.33 
4.44 

7.77 

1.46 
4.30 

5.76 

2.43 
7.17 

9.60 

2.15 
4.00 

6.75 

4.18 

Invalided  per  1,000.    .  . . 

Total  died  and  invalided 

per  1  000 

9.82 
14.00 

From  this  table  it  may  be  seen  that  up  to  1876  there  was  a  slight  di- 
minution of  mortahty  in  the  household  cavalry  and  in  the  infantry  of  the 
hne,  but  that  the  rates  were  nearly  stationary  in  the  cavalry  of  the  Ime  and 
the  foot  guards,  and  very  high  in  the  depots.  In  the  invaliding  the  rates 
were  decidedly  lower  in  the  household  cavalry,  the  foot  guards,  and  the 
infantry  of  the  line,  whilst  there  was  a  slight  increase  in  the  cavalry  of  the 
line,  and  the  rate  was  high  in  the  depots. 

"Unfortunately,  since  1876  this  information  is  no  longer  available,  it 
being  omitted  from  the  "Ai-my  Medical  Reports." 

How  does  this  mortality  compare  \Nith  that  of  the  male  ci\'il  pojjulation 
at  the  soldiers'  ages  ? 


'  Both  and  Lex,  op.  cit.,  vol.  iii.,  p.  392. 


i25 

3.5 

30 

4.0 

35 

4.1 

40 

4.1 

55 

8.7 

45 

4.02 

55 

4.5 

..   5.0 

THE    EFFECTS    OF   MILITAEY    SERVICE.  277 

Mortality  from,  Phthisis. 
Male  Civilians.'  Age. 

AU  England  and  Wales 20  to  25 

25 

«  "  30 

"  "  35 

«  " 15 

25 

London 15 

Worst  districts  in  England,  excluding  hospitals 5.0 

Best  districts  in  England 1.96 

The  deaths  in  the  anny  from  phthisis  and  haemoptysis  are  less  than  the 
deaths  in  the  population  generally.  They  are,  however,  on  an  average 
gTeater  than  in  the  best  districts  in  England,  although  the  rate  for  1880 
(viz.,  1.98)  was  very  nearly  the  same.  But  in  the  army  there  is  invaliding 
also  ;  that  is,  men  with  a  fatal  disease  ai-e  discharged  into  the  civil  popula- 
tion. In  1880  there  were  invahded  for  tubercular  disease  4.15  per  1,000, 
and  this  added  to  the  deaths  (1.98)  gives  6.13  as  the  ratio  of  loss  from  that 
class  of  disease.  Taking  this  into  consideration,  it  seems  certain  that 
phthisical  disease  is  still  in  excess  in  the  ai-my  as  compared  with  the  male 
civil  population. 

Did  the  army  suffer  more  from  phthisis  in  former  years  than  it  does 
now  ?     The  following  table  will  answer  this  question  :  — 

Deaths  from  Phthisis  per  1,000  of  Strength. 

Years  1830-36,  Tears  1837-46, 
=  7  years.  =  10  years. 

Household  Cavalry 7.4  6.28 

Cavah-y  of  the  Line 5.29  5.65 

Foot  Guards 10.8  11.9 

Infantry 7.75 

Mean 7.83  7.89 

During  these  two  periods,  which  make  a  total  of  seventeen  years,  the 
mortality  was  7.86  per  1,000,  and  there  was  no  dechne  in  the  later  as  com- 
pared with  the  earlier  period. 

But  as  in  the  8  years  ending  with  1866  the  mortaUty  was  only  3.1  per 
1,000,  in  the  5  years  ending  1871,  only  2.6,  in  the  9  years  ending  1880, 
only  2.3,  and  in  1880  itself  under  2  per  1,000,  giving  for  the  whole  period 
of  22  years  only  2.6,  there  must  have  been  an  enormous  excess  of  mortality 
in  the  earher  period,  unless  it  can  be  explained  in  some  way. 

(a)  In  the  earhest  periods  the  mortality  from  chronic  bronchitis  was  in- 
cluded in  the  phthisical  mortality.  If  a  correction  is  made  for  this,  the 
mortahty  of  the  period  1859-1880  would  not  reach  3.0  ;  so  that  will  not  ex- 
plain the  difference. 

(b)  Was  the  invaliding  more  active  in  the  last  period,  so  as  to  lessen  the 
deaths  occurring  in  the  army  below  what  would  have  taken  place  without 
invahding  ?     The  information  about  the  early  periods  is  scarcely  obtain- 

^  Parliamentary  Return  of  Annual  Average  Mortality  during  the  Decennial  Period, 
1851-60,  February,  1864 ;  and  Dr.  Farr's  Report  to  the  Sanitary  Commission,  p.  507. 


278  PRACTICAL    HYGIENE. 

able,  but  there  seems  no  reason  to  think  it  was  less  than  subsequently,  but, 
on  the  contrary,  it  was  very  large  from  the  foot  guards.  That  invaliding 
cannot  account  for  the  difierence  is  seen  by  the  fact  that  the  annual  deaths 
per  1,000  in  the  seventeen  years  ending  184G  (viz.,  7.86)  were  more  num- 
erous (in  the  cavalry  and  infantry  of  the  line)  than  the  average  of  deaths 
and  invaliding  together  in  the  period  of  five  years  ending  1871. 

(c)  The  Limited  Enlistment  Act,  by  which  a  certain  number  of  weakly 
men  may  possibly  have  l^ft  the  army,  was  in  action  in  the  last  period.  It 
is  impossible  to  estimate  the  amount  of  this  action,  but  it  is  in  the  highest 
degree  improbable  that  it  had  nuich  dii'ect  effect ;  for  if  a  man  of  nearly 
ten  years'  service  were  ill  with  phthisis,  he  would  be  sure  to  get  invalided, 
in  order  to  enjoy  his  temporary  pension  for  two  or  thi'ee  yeai's,  and  would 
not  simjily  take  his  discharge. 

(d)  The  lessened  age  of  the  army  at  large,  if  the  Limited  Enlistment 
Act  has  produced  that  effect,  might  perhaps  have  had  some  effect,  as  mor- 
tahty  from  phthisis  increases  with  age  in  the  French  army,  and  probably 
in  our  own  ;  but  this  would  never  account  for  the  astonishing  difference  ; 
for  in  the  French  army  the  increase  from  phthisis  of  the  men  over  fourteen 
years'  service,  as  compared  with  those  under,  is  only  1  jDer  1,000  of 
strength. 

We  may  conclude,  then,  that  there  was  a  gi-eater  excess  of  the  disor- 
ganizing lung  diseases  classed  as  phthisis  in  the  earlier  period  (1830-46). 
The  amount  of  phthisis  strongly  attracted  the  attention  of  Sir  Alexander 
Tulloch  and  Dr.  Balfour  in  1839,  They  state  that  in  the  Equitable  Assur- 
ance Company  at  that  time  the  annual  mortality  (at  the  ages  20  to  40) 
from  disease  of  the  lungs  was  3.4  per  1,000  ;  while  in  the  years  1830-36 
the  mortality  from  disease  of  the  lungs  among  the  foot  guards  was  no  less 
than  14.1  per  1,000,  of  which  phthisis  alone  caused  10.8,' 

How  does  our  army  contrast  with  others  ? 

In  France  the  deaths  from  phthisis  and  chronic  bronchitis  together 
amount  to  2.75  i:)er  1,000  of  "present," but  some  die  "en  conge;""  and  it  is 
probable  that  there  is  at  present  at  least  as  much  phthisis  in  the  French  as 
in  our  own  army.  Li  the  Prussian  army  the  men  are  also  discharged  early, 
so  that  comparison  is  difiicult. 

In  the  Prussian  army  the  mean  yearly  mortality  from  lai-jTigeal  and  lung 
phthisis  was  1,28  per  1,000  of  strength  (years  1846-63)  ;  in  100  deaths 
there  were  13.57,  What  the  amount  of  invahding  was  at  that  time  does 
not  appear  to  be  recorded,  but  in  1868-69  it  was  about  3  per  1,000  of 
strength,'^ 

We  may  conclude,  then,  with  regard  to  phthisis — 

1.  That  it  was  formerly  in  enormous  excess  in  the  army  over  the  civil 
population,  and  particularly  in  the  foot  guards  ;  in  other  words,  a  large 
amount  of  consumption  was  generated. 

2.  That  there  has  been  a  great  decline  of  late  years,  though  there  is  still 
in  all  probabiUt}''  some  excess,  especially  in  the  household  troops. 

What  are  the  causes  of  this  phthisical  excess  in  the  years  1830-46  ?  It 
is  noticeable  that  in  the  earlier  periods  all  affections  of  the  lungs  were  also 

'  In  commenting  on  this  fact  the  reporters  say  (Army  Medical  Report  of  1839,  p 
13) — "  If  the  aggregation  of  a  number  of  men  into  one  apartment,  even  though  the 
space  is  not  very  confined,  creates  a  tendency  to  this  disease,  then  it  clearly  points  out 
the  propriety  of  affording  the  soldier  as  ample  barrack  accommodation  as  possible." 
Thus,  even  at  that  time,  it  was  seen  that  no  other  cause  but  overcrowding  could  account 
for  the  great  amount  of  lung  disease. 

"  Roth  and  Lex,  op.  cit.,  vol.  iii.,  p.  391. 


THE   EFFECTS    OF    MILITARY    SERVICE.  279 

in  excess,  and  we  can  readily  see  that  a  number  of  antecedents  may  com- 
bine in  producing  the  result,  and  that  destructive  lung  diseases  may  proceed 
from  many  causes.  Still  there  must  have  been  some  predominating  in- 
fluence at  work. 

The  phthisis  was  not  owing  to  climate,  for  that  is  unchanged.  More' 
over,  we  shall  hereafter  see  that  the  same  excess  was  seen  in  the  Mediter- 
ranean stations  and  the  West  Indies. 

It  was  not  owing  to  syphilis,  for  until  late  years  the  amount  of  syphilis 
has  rather  increased  than  diminished,  while  phthisis  has  lessened. 

It  was  not  owing  to  bad  food,  for  the  food  was  the  same  in  all  the 
branches,  and  yet  the  amount  of  phthisis  was  widely  different.  Besides, 
the  food  has  been  comparatively  little  altered. 

It  can  hardly  haye  been  the  duties  or  clothing,  for  there  has  been  no 
sufficient  change  in  either  to  account  for  the  alteration,  unless  the  abolition 
of  one  of  the  cross-belts  some  years  ago  had  some  effect.  But  then  this 
would  have  only  affected  the  infantry. 

It  must  have  been  some  conditions  acting  more  on  the  foot  guards  than 
in  the  household  cavalry,  and  less  in  the  line  regiments  ;  also  it  must  have 
been  acting  in  the  troops  stationed  in  the  Mediterranean  and  the  West 
Indies.  There  is  only  one  condition  common  to  all  which  seems  capable 
of  explaining  it,  and  that  the  cause  noticed  in  the  Eeport  of  1839,  viz., 
overcrowding.  This  condition  was,  and  is  still  most  marked  in  the  barracks 
of  the  foot  guards,  and  least  in  the  barracks  of  the  cavalry  of  the  line.  It 
is  the  only  condition  which  has  undergone  a  very  decided  change  both  at 
home  and  abroad.  This  consideration,  as  well  as  those  formerly  noticed  in 
the  section  on  Air,  seems  to  make  it  almost  certain  that  the  breathing  the 
foul  barrack  atmosphere  was  the  principal,  perhaps  the  only,  cause  of  this 
great  mortality  from  lung  diseases.  If  this  be  so,  it  shows  that  the  foot 
guards  are  still  the  worst  housed  of  any  troops. 

2.    DISEASES    OF    THE    HEART    AND   VESSELS. 

The  fact  that  diseases  of  the  circulatory  system  rank  second  as  causes 
of  death  in  the  army  at  home  may  well  surprise  us.  It  is  marked  in  all 
arms,  as  much  in  the  artillery  and  cavalry  as  in  the  infantry.  The  ratio 
per  1,000  of  strength  for  the  five  years  (1867-71)  for  all  diseases  of  the 
organs  of  circulation  was  1.462,  and  in  those  years  out  of  eveiy  100  deaths 
no  less  than  16.7  were  from  disease  of  the  heart  and  vessels.  In  addition, 
there  was  a  large  amount  of  invaliding  from  this  cause. 

If  the  fatal  diseases  of  the  cu-culatory  system  of  the  five  years  (18G7-71)' 
are  divided  into  two  classes,  those  referred  to  some  disease  of  the  heart 
itself  (chiefly  chronic),  and  those  referred  to  aneurism  (including  an  occa- 
sional rare  return  headed  "  Degeneratio  Aortse  "),  it  is  found  that  the  deaths 
are : — 

Per  1,000  of  Strength.     In  100  Deaths. 

From  cardiac  disease .727  8.31 

From  aneurism .735  8.4 

Total 1.462  16.71 

These  numbers  are  higher  than  those  of  the  nine  years  (1859-67),  when 

'  In  the  recent  returns  the  differential  diagnosis  is  not  given.  In  the  9  years,  1872- 
80,  the  deaths  per  1,000,  from  diseases  of  the  circulating  system,  were  1.17,  and  the  per- 
centage of  total  deaths,  14.8. 


280 


PRACTICAL    HYGIENE. 


tlie  mortality  from  circulatory  diseases  was  only  .908  per  1,000  of  strength, 
and  the  percentage  on  the  total  deaths  was  9. 

This  mortality  is  in  excess  of  that  of  the  civil  male  population  of  the 
same  age,  especially  as  regards  aneui-ism.  Dr.  Lawson  has  calculated  that 
aneiu'ism  is  eleven  times  more  frequent  among  soldiers  than  ci\alians  ;  and 
he  has  also  calculated  that  among  civilians,  aged  15  to  44,  the  ratio  of 
mortality  from  cardiac  affections  alone  is  .45  per  1,000.  The  army,  then, 
in  the  je-avs  1867-71,  had  an  excess  of  .277  per  1,000  of  heart  disease. 
Myers'  statistics  are  contirmatoiy.  The  amount  of  heart  disease  is  greater 
among  the  foot  guards  than  among  the  metropohtan  poUcemen.  Myers 
in  his  able  treatise  '  gives  the  following  numbers  :— 


Foot  Guai'ds . 
Police , 


Died  per  1,000. 


.29 


Invalided  per  1,000. 
3.2 
1.37 


It  is  greater  among  soldiers  than  sailors  ;  from  six  years'  observations 
(1860-65)  Myers"  makes  the  navy  mortality  .66,  and  the  invahding 3.44 per 
1,000  ;  while  in  the  army  in  the  same  years  the  mortality  was  .9,  and  the 
invaliding  5.26. 

If  the  different  arms  of  the  service  are  taken,  the  following  numbers  are 
given  by  the  five  years  1867-71 : — 


Cavalry  of 
Guard. 

Cavalry  of 
Line. 

Artillery. 

Foot 
Guards. 

Infantry 
of  Line. 

Mean  yearly  strentrtli   

1,213 
1 

2 

.181 

.329 

8,468 

24 

37 
.566 

.873 

9,417 

57 

49 
1.210 

1.041 

5,749 

19 

20 
.661 

.695 

31,729 

Total  deaths  from  disease  of  the 
heart  in  five  vears 

73 

Total  deaths  from   aneurism   in 
five  years 

103 

Heart  deaths  per  1 ,000  of  strength 

Aneurismal  deaths  per  1,000  of 

strength  per  annum 

.460 
.649 

The  numbers  in  the  household  cavah-y  are  so  small,  it  is  not  safe  to  use 
them  ;  but  the  other  numbers  are  sufficiently  large  to  render  it  probable 
that  the  artillery  show  a  larger  proportion  of  fatal  cardiac  and  aneurismal 
cases  than  any  other  body  of  troops.  The  line  cavahy  and  hne  infantry 
both  show  rather  an  excess  of  aneurismal  over  heart  deaths  ;  while  the 
ai'tillery  show  more  heart  than  aneurismal  deaths,  and  in  the  foot  guards 
the  proportion  is  equal.  The  point  which  comes  out  clearly  from  the  table, 
in  addition  to  the  large  amount  in  all,  is  the  excess  of  both  classes  of  deaths 
in  the  ai'tiUery  ;  that  it  is  a  real  excess  is  seen  b}-  comparing  the  yearly 
number  of  the  ai-tillery  and  cavalry  of  the  hne,  who  did  not  differ  greatly 
in  mean  strength.  The  production  of  these  diseases  of  the  circulatory 
organs  begins  very  early  in  the  mihtary  career.  In  1860-62  Dr.  Parkes 
calculated  out  the  causes  of  invaliding  in  6,856  men.  Of  these  1,014  were 
under  two  years'  service.  In  the  whole  number  the  percentage  of  heart 
and  vessel  disease  as  the  cause  of  the  invaliding  was  7.7  ;  among  the  men 
under  two  years'  service  it  was  14.23  jjer  cent.  As  these  men  had  presum- 
ably healthy  hearts  when  they  enhsted,  the  effect  both  of  the  mihtary  life 


'  Diseases  of  Heart  among  Soldiers,  by  A.  B.  R.  Myers,  Coldstream  Guards, 
don,  1870.  2  Ibid.  ^  p.  11. 


Lou- 


THE    EFFECTS    OF    MILITARY    SERVICE.  281 

in  producing  diseases  of  the  cii'culatory  organs,  and  the  greater  suffering 
from  it  of  young  soldiers,  seems  certain.  The  statistics  in  the  Knapsack 
Committee's  Report  confirm  this. 

The  cause  of  this  preponderance  in  the  army  of  diseases  of  the  circula- 
toiy  organs  is  a  matter  of  great  importance.  Whatever  they  may  be,  it  is 
probable  that  they  produce  both  the  cardiac  and  the  arterial  disease. 

The  two  most  common  causes  of  heari  disease  in  the  civil  population 
are  rheumatic  fever  in  young,  and  renal  disease  in  older  persons.  The 
latter  cause  is  certainly  not  acting  in  the  army,  and  the  foiTuer  appears 
quite  insufficient  to  account  for  the  facts.  A  great  number  of  the  men 
■who  suffer  from  heart  and  vessel  disease  have  never  had  acute  rheumatism  ; 
and  if  we  refer  the  affection  to  slight  attacks  of  muscular  rheumatism, 
which  almost  e\ery  man  has,  we  ai-e  certainly  going  beyond  what  medical 
knowledge  at  present  waiTants.  The  effect  of  lung  disease  in  producing 
cardiac  affections  is  also  not  seen  in  the  army  to  any  extent. 

The  influence  of  sypMhs  in  producing  structural  changes  in  the  aortic 
coats  was  noticed  by  Morgagni.  In  114  post-moiiem  examinations  of 
soldiers  dying  at  Netley,  Dr.  Davidson  ^  found  22  cases  of  atheroma  of  the 
aorta.  Of  those  17  had  a  syphilitic  histoiy,  1  was  doubtful,  and  4  had 
had  no  syphihs,  but  had  heart  and  lung  diseases.  Of  the  whole  114  cases,  78 
had  no  syphUitic  history  and  had  4  cases  of  atheroma,  or  5.1  per  cent. ;  28 
had  a  mai'ked  syphihtic  history  and  17  had  atheroma,  or  no  less  than  60.7 
per  cent.  This  seems  very  strong  evidence  as  to  atheroma.  "With  respect, 
however,  to  actual  aneurism,  no  corresponding  analysis  of  cases  has  been 
made,  and  therefore  at  present  the  effect  of  syphilis  must  be  considered 
uncertain  ;  but  it  is  c[uite  clear,  even  admitting  its  influence,  there  is  no 
reason  to  think  that  syphilis  prevails  more  among  soldiers  than  among  the 
civil  male  population  of  the  same  class.  It  is,  therefore,  unlikely  that  an 
excess  of  syphilis,  if  it  really  occm-s  among  soldiers,  and  if  it  actually  predis- 
poses to  aneurism,  as  seems  probable,  coiild  produce  11  times  as  many  an- 
etuisms  as  in  ciril  persons.  Myers  has  also  given  evidence  that  both  in 
the  ai-my  and  navy  aneurism  is  sometimes  not  preceded  by  degeneration  of 
the  arterial  coats,  and  in  these  cases  mere  improper  exertion  seemed  to 
produce  it. 

The  effect  of  excessive  smoking  again  has  been  assigned  as  a  cause  of 
the  soldier's  cardiac  disease  ;  but  no  one  who  knows  the  habits  of  many 
continental  nations,  and  of  some  classes  among  our  own,  could  for  a  mo- 
ment believe  this  to  be  the  cause. 

Again,  the  effects  of  alcohol  in  constantly  maintaining  an  excessive  action 
of  the  heart,  are  so  marked  as  to  make  it  highly  probable  that  this  is  a  fact 
of  gi'eat  importance  ;  but  soldiers  do  not  diink  so  much,  as  compared  with 
civilians,  as  to  lead  us  to  think  the  cause  can  explain  the  prevalence. 

There  is,  however,  one  cause  wliich  is  continually  acting  in  the  case  of 
soldiers,  and  that  is  the  exertion  (often  rapid  and  long  continued )  which  some 
of  the  duties  involve."  The  artillery  have  very  heavy  work  ;  often  it  is  very- 
violent  and  sudden,  more  so  perhaps  than  in  any  other  coi-ps  ;  the  cavah-y 
also  have  sudden  work  at  times  ;  and  the  infantry  soldier,  though  his  usual 
labor  is  not  excessive,  is  yet  sometimes  called  upon  for  considerable  exertion, 
and  that  not  slowly,  or  with  rests,  but  vnth.  gi-eat  rapidity.    And  this  exertion 

'  Army  Medical  Department  Report,  vol.  v.,  p.  481. 

-  For  a  full  and  able  discussion  on  all  those  points,  and  for  additional  evidence,  ref- 
erence must  be  made  to  Mr.  Myers'  excellent  -svork.  On  the  effect  of  exertion  during 
war  in  causing  cardiac  hypertrophy,  reference  may  be  made  to  Dr.  Frantzel's  paper  in 
Virchow's  ArcMv,  Band  Ivii.,  p.  215. 


282  PRACTICAL    HYGIENE. 

is  in  all  arms  undertaken  with  a  bad  arrangement  of  dress  and  of  equipments. 
The  cavali-y  and  artillery  men  are  very  tightly  clothed,  and  though  the  horse 
carries  some  of  the  burden,  it  is  imdoubted  that  the  men  are  overweighted. 
In  the  infantry,  till  lately,  they  wore  very  tight-fitting  tunics,  with  collars 
made  close  round  the  neck,  and  trousers  (which  were  often  kept  up  by  a 
tight  belt)  ;  there  was  a  broad  straj)  weighted  below  with  a  heavy  pouch 
and  ammunition,  crossing  and  binding  down  the  chest ;  and  there  was  the 
knapsack  constricting  the  upper  part  of  the  chest,  and  hindering  the  au' 
from  passing  into  the  proper  lobes. 

The  production  of  heart  disease  ought  not  to  be  attributed  solely  to  the 
knapsack,  as  is  sometimes  done  ;  the  knapsack  is  only  one  agency ;  the  cross- 
belt  was  probably  worse,  and  the  tight  clothes  add  their  influence.  But  even 
with  the  knapsack  alone  the  effect  on  the  pulse  is  considerable,  and  one  or 
two  of  Dr.  Parkes'  experiments  may  be  given  in  illustration.  Thus,  four 
strong  soldiersc  arried  the  old  regulation  knapsack,  service  kit,  great-coat, 
and  canteen,  but  no  pouch  and  no  waist-belt  (except  in  one  man).  The 
pulse  (standing)  before  marching  was  on  an  average  88  ;  after  35  minutes 
it  had  risen  on  an  average  to  105 ;  after  doubling  500  yards,  to  139,  and  in 
one  of  the  men  was  164,  irregular  and  unequal  After  the  double  they 
were  all  unfit  for  'further  exertion.  In  a  fifth  man,  who  was  not  strong,  the 
85  minutes'  marching  raised  the  pulse  from  120  to  194  ;  after  doubling  250 
yards,  he  stopped  ;  the  pvdse  then  could  absolutely  not  be  felt.  In  another 
series,  the  average  pulse  of  four  men,  with  the  knapsack  only,  was  98  (stand- 
ing), after  one  hour's  march,  112  ;  after  their  doubling  500  yards,  141.  If 
the  jjouch  with  ammunition  is  added,  the  effect  is  still  greater.  Dr.  Parkes 
also  took  the  pulse  and  respu'ations  after  long  marches,  and  found  the  effect 
still  more  marked.  Walking,  of  com-se,  will  quicken  the  pulse  and  respira- 
tion in  any  man,  but  not  to  such  an  extent,  and  the  sense  of  fatigue  in  un- 
incumbered men  is  much  less. 

In  the  lecture  formerly  alluded  to,'  Dr.  Maclean  put  this  matter  most 
forcibly  before  the  authorities,  and  he  is  undoubtedly  quite  justified  in  the 
expression  that  one  cause  of  the  cardiac  (and  perhaps  of  the  aortic  and 
pulmonar}')  disease  in  the  army  is  to  be  found  in  exertion  carried  on  imder 
unfavorable  conditions. 

Happily,  much  has  been  lately  done  by  the  authorities  to  remove  this 
cause  ;  but  still,  especially  in  the  artillery  and  mounted  service,^  changes 
appear  to  be  necessary,  and  in  all  arms  it  is  desirable  that  oflicers  should 
allow  their  men  to  do  then-  work  under  the  easiest  conditions,  as  regards 
clothes,  weights,  and  attitudes,  consistent  with  miUtary  discipline  and 
order. 

3,    THE   NERVOUS   DISEASES. 

These  form  a  very  heterogeneous  class  ;  apoplexy,  meningitis,  paralysis, 
mania,  etc.,  are  the  chief  headings.  The  proportion  to  1,000  of  strength 
is  about  .6,  and  6.G  deaths  of  every  100  are  owing  to  nervous  diseases. 

'  Eoyal  United  Service  Institution  Journal,  1863,  vol.  viii. 

"The  cardiac  diseases  are  of  the  most  varied  kind.  Dr.  Parkes  wrote — "  I  have 
seen  at  Xetley,  in  Dr.  Maclean's  wards,  in  one  hour  in  the  summer,  when  the  hospital 
is  full,  almost  all  the  combinations  of  heart  affections.  It  has  appeared  to  me  that  it" 
anything  gives  the  tendency  to  heart  affections,  then  tlie  dress  and  accoutrements  como 
in  as  accessory  causes,  and  prevent  all  chance  of  cure.  In  some  cases  tliere  is  no  valvu- 
lar disease,  and  not  much  hypertrophy  of  the  heart,  but  a  singular  excitability,  so  that 
the  heart  beats  frightfully  quick  on  the  least  exertion." 


THE    EFFECTS    OF    MHJTAEY    SERVICE. 


283 


As  among  tiie  male  civil  population  (ages  25  to  35)  tlie  deaths  are  also  6. 6 
per  cent,  of  total  deatlis,  soldiers  do  not  appear  to  suffer  more. 

4.  p^■EImox[A  AinD  acute  beoxchitis/ 

Table  to  shoic  the  admissions  and  deaths  per  annum,  per  1,000  of  strength, 
years  1859-71  {thirteen  years). 


Average 

Highest  in  tliirteen  years 
Lowest  in  thirteen  years. 


Pnenmonia. 


Acute  Bronchitis. 


Admissions. 


5.25 

7.13 
3.49 


.641 
.741 
.423 


55. 65 

88.00 
39.10 


.227 
.380 
.080 


The  acute  inflammatory  diseases  of  the  lungs  give,  therefore,  a  mean 

annual  mortality  of  .856  per  1,000  of  strength.  The  mean  total  deaths 
from  diseases  of  the  respiratory  system,  for  the  nine  years  (1872-80j  was 
1.34  per  1,000,  causing  IT  jDer  cent,  of  total  deaths. 

In  the  French  army  pneumonia  gives  a  lower,  and  acute  bronchitis  a 
higher,  mortality  than  in  oui'  own,  but  this  is  perhaps  a  mere  difference  of 
nomenclatui'e. 

The  opinion  that  the  military  suffer  more  than  the  civil  population  fi-om 
pneumonia  is  an  old  one.  It  is  also  generaUy  beheved  that  they  suffer  less 
in  the  field  than  in  ganison.  Tinistworthy  statistics  seem  wanting  as  to 
the  amount  among  the  civil  poj)ulation.  In  the  Eui'opean  population,  gen- 
erally, Ziemssen"  gives  the  deaths  fi'om  pneumonia  as  1.5  ;  and  Oesterlen,^ 
1.25  per  1,000  ;  but  this  includes  aU  ages,  and  both  sexes.  Among  men 
alone  it  is  certainly  gi'eater  than  among  women.  In  London,  in  1865,  the 
mortality  from  pneumonia,  between  the  ages  20  and  40  (both  sexesj,  was 
1  per  1,000  population.'' 

If  this  be  con-ect,  the  mortality  among  soldiers  is  below  the  civil  mor- 
tality, or  soldiers  ai'e  less  subject  than  civilians  ;  for,  as  men  are  more 
subject  to  pneumonia  than  women,  the  mortality  among  the  ci^ihan  males 
•would  be  greater  than  1  per  1,000,  but  the  mihtary  mortahty  is  only  .641. 
The  mortahty  among  the  army  pneumonic  cases  (deaths  to  treated) 
amounts  (average  of  thirteen  years)  to  12.18  per  cent.,°  and  as  this  is  very 
neai'ly  the  civil  proportion,  ever\-  1,000  of  population  in  London  gave  nine 
cases  of  pneumonia,  while  1,000  soldiers  gave  only  five.  It  may  be  said, 
however,  that  London  is  not  a  fair  test  ;  but  as  a  place  of  residence  for  sol- 
diers it  does  not  appear  to  predispose  to  pneumonia,  as  will  be  seen  from 
the  foUovring  table  : — 

Per  1.000  of  Strength, 
yeaK  1864-71. 
Foot  Guards        Infantry  in  the 
in  London.      Kingdom  generally. 

Admissions  from  pneumonia 3.75  6.06 

Deaths  from  pneumonia 44  .66 

^  Separate  data  are  not  published  in  the  Armr  ^ledical  Eeports,  for  the  later  years. 

'Monats-Bl.  fiir  Med.  Stat.,  1S57,  and  Schmidt's  Jahrb.,  1862,  Xo.  3,  p.  337. 

SMed.  Statist.,  2d  edit.,  p.  567. 

*  Tacher,  Sur  la  Mort.  en  1865,  Paris,  1866,  p.  137. 

°  In  thirteen  years  there -vrere  4,826  cases  treated,  and  588  deaths,  or  12.18  deaths 
per  cent.  In  Canada  the  deaths  to  admissions  were  only  7.13  deaths  per  cent,  (average 
of  twelve  years  ending  1S70). 


284  PRACTICAL    HYGIENE. 

The  mortality  to  cases  treated  in  the  five  years  (1867-71)  was,  in  the 
Guards,  10. G8,  and  in  the  infantry,  11.7  percent. 

Although  it  does  not  seem  that  pneumonia  (and  acute  bronchitis  ?)  are 
more  common  or  more  fatal  among  soldiers  serving  at  home  than  among 
civihans,  the  above  figures  show  what  a  fatal  disease  pneumonia  is,  and 
how  worthy  of  renewed  study  its  causes  are. 

5.    THE    CLASS    OF    CONTINUED    FEVERS. 

Tlie  returns  do  not  carefully  distinguish  the  several  forms,  but  practi- 
cally the  majority  of  the  fatal  cases  of  "  continued  fever  "  are  from  enteric 
(tj'jihoid)  fever. 

There  has  been  a  great  decline  in  this  class  of  late.  In  the  ten  years 
(1837—46)  the  average  admissions  were  62,  and  the  deaths  1.72  per  1,000  of 
strength.  In  the  eight  years  ending  1867,  the  admissions  averaged  22,  and 
the  deaths  .5  per  1,000  of  strength.  In  1871  there  were  onh'  80  cases  of 
enteric  fever  and  22  deaths  in  the  whole  army  of  87,000  men.  In  the  four 
years  ending  1875  the  mean  total  deaths  from  continued  fever  were  0.37  per 
1,000,  and  they  amounted  to  4.4  per  cent,  of  the  total  deaths.  In  the  five 
years  ending  1880  the  total  deaths  were  0.30  per  1,000,  and  the  numbers 
to  total  deaths  4.1  ;  in  1880  the  numbers  were  respectively,  0.26  and  3.8. 

This  mortality  is  decidedly  below  that  of  the  male  civil  population  of 
the  same  age,  which  amounts  to  9.6  per  cent,  of  total  deaths,  and  veiy 
nearly  1  per  1,000  of  population. 

During  late  years  no  points  have  been  more  attended  to  in  the  army 
than  pure  water  supply  and  good  sewerage,  and  we  see  the  results  in  this 
very  large  diminution  of  deaths  from  the  rate  of  the  former  period,  and  in 
the  fact  that  in  this  jjarticular  class  of  disease  the  soldier  is  far  better  off 
than  the  civil  population.  So  also  the  cholera  of  1866  passed  very  lightly 
over  the  ai-my  at  home  (only  13  deaths  out  of  70,000  men),  although  in 
former  epidemics  the  army  suffered  considerably. 

The  decline  of  enteric  fevers  confirms  most  strongly  the  doctrine  of  its 
intimate  dependence  on  bad  sewage  aiTangemeuts. 

The  greatest  amount  of  t^'phoid  fevers  in  the  army  is  in  the  gamsons 
in  the  seaports,  the  least  in  the  camps. 

The  other  classes  of  disease  causing  mortality  need  no  comment. 
Chronic  bronchitis  is  no  doubt  to  be  chiefly  refeiTed  to  phthisis  (using  that 
term  as  a  generic  word  to  include  various  disorganizing  lung  diseases), 
and  delii'ium  tremens  is  a  return  which  Avill,  no  doubt,  gradually  disappear 
in  fact,  as  it  has  ah-eady  done  in  figaren  from  the  published  Eeports. 

The  smaller  items  of  mortality,  making  up  about  22  out  of  eveiy  100 
deaths,  are  various  ;  erysipelas,  pypemia,  syphilis,  hej^atitis  (in  men  fi'om 
foreign  service),  enteritis,  rheumatism  (from  heart  comj^lication  probably, 
but  rettu-ned  as  rheumatism),  diabetes,  ebriositas,  scarlet  fever,  and  dijoh- 
theria,  are  a  few  of  the  many  causes  which  cany  off  a  small  number  every 
year.  The  cancerous  and  kidney  diseases  are  very  few,  as  we  might  expect 
from  the  age  of  the  men. 

To  sum  up  the  case  as  regards  the  present  mortality  on  home  service, 
it  may  be  stated  that  for  the  last  twenty-one  years  (up  to  1880)  there  has 
been  some  lessening,  but  no  great  fall  in  the  number  of  deaths.  There  is 
still  much  to  be  done  in  resj^ect  of  jjreventing  disorganizing  lung  disease, 
disease  of  the  circulatory  organs,  and  even  fever,  for  we  ought  not  to  be 
satisfied  until  the  term  enteric  fever  is  altogether  obliterated.  A  renewed 
study  of  the  causes  of  pneumonia  is  also  necessary,  in  order  to  see  if  some 


THE    EFFECTS    OF   MILITAEY    SERVICE.  285 

way  or  other  the  attacks  of  that  fatal  disease  cannot  be  lessened.  There 
is  no  reason  to  think  that  we  have  yet  toj.3hed  the  lowest  jjossible  Hmit  of 
preventable  disease  ;  but,  on  the  contrary,  we  can  see  clearly  that  the 
soldier,  compai::tively  healthy  as  he  is,  may  be  made  more  healthy  still. 
Some  evidence  in  support  of  such  a  view  may  be  found  in  the  fact,  that 
both  at  Gibraltar  and  in  some  of  the  West  Indian  stations  the  mortality 
has  been  lower  in  some  years  than  it  has  ever  been  at  home.  But  there  is 
no  reason  why  the  home  mortaUty  should  not  be  reduced  to  the  standard 
of  those  foreign  stations. 

A  question  now  arises — Why,  after  thirty  years  of  age,  should  the 
soldier  die  more  rapidly  than  the  civilian,  though  for  the  first  ten  years  of 
his  service  he  has  a  smaller  mortahty  ?  The  causes  may  be  foreign  ser- 
vice, bad  social  habits  (i.e.,  excess  of  drinking  and  syphilis,  or  other  effects 
of  enforced  celibacy),  night  duty,  exposure  on  guard,  and  prolonged  influ- 
ence of  impure  barrack  air.  But  to  which  of  these  the  result  is  owing 
could  only  be  determined  by  accurate  statistical  inquiries  of  the  causes  of 
mortality  at  the  older  ages.  We  do  not  know  these,  and  if  the  short  ser- 
vice system  continues  we  are  hardly  hkely  to  know  them,  so  it  is  of  no  use 
to  discuss  a  topic  on  which  sufficient  facts  are  not  available. 

B.  Loss  OF  Strength  of  the  Aemy  by  iNVALrorNG. 

The  amount  of  invaliding  is  influenced  by  other  causes  than  mere  inef- 
ficiency of  the  men  ;  sometimes  a  reduction  is  made  in  the  army,  and  the 
opportunity  is  taken  to  remove  weakly  men  who  would  otherwise  have 
continued  to  serve.  This  was  the  case  in  1861.  As  invaliding  greatly  af- 
fects the  mortality  of  the  army,  a  source  of  fallacy  is  introduced  which  it  is 
not  easy  to  avoid. 

During  the  seven  years  (1860-66),  there  were  invalided  every  year 
nearly  37  men  out  of  every  1,000,  thus  making  a  total  loss  by  death  and 
invaliding  from  disease  of  nearly  46  men  per  1,000,  or  about  one-twenty- 
second  part  of  the  whole  force.  In  1867  the  invaUding  was  lower,  viz.,  22.18 
per  1,000.  For  the  ten  years  (1870-1879),  the  invaliding  in  the  United 
Kingdom  was  at  the  rate  of  27.18  per  1,000,  and  the  deaths  were  8.18, 
— making  together  35.36,  or  one-twenty-eighth  part  of  the  force.  For  the 
whole  army  the  numbers  were,  22.15  and  12.67 — together  34.82,  or  slightly 
less.  In  1880  the  total  loss  for  the  United  Kingdom  was  only  one-thirty- 
fourth,  and  for  the  whole  army  one-twenty- eighth.  The  causes  of  the  in- 
validing were  formerly  very  carefully  ascertained  by  Dr.  Balfour,  and  in- 
serted in  his  Reports,  but  the  information  is  now  omitted  from  the  "Army 
Medical  Department  Reports."  Speaking  in  round  numbers,  for  the  j)eriod 
when  detailed  returns  were  furnished,  phthisis  and  scrofula  account  for 
about  one-foiu'th  of  the  invalids,  and  if  chronic  bronchitis  was  included, 
for  nearly  seven-twentieths,  the  two  items  of  hypertrophia  cordis  and 
morbus  valv.  cord,  accounted  for  one-tenth,  and  chronic  rheumatism  for 
one-fourteenth.  The  three  nervous  diseases  of  amentia,  mania,  and  epi- 
lepsy always  caused  a  large  number  of  invahds,  amounting  nearly  to  one- 
tenth,  or  almost  the  same  as  the  two  classes  of  heart  diseases.  All  the  other 
items  were  smaller.  In  men  invalided  under  one  year's  service  nearly  one 
quarter  were  so  from  epilepsy  ;  the  remaining  chief  causes  were  phthisis 
and  diseases  of  the  circulatory  organs.  It  is  probable  that  the  loss  from 
invaliding  will  continue  to  diminish  as  a  consequence  of  the  short  service 
system. 


286  PRACTICAL    HYGIENE. 

SECTION  n. 

LOSS  OF  SERVICE  FROM  SICKNESS  PER  1,000  PER  ANNUM. 

(a)  Number  of  Admissions  into  Hospital. — On  an  average,  1,000  soldiers 
furnish  rather  under  1,000  admissions  into  hosi:»ital  per  annum  ;  809.1  in 
ten  years  (1870-79).  The  number  varies  in  the  different  arms  from  about 
600  in  the  Household  Cavalry  and  Engineers,  which  is  usually  the  lowest, 
to  about  1,100  in  the  Cavalry  and  Artillery  Depots.  In  the  first  case  the 
steady  character  of  the  men,  many  of  whom  are  married,  and  in  the  second 
the  frequency  of  contusions  during  drill,  account  for  this  great  range.  In 
the  Infantry  the  average  is  from  850  to  1,020.  In  1880  the  highest  rate  was 
in  the  cavalry,  1,016.4,  and  the  lowest  in  the  Royal  Engineers,  587.8,  the 
Foot  Guards  showing  1,003.8,  and  the  Infantry  (including  depots),  943.6. 

The  number  of  admissions  remained  tolerably  constant  for  twenty-five 
years,  but  during  late  years  has  been  sensibly  declining. 

The  admissions  in  the  French  army  are  not  comparable  with  ours  ; 
slight  cases  of  sickness  (which  with  us  are  often  not  recorded)  are  treated 
in  barracks  [d  la  chambre),  severer,  but  still  slight,  cases  in  the  infirmaries, 
bad  cases  in  the  general  hospitals.  The  mean  of  five  years  (1862-66)  gives 
2,028  total  admissions  per  1,000  "present."  The  admissions  to  the  infirm- 
aries in  France  (in  1866)  were  323  per  1,000  "present;  "  to  the  hospitals, 
306  ;  making  a  total  of  the  severer  cases  of  only  629  per  1,000  in  that  year. 
This  shows  how  many  slight  cases  there  are  in  the  French  army.  In  the 
eight  years  (1862-69)  the  mean  number  of  slight  cases  in  France  was  1,745 
per  1,000  (Morache). 

In  the  Prussian  army  the  average  admissions  (mean  of  18  years,  1846- 
63)  were  1,336.  In  1867  there  were  1,125.6  per  1,000.  In  1873-75  it  was 
750,  and  in  1876  only  620  (Roth). 

(&)  Daily  number  of  Sick  in  Hosjntal  per  1,000  of  Strength. — About  one- 
twenty-fifth  of  the  army  is  constantly  sick  in  time  of  peace,  or  4  per  cent. 
The  mean  for  the  ten  years  1860-69  was  4.78  per  cent.,  (or  one-twenty-first 
part),  and  for  the  ten  years  1870-79,  it  was  3.95  per  cent.,  or  just  under 
one-twenty-fifth.     The  numbers  are  therefore  diminishing. 

It  is  not  possible  to  compare  the  army  sickness  with  the  civil  popula- 
tion, or  even  with  other  armies. 

In  England,  the  number  of  members  of  friendly  societies,  between 
twenty  and  thirty  years  of  age,  who  are  constantly  sick,  is  nearly  16  per 
1,000. 

In  the  French  army,  the  mean  sick  in  hospital  are  29  per  1,000  present ; 
in  both  hospital  and  infirmary,  50  ;  in  the  Prussian,  44  (in  1876  only  25.5)  ; 
in  the  Austrian,  45  ;  in  the  Belgian  (1859),  54.2  ;  in  the  Portuguese  (1851- 
53),  39.4. 

The  number  of  daily  sick  has,  of  course,  a  wide  range  ;  sometimes  an 
hospital  is  almost  closed,  at  other  times  there  may  be  more  than  100  sick 
per  1,000,  of  strength. 

(c)  Number  of  Days  spent  in  Hospital  pter  head  in  each  1,000  of  Strength. 
— The  number  of  days'  service  of  a  battalion  1,000  strong  in  a  year  would 
be  of  course  (1,000  x  365  =)  365,000.  If  we  assume  the  average  number 
of  sick  to  be  39^  per  1,000,  there  are  lost  to  the  State  (39^  x  365  =)  14,- 
417  days'  service  per  annum,  or  14|  days  per  man.  As  already  said,  it  is 
difiicult  to  compare  the  sickness  of  soldiers  and  civiUans,  but  the  above 
amount  seems  large  when  we  remember  that,  in  the  friendly  societies,  the 


THE    EFFECTS    OF    MILITARY    SERVICE.  287 

average  sickness  per  man  per  annum  (under  forty  years  of  age)  is  less  tlian 
seven  days. 

Mean  Duration  of  Gases  of  Illness. — The  number  of  days  each  sick  man 
is  in  hospital  (mean  duration  of  cases)  is  rather  greater  (17.8,  average  of  10 
years,  1870-79),  as  the  number  of  admissions  is  below  the  strength. 

It  can  be  most  easily  calculated  as  follows  :  multiply  the  mean  daily 
number  of  sick  (sick  jDopulation)  by  the  number  of  days  in  the  period,  and 
divide  by  the  cases  treated.  The  number  of  "  cases  treated  "  is  the  mean 
of  the  admissions  and  discharges  in  the  period. 

Austrian  army,  17  to  18  days.  [  French  d  la  chambi'e,  3.10  days. 

French  at  home,  all  cases  (1862-66),   Prussian  (1859-63)  in  hospitals,  18.9 

7.97  days.  '  days. 

French  in  hospitals  only  (1862-66),  j  Belgian,  23.6  days. 

26.3  days.  I  Portuguese,  19  days. 

French  in  infii'mary,  12  days.  I  ^ 

(a)  Mortality  to  Sickness.  — This  is,  of  course,  a  different  point  from  that 
of  the  relation  of  mortality  to  strength.  A  few  cases  of  very  fatal  illness 
may  give  a  large  mortality  to  cases  of  sickness,  but  the  mortahty  to  strength 
may  be  very  small. 

The  mere  statement  of  the  ratio  of  mortality  to  sickness  gives  little  in- 
formation ;  what  is  wanted  is  the  mortahty  of  each  disease,  and  at  every 
age.  Otherwise  the  introduction  of  a  number  of  trifling  cases  of  disease 
may  completely  mask  the  real  facts. 

When,  however,  the  general  ratio  is  to  be  determined,  it  must  be  calcu- 
lated in  one  of  three  ways  : — ■ 

1.  Mortality  to  admissions  in  the  time.  This  is,  however,  an  uncertain 
plan  ;  a  number  of  cases  admitted  toward  the  close  of  a  period,  and  the 
greater  part  of  whose  treatment  and  mortality  falls  into  the  next  period, 
may  cause  an  error. 

2.  Mortality  to  cases  treated  (  =mean  of  admissions  and  discharges).* 
This  is  the  best  method  of  calculation. 

3.  Mortality  to  sick  population,  i.e.,  the  number  of  deaths  furnished 
per  annum  by  a  daily  constant  number  of  sick.  This,  however,  must  be 
taken  in  connection  with  the  absolute  number  of  sick  in  the  time,  and  with 
the  duration  of  the  cases,  or,  in  other  words,  with  the  kind  of  cases. 

The  degree  of  mortality  to  the  several  causes  of  sickness  was  given  very 
fully  in  the  statistical  part  of  the  "Army  Medical  Department  Keports,"  up 
to  the  year  1873,  since  which  time  the  detailed  returns  have  been  discon- 
tinued. 

Calculated  on  the  admissions,  the  mortality  to  total   sickness  in  the 

^  It  has  not  infrequently  happened  that  the  mortality  on  sickness  has  been  caleu' 
lated  in  this  way :  the  niTmber  of  sick  remaining  in  hospital  at  the  commencement  of 
the  period,  say  a  year,  are  added  to  the  admissions  in  the  year,  and  the  mortality  is 
calculated  on  this  number.  At  the  end  of  the  year  a  certain  number  of  sick  remaining 
in  hospital  are  carried  on  to  the  next  year,  and  added  to  the  admissions  of  that  second 
year  for  the  calculation  of  the  mortality  of  that  year.  In  this  way  they  are  counted 
twice.  This  has  been  done  in  calculations  of  weekly  mortality,  and  in  this  way  the 
same  sick  man  has  been  made  to  do  duty  as  a  fresh  case  many  times  over.  This  is  to 
be  avoided  by  either  calculating  on  the  admissions,  or  by  considering  half  the  "remain- 
ing" at  the  beginning  to  belong  to  the  previous  period,  and  half  the  "  remaining  "  at 
the  end  of  the  period  to  belong  to  the  following  period,  or,  what  is  the  same  thing, 
taking  half  the  admissions  and  half  the  discharges  in  the  period  as  representing  the 
"  cases  treated  "  in  that  time. 


i!S8  PRACTICAL    HYGIENE. 

English  army  at  home  is  a  little  above  the  mortality  to  strength,  or  about 
10.2  per  1,000  per  annum  (1870-79).  In  1880  the  ratio  was  7.6.  In  the 
Prussian  army  it  was  7.25  (years  1846-62) ;  in  1872  it  was  7.7.' 

Causes  of  Sickness. 

The  causes  leading  men  to  go  into  hospital  are,  of  course,  veiy  different 
from  those  which  produce  mortality.  For  example,  admissions  from 
phthisis  will  be  few,  mortality  great ;  admissions  from  skin  diseases  nu- 
merous, mortality  trifling. 

Taking  the  most  common  causes  of  admission  in  the  order  of  frequency, 
we  find — 

1.  Venereal  Disea-^'es. — Under  the  term  Venereal,  all  diseases,  immediate 
or  remote,  resulting  from  sexvial  intercourse,  are  included.  Secondary  as 
well  as  primary  syphilis  ;  stricture  and  orchitis,  as  well  as  gonon-hoea,  etc.  ; 
also  a  few  cases  not  strictly  venereal.  The  primary  venereal  forms  are, 
however,  of  the  most  importance. 

In  stations  under  the  Contagious  Diseases  Act,  1,000  men  give  67  ad- 
missions from  primary  venereal  sores  and  82  from  gonorrhoea  (average  of 
11  years  1870-80).  In  stations  not  under  the  Act,  the  amounts  have  been, 
respectively,  107  and  100.  There  are  other  admissions  from  secondary  and 
tertiary  syphiHs,  which  somewhat  increase  the  total  admissions. 

We  have  no  certain  facts  with  w'hich  we  can  comjDare  the  sj'philitic  dis- 
ease of  the  civil  population  with  that  of  the  army.  The  amount  among  the 
ci\il  population  at  large  is  reaUy  a  matter  of  conjecture.  But  whether  it  is 
greater  or  less  than  that  of  the  army  does  not  affect  the  result  drawn  from 
the  above  figures,  viz.,  that  there  is  an  appalling  loss  of  ser\ice  every  year 
from  the  immediate  or  remote  effects  of  venereal  disease.^ 

It  should  be  understood,  also,  that  the  action  of  sj'philis  is  long  con- 
tinued. Many  soldiers  die  at  Netley  ^  from  various  diseases,  whose  real 
affection  has  been  sji^hilis,  so  that  the  influence  of  this  cause  is  very  imper- 
fectly indicated  by  the  number  of  admissions  and  ser^dce  lost  under  the 
head  of  s^^j^hilitic  disease  only. 

2.  General  Diseas^es. — The  imjDortant  diseases  included  under  this  class 
give  about  one-fourth  of  the  total  admissions,  or  about  199  per  1,000 
(1870-80). 

(a)  Eruptive  fevers  are  not  very  common,  about  5  per  1,000,  Smallpox 
is  checked  by  vaccination ;  measles  and  scarlatina  are  not  frequent. 

(b)  Paroxysmal  fevers  (most  of  which  have  been  contracted  out  of  Eng- 
land) give  about  13  per  1,000. 

(c)  The  continued  fevers  are  more  common,  but  their  frequency  is 
lessening.  There  is  no  doubt  that  tyi^hoid  is  the  chief,  perhaps  almost  the 
only  fever  besides  febricula  which  is  now  seen.  Spotted  typhus  is  at  pres- 
ent uncommon,  but  does  occasionally  occur.  The  continued  fevers  cause 
about  20  admissions  per  1,000  of  strength.  Of  late  years  there  have  been 
some  cases  of  cerebro-spinal  meningitis. 

'  For  numerous  statistical  details  of  foreign  armies,  see  Roth  and  Lex,  op.  cit.,  vol. 
iii.,  p.  411  et  seq. 

"  The  order  issued  in  1873,  directing  stoppages  to  be  made  from  men  in  hospital  af- 
fected with  venereal  disease,  was  a  most  unfortunate  one,  as  giving  every  inducement 
for  the  concealment  of  disease.     Happily  it  has  now  been  rescinded. 

3  Professors  Maclean  and  Aitken,  of  the  Army  Medical  School,  are  both  very  much 
impressed  with  the  frequent  occurrence  of  marks  of  continued  and  dominant  syphilitic 
action  in  the  bodies  of  men  who  die  from  what  are  considered  other  diseases. 


THE    EFFECTS    OF   MILITAEY    SERVICE.  289 

(d)  Eheumatism  gives  46  cases  per  1,000  of  strength. 

3.  Accidents  give  the  next  greatest  number  ;  mean  (1870-1880)  107  ; 
range  from  65  to  114  per  1,000. 

4.  Diseases  of  the  Digestive  system  follow,  with  nearly  the  same  num- 
ber, about  107  ;  range  from  96  to  122. 

5.  Cutaneous  diseases  give  a  mean  of  104  ;  range  from  92  to  123. 

6.  Respiratory  diseases  (not  including  Phthisis)  give  a  mean  of  85  per 
1,000  ;  range  from  76  to  103. 

7.  Diseases  of  the  Eye,  mean  16,  with  little  variation. 

8.  Diseases  of  the  Circulatory  system,  14. 

9.  Phthisis,  13,  with  range  between  11  and  14. 

10.  Nervous  system,  12,  with  a  range  between  11  and  14. 

11.  The  remaining  diseases  of  numerous  smaller  items,  such  as  those 
of  the  generative  {venereal  excluded),  locomotive,  urinary  [gonorrhoea  ex- 
cluded), etc. 

As  almost  all  details  of  these  different  groups  are  now  omitted  from  the 
"Army  Medical  Reports,"  it  is  difficult  to  discuss  their  causation  and  possi- 
ble diminution. 

There  is  no  room  for  doubt  that  the  venereal  admissions  could  be 
greatly  lessened ;  so  also  could  the  admissions  from  fever,  which  have  in 
fact  been  already  reduced  from  60  to  22  per  1,000  of  strength  ;  in  1879  and 
1880  they  were  only  16  and  17  respectively.  The  large  class  of  integu- 
mentary diseases  would  probably  admit  of  reduction.  What  is  the  exact 
nature  of  the  phlegmon  and  ulcers  which  form  so  large  a  proportion  of  the 
admissions  ?  Ti'ifling  as  the  cases  are,  they  form  a  large  aggregate,  and  a 
careful  study  of  their  mode  of  production  might  show  how  they  might  be 
diminished.  Probably,  however,  these  are  mere  conventional  terms,  under 
which  a  number  of  trifling  cases  are  conveniently  recorded,  but  a  com- 
plete analysis  of  the  returns  of  one  year  under  phlegmon  would  be  desira- 
ble. So  also  of  all  the  other  classes,  it  may  be  concluded  that  an  active 
medical  officer  might  succeed  in  reducing  the  cases  of  rheumatism,  bron- 
chitis, and  dyspepsia.'  Many  cases  of  acute  respiratory  diseases  are  pi'O- 
duced  by  exposure  on  guard,  especially  by  the  passage  into  and  from  the 
hot  close  air  of  the  guard-room  to  the  ojDen  air  on  sentry  duty.  Good  ad- 
ditional overcoats,  means  of  drying  the  clothes,  and  proper  ventilation  of 
the  guard-rooms,  would  probably  lessen  the  cases  of  bronchitis  and  pleu- 
risy. 

Sickness  in  Military  Prisons. — The  admissions  into  hospital  in  the  mili- 
tary prisons  do  not  appear  to  be  great  ;  they  have  varied  per  1,000  of  ad- 
missions of  prisoners  from  316  (in  1851)  to  725.5  in  1863.'*  Calculated  on 
the  mean  strength,  the  result  is  as  follows  : — In  1863,  the  daily  average 
number  of  prisoners  was  1,064  ;  the  admissions  for  sickness,  722  ;  the  mean 
daily  sick,  21  ;  the  mortality,  0.  These  numbers  give  725.5  admissions^ 
and  19.74  mean  daily  sick  per  1,000  of  strength.  Prisoners  are  healthier 
than  their  comrades  at  duty  in  the  same  garrisons  where  the  prisoners  are 
under  sentence. 

'  It  is  right,  however,  to  say  that  no  medical  officer  ought  to  sacrifice  his  men  in  the 
slightest  degree  for  the  purpose  of  appearing  to  have  a  small  sick  list  and  an  empty  lios- 
pital.  There  is  a  temptation  in  that  direction  which  we  have  to  guard  against,  and  to 
remember  that  the  only  question  to  be  asked  is,  What  is  the  best  for  the  men  ?  not, 
What  will  make  the  best  appearance  ? 

"^  Report  on  Prisons  for  1863,  p.  24. 
Vol.  II.— 19 


290  PRACTICAL    HYGIENE. 


SECTION  m 

Such,  then,  being  the  amount  of  mortality  and  sickness  at  home,  it  may- 
be concluded  that  the  soldier  at  present  is  not  yet  in  so  good  a  condition 
of  physical  health  as  he  might  be  ;  and  we  can  confidently  look  to  future 
years  as  likely  to  show  a  continuance  in  the  improvement  now  going  on. 
In  future  years,  however,  the  new  system  of  limited  service  will  render  it 
difficult  to  trace  the  progress  in  the  infantry. 

Health  is  so  inextricably  blended  with  all  actions  of  the  bod}^  and  mind, 
that  the  medical  officers  must  consider  not  only  all  j)hysical  but  all  mental 
and  moral  causes  acting  on  the  men  under  their  charge. 

The  amount  of  work,  the  time  it  occupies,  its  relation  to  the  quantity  of 
food,  the  degree  of  exliaustion  it  produces,  the  number  of  nights  in  bed, 
and  other  points  of  the  like  kind  ;  the  mental  influences  interesting  the 
soldier,  or  depressing  him  from  ennui  ;  the  moral  effect  of  cheerfulness, 
hope,  discontent,  and  despondency  uj)on  his  health,  as  well  as  the  supply 
of  water,  air,  food,  clothing,  etc.,  must  be  taken  into  account.  And  just 
as  the  body  is  ministered  to  in  all  these  ways,  so  should  there  be  ministra- 
tion of  the  mind.  It  is  but  a  partial  view  which  looks  only  to  the  body  in 
seeking  to  improve  health  ;  the  moral  conditions  are  not  less  important ; 
without  contentment,  satisfaction,  cheerfulness,  and  hope,  there  is  no 
health. 

Hygiene,  indeed,  should  aim  at  something  more  than  bodily  health,  and 
should  indicate  how  the  mental  and  moral  qualities,  essential  to  the  partic- 
ular calling  of  the  man  can  be  best  developed. 

How  is  a  soldier  to  be  made  not  merely  healthy  and  vigorous,  but  cour- 
ageous, hopeful,  and  enduring  ?  How,  in  fact,  can  we  best  cultivate  those 
martial  quaHties  which  fit  him  to  endure  the  hardships,  vicissitudes,  and 
dangers  of  a  career  so  chequered  and  perilous  ? 

Without  attempting  to  analyze  the  complex  quality  called  courage, — a 
quality  arising  from  a  sense  of  duty,  or  love  of  emulation,  or  fear  of  shame, 
or  from  physical  hardihood,  springing  from  familiarity  with  and  contempt 
of  danger, — it  may  well  be  believed  that  it  is  capable  of  being  lessened  or 
increased.  In  modern  armies,  there  is  not  only  little  attempt  to  cultivate 
courage  and  seK-reliance,  bvit  the  custom  of  acting  together  in  masses  and 
of  dependence  on  others,  actually  lessens  this.  It  is,  then,  a  problem  of 
great  interest  to  the  soldier  to  know  what  mental,  moral,  and  physical 
means  must  be  used  to  strengthen  the  martial  quahties  of  boldness  and 
fortitude. 

The  Enghsh  army  has  never  been  accused  of  want  of  courage,  and  the 
idea  of  pusillanimity  would  seem  impossible  to  the  race.  But  drunken^ 
ness  and  debauchery  strike  at  the  very  roots  of  courage  ;  and  no  army  ever 
showed  the  highest  amount  of  martial  qualities  when  it  permitted  these 
two  vices  to  prevail. '     In  the  army  of  Marlborough,  the  best  governed 

'  There  are  many  sober  and  excellent  men  in  the  army  But  as  a  rule,  the  English 
soldier  cannot  be  depended  upon  under  any  circumstances,  if  he  can  get  drink.  Well 
does  Sir  Ranald  Martin,  say,  "  Before  that  terrible  vice  can  be  overcome,  something 
far  more  powerful  than  medical  reasoning  on  facts,  or  the  warnings  of  experience 
founded  on  them,  must  be  brought  into  active  operation.  Discipline  must  still  further 
alter  its  direction  :^in  place  of  being  active  only  to  punish  wrong,  it  ought  and  must 
be  exerted  further  and  further  in  the  encouragement  to  good  conduct."— Ranald  Mar- 
tin, Tropical  Climates,  p.  263. 


THE    EFFECTS    OF   MILITARY    SERVICE.  291 

army  we  ever  had,  and  the  most  uniformly  successful,  we  are  told  that  the 
"  sot  and  the  drunkard  were  the  objects  of  scorn."  To  make  an  army  per- 
fectly brave,  it  must  be  made  temperate  and  chaste. 

Good  health  and  physical  strength,  by  increasing  self-confidence,  in- 
crease courage  ;  and  self-reliance  is  the  consequence  of  feeling  that,  under 
all  circumstances,  we  can  face  the  dangers  and  difficulties  that  present 
themselves. 

Few  wiser  words  were  ever  wi-itten  than  those  by  William  Fergusson/ 
at  the  close  of  his  long  and  eventful  service. 

"  Of  the  soldier's  life  within  these  barracks,"  writes  Fergusson,  "there 
is  much  to  be  said,  and  much  to  be  amended.  To  take  his  guards,  to 
cleanse  his  arms,  and  attend  parade,  seems  to  comprehend  the  sum  total  of 
his  existence ;  amusement,  instruction  beyond  the  drill,  mihtary  labor, 
and  extension  of  exercises,  would  appear,  until  very  recently,  to  be  im- 
thought  of  ;  as  it  is  impossible  that  the  above  duties  can  fully  occupy  his 
time,  the  u'ksomeness  of  idleness,  that  most  intolerable  of  all  miseries, 
must  soon  overtake  him,  and  he  will  be  driven  to  the  canteen  or  the  gin- 
shop  for  relief. 

"  Labor  in  every  shape  seems  to  have  been  strictly  interdicted  to  the 
soldier,  as  water  for  his  drink.  All,  or  nearly  all,  must  have  been  bred  to 
some  trade  or  other  before  they  became  soldiers  ;  Ibut  there  is  work  for  them 
no  longer.  Labor  (the  labor  of  field-works  and  fortifications)  strengthens 
the  limbs  and  hardens  the  constitution,  but  that  is  never  thought  of  in  our 
mihtary  life  at  home  ;  so  thought  not  the  ancient  Romans,  whose  military 
highways  still  exist,  and  who  never  permitted  their  soldiers  to  grow  ener- 
vated in  idleness  duiing  peace.  Better,  surely,  would  it  be  that  every  one 
should  work  at  his  own  craft,  or  be  employed  on  the  public  works,  in  regu- 
lated wholesome  labor,  than  thus  to  spend  his  time  in  sloth  and  drunken- 
ness. But  his  exercises,  without  even  going  beyond  the  barrack  premises, 
may  be  made  manifold — running,  wi-estling,  gymnastic  games  of  every 
kind,  swimming,  leaping,  pitching  the  bar,  the  sword  exercise  (that  of  the 
artillery),  all  that  hardens  the  muscles  and  strengthens  the  hmbs,  should  be 
encouraged  ;  and  when  the  weather  forbids  out-door  pastimes,  the  healthy 
exercise  of  single-stick,  in  giving  balance  and  power  to  the  body,  quickness 
to  the  eye,  and  vigor  to  the  arm,  may  properly  be  taken  as  a  substitute  for 
the  drill  which,  after  the  soldier  has  been  perfected  in  his  exercise,  is  al- 
ways felt  to  be  a  punishment.  So  is  the  unmeaning  evening  pai-ade  and 
perpetual  roll-calling. 

"Foot-racing  too,  the  art  of  running,  so  little  practised,  and  so  su- 
premely useful,  should  be  held  amongst  the  qualities  that  constitute  mili- 
tary excellence.  It  was  so  held  at  the  Isthmian  games  of  ancient  Greece, 
and  deserves  a  better  place  than  has  hitherto  been  assigned  to  it  in  the 
mihtary  pastimes  of  modern  Britain.  In  our  school-books  we  are  told  that 
the  youth  of  ancient  Persia  were  taught  to  launch  the  javelin,  to  ride  the 
war-horse,  and  to  speak  the  truth.  Let  the  young  British  warrior  be  taught 
to  use  his  limbs,  to  fire  ball-cartridge,  to  cook  his  provisions,  and  to  drink 
water.  The  tuition  may  be  less  classical,  but  it  will  stand  him  in  far  better 
stead  during  every  service,  whether  at  home  or  abroad. 

"Regular  bodily  pleasurable  exercise  has  been  said  to  be  worth  a  host 
of  physicians  for  preserving  military  health  ;  and  occujDation  without  dis- 
tress or  fatigue  is  happiness.  The  philosopher  can  make  no  more  of  it ; 
and   every  idle   hour  is   an   hour  of   irksomeness,  and   every  idle    man 

'  Notes  and  Recollections  of  Professional  Life,  1846,  p.  49. 


292  PRACTICAL    HYGIENE. 

is,  and  must  be,  a  vicious  man,  and  to  a  certain  extent  an  unhealthy 
one." 

In  many  of  the  foreign  stations  of  the  British  army,  excellent  oppor- 
tunities exist  for  both  occupying  the  men  and  developing  their  spiiit.  All 
history  teaches  us  that  a  hunting  race  is  a  martial  one.  The  remarkable 
fighting  qualities  of  the  Enghsh,  as  drawn  in  Fi'oissart's  "  Chronicles,"  were 
owing  to  the  fact  that  at  that  time  they  were  "  a  nation  of  hunters,"  and 
trained  from  infancy  to  face  dangers  alone.  In  India  there  ai'e  many  places 
where  men  could  not  only  be  allowed  to  hunt,  but  where  such  permission 
would  be  the  greatest  boon  to  the  inhabitants. 

The  Enghsh  ai'my  has  hitherto  offered  but  few  incentives  to  good  con- 
duct, and  scanty  encotu-agement  for  the  cultivation  of  martial  qualities. 
Men  must  have  rewards,  and  feel  that  earnest  endeavor  on  then-  part  to 
become  in  all  respects  better  soldiers  is  neither  overlooked  nor  unre- 
warded. The  new  order  of  things  introduced  by  Lord  Cardwell  seems 
likely  to  open  up  means  of  progress  for  men  who  can  acquii-e  knowledge 
and  desei've  advancement. 

The  cviltivation  of  the  martial  qualities  of  the  soldier  is  in  reality  a  part 
of  hygiene  considered  in  its  largest  sense,  biit  this  part  of  hygiene  must 
be  studied  and  cai-ried  into  eft'ect  by  the  combatant  oflScers.  Let  us  trust 
it  mav  not  be  long  before  they  seriously  study  and  endeavor,  by  precept 
and  example,  to  promote  the  formation  of  those  habits  of  boldness  and 
endurance,  and  that  fertility  in  resources,  which  are  as  necessary  as  techni- 
cal knowledge  to  render  an  ai'my  the  formidable  instiTiment  it  is  capable 
of  becoming. 


CHAPTER  IV. 

FOREIGN  SERVICE. 

Tee  foreign  seryice  of  the  Britisli  army  is  perforraed  in  every  pai't  of  the 
world,  and  in  almost  eyery  latitude,  and  probably  more  than  tyro-thirds  of 
each  line  soldier's  seryice  is  passed  abroad.  The  mere  enumeration  of  the 
stations  is  a  long  task  ;  the  description  of  them  would  demand  a  large 
volume.  In  this  short  chapter,  to  give  a  few  general  statements  as  to 
ehmate  and  geolog;^',  and  the  past  and  present  medical  history  of  the  sta- 
tions, only  can  be  attempted  ;  such  an  outhne  as  may  giye  medical  officers 
a  sort  of  iDrief  summary  of  what  seems  most  important  io  be  knoTsm. 

Detailed  and  excellent  accounts  of  most  of  the  foreign  stations  exist, 
either  in  the  independent  works  of  army  sui'geons,  such  as  those  of  IMar- 
shall,  Hennen,  Davy,  and  many  others,  or  in  reports  di'awn  up  for  Govern- 
ment, and  pubhshed  by  them.  In  the  early  "  Statistical  Eeports  of  the  Medi- 
cal Department  of  the  Army,''  short  topographical  notices  of  the  stations 
were  inserted  ;  they  are  models  of  what  such  reports  should  be,  and  must 
have  been  dra^yn  up  by  a  master  in  the  art  of  condensatiom  In  the  "Annual 
Eeports"  now  pubhshed  many  excehent  topographical  descriptions  "^ill  be 
found  ;  and  some  of  the  Indian  Governments  have  published  complete 
descriptions  of  all  their  stations.  In  the  "Bombay  Transactions,"  the 
'Madras  Medical  Journal,  and  the  "Bengal  Indian  Annals"  are  very  full  ac- 
counts of  almost  every  station  that  has  been,  or  is,  occupied  by  European 
troops  in  India.  Finally,  in  the  "Indian  Sanitary  Eepoi't"  is  much  impor- 
tant information  on  the  meteorologv'  and  topography  of  the  present  Indian 
stations.  Young  medical  officers  first  entering  on  foreign  service  are 
strongly  advised  to  study  these  accounts  of  the  stations  in  the  command 
where  they  are  serving  ;  it  will  not  only  give  them  interest  in  their  service, 
but  will  aid  them  in  their  search  how  loest  to  meet  the  chmatic  or  sanitary 
conditions  which  affect  the  health  of  the  men  under  their  char<?e. 


SECTION  I. 
mediterea]st:a^  stations.  ^ 

GrBEALTAK. 

Usual  peace  garrison  =  4,500  to  6,000  men.  Period  of  service,  three 
years.  Civil  population  =  18,381  (in  1881).  Height  of  rock,  1,439  feet  at 
highest  point.  Nature  of  rock,  grey  hmestone,  with  many  cavities  filled 
with  reddish  clay  ;  under  town,  an  absorbent  red  earth  forms  the  subsoiL 

'  A  very  important  Report  on  the  Mediterranean  Stations  was  published  bv  the 
Barrack  Improvement  Commissioners  (Dr.  Sutherland  and  Captain  Galton). — Blue 
Book,  1868. 


294  PRACTICAL    UYGIENE. 

Climate. — Mean  temperature  of  year  =  64. 1 ; '  hottest  month,  August 
(invariably  in  eight  years)  =  76.6  ;  coldest  month,  either  January  or  Feb- 
ruary, in  equal  proportions,  53.77  ;  amplitude  of  the  yearly  fluctuation, 
22.83  (=  difference  between  hottest  and  coldest  months). 

Mean  monthly  maximum  and  minimum  in  shade* — hottest  month, 
July  or  August — mean  maximum  =  89°  ;  coldest  month,  December,  January, 
or  Februai-y — mean  minimum,  42°.  Range  of  highest  and  lowest  monthly 
means  of  maximum  and  minimum,  47°.  Extreme  yearly  range  (difference 
between  highest  and  lowest  temperature  recorded  in  the  time)  about  50° 
to  58°.  The  minimum  thermometer  on  grass  sometimes  falls  to  4°  or  6° 
below  freezing. 

Raivfall. — Mean,  32.8  inches  (mean  of  seventy  years,  1790-1860). 
Greatest  amount  in  any  one  year,  75.8  (1855).  Least  amount  in  any  one 
year,  15.1  (1800).  The  importance  of  this  gi-eat  variation,  as  regards 
sieges,  is  evident ;  Gibraltar  might  be  embaiTassed  for  water,  if  the  rain- 
fall were  only  15  inches  in  a  j^ear  of  siege. 

Number  of  Rainy  Days  —  68,  The  rain  is  therefore  infrecjuent,  but 
heavy.  The  rain  falls  in  nine  months,  September  to  May ;  greatest 
amoimt  in  January  and  November ;  most  rainy  days  in  April.  Summer, 
rainless. 

Humidity. 

Grains  of  Relative 

Dew-point.        Vapor  in  a        Humidity 
cubic  foot.       Sat.  =  100. 

Mean  dew-point  of  year 55.9°  5.75  72.3 

Mean  highest  dew-point  in  August 67.9°  7.5  70.7 

Lowest  dew-point  in  January  or  February 43.5°  3.25  69.1 

Gibraltar  is  thus  seen  to  be  rather  a  drv'  chmate  ;  at  any  rate,  the  air 
is  on  an  average  only  three  parts  saturated  with  moisture,  and  therefore 
evaporation  from  the  skin  and  lungs  will  be  tolerably  rapid,  jjrovided  the 
wind  moves  freely.  It  is  certainl}'  not  a  moist  insular  chmate,  as  might 
have  been  anticipated.  At  the  tunes  of  rain,  how'ever,  and  during  the  fogs 
and  moist  sirocco,  the  air  is  nearly  saturated. 

Winds. — Chiefly  N.W.  or  S.W.  or  W.,  in  Januarj^,  April,  May,  June, 
and  October.  Eastei'ly  in  July,  August,  and  September.  But  sometimes 
the  easterly  winds  are  more  prevalent,  or  may  be  moderate  for  almost  the 
whole  year.  The  east  and  south-east  winds  are  sirocco  (Levanteros),  and 
are  often  accompanied  by  rain  and  fogs. 

Sanitary  Conditions. 

Water  Supply. — The  quantity  was  formerly  veiy  deficient;  in  1861 
only  2^  gallons  daily  were  supplied  for  non-commissioned  officers  and 
privates. 

Sources. — Wells  and  tanks,  rain  water,  and  a  small  aqueduct  carrying 
surface  water.     Very  large  tanks  have  been   constiiicted  in  two   of  the 

*  Mean  of  eight  years'  observations  by  the  Royal  Engineers  (1853-60),  as  given  in 
the  Barrack  Commissioners'  Blue  Book  (1808). 

*  Of  the  eight  years  (ly.'jS-OO)  given  in  the  report  above  quoted,  the  difference  be- 
tween the  monthly  mean  maximum  and  minimum  is  so  much  less  in  the  last  three 
years,  as  to  make  one  suspect  some  error  in  observation.  In  1880  the  mean  maximum 
in  July  was  87.4  ,  the  mean  minimum  in  January  47.9" — range  39.5^ ;  absolute  maxi- 
mum 98.8    in  August,  absolute  minimum  42.5"  in  January — range  49.3  . 


FOEEIGN    SERVICE.  295 

ravines,  -with  arrangements  for  passing  into  tliem  a  large  amount  of  sm-face 
water  ;  and  fresli  wells  have  been  dug  at  the  north  end,  near  the  neutral 
ground,  which  yield  a  large  supply  of  water. 

Quality. — The  most  of  the  well  water  is  very  hard,  and  in  some  cases 
almost  brackish.  In  one  sample  analyzed  at  Netley  there  were  nearly  83 
grains  of  chlorine  per  gallon,  equal  to  nearly  l-iO  gi-ains  of  alkaline 
chlorides.  Some  of  the  weUs  contain  a  good  deal  of  organic  matter,  while 
others  are  comparatively  free.  In  most  of  them  there  is  a  lai'ge  quantity 
of  nitrates,  pointing  unequivocally  to  the  oxidation  of  animal  organic  mat- 
ter. Rscent  experimental  borings  have  not  been  very  encouraging  as 
regards  quality  of  water. '  The  tank  water  is  good  when  filtered  ;  but  the 
tanks  requu'e  frequent  inspection  and  cleaning. 

Many  of  the  houses  of  the  ci\Tlians  have  tanks,  and  no  new  house  is 
allowed  to  be  built  ■s\-ithout  a  tank.  The  distribution  of  water,  both  to 
soldiers  and  civilians,  is  defective  ;  it  is  almost  entirely  by  hand. 

Drainage. — The  sewers  have  been  much  improved.  Surgeon-General 
Munro,  C.B.,  reported  in  1880  that  "the  system  was  excellent,"  although 
the  working  was  defective.      Steps  were  taken  to  remedy  this. 

Barracks. — More  than  half  the  garrison  is  in  casemates,  which  have 
been  described  as  "  mere  receptacles  of  foul  air,  damp,  dark,  and  unwhole- 
some."^ The  barracks  ai-e,  for  the  most  part,  badly  arranged,  and  are  over- 
crowded ;  the  average  cubic  space  in  1862  was  only  about  450  feet,  and 
the  average  superficial  sjDace  under  40.  Ventilation  was  very  defective, 
especially  in  the  casemates.  The  means  of  ablution  and  the  latiines  and 
uiinals  were  also  defective.  In  all  those  points,  however,  great  improve- 
ment has  taken  j)lace.  The  duties  are  not  heavy,  and  the  rations  are  said 
to  be  good.  In  1860  some  improvements  were  made  in  the  dress  of  the 
troops,  and  a  Hght  summer  suit  ordered.  Flannel  next  the  skin  has  been 
recommended  strongly  for  Gibraltar,  on  account  of  the  occasional  cold 
"winds. 

Health  of  the  Civil  Population. 

Gibraltar  is  now  a  place  of  considerable  trade ;  whether  the  Govern- 
ment have  been  right  in  allo'sv'ing  a  mass  of  people  to  herd  closely  together 
in  the  midst  of  the  most  important  fortress  we  possess,  is  very  question- 
able. In  case  of  a  siege  they  would  be  a  serious  embarrassment,  and  even 
in  time  of  peace  they  are  objectionable.  The  health  of  this  community  is 
bad  ;  in  1860,  the  northern  district,  where  population  is  densest,  gave  38 
deaths  per  1,000,  or  excluding  cholera,  33.5  ;  in  the  more  thinly  populated 
southern  end,  the  mortality  was  27.5  per  1,000,  or  more  than  St.  Giles',  in 
London.  The  deaths  in  children  under  one  year  form  17.33  per  cent, 
of  the  total  mortality.  The  prevailing  causes  of  this  mortality  are  fevers 
(in  all  probability  typhoid),  and  tuberculous  consumption,  which  causes  13 
per  cent,  of  the  total  deaths  at  all  ages,  or  37.6  per  cent,  of  the  total  deaths 
at  the  soldiers'  ages.     Dj^sentery  and  diaiThoea  are  common. 

In  this  compressed  and  dirty  population  several  great  epidemics  have 
occurred.  The  bubo  plague  does  not  appear  to  have  been  seen  since  1649, 
but  the  earlier  records  are  veiy  imperfect ;  yellow  fever,  however,  prevailed 
in  1804, 1810,  1813,  and  1828.  Cholera  has  prevailed  several  times ;  the 
last  time  was  in  1865. 

'  For  analyses  of  water  of  Gibraltar,  see  Reports  on  Hygiene,  Army  Medical  Reports, 
vols,  xviii. ,  xis. ,  xx. ,  and  xxi. 

^  Barrack  Commissioners'  Report,  p.  37. 


296  PRACTICAL    HYGIENE. 

Health  of  the  Troops. 

1.  loss  of  strength  by  death  and  invaliding. 

(a)  By  Death. — Gibraltar  has  never  suffered  from  any  great  sickness  or 
mortality,  except  in  yellow  fever  or  cholera  years.  At  the  time  v^hen  the 
mortality  on  home  service  was  17  or  18  per  1,000  of  strength,  it  was 
usually  not  more  than  12  at  Gibraltar.  Of  late  years  both  sickness  and 
mortality  have  been  below  that  of  home  service,  especially  in  the  latter 
years.  In  sjDite  of  this  comparative  healthiness,  it  is  quite  certain  that 
much  preventable  disease  existed,  and  in  part  still  exists  on  the  Rock. 

Mortality  per  1,000  of  Strength. 

■o-  m  .  1  T\    iv  Deaths  from 

^^^^^-  ■  Total  Deaths.  Disease  alone. 

1837-46  (10  years) 12.9                        5.65 

1861-70  (10  years)' 8.54 

1870-79  (10  years) 6.98 

1880 4.24         3.57 

The  progressive  diminution  is  remarkable,  and  shows  what  is  possible 
in  reducing  mortality  among  soldiers. 

Causes  of  Death. — In  the  earlier  years  the  chief  causes  of  death  were 
phthisis  and  continued  fever,  which  was  doubtless  enteric  fever.  Of  late 
years  phthisis  has  declined  ;  enteric  fever,  on  the  contrary,  increased  up  to 
1863,  has  since  then  declined  in  fi'equency,  though  not  in  fatahty  j^er"  cent. 
of  attacked. 

The  admissions  from  phthisis  averaged  11  per  1,000  of  strength  in  the 
ten  years,  1837-46  ;  while  in  the  eight  years,  1859-66,  they  were  only 
7.63.  In  the  years  1863-66  the  deaths  and  invaliding  together  from  j^hthisis 
were  only  3.72  per  1,000  of  strength,  or  hardly  more  than  the  deaths  alone 
at  home.  In  1880  the  admissions  were  5.3,  the  deaths  0.45,  and  the  invalid- 
ing 2.23.  The  two  last  together  make  2.68,  against  6.13  at  home.  The 
decline  in  phthisis  seems  therefore  certain,  but  still  it  is  possible  that  it  is 
not  even  now  so  low  as  it  might  be." 

The  continued  fevers  gave  75.7  admissions  per  1,000  of  strength  in  the 
years  1837-46,  and  98.5  in  the  five  years  ending  1863,  There  was  also  an 
increase  in  mortality.  In  the  three  years  ending  1866  the  admissions  fell 
to  an  average  of  42,  and  the  decline  Avas  progressive.  Of  late  the  admis- 
sions have  increased,  the  numbers  for  1869-78  being  77  per  1,000,  in  1879 
nearly  97,  and  in  1880  no  less  than  133,  but  of  these  last  only  5  were  en- 
teric, the  remainder  being  febricula  and  so-called  Rock-fever. 

During  late  years,  much  has  been  done  in  Gibraltar  to  give  the  men 
more  breathing  space  and  ventilation,  hence  the  decline  in  jahthisis  which 
was  so  fatal  formerly  when  the  men  were  crowded  in  casemates.  When 
their  barracks  are  still  further  improved,  we  shall  see  a  still  greater  lessen- 
ing of  phthisis. 

The  amount  of  heart  disease  was  formerly  great,  and  probably  arose 
from  the  same  conditions  as  at  home.  It  has  latterly  diminished  con- 
siderably. 

'  Cholera  prevailed  in  1865,  and  raised  the  mortality  to  23. 74.  Without  cholera  it 
was  7.91. 

^  Of  course  invaliding  has  an  effect,  but  the  invalids  who  died  at  Netley  are  included 
in  the  above  numbers. 


FOREIGN    SERVICE. 


297 


The  liabits  of  the  men  are  much  improved,  and  deh'rium  tremens,  for- 
merly common,  is  rare.  In  1865  and  1866  only  one  man  died  in  two  years 
from  this  cause,  or  at  the  rate  of  scarcely  more  than  .1  per  1,000  of 
strength. 

Formerly  dysentery  and  diarrhoea  were  common  ;  now  they  are  infre- 
quent and  mild.  The  average  admissions  from  dysentery  in  three  years 
(1864-66)  were  only  2  per  1,000  ;  in  1864  and  1866,  from  diarrhoea  were 
only  12  per  1,000.'     In  1880  they  were  under  11. 

Everything  points  to  the  fact  that  Gibraltar  itself  is  a  perfectly  healthy 
place,  and  that,  when  the  sanitary  alterations  now  going  on  are  completed, 
the  sickness  and  mortality  wiU  be  trifling. 

Influence  of  Age  on  Mortality  at  Gibraltar. 


Deaths  per  1,000  of  Strengtli  at  each  Period. 

Tears. 

Under 
20. 

20  and    !     25   and 
under  25. '  under  30. 

1 

30   and 
under  35. 

35   and 
under  40. 

40   and 
upward. 

1870-79  .... 
1880 

1.57 

4.04 
2.93 

5.59 
1.68 

.    7.29 
2.14 

7.51 
14.76 

21.71 
31.86 

These  numbers  compare  very  favorably  with  the  home  returns. 

[b)  By  Invaliding. — The  number  of  men  sent  home  for  change  of  air 
and  discharge  varies  gTeatly  from  year  to  year  ;  about  20  to  30  per  1,000 
of  strength  is  the  average.  The  chief  diseases  are  general  debility,  rheu- 
matism, phthisis,  and  cardiac  disease.  The  other  diseases  are  in  smaller 
number,  but  are  numerous.  Dysentery  and  liver  diseases  used  to  be  com- 
mon causes  of  invaliding,  but  both  are  now  declining. 

2.    LOSS    OF    SERVICE   BY    SICKNESS. 

The  admissions,  the  mean  daily  sick,  and  the  duration  of  the  cases,  are 
all  below  the  liome  standard. 


Per  1,000  of  Strength. 


Years. 

Admissions  per 
Annum. 

Mean  daily  Sick. 

Mean   Stay  in  Hos- 
pital of  each  Sick 
Man  in  days. 

1837-56  

976 
742 
669.4 
738.1 

36.57 
35.88 
43.11 

1861-70 ; 

18.39 

1870-79  

19.62 

1880 

-  21.77 

The  venereal  diseases  cause  fewer  admissions  than  at  home  ;  the  average 
of  the  whole  venereal  class  is  only  about  120  per  1,000.  For  s.yphilis  alone 
the  average  (1869-77)  is  only  50.8.     This  is  owing  to  the  police  reg-ulation 


^  Cholera  prevailed  in  1865,  so  that  year  has  been  left  out. 


298  PRACTICAL    HYGIENE. 

of  prostitutes.  Integumentary  diseases  cause  about  35  admissions  per 
1,000.  In  1880  there  was  a  very  considerable  increase.  Digestive  dis- 
orders give  a  large  number  of  admissions,  and  have  always  done  so,  but  in 
the  latest  returns  they  are  somewhat  declinuig. 

Sanitary  Duties  at  Gibraltar. — Captain  Gallon  and  Dr.  Sutherland  indi- 
cated the  measui-es  which  must  be  adojoted,  viz.,  a  better  supply  of  water, 
by  arranging  a  larger  storage  ;  a  better  drainage,  with  sea-water  for  flush- 
ing, and  a  different  outlet ;  and  an  improved  ventilation,  with  less  crowding 
in  barracks.  Most  of  the  j^lans  have  been  carried  out  as  far  as  practicable. 
There  is  no  doubt  these  measures  will  greatly  improve  health. 

Supposing  war  were  to  arise  at  this  moment,  and  that  we  lose  the  com- 
mand of  the  sea  for  a  time,  the  points  of  danger  would  apparently  be 
these  : — 

1.  Deficient  Water,  the  Rainfall  being  uncertain. — The  new  wells  near  the 
neutral  ground  will  perhaps  obviate  this  danger,  but  the  water  is  not  of 
good  quality  ;  but  if  not,  it  would  have  to  be  supplied  by  distillation,  and 
it  would  be  prudent  to  keep  a  good  apparatus  always  at  Gibraltar.  The 
amount  of  storage  has  been  increased  of  late  years. 

2.  Overcrowding  and  Bad  Ventilation,  leading  to  Spotted  TypJuis. — With 
a  full  garrison,  and  with  some  barracks  untenable,  there  is  no  doubt  there 
would  be  serious  danger  of  this  disease  ;  and  it  is  a  matter  of  great  moment 
to  ventilate  as  perfectly  as  possible  all  casemates  whicli,  even  if  now  dis- 
used, must  be  used  in  time  of  war. 

3.  Ti/phoid  Fever. — By  means  of  imj)roved  drainage  this  cause  of  danger 
might  soon  be  entirely  removed. 

4.  Diseases  arising  in  the  Town,  and  spreading  to  the  Garrison. — In  case 
of  war,  it  w^ould  seem  most  desirable  to  clear  out  the  native  town  as  far  as 
it  can  be  done.  More  space  and  more  water  would  be  available.  There 
would  be  less  chance  of  famine,  destitution,  and  disease. 

In  the  war  in  1792,  scurvy  prevailed  from  deficiency  of  food  and  fresh 
vegetables. 

Malta. 

Size,  17  miles  by  9.  Usual  peace  garrison  =  5,000  to  7,000  ;  period  of 
service,  three  years  ;  population  (civil)  in  1879  =  15-4,198. 

Geology. — Soft,  jiorous  rock  ;  the  greater  part  is  sandstone  resting  on 
hard  limestone  ;  in  some  jDarts  there  is  marl  and  coral  limestone  over  the  sand- 
stone. In  the  centre  of  the  island,  at  Citta-Yecchia,  there  is,  in  order  from 
the  surface,  alluvium,  uj^per  hmestone,  red  sand,  marl,  sandstone,  and  lower 
limestone.  Valetta  is  on  thin  alluvium,  with  thick  sandstone  below,  and 
beneath  this  the  lower  limestone. 

Climate  (at  Valetta). — Mean  of  the  year,'  GG.8°  ;  hottest  month  (Jvdy), 
77^  ;  coldest  (January),  57°  ;  amplitude  of  the  yearly  fluctuation,  20°  ; 
extreme  yearly  range  (from  highest  to  lowest  temperature  in  shade),  59°, 
from  99°  in  July  to  40°  in  January  ;  mean  yearly  range,  about  53°. 

Un^Iulations  of  temperature  are  frequent,  and  there  are  often  cold  winds 
in  winter  from  N.W.  The  south-east  wind  is  an  oi^pressive  sirocco,  raising 
the  temperature  to  94°  or  95°.  It  is  chiefly  in  the  autumn,  and  blows  for 
from  60  to  80  days  every  year.  At  Citta-Vecchia  (600  feet  above  the  sea) 
the  temperature  is  lower  and  the  air  keener.  Rainfall  about  22  inches. 
Chief  rain  in  November,  December,  and  January ;  less  in  February  and 

'  For  eleven  years  (1869-80),  witli  the  exception  of  1874,  not  recorded  in  A.  M,  D. 
Reports, 


FOREIGN"    SERVICE.  299 

March  ;  small  in  amount  in  the  other  months.  From  June  to  August  al- 
most rainless. 

Humidity  (mean  of  1869-80). — Observations  at  9.30  a.tj.  Relative 
humidity,  70. 

Malta  thus  appears  to  be  a  diy  chmate,  i.e.,  with  a  moderate  relative 
humidity. 

Sanitary  Condition. 

Much  has  been  done  of  late  years,  and,  as  fai'  as  external  cleanhness 
goes,  Valetta  is  very  clean.  Water  sujDply  from  rain  and  springs  (the  larg- 
est of  which  is  in  the  centre  of  the  island,  and  the  waters  of  which  are  led 
by  aqueduct)  is  not  very  deficient  in  quantity  (8  to  10  gallons  per  head), 
and,  except  in  some  places,  good  in  quality,  though  the  rain-water  contains 
chloiides  from  the  spray  falling  on  the  roofs  of  buildings.  Some  of  the 
tanks  are  too  near  the  sea,  which  percolates  into  them.  The  tanks  require, 
however,  careful  looking  after.  Within  the  hues  there  are  272  public  and 
military  tanks,  with  storage  for  55  millions  of  gallons,  and  4,294  private 
tanks,  with  storage  for  323  millions  of  gallons.  The  mihtaiy  tanks,  if  full, 
would  give  6  gallons  of  water  per  man  daily  for  eleven  months,  but  even 
now  the  water  often  falls  short.  The  water  is  carried  everj^where  by  hand, 
and  the  drinking-water  for  the  men  is  not  filtered,  or  only  partially  so.  An 
attempt  to  get  water  by  sinking  into  the  sandstone  was  made  in  1866-67, 
but  failed.  The  sewers  in  Yaletta  are  bad  in  construction  and  outlet,  and 
much  tj'phoid  has  been,  and  is  still,  caused  in  consequence.  In  many 
cases  "  they  are  nothing  but  long  cesspools."  '  PijDe  drains  are,  however, 
now  being  laid  in  the  old  drains,  which  were  merely  nan-ow  deep  channels 
cut  in  the  soft,  porous  rock.  The  old  style  of  drain  has  now  quite  ceased 
to  exist  in  the  barracks. 

The  baiTacks  are  bad,  many  casemates  being  used,  and  buildings  which 
were  intended  for  stores  and  not  for  habitations.  They  are  built  of  soft 
sandstone,  which  both  ci-umbles  and  absorbs  wet.  In  some  cases,  all  san- 
itary considerations  have  been  sacrificed  for  the  piu'j)oses  of  defence.  The 
ventilation  of  the  casemates  is  very  bad,  but  some  improvements  have  taken 
place.  The  Barrack  Commissioners,  in  then-  "  Report,"  recommended  that 
in  every  way  which  could  be  done  the  ventilation  should  be  improved  by 
admitting  the  wind,  especially  from  the  north,  and  that  each  barrack 
would  rec[uire  a  separate  plan  to  meet  the  particular  case.  They  recom- 
mended that  au'-shafts  should  be  made,  much  larger  than  ordered  for  home 
service,  \\z.,  1  square  inch  for  eveiw  20  cubic  feet  of  space,  or  for  a  bai'rack 
of  twelve  men  with  regulation  space  (7,200  x  20=)  360  square  inches  (= 
2^  square  feet)  of  outlet  opening.  Some  of  those  points  have  been  carried 
out  -nith  very  good  results.  At  the  present  time  the  amount  of  cubic  space 
is  below  the  home  service  amount  ( 600  cubic  feet),  and  the  superficial  area 
is  very  small,  in  some  cases  being  as  low  as  40  square  feet  per  head.  All 
the  barracks  are  now  supplied  with  new  and  remodelled  married  quarters, 
vsdth  proper  appliances. 

During  the  hot  weather  the  space  is  increased  by  making  the  men  sleep 
under  canvas  every  alternate  night. ^ 

A  gymnasium  is  prorided  both  in  Cottonera  and  Valetta,  and  all  the 
barracks   are  well  pro"vided  with  reading,  recreation,   and  school  rooms. 

^  Barrack  Commissioners'  Report,  p.  111. 

'  Report  by  Surgeon-General  W,  A,  Mackinnon,  C.B.,  A.  M  .D.  Reports,  vol.  sxii.,  p. 
235. 


300 


PRACTICAL    HYGIENE. 


The  means  of  ablution  are  now  very  good  in  all  the  barracks,  and  there  are 
new  water  latrines  and  slate  or  earthenware  urinals  provided. 

We  may  therefore  hope  that  a  diminished  amount  of  disease  may  be  the 
result  of  these  improvements,  although  much  remains  to  be  done  to  make 
the  condition  of  the  troops  as  good  as  it  ought  to  be. 

Health  of  the  Cidl  Poimlation. 

There  is  some,  but  no  great  amount,  of  malarious  disease,  but  a  good 
deal  of  the  so-called  bilious  remittent,'  and  typhoid.  T^i^hus  is  not  at 
present  seen.  Bubo  plague  has  prevailed  seven  times,  the  last  in  1841, 
slightly.  YeUow  fever  has  been  known,  but  not  of  late  years.  Cholera 
has  occurred  thrice.  Dysentei-y  is  common ;  teenia  not  infrequent ; 
ophthalmia  common,  from  dust  and  glare.  Boils  or  anthrax  are  frequent ; 
rheumatism  is  not  uncommon,  and  phthisis  is  said  to  be  frequent  (from 
dust?).  The  death-rate  is  said  to  be  21.3  per  1,000  in  the  towns,  and  28.7 
in  the  country  districts  ;  while  nearly  57^  per  cent,  of  this  is  in  children 
under  five  years,'  the  great  causes  of  infantile  mortality  being  registered 
as  teething  and  con^-ulsions. 

Health  of  the  Troops. 

The  health  of  the  troops  is  worse  than  at  Gibraltar,  but  it  has  singular- 
ly fluctuated  (even  without  gi'eat  epidemics),  more  so  probably  than  at  any 
station  in  the  same  latitude.  The  mortality  has  varied  as  much  as  three- 
fold without  cholera. 


Loss  of  strength  per  1,00U  per  annum. 

Loss  of  Service  per  1,000  per  annum. 

Years. 

Total 
Deaths. 

Deaths 
from          Invaliding. 
Disease. 

Admissions.!  ^^ifyX^. 

Days  in 

Hospital  to 

each  Sick 

Man. 

1837-46      

15.3 
13.49 

9.77 
10.03 
26.44 

6.53 

'8.*80 

24.63 

4.58 

22.3 

30.00 

18.01 

1120 
798.6 
837.8 
857.1 

43.79 
43.31 
42.35 
46.56 

1861-70  (10  vears). . .  . 
1870-79  (10  years)   . . . 

1880 

Highest  (1865,  cholera) 
Lowest  (1864) 

19.81 
18.45 
19.88 

The  mortality  in  1864  was  as  low  as  it  has  ever  been ;  but  it  has  in 
former  years  been  as  low  as  5.6  from  disease  alone.  It  is  cuiious  how 
alternations  of  health  and  sickness  occur  chiefly  from  the  variations  in  the 
fevers  of  different  kinds,  especially  enteric  (typhoid)  and  the  remittent  or 
so-caUed  Malta  fever,  which  has  a  long  course,  a  great  tendency  to  rheumatic 
sequel,  and  little  mortahty. 

In  1867  there  was  a  tenible  outbreak  of  continued  fever,  chiefly  among 

'  See  Dr.  Marston's  excellent  Report  in  the  Army  Medical  Report  for  1861,  for  the 
symptoms  of  this  disease  among  troops.  See  also  Dr.  Boileau's  interesting  essay  in 
the  same  publication,  vol.  viii. 

^  Report  of  Barrack  Commissioners,  p.  87.  The  Commissioners  justly  remark  that 
these  figures  are  so  striking  as  to  demand  further  inquiry.  Probably  they  are  quite 
nntrustworthy  ;  yet  both  at  Gibraltar  and  Malta,  it  would  be  of  the  greatest  importance, 
not  merely  for  the  health  of  the  troops  in  peace,  but  for  the  security  of  the  fortress  in 
war,  to  know  everything  about  the  social  life  and  the  diseases  of  the  native  population. 


rOREIGN    SERVICE.  301 

the  troops  quartered  in  the  notoriously  unhealthy  barracks  of  Lower  St. 
Elmo  and  Fort  Eicasoh.  The  admissions  rose  to  228,  and  the  deaths 
actually  amounted  to  no  less  than  7.93  per  1,000  of  strength.  Out  of  100 
deaths  no  less  than  32.2  or  nearly  one-third,  were  from  "continued  fever," 
i.e.,  enteric  fever  in  great  measure.  In  1872  there  was  also  a  great  deal  of 
fever,  the  admissions  being  233,  and  the  deaths  3.91,  per  1,000  of  strength. 
In  1878,  also,  there  were  209  admissions  and  5.16  deaths  per  1,000  of 
strength,  the  deaths  being  in  almost  all  cases  enteric. 

In  former  years  phthisis  was  the  cause  of  39  per  cent,  of  the  deaths,  or 
nearly  the  same  as  at  Gibraltar,  Latterly  there  have  been  fewer  deaths  at 
Malta,  but  a  considerable  number  of  tubercular  cases  are  sent  home.  The 
disease  is  probably  detected  earlier,  and  the  men  do  not  die  as  formerly 
at  the  station.  StiU  Ihis  does  not  account  for  the  whole  diminution,  and 
there  has  been  clearly  a  lessening  of  phthisis.  There  was  formerly  a  large 
amount  of  stomach  and  bowel  disease,  and  dysentery  was  forty  times  as 
frequent  as  in  England.'  It  is  certainly  a  very  remarkable  circumstance, 
that  both  at  Gibralta  and  Malta  there  should  have  been  this  extraordinary 
liability  to  affections  of  the  ahmentary  canal.  At  Malta,  as  at  Gibraltar,  it 
may  have  been  chiefly  owing  to  impiu-e  water  and  to  food.  ^  Of  late  years 
stomach  and  bowel  affections  have  been  less  frequent,  but  are  still  more 
common  than  at  home  ;  in  1861  the  89,000  men  on  home  service  gave  only 
67  cases  of  acute  dysentery,  and  no  deaths,  while  the  6,000  men  at  Malta 
had  34  cases  and  2  deaths.  In  1864  there  were  three  deaths  from  acute 
dysentery  among  5,654  men,  while  iu  the  home  stations  there  was  only  1 
death  among  73,252  men.  If  it  had  been  equally  fatal  at  home,  there 
would  have  been  nearly  39  deaths.  In  the  three  years  (1878-80)  the  ad- 
missions at  Malta  were  only  4.4,  and  in  1880  only  2.2  per  1,000  and  no 
deaths. 

In  the  "  Statistical  Report"  for  1853  it  is  observed  that  the  number  of  cases 
of  liver  disease  at  Malta  is  remarkably  high  ;  and  the  wi'iters,  while  believ- 
ing there  must  be  "something  in  the  climate  of  Malta  peculiarly  favorable 
to  the  production  of  hej)atic  affections,"  were  unable  to  find,  on  bringing 
the  cases  into  relation  with  the  temperature,  any  connection.  The  cause  of 
this  may  be  something  very  different,  and  it  is  very  desirable  that  the  food 
should  be  looked  to.  There  is  a  suspicion  at  Netley  (which  requii'es  a  few 
years  more  experience  to  test  it),  that  the  cases  of  echinococcus  of  the  liver 
are  more  frequent  in  men  from  the  Mediterranean  stations  than  others  (Dr. 
Maclean).     The  case  of  Iceland  should  lead  us  to  look  into  this  point. 

The  history  of  admission  for  venereal  disease  is  important  ;  in  1837- 
1846,  inclusive,  the  admissions  were  only  99  per  1,000,  or  two-thirds  less 
than  at  home  ;  in  1859,  when  the  next  report  appeared,  they  were  149  per 
1,000  ;  and  in  1860  they  were  147.9  per  1,000.  In  the  early  period  there 
were  police  regulations,  which  were  suspended  in  the  two  latter  years.  In 
June,  1861,  the  police  regulations  were  re-enforced,  and  the  admissions  for 
the  year  sank  to  102.  The  4th  battalion  of  the  Eifle  Brigade  showed  the 
following  remarkable  result :  —  In  the  first  half  of  1861  there  were  57  ad- 
missions ;  in  the  last  half  only  17.  In  1862  the  total  number  of  cases  of 
"enthetic  disease "  in  the  whole  garrison  were  only  49.5;  in  1863,441; 
and  in  1864,  53.2  per  1,000.  They  were  increased  in  that  year  by  the 
women  who  came  from  Ionia  with  the  troops.     In  1865  they  were  44  ;  in 

'  In  England,  in  1837-46,  every  1,130  men  gave  one  case  of  dysentery  ;  in  Malta,  in 
the  same  years,  every  twenty-eight  men  gave  one  case  of  dysentery.  The  mortality  of 
the  disease  was,  however,  nearly  the  same  ^see  pages  31  and  118  of  the  Report  of  1853). 

2  Report  of  1853,  p.  118. 


302 


PRACTICAL    HYGIENE. 


1866,  59.6  per  1,000.  Li  1870  and  1871  the  admissions  were  very  few ; 
in  the  latter  year,  which  was  the  worst,  the  admissions  of  j^rimarj-  SA-jjhihs 
were  only  8.3  per  1,000  of  strength.  If  the  home  return  is  looked  at,  it 
will  be  seen  what  an  effect  has  been  produced  at  Malta  by  good  regulations, 
although  the  number  of  cases  fluctuates  from  causes  traceable  to  special  in- 
fluences ;  the  reduction  is  almost  entirely  of  syphilis,  not  of  gonorrhoea. 
In  the  later  years  there  has  been  an  increase  and  considerable  fluctuations. 
Such,  then,  in  brief,  seem  to  be  the  chief  medical  points  of  importance  at 
Malta,  viz.,  a  habihty  to  phthisis,  less  marked  of  late  years  ;  a  great  amount 
of  fever,  from  bad  sanitary  conditions  in  great  part ;  a  liability  to  stomach 
and  intestinal  affections,  which,  though  less  obvious,  is  still  great,  and  a 
singular  tendency  to  a  liver  affection,  which  may  be  parasitic.  The  chief 
improvements  ad\dsed  by  the  Barrack  Commissioners  refer  to  a  larger  water 
supply,  a  better  distribution,  imj)roved  drainage,  and  efiicient  ventilation. 
In  the  time  of  war,  the  dangers  at  Malta  would  be  the  same  as  at  Gib- 
raltar ;  the  aqueducts  might  be  cut  by  a  besieging  force,  and  the  water 
supply  restricted  to  the  tanks. '  Although  these  are  supposed  to  hold  a 
large  quantity,  they  are  not  kept  full,  and  could  not,  perhaps,  be  rapidly 
filled.  The  garrison  might  be  driven  to  distil  the  sea  Avater.  A  still  more 
serious  danger  woiild  be  the  overcrowding  of  a  war  garrison.  Doubtless, 
in  case  of  a  war,  the  garrison  would  only  be  concentrated  in  the  lines  when 
the  siege  commenced,  but  the  crowding  during  a  siege  of  three  or  six 
months  might  be  very  disastrous.  The  danger  should  be  provided  for  be- 
forehand by  a  clear  recognition  of  what  accommodation  would  be  granted 
for  war,  and  how  it  is  to  be  obtained  without  "siolating  either  the  condi- 
tions of  health  or  of  defence. 


On  the  Influence  of  Age  on  Mortality  in  Gibraltar  and  Malta. 


Deaths  per  1,000  of  Strength  at  each  Period. 

Under 
20. 

20  and 
under  25. 

25  and 
under  30. 

SO  and 
under  35. 

35  and 
under  40. 

40  and 
upward. 

187(>-79  (10  years). . 
1880 

3.72 

8.33 

7.76 
12.(50 

7.65 
6.19 

10.41 
3.88 

11.96 
16.81 

12.18 
27.40 

CrPBus. ' 

This  station  was  first  occupied  in  1878.  It  is  an  island  in  the  Levant, 
about  50  miles  from  the  nearest  maiidand,  nnd  240  from  Port  Said  at  the 
entrance  of  the  Suez  Canal.  Size,  90  miles  by  40  ;  area,  about  4,000  square 
miles  ;  civil  population,  about  185,000  (in  1881).  Our  information  about 
the  climate  is  as  yet  imperfect,  but  it  ajopears  to  resemble  that  of  Malta, 
with  greater  rainfall. 

The  stations  at  present  occupied  are  Nicosia  (592  feet  above  the  sea), 
as  headquarters  ;  Polymedia  camp  (400  feet),  by  the  bulk  of  the  troops, 
from  October  to  May  ;  and  Mount  Troados  (5,720  feet),  from  Maj'  to  Octo- 
ber.    The  average  strength  (1880)  was  443  officers  and  men.     The  mean 


'  Dr.  Notter   analyzed,  in  1872,  fourteen  of  the  tank  waters  of  the  different  forts, 
and  found  the  condition  of  the  water  to  be  satisfactory. 


FOREIGIS"    SERVICE.  303 

temperature  at  Polymedia  during  the  cooler  season  (November  to  May  in- 
clusive) is  about  59°  to  60°;  of  Mount  Troados  (May  to  September  inclu- 
sive), about  64°  Fahr.  The  rainfall  appears  to  be  considerable,  for  in  seven 
months  (November  to  May)  in  1880,  31.81  inches  fell,  of  which  no  less 
than  12.26  were  recorded  in  December  alone.  The  number  of  rainy 
days  in  the  seven  months  was  58.  The  prevailing  wind  would  appear  to 
be  N.  W. 

On  the  first  occupation  in  1878  there  was  a  great  amount  of  sickness, 
chiefly  from  paroxysmal  fever.  This  appeared  to  arise  from  the  unsuitable 
sites  selected  for  the  temporary  camps  and  the  turning  up  of  soil  infil- 
trated with  organic  matter.  During  the  five  months  (2J:th  July  to  31st 
December,  1878)  there  were,  out  of  a  strength  of  894  non-commissioned 
officers  and  men,  3,931  admissions  for  disease  and  36  deaths,  or  at  the 
rates  of  4,397  and  40.3  per  1,000  respectively.  Expanding  these  to  an 
annual  rate,  they  amount  to  10,094  admissions  and  92  deaths  per  1,000  of 
strength,  an  enormous  amount.  Eighty-four  per  cent,  of  the  admissions 
and  61  per  cent,  of  the  deaths  were  due  to  fever,  almost  all  jDaroxysmal  (so- 
called  remittent),  only  14  admissions  (actual  number)  and  2  deaths  being 
due  to  enteric.  In  1879  (strength  660)  there  was  a  great  improvement — the 
ratios  being  1,470  admissions  and  21  deaths  per  1,000,  35  per  cent,  of  the 
admissions  and  50  per  cent,  of  the  deaths  being  still  due  to  paroxysmal 
fever.  There  were  3  deaths  from  dysentery,  against  4  in  1878.  In  1880 
(strength  443)  the  total  admissions  were  1002.2  and  the  deaths  only  2.26 
per  1,000  strength.  Paroxysmal  fevers  gave  only  196.4  of  admissions  and 
no  deaths.  The  only  death  in  the  command  was  from  pulmonary  extrava- 
sation, and  occurred  out  of  hospital.  On  the  whole,  we  may  consider  the 
station  healthy  if  proper  precautions  are  taken  :  for,  if  we  omit  the  ad- 
missions for  injuries,  the  ratio  for  disease  in  1880  was  only  884.8  per  1,000 
of  strength,  and  of  these  383. 7  were  venereal  or  the  sequelfe  of  venereal 
disease.  The  invaliding  in  1880  amounted  to  18.07  per  1,000,  one-fourth 
of  which  was  due  to  syphilis  ;  the  number  constantly  sick  was  53.27  per 
1,000,  of  whom  4.45  were  cases  of  injury  and  28.69  venereal  or  its 
sequelfe  ;  and  the  average  duration  of  each  case  of  sickness  was  19.45  days. 

The  possibility  of  placing  the  troops  in  the  hills  at  a  considerable  ele- 
vation (IVIount  Troados,  5,720  feet)  dimng  the  hottest  months,  will  always 
be  a  great  advantage  to  this  station. 


SECTION  n. 

WEST  INDIES. 

The  history  of  sanitary  science  affords  many  striking  instances  of  the 
removal  of  disease  to  an  extent  almost  incredible,  but  no  instance  is  more 
wonderful  than  that  of  the  West  Indies.  Formerly  service  in  the  West 
Indies  was  looked  on  as  almost  certain  death.  It  is  little  over  sixty  years 
since  the  usual  time  for  the  disappearance  of  a  regiment  1,000  strong  was 
five  years.  Occasionally  in  a  single  year  a  regiment  would  lose  300  men, 
and  there  occurred  from  time  to  time  epochs  of  such  fatality  that  it  was  a 
common  opinion  that  some  wonderful  morbid  power,  returning  in  cycles 
of  years — some  wave  of  poison — swept  over  the  devoted  islands,  as  sud- 
den, as  unlooked-for,  and  as  destructive,  as  the  hurricanes  which  so  sorely 
plague  the 

**  Golden  isles  set  in  tlie  silver  sea." 


30  i  PRACTICAL   HYGIENE. 

"Wliat  gave  countenance  to  this  liypotbesis  was,  that  sometimes  for 
months,  or  even  for  a  year  together,  there  would  be  a  period  of  health  so 
great  that  a  regiment  would  hardly  lose  a  man.  But  another  fact  less 
noticed  was  not  so  consistent  with  the  favoiite  view.  In  the  very  worst 
years  there  were  some  stations  where  the  sickness  was  trifling ;  while, 
more  wonderful  still,  in  the  worst  stations,  and  in  the  worst  years,  there 
were  instances  of  regiments  remaining  comparatively  healthy,  while  their 
neighbors  were  Hterally  decimated.  And  there  occurred  also  instances  of 
the  soldiers  d;\-ing  by  scores,  while  the  health  of  the  civil  inhabitants  in 
the  immediate  A-icinity  remained, as  usual. 

If  anything  more  wei*e  wanted  to  show  the  notion  of  an  epidemic  cycle 
to  be  a  mere  hypothesis,  the  recent  medical  history  of  the  West  Indies 
would  prove  it.  At  present  this  di-eaded  service  has  almost  lost  its  ter- 
rors. There  still  occur  local  attacks  of  yellow  fever,  which  may  cause  a 
gi'eat  mortality  ;  but  for  these  local  causes  can  be  found  ;  and  otherwise 
the  stations  in  the  "West  Indies  can  now  show  a  degree  of  salubrity  almost 
equalling,  in  some  cases  surpassing,  that  of  the  home  sei-vice. 

The  causes  of  the  production,  and  the  reasons  of  the  cessation,  of  this 
great  mortality  are  found  to  be  most  simple.  It  is  precisely  the  same 
lesson  which  we  should  grow  weary  of  learning  if  it  were  not  so  vital  to 
us.  The  simplest  conditions  were  the  destructive  agents  in  the  West 
Indies.  The  years  of  the  cycles  of  disease  were  the  j-ears  of  overcrowding, 
when  military  exigencies  demanded  that  large  garrisons  should  hold  the 
islands.  The  sanitary  conditions  at  all  times  were,  without  exception,  in- 
famous. 

There  was  a  great  mortality  from  scorbutic  dysentery,  "which  was  al- 
most entii-ely  owing  to  diet.'  Up  to  within  a  compai'atively  late  date,  the 
troops  were  fed  on  salt  meat  three,  and  sometimes  five,  days  a  week,  and 
the  supply  of  fresh  vegetables  was  scanty.  It  required  all  the  influence  of 
Lord  Howick,  the  then  Secretary  at  War,  to  cause  fresh  meat  to  be  issued, 
though  it  had  been  pointed  out  by  successive  races  of  medical  officei-s 
that  fresh  meat  was  not  only  more  wholesome,  but  was  actually  cheaper. 
The  result  of  an  improvement  in  the  diet  was  manellous  ;  the  scorbutic 
dysenteiy  at  once  lessened,  and  the  same  amount  of  mortahty  from  this 
cause  is  now  never  seen.  Another  cause  of  dysentery  was  to  be  found  in 
the  water,  which  was  impure  from  being  drawn  from  calcareous  strata,  or 
was  turbid  and  loaded  with  sediment.  The  substitution  of  rain-water  has 
sufficed  in  some  stations  to  remove  the  last  traces  of  dysentery. 

If  the  food  and  water  were  bad,  the  air  was  not  less  so.  Sir  Alex- 
ander TuUoch  has  given  a  picture  of  a  single  ban-ack  at  Tobago,  said  to  be 
the  "best  in  the  whole  Windward  and  Leeward  Command,"''  the  figures 
of  which  tell  their  own  tale. 

Barrack  at  Tobago  in  1826. — Superficial  space  per  man,  22^  feet ; 
breadth,  23  inches  ;  cubic  space,  250  feet. 

The  men  slept  in  hammocks,  touching  each  other.  In  these  barracks, 
crowded  as  no  ban-acks  were  even  in  the  coldest  climates,  there  was  not  a 
single  ventilating  oj)ening  except  the  doors  and  windows  ;  the  air  was 
fetid  in  the  highest  degree.  With  this  condition  of  atmosphere  it  is  im- 
possible not  to  bring  into  connection  the  extraordinary  amount  of  phthisis 
which  prevailed  in  the  soft  and  equable  climate  of  the  West  Indies.    There 

'  This  is  pointed  out  in  the  Statistical  Beport  (1838)  on  the  West  Indies,  by  Tulloch 
and  Balfour  ;  and  it  is  believed  that  the  improvement  in  the  diet  was  in  a  great  meas- 
ure owing  to  these  gentlemen.  '■'  Eeport,  1838. 


FOEEIGN    SERVICE.  305 

was  more  phthisis  than  in  England,  and  far  more  than  in  Canada.  The 
first  great  improvement  was  made  in  1827,  when,  iron  bedsteads  being  in- 
troduced, each  3  feet  3  inches  wide,  greater  space  was  obHged  to  be  given 
to  each  man. 

Every  arrangement  for  removal  of  sewage  was  barbarous,  and  in  every 
barrack  sewage  accumulated  round  the  buildings  and  was  exposed  to  heat 
and  air.  When  yellow  fever  attacked  a  regiment,  every  stool  and  evacua- 
tion was  thrown  into  the  cesspools  common  to  all  the  regiment ;  and  in 
this  way  the  disease  was  propagated  with  gi'eat  rapidity,  and  was  locahzed 
in  a  most  singular  manner,  so  that  a  few  hundred  yards  from  a  barrack, 
where  men  were  dying  by  scores,  there  would  be  no  case  of  fever.  In 
spite  of  this,  it  was  many  years  before  the  plan  of  at  once  evacuating  a  bar- 
rack where  yellow  fever  prevailed  was  adopted. 

The  barracks  themselves  were  usually  very  badly  constructed,  and  when 
in  some  cases  the  architects  had  raised  the  barracks  on  arches  from  the 
ground,  in  order  to  insure  perflation  of  air  below  the  buildings,  the  arches 
wer%  blocked  up  or  converted  into  store-rooms ;  and  the  bari'acks,  with 
spaces  thus  filled  with  stagnant  air  beneath  them,  were  more  unhealthy 
than  if  they  had  been  planted  on  the  ground. 

The  locahties  for  barracks  were  often  chosen  without  consideration,  or 
for  military  reasons,'  into  which  no  consideration  of  health  entered.  Al- 
most all  were  on  the  plains,  near  the  mercantile  towns,  where  the  soil  was 
most  malarious,  and  the  climate  hottest  and  most  enervating.  Malarious 
fevers  were,  therefore,  common. 

To  all  these  causes  of  disease  were  added  the  errors  of  the  men  them- 
selves. For  the  officers  there  existed,  in  the  old  slave  times,  the  greatest 
temptation.  A  reckless  and  dangerous  hospitality  reigned  everywhere  ; 
the  houses  of  the  rich  planters  were  open  to  all.  A  man  was  deemed 
churlish  who  did  not  welcome  every  comer  with  a  full  wine,  or  more  often 
a  brandy,  cup. 

In  a  climate  where  healthy  physical  exertion  was  deemed  impossible,  or 
was  at  any  rate  distasteful,  it  was  held  to  be  indispensable  to  eat  largely  to 
maintain  the  strength.  To  take  two  breakfasts,  each  a  substantial  meal, 
was  the  usual  custom  ;  a  heavy  late  dinner,  frequently  followed  by  a  sup- 
per, succeeded  ;  and  to  spur  the  reluctant  appetite,  glasses  of  bitters  and 
spirits  were  taken  before  meals. 

The  private  soldiers  obtained  without  difficulty  abundance  of  cheap 
rum,  which  was  often  poisoned  with  lead.  Drunkenness  was  almost  uni- 
versal, and  the  deaths  from  delirium  tremens  were  frequent  and  awfully 
sudden.  The  salt  meat  they  were  obhged  to  eat  caused  a  raging  thirst, 
which  the  rum-bottle  in  reality  only  aggravated. 

To  us  these  numerous  causes  seem  sufficient  to  account  for  everything, 

'  The  history  of  the  old  St.  James's  Barracks  in  Trinidad  is  too  remarkable  to  be 
passed  over.  It  was  determined  to  build  a  strong  fort — a  second  Gibraltar — on  the 
lower  spurs  of  the  hills  overlooking  the  plain  where  the  barracks  now  stand.  When 
the  works  had  been  carried  on  for  some  time,  it  was  discovered  that  they  could  not 
hold  the  troops.  The  barracks  were  then  ordered  to  be  placed  on  the  plain,  under 
cover  of  the  guns  of  the  fort.  Before  the  fort  was  quite  finished,  it  was  fotmd  to  be  so 
unhealthy  that  neither  white  nor  black  men  could  live  there,  and  it  was  abandoned. 
The  barrack,  it  is  said,  was  not  then  commenced  ;  yet  though  the  reason  for  placing  it 
in  that  spot  had  gone,  it  was  still  built  there,  on  a  piece  of  ground  near  two  marshes 
(Cocorite  and  the  Great  Western  Marsh),  below  the  general  level  of  the  plain,  and  ex- 
posed to  the  winds  from  the  gullies  of  the  neighboring  hills.  Yet  this  bad  position,  so 
fruitful  of  disease,  was  in  reality  less  injurious  than  the  bad  local  sanitary  arrange- 
ments of  the  old  St.  James's  Barrack  itself. 
Vol.  II. -20 


306  PRACTICAL    HYGIENE. 

but  in  former  days  an  easier  explanation  was  given.  It  was  held  to  be  the 
climate  ;  and  the  climate,  as  in  other  parts  of  the  world  besides  the  West 
Indies,  became  the  convenient  excuse  for  pleasurable  follies  and  agreeable 
vices.  In  order  to  do  away  with  the  effects  of  this  dreaded  climate,  some 
mysterious  power  of  acclimatization  was  invoked.  The  European  system 
required  time  to  get  accustomed,  it  was  thought,  to  these  climatic  influ- 
ences, and  in  order  to  quicken  the  process  various  measures  Avere  pro- 
posed. At  one  time  it  was  the  custom  to  bleed  the  men  on  the  voyage,  so 
that  their  European  blood  might  be  removed,  and  the  fresh  blood  which 
was  made  might  be  of  the  kind  most  germane  to  the  West  Indies.  At 
other  times  an  attack  of  fever  (often  brought  on  by  reckless  drinking  and 
exposure)  was  considered  the  grand  preservative,  and  the  seasoning  fever 
was  looked  for  with  anxiety.  The  first  statistical  report  of  the  army  swept 
away  all  these  fancies,  and  showed  conclusively  that  instead  of  prolonged 
residence  jaroducing  acclimatization  and  lessening  disease,  disease  and 
mortality  increased  regularly  with  every  year  of  residence. 

The  progress  of  years  has  given  us  a  different  key  to  all  these  reftilts. 
It  is  now  fully  recognized  that  in  the  West  Indies,  as  elsewhere,  the  same 
customs  will  insure  the  same  results.  Apart  from  malaria,  we  hold  our 
health  and  life  almost  at  will.  The  amount  of  sickness  has  immensely 
decreased  ;  occasionally  in  some  stations  which  used  to  be  very  fatal  (as  at 
Trinidad)  there  has  not  been  a  single  death  in  a  year  among.  200  men. 
Among  the  measures  which  have  wrought  such  marvels  in  the  West  Indies 
have  been — 

1.  A  better  supply  of  food  ;  good  fresh  meat  is  now  issued,  and  vege- 
tables, of  which  there  is  an  abundance  everywhere. 

2.  Better  water. 

3.  More  room  in  barracks,  though  the  amount  of  cubic  space  is  still 
small. 

4.  Eemoval  of  some  of  the  stations  from  the  plains  to  the  hills  ;  a  meas- 
ure which  has  done  great  good,  but  which  can  explain  only  a  portion  of 
the  improvement.  The  proper  height  to  locate  troops  is  by  most  army 
surgeons  considered  to  be  at  some  point  above  2,500  feet. 

5.  Better  sewage  arrangements,  and  more  attention  generally  to  sani- 
tary conservancy. 

6.  A  more  regular  and  temperate  life,  both  in  eating  and  drinking,  on 
the  part  both  of  officers  and  men. 

7.  The  occupancy  of  the  unhealthy  places,  when  retained  as  stations, 
by  black  troops. 

8.  A  better  dress.  It  is  only,  however,  within  recent  years  that  a 
more  suitable  dress  has,  at  the  instance  of  the  late  Sir  J.  B.  Gibson,  for- 
merly Director-General,  A.M.D.,  been  provided  for  the  West  Indian  Isl- 
ands. 

The  army  stations  in  the  West  Indies  are  Jamaica,  Barbadoes,  Trinidad, 
St.  Vincent  ;  the  last  three  being  included  in  the  term  "  Windward  and 
Leeward  Command."  British  Guiana,  on  the  mainland,  is  part  of  this 
command.  There  are  small  parties  of  artillery  and  some  black  troops  in 
Hondm-as  and  the  Bahamas. 

The  period  of  service  is  now  three  or  four  years :  formerly  it  was  eleven 
or  twelve,  but  this  was  altered  after  the  first  statistical  report.  Usually  the 
Mediterranean  regiments  pass  on  to  the  West  Indies,  and  subsequently  to 
Canada.  The  total  number  of  men  serving  in  the  West  Indies  is  now  very 
small. 

The  proper  time  for  arriving  in  the  West  Indies  is  in  the  beginning  of 


FOREIGN    SERVICE.  307 

the  cold  season,  viz.,  about  the  beginning  of  December,  when  the  hurricanes 
and  autumnal  rains  are  usually  over. 

Jamaica. 

Present  strength  of  white  garrison,  200  to  300  ;  black  troops,  500  to 
600.  Population  of  island  estimated  at  560,000.  A  range  of  lofty  hills 
(Blue  Mountains)  divides  Jamaica  into  two  parts,  connected  by  a  few 
passes.  The  troops  were  formerly  stationed  chiefly  in  the  south  plains,  at 
Kingston  (30,000  inhabitants).  Port  Royal,  Spanish  Town,  Up-Park  Camp, 
Fort  Augusta,  etc.  After  the  Maroon  war  in  1795  some  troops  were  sta- 
tioned at  Maroon  Town  (2,000  feet  above  the  sea)  on  the  north  side,  and  at 
Montego  Bay.  Subsequently  Stony  Hill  (1,380  feet  above  the  sea),  at 
the  mouth  of  one  of  the  passes,  was  occupied. 

Since  1842  some,  and  now  nearly  all  the  troops,  are  at  Newcastle,  in 
the  hills,  4,000  feet  above  the  sea,  Avith  detachments  at  Kingston  and  Port 
Eoyal.  The  other  stations  are  now  disused  for  white  trooiDS.  The  sanitary 
condition  at  Newcastle  was  formerly  not  good  ;  the  sewage  arrangements 
are  very  imperfect ;  it  is  now  somewhat  improved. 

Climate. — The  climate  is  very  different  at  the  different  stations.  At 
Kingston  (sea-level) — temperature,  mean  of  year  =  78°  ;  hottest  month, 
July,  mean=  81°.  71  ;  coldest  month,  January,  mean  =  75°. 65  ;  mean  yearly 
fluctuations  =  6°. 06.  Undulations  trifling.  The  climate  is  limited  and 
equable.  At  Newcastle  the  mean  annual  temperature  is  about  QQ>°  ;  hottest 
month,  August  =  67°.  75  ;  coldest  month,  February  =  61°.  The  diurnal 
range  is  considerable,  but  the  annual  fluctuation  is  trifling  (about  6°).  The 
mean  of  the  year  is  therefore  much  lower  than  on  the  plains  ;  the  ampli- 
tude of  the  yearly  fluctuation  about  the  same  ;  the  diurnal  change  greater. 

Humiditif.— This  is  considerable  in  the  plains — often  from  80  to  90  per 
cent,  of  saturation =7  to  9  grains  of  vapor  in  a  cubic  foot.  At  Newcastle 
the  mean  yearly  dew-point  is  about  60°  ;  the  amount  of  vapor  in  a  cubic 
foot  of  air  is  5.77  ;  the  mean  yearly  relative  humidity  is  68  per  cent,  of 
saturation. 

Bain. — Amount  on  the  plains  =  50  to  60  inches,  in  spring  and  autumn, 
viz.,  April  and  May,  and  October  and  November.  Showers  in  July  and 
August. 

Wi7ids. — Tolerably  regular  land  winds  at  night,  and  sea  breezes  in  the 
hot  and  dry  months  during  the  heat  of  the  day.  The  central  chain  of 
mountains  turns  the  northeast  trade  wind,  so  that  it  reaches  the  south 
side  diverted  from  its  course  ;  from  December  to  February  the  wind  is 
often  from  the  north,  and  brings  rain  and  fogs  ("wet  northers").  The 
southwest  wind  in  April  and  May  is  very  moist.  The  hurricane  months 
are  fi'om  the  end  of  July  to  the  beginning  of  November.  The  chmate  in 
the  plains  is  therefore  hot,  equable,  and  humid. 

Health  of  the  Black  Civil  Population. 

Of  the  specific  diseases,  small-pox  and  the  other  exanthemata  are  com- 
mon. Spotted  typhus  is  said  to  be  unknown  ;  typhoid  is  said  to  be  un- 
common, but  is  probably  more  common  than  is  supposed.  Influenza  has 
prevailed-  at  times,  and  also  the  so-called  dandy  or  polka  (Dengue). 
Cholera  has  prevailed  severely.  Malarious  fever  is  common  over  the 
whole  of  the  south  plains.  Yellow  fever  is  common,  though  less  frequent 
and  severe  among  the  blacks  than  the  whites.     Dysentery  is  common, 


308 


PEACTICAL    HYGIENE. 


though  it  has  always  been  less  frequent  than  among  the  troops.  Organic 
heart  disease  is  frequent.  Liver  diseases  are  uncommon.  Spleen  disease, 
in  the  foi-m  of  leucocythsemia,  is  common  among  the  blacks  (Smarda), 
Gout  is  said  to  be  frec^uent,  and  scrofula  and  rickets  to  be  infrequent. 
Syphilis  is  not  common,  but  gonorrhoea  is.  Cancroid  of  the  skin  and  ele- 
phantiasis of  the  Ai-abs  (Pachydermia)  ai-e  common.     Leprosy  is  also  seen. 

Health  of  the  Troops. 

Li  the  years  1790-93  the  annual  mortahty  of  the  white  troops  varied  in 
the  diflferent  stations  from  111  (Montego  Bay)  to  15.7  per  1,000  of  strength 
at  Stony  Hill  (1,380  feet  above  sea-level).  In  the  years  1794-97  the 
mortality  was  much  greater  ;  the  most  unhealthy  regiment  in  the  plains 
lost  333  ;  the  most  healthy,  45.4  per  1,000  of  strength  ;  at  the  hill  station 
of  !Maroon  Town  (2,OoO  feet)  the  mortality  was,  however,  only  15.6  per 
1,000.  Li  the  years  1817-36  the  mean  mortality  was  121.3  ;  the  mean  of 
the  four  healthiest  years  gave  67,  and  of  the  four  unhealthiest  years  259 
per  1,000.     The  causes  of  death  in  these  twenty  years  were — 

Fevers 101.9  per  1,000  of  strength. 

Lung  diseases 7.5         "  " 

Bowel  complaints 5.1         "  " 

Brain  disease 2.6         "  " 

Liver  diseases 1  "  " 

Other  complaints 3.2 

121.3 

The  admissions  in  these  years  were  1,812  per  1,000  of  strength.  In 
1837-55  the  follo'o-ing  were  the  mean  results  :  Mortality  per  1,000  of 
strength — white  troops,  60.8;  black  troops,  38.2.  Admissions  per  1,000 
white  troops,  1,371 ;  black  troops,  784.  So  that  the  mortality  had  declined 
one-half. 

In  1864  the  mortahty-  was  much  below  the  home  standard.  In  1867  it 
ran  up  neai'ly  to  the  old  amount,  from  the  prevalence  of  yellow  fever,  which 
in  that  year  prevailed  again  in  Newcastle,  and  caused  a  gi-eater  loss  than 
it  had  done  in  1860.     The  statistics  of  the  white  troops  are — 


Loss  of  Strength  per 
Annum. 

1,000  per 

Loss  of  Service  per  1,000  per 
Annum. 

Years. 

Total 
Deaths. 

Deaths 

from 

Disease. 

Invalids. 

Admis- 
sions. 

1    Days  in 
Mean       Hospital  in 
Daily  Sick. '  each  Sick 
j       Man. 

1861-70  (10  rears) 

1871 

Highest  in  1867 

20.36 
13.51 

71.09 

13.51 
69.80 

5.88 

27.6 
30.4 
45.91 

930.8 
1192.9 

40.63 
32.43 

78.95 

16.10 
15.17 
21.95 

Lowest  inl864 

In  1875  the  death  rate  was. 

7.35 
12.99 



Since  1875  no  separate  return  is  furnished  in  the  A.]VLD.  Eeports.  An 
increase  in  admissions  and  mortality  occurred  in  1865  and  1866,  owing  to 
the  exposure  of  the  troops  in  the  time  of  the  negro  distm-bances,  and  their 
subsequent  partial  location  on  the  plains. 


FOEEIGN    SERVICE.  309 

Before  this  period  Jamaica  contrasted  favorably  even  with  home  service, 
and  particularly  so  vv^ith  India. 

A  decrease  of  admissions  in  1859-64  was  chiefly  owing  to  the  compara- 
tively small  number  of  cases  of  paroxysmal  disease  ;  a  decline  consequent 
on  the  removal  of  most  of  the  troops  from  the  plains  (in  1859  Newcastle 
gave  29.1  admissions,  and  Port  Koyal,  on  the  plain,  443.5  per  1,000  of 
strength,  from  malarious  disease).  la  1863  some  white  troops  were  sent 
to  Up-Park  Camp,  and  furnished  a  large  number  of  malarious  cases  (547.6 
admissions  per  1,000  of  strength),  while  at  Newcastle  they  were  only  48 
per  1,000.  The  decrease  in  the  mortality  in  the  years  1859-64  was  owing 
to  lessened  fever  and  dysentery.  Among  the  black  troops  there  is  now 
greater  sickness  and  mortality  than  among  the  whites  ;  the  mortality  in 
1837-55  was  38.2  per  1,000  ;  in  1859-65  it  was  27.33  ;  in  1866,  23.03  ;  in 
1875  it  was  only  14.67.  There  is  among  these  troops  a  large  mortality 
from  paroxysmal  fevers,  phthisis,  and  diseases  of  the  aUmentary  canal ;  and 
it  is  evident  that  their  condition  requires  a  close  examination. 

The  mortality  of  the  white  troops  shows  a  marked  increase  vrith  age. 

The  following  seem  to  be  the  most  important  points  connected  with  the 
white  troops  which  require  notice. 

It  is  impossible  to  avoid  paroxysmal  fevers  without  placing  all  the  troops 
in  the  hills,  and  it  is  very  desirable  Newcastle  should  be  made  the  only 
station  for  white  troops. 

The  possibility  of  yellow  fever  occurring  at  an  elevation  of  4,000  feet 
was  shown  by  the  appearance  of  yellow  fever  at  Newcastle  in  1860  and  1867. 
In  1860  occurred  the  remarkable  instances  of  contagion  on  board  the  ships 
Icarus  and  Imaum  described  by  Dr.  Bryson.  Whether  yellow  fever 
was  imported  into  Newcastle  or  not  was  a  subject  of  discussion  ;  it  certainly 
appears  probable  that  it  was  carried  there  ;  but  the  important  point  for  us 
is  that  mere  elevation  is  not  a  perfect  security.  There  were,  however,  only 
a  small  number  of  cases.  In  1867,  when  yellow  fever  again  appeared 
at  Newcastle,  it  was  imported,  apparently,  from  Kingston  and  Up-Park 
Camp. 

In  the  returns  for  a  number  of  years,  cases  were  returned  as  "  continued 
fever  ; "  it  had  never  been  clearly  made  out  whether  or  not  these  were  cases 
of  tj^Dhoid  fever  until  1873-4,  when  a  sharp  epidemic  occurred  at  New- 
castle. 

Formerly  there  was  a  large  number  of  cases  of  phthisis  ;  phthisis  is 
now  uncommon  ;  in  1817-36  lung  diseases  (almost  entirely  phthisis)  caused 
7.5  deaths  per  1,000  of  strength,  or  more  than  in  England.  In  1859-66 
the  ratio  was  only  1.42  per  1,000  of  strength  ;  and  in  1861,  out  of  636  men 
there  was  not  a  single  death,  though  four  men  were  sent  home  with  con- 
sumption.    In  1865  there  was  no  death ;  eight  men  were  sent  home. 

At  Newcastle  there  occurred  for  some  years  an  excess  of  affections  of 
the  alimentary  canal,  chiefly  indigestion  ;  at  present  these  have  lessened, 
but  it  would  he  important  to  make  out  the  cause.  In  1860  there  was  not 
a  single  admission  from  dysentery  at  any  station. 

In  the  worst  times  in  Jamaica  it  was  always  remarked  that  there  was 
rather  a  singular  exemption  from  acute  liver  disease  ;  very  few  cases  appear 
in  the  returns  under  hepatitis ;  whether  this  is  a  matter  of  diagnosis,  or 
whether  there  was  reaUy  an  immunity  compared  with 'India  or  the  Mauri- 
tius, is  a  question  of  great  interest  which  cannot  now  be  solved.  At  pres- 
ent, liver  disease  unconnected  with  drinking  is  uncommon. 

There  is  still  too  much  drinking,  and  the  medical  officers  have  strongly 
advised  the  issue  of  beer  instead  of  tht  daily  diam. 


310  PRACTICAL    HYGIENE. 

Venereal  diseases  have  never  prevailed  much  in  Jamaica ,  they  have 
caused,  on  an  average,  from  70  to  90  admissions  per  1,000  of  strength.  In 
1862  there  were  only  47  admissions  per  1,000  of  strength.  On  an  average 
in  1859-65,  enthetic  diseases  gave  118  admissions  per  1,000.  This  is- owing 
to  the  connection  usually  formed  between  the  black  women  and  the  soldiers, 
and  to  a  lessened  amount  of  promiscuous  intercourse. 

The  history  of  the  years  1865-67  shows  that  the  greatest  care  and  the 
most  judicious  aiTangement  of  the  men  is  necessary  to  guard  against  a 
recurrence  of  the  old  evils. 

The  black  troops  gave  a  mortality  of  24.6  per  1,000  (mean  of  ten  years, 
1861-70),  especially  from  phthisis. 

Trinidad. 

Strength  of  garrison,  200  men.  Civil  population  (in  1881),  about 
153,000. 

Geology. — Tertiaiy  formation  of  miocene  age  ;  central  range  of  hills  is 
an  indurated  formation  of  cretaceous  age  ;  the  northern  littoral  range  con- 
sists of  micaceous  slates,  sandstones,  limestones,  and  shales.  The  highest 
hill  is  3,012  feet  ;  the  central  hiU  (Tamana)  is  1,025  ;  one-seventeenth  of 
the  island  is  swampy. 

Climate. — Temperature  of  the  plains  :  Mean  of  year  about  79'^. 3  ;  coldest 
month,  January  =  78'  ;  hottest  month,  May  =  81°. 5  ;  next  hottest,  October 
=  80°.4.  Mean  annual  fluctuation,  3°. 5.  The  climate  is  therefore  very 
equable  and  Hmited.  There  are,  however,  cold  winds  from  the  hills  blow- 
ing over  small  areas, 

Hijgromelrij. — Mean  dew-point,  75^.1  ;  mean  relative  humidity  =  81  per 
cent,  of  saturation  ;  mean  weight  of  vapor  in  a  cubic  foot  =  9.4  grains  ; 
most  humid  month  is  May,  as  far  as  the  amount  of  vapor  is  concerned. 
Month  Avith  greatest  relative  humidity,  August. 

Winds  from  east  to  northeast  and  southeast.  "West  winds  rare,  and 
oppressive. 

Fuiin  on  the  plains,  about  60  to  70  inches.  Greatest  rainfall  in  one  day, 
4.67  inches.  Dry  season,  December  to  May.  June  and  July  showery. 
Heavy  rain  in  August,  September,  and  October. 

Sanitary  Condition. — St.  James's  BaiTack  is  on  a  depression  on  an  allu- 
vial soil  three  miles  from  Port  of  Spain,  the  capital ;  it  is  one  mile  from  the 
Cocorite,  and  three  from  the  Great  Eastern  Swamp  ;  the  drainage,  for  many 
years  most  defective,  is  now  improved,  as  the  main  sewer  is  carried  to  the 
sea.  On  many  occasions  yellow  fever  has  prevailed  in  this  barrack,  and 
nowhere  else  in  the  island ;  the  last  occasion  was  in  1858-59,  and  then  it 
was  proposed  by  Dr.  Jameson  (the  principal  medical  officer)  to  erect  bar- 
racks on  a  spot  2,200  feet  above  sea-level. 

The  capital,  the  Port  of  Spain  (32,000  inhabitants),  is  buUt  at  the  prin- 
cipal outfall  of  the  island ;  it  is  on  a  low  and  unhealthy  plain.  Formerly, 
it  was  so  unhealthy  as  to  be  scarcely  habitable,  but  after  being  well  drained 
and  paved  by  Sir  Ralph  Woodford,  it  has  become  much  healthier.  This 
was  the  result  of  great  sanitaiy  efforts  in  a  very  unpromising  locality,  and 
should  be  a  lesson  for  all  chmates. 

There  is  still,  however,  much  malarious  disease,  dysentery,  and  at  times 
yellow  fever  ;  but  this  last  disease  has  occasionally  been  very  severe  at  St. 
James's  Barracks,  without  a  single  case  being  seen  in  Port  of  Spain,  The 
ascent  of  the  malaria  from  the  barrack  plain  is  certainly  more  than  500,  and 
probably  as  much  as  1,000  feet. 


FOREIGN    SERVICE.  311 

Diseases  of  Troops. — The  state  of  health,  has  been  and  is  very  similar  to 
that  of  Jamaica,  ^\ith,  however,  a  large  percentage  in  former  years  both  of 
phthisis  and  diseases  of  the  stomach  and  bowels,  chietiy  dysentery. 

In  the  years  1817-36,  the  average  mortahty  of  the  white  troops  was 
106.3  per  1,000  of  strength,  and  of  these  deaths  there  were — 

From  fevers 61.6 

Lung  diseases 11.5 

Diseases  of  stomach  and  bowels 17.9 

Dropsies  (probably  partly  maLarious,  parily  renal) 7.7 

Brain  diseases  (especially  from  intemperance)  , 4.7 

Liver  diseases 1.1 

All  other  diseases 1.8 


106.3 


As  in  Jamaica,  the  statistics  of  the  white  troops  of  late  yeai-s  tell  a  very 
different  story. 

In  1859  there  was  an  outbreak  of  yellow  fever,  and  the  deaths  from 
disease  rose  to  81.27  per  1,000.  In  the  next  seven  years  (ending  1866) 
the  average  number  was  7.48  deaths  from  disease  per  1,000.  In  two  years 
(1860  and  1865)  there  were  no  deaths. 

Even  in  1859,  when  the  mortahty  was  so  large,  there  were  only  10 
deaths  from  yellow  fever  among  190  men,  while  there  were  no  less  than  4 
deaths  fi'om  delirium  tremens. 

Among  the  diseases  in  the  returns,  the  largest  item  is  malarious  fever  ; 
there  are  also  cases  of  "  continued  fever,"  as  in  Jamaica  ;  and  this  term,  in 
fact,  has  never  been  absent  from  the  reports.  Is  this  typhoid  fever  ?  In 
all  probabihty  it  is,  as  unequivocal  typhoid  fever  does  occm-  in  Trinidad.^ 
A  considerable  number  of  cases  of  dyspepsia  are  admitted  ;  in  1860  there 
were  16  cases  out  of  221  men,  or  72  per  1,000  of  strength.  In  1862  there 
were  103  per  1,000  admissions  from  "  digestive  "  diseases.  Venereal  dis- 
eases have  alwavs  been  low  ;  in  1860,  1861,  1862,  and  1864,  there  were 
only  49.8,  44.4,  20.6,  and  63.8  admissions  per  1,000  of  strength.  Dysen- 
tery is  now  infrequent.  In  1860,  out  of  221  men,  and  1861,  out  of  225 
men,  there  was  not  a  single  case.  In  1864,  out  of  235  men,  there  was 
only  1  case.  In  1865  there  were  no  admissions  from  phthisis.  Phthisis 
is  much  less  common,  yet  in  some  years  there  is  still  too  much  of  it. 
Separate  statistics  are  no  longer  available  fi'om  the  A.M.D.  Reports. 

It  is  evident  that  if  Dr.  Jameson's  suggestion  is  acted  upon,  and  the 
troops  are  removed  to  the  hills,  malarious  fever  will  disappear,  and  yellow 
fever  can  be  prevented.  In  such  a  case,  if  the  men  w-ill  abstain  from 
drinking,  this  island,  which  formerly  killed  rather  more  than  1  man  in 
every  10  yearly,  will  be  one  of  the  healthiest  sjDots  in  the  world. 

The  black  troops  are  now  less  healthy  than  the  white,  having  in  1859-65 
an  annual  mortality  of  nearly  20  per  1,000,  of  which  18  were  from  disease. 
Their  condition  requu-es  looking  into.  Of  late  years  a  very  small  number 
of  black  troops  have  been  stationed  at  Trinidad. 

The  invaliding  from  Trinidad  is  combined  in  the  Ai-my  Eeports  with 
that  of  the  other  islands  of  the  Windward  and  Leeward  Command. 

^  Dr.  Stone's  paper  in  the  Medical  Times  and  Gazette,  February,  1860. 


312  PKACTICAL    HYGIENE. 


Barbadoes. 


strength  of  garrison,  300  to  400  men.  Civil  population  (in  1881), 
172,000. 

Geology. — Limestone  (coralline)  ;  sandstone  (tertiary)  ;  beds  of  bitu- 
minous matter  and  coal  (tertiary),  clay  in  parts  (especially  in  the  hilly  dis- 
trict called  "  Scotland  "). 

An  open  country,  well  cultivated,  no  marshes  except  a  small  one  at 
Grteme  Hall,  one  mile  to  the  east  of  St.  Ann's  Barracks. 

The  country  is  divided  into  two  parts  :  a  mountainous  district  termed 
"  Scotland,"  and  a  lower  country  consisting  of  a  series  of  five  gigantic  ter- 
races, rising  with  some  regularity  one  above  the  other.  The  highest  hill 
is  1,100  feet. 

Climate  of  the  Plain. — Temperature  :  Mean  of  year,  80°  ;  hottest 
month  (October),  83°  ;  coldest  month  (January), 78°  ;  mean  yearly  fluctua- 
tion, 5°.     Climate  equable  and  limited.     Relative  humidity,  70  per  cent. 

Wind. — N.E.,  trade,  strongest  in  Februaiy  to  May;  weak  in  September 
to  November  inclusive  ;  hurricane  mouth,  August. 

Rain. — About  56  to  58  inches,  on  an  average,  but  varying  a  good  deal 
in  the  autumn  chiefly,  though  there  is  rain  in  all  months,  but  much  less. 
The  dry  season  is  from  December  to  May. 

Water. — Formerly  supplied  from  wells  ;  it  was  highly  calcareous.  At 
present  good  water  is  supphed  by  a  water  company.  Rain-water  is  also 
collected  in  tanks. 

Sanitary  Condition. — St.  Ann's  Barracks  are  placed  above  one  and  a 
half  mile  from  Bridgetown,  on  the  sea  ;  the  locality  and  the  construction 
of  the  barracks  have  been  much  comj^lained  of,  and  a  position  in  the  hills 
advised.'  Ai'rangemeuts  for  sewering  and  the  water  supply  were  both  for- 
merly bad  ;  considerable  impi'ovements  have  been  made,  and,  since  1862, 
30,000  gallons  are  supplied  daily  to  St.  Ann's  Barracks.  It  is  a  limestone 
water,  containing  carbonate  of  lime,  but  no  sulphate  of  lime,  and  is  re- 
markably fi'ee  fi'om  organic  matter.  The  total  solids  are  18.72  gi-ains  per 
gallon.  The  troops  are  still  too  much  crowded  in  barracks,  the  allowance 
being  under  600  cubic  feet.  Since  1872  new  latrines  (Jennings'  j^attern) 
have  been  provided  and  the  old  ones  closed. 

Formerly  vegetables  were  very  deficient  in  Barbadoes,  and  even  now 
there  is  some  difficulty  in  procuring  them.  They  are  often  imported  from 
other  islands. 

Diseases  among  Cicil  Population. — Yellow  fever  has  appeared  frequently, 
although  the  island  is  not  marshy.  It  is  not  so  frequent  as  formerly ;  it 
used  to  be  expected  every  four  years. 

Barbadoes  and  Trinidad  contrast  greatly  in  the  freedom  fi-om  marshes 
of  the  one,  and  the .  existence  of  marshes  and  malarious  diseases  in  the 
other  ;  yet  Barbadoes  has  had  as  much  yellow  fever  as  Trinidad. 

Dysentery  was  common  formerly,  partly  from  bad  water  ;  influenza 
has  been  epidemic  several  times.  Barbadoes  leg,  or  Elephantiasis  of  the 
Arabs,  is  frequently  seen.  Lej^rosy,  or  Elephantiasis  Graecorum,  is  also 
not  very  uncommon.  Variola  and  Pertussis  have  from  time  to  time  been 
very  bad. 

Hillary,  in  1766,  described  a  "  slow  nervous  fever,"  under  which  term 

'  For  an  extremely  good  and  concise  account  of  Barbadoes,  see  Dr.  Jameson's  Report 
in  the  Army  Medical  Report  for  18G1,  p.  261. 


FOREIGN    SERVICE.  313 

our  typhoid  fever  appears  to  have  been  indicated  by  most  writers  of  that 
period.  His  description  is  not  quite  clear,  but  resembles  typhoid  fever 
more  than  any  other.  He  also  speaks  of  "  diarrhoea  febrilis."  Can  this 
have  been  typhoid  ? 

Dracunculus  was  formerly  very  frequent,  and  Hillary  attributes  it  to 
the  drinking-water,  and  states  that  there  were  some  ponds  the  water  of 
which  was  known  to  "  generate  the  worm  if  washed  in  or  drank." 

Yaws  used  to  be  common. 

Colica  pictonum  was  formerly  frequent. 

Diseases  of  Troops. — Yellow  fever  has  several  times  been  very  fatal. 

Scorbutic  dysentery,  arising  from  the  wretched  food,  was  formerly  very 
frequent,  and  appears,  from  Sir  Andrew  Halliday's  work  to  have  been  very 
bad  even  in  his  time  (1823  to  1832). 

From  1817  to  1836  (20  years)— 

Average  mortahty  (white  troops),  58.5  per  1,000  of  strength. 
Greatest         "  "  204  "  "  (in  1817). 

Least  "  "  18  "  "  (in  1823). 

In  1817  there  were  1,654  men  on  the  island,  and  yellow  fever  broke  out. 
In  1823  there  were  only  791. 

Of  late  years,  as  in  all  the  other  islands,  the  sickness  and  mortality  has 
been  comparatively  trifling. 

In  1859-65  the  total  deaths  were  6.98  per  1,000,  and  in  1866  they  fell  to 
3.28  per  1,000,  which  is  only  one-third  the  mortality  of  home  service.  The 
highest  mortality  of  late  years  was  in  1862,  viz.,  16.77  ;  the  average  num- 
ber of  admissions  is  about  1,200. 

In  1864  there  was  an  outbreak  of  a  mild  fever,  termed  "remittent;" 
the  nature  is  unknown  ;  no  case  was  fatal. 

The  increased  mortality  of  1862  was  owing  to  yellow  fever.  It  ajDpeared 
first  among  the  civil  population  in  Bridgetown,  and  afterward  attacked  the 
troops  in  the  (stone)  barracks.  As  it  continued  to  spread,  the  men  were 
moved  out  and  placed  under  canvas,  with  the  best  effects.  A  remarkable 
feature  of  this  epidemic  was  that  the  officers  suffered  in  attacks  six-fold 
more  than  the  men,  and  had  a  mortality  more  than  twenty-fold.  The 
women  also  suffered  three-fold  more  than  the  men.  Formerly  the  case 
would  have  been  reversed.  In  1861  there  were  only  two  eleaths  out  of  787 
men,  one  from  phthisis  and  one  from  apoplexy  ;  and  in  1864  there  were  also 
only  two  deaths  (diarrhoea  and  phthisis)  among  930  men. 

Dysentery  is  now  uncommon. 

The  great  improvement  to  be  made  at  Barbadoes  is  decidedly  a  complete 
change  of  barracks.  The  persistent  recurrence  of  yellow  fever  in  these  old 
barracks,  with  their  imperfect  arrangements,  shows  them  to  be  the  main 
cause  of  the  appearance  of  the  disease.  The  saving  in  the  cost  of  a  single 
epidemic  would  amply  repay  the  outlay. 

As  in  the  other  islands,  the  black  troops  are  now  much  more  unhealthy 
than  the  white,  and  the  sanitary  condition  of  their  barracks  and  then-  food 
evidently  require  looking  into.  Phthisis  and  chronic  dysentery  are  the  chief 
diseases  causing  mortality.  The  average  of  1859-64  gave  1,015  admissions 
and  20.46  deaths  per  1,000  of  strength.  In  1865  there  were  22.64  deaths 
per  1,000  of  strength,  or,  excluding  violent  deaths,  20.49  ;  of  these  phthisis 
caused  14.34,  or  no  less  than  70  per  cent,  of  total  deaths. 

No  separate  information  is  now  available  from  the  "  Army  Medical  De- 
partment Reports." 


314  PKACTICAL    HYGIENE. 


St.  Lucia. 

Strength  of  garrison  =  100  men,  now  usually  black  troops.  Civil  popu- 
lation (in  1871),  36,610. 

St.  Lucia  is  divided  into  two  pai'ts  :  Basseterre,  the  lowest  and  most 
cultivated  part,  is  very  swampy  ;  Capisterre,  hilly,  with  deep  naiTow  ravines, 
fvill  of  vegetation.  The  climate  is  similar  to  that  of  the  other  islands,  but 
is  more  rainy  and  humid. 

Diseases  of  the  Wliite  Troops. — From  1817-36;  average  strength,  241; 
average  deaths,  30  =  122.8  per  1,000  of  strength.  Of  the  122.8  deaths, 
63.1  were  from  fevers,  39.3  from  bowel  disease,  and  12.5  from  lung 
disease. 

Pigeon  Island  (a  few  miles  from  St.  Lucia)  was  formerly  so  unhealthy 
that  on  one  occasion  22  men  out  of  55  died  of  dysentery  in  one  year,  and 
of  the  whole  55  men  not  one  escaped  sickness.  The  cause  is  supposed  to 
have  been  bad  water.     Now  Pigeon  Island  is  considered  healthy. 

Although  the  mortality  was  formerly  so  great,  St.  Lucia  has  been  very 
healthy  for  some  years. 

In  1859,  mean  strength  of  white  troops,  96  ;  admissions,  113,  and  there 
was  not  a  single  death,  although,  if  the  mortality  had  been  at  the  rate  of 
the  twenty  years  ending  1836,  12  men  would  have  died. 

Better  food,  some  improvement  in  barracks,  and  the  use  of  rain-  instead 
of  well-water,  have  been  the  causes  of  this  extraordinary  change. 

Twenty  two  men  were  admitted  with  "  continued  fever,"  18  with  ophthal- 
mia, and  only  2  with  venereal. 

In  1860  there  was  no  case  of  dysentery  and  only  two  of  dian-hcea  among 
100  men  in  this  island,  where  formerly  there  would  have  been  not  only 
many  cases,  but  4  deaths.  One  man  died  fi'om  phthisis,  or  at  the  rate  of 
10  per  1,000. 

In  1861,  out  of  94  men,  there  was  one  death  fi-om  jaundice,  or  at  the 
rate  of  10.6  per  1,000. 

In  1862  there  were  88  men  on  the  island  ;  one  man  was  drowned  ;  there 
was  no  death  from  disease.     No  case  of  jaundice  was  admitted. 

"In  1863  there  were  55  men,  and  one  death  fi'om  accident;  there  were 
64  admissions,  of  which  15  were  accidents. 

The  total  death  rate  among  the  white  troops  in  the  West  Indian  Com- 
mand was,  in  1880,  8.68  per  1,000,  of  which  5.79  only  were  due  to  disease  ; 
invalids  sent  home,  42.43  per  1,000,  of  whom  12.54  were  finally  discharged. 

British  Guiana  (252,000  inhabitants  in  1881). 

No  white  troops  are  at  present  stationed  at  Demerara. 

This  station  in  the  West  Indian  Command  is  on  the  mainland,  extend- 
ing from  the  equator  (nearly)  to  10°  N.,  200  to  300  miles,  and  inland  to  an 
uncertain  distance. 

It  is  a  flat  alluvial  soil  of  clay  and  sand,  covered  with  vegetation. 

The  water  of  Georgetown  is  not  good  ;  it  is  drawn  from  a  fi-esh-water 
lake  and  an  artesian  well ;  the  water  from  this  well  contains  a  good  deal 
of  iron. 

Trade- winds  from  N.E.  an  E.  for  nine  months.  In  Jul}^,  August,  and 
September,  S.E.  and  S.  and  laud- winds.     This  is  the  imhealthy  season. 

Two  wet  seasons,  January  and  June  ;  the  last  is  the  longest. 

Temperature  of  summer,  86°  ;  of  winter,  82°.     Bain,  about  100  inches. 

Formerly  there  was  an  enormous  mortahty  among  the  troops  from 


FOREIGN    SERVICE.  315 

yellow  fever  and  scorbutic  dysentery.  The  men  used  to  have  salt  meat  five 
times  a  week. 

The  climate  is  most  highly  malarious,  but  this  does  not  cause  much 
mortahty. 

Yellow  fever  has  prevailed  here  several  times.  On  one  occasion  (1861) 
the  troops  were  moved  out  and  encamped  at  some  distance  from  George- 
town ;  they  escaped  (7  mild  cases  only),  although  they  were  on  a  swampy 
plain. 

In  1817-36  the  average  deaths  were  74  per  1,000  of  strength. 

In  1859,  out  of  a  mean  strength  of  143,  there  were  156  admissions  = 
1,091  per  1,000  of  strength  ;  2  deaths  =  13.9  per  1,000  of  strength.  One 
death  from  apoplexy,  one  from  drowning.  The  deaths  from  disease  were 
only  6.9  per  1,000.  "Of  the  156  admissions,  no  less  than  81  were  from 
malarious  disease,  or  at  the  rate  of  519  per  1,000  of  strength,  or  nearly  one- 
half  the  total  admissions. 

In  1860,  1861,  and  1862,  the  admissions  from  malarious  disease  con- 
tinued high  (673,  1,380,  and  1,104  per  1,000  of  strength),  the  mortality 
was  very  small,  being  only  6.6  per  1,000  in  each  year  ;  in  fact,  the  single 
death  in  1860  and  in  1861  was  in  the  one  year  from  "acute  hepatitis,"  and 
in  the  other  from  accident.  In  1862,  in  spite  of  the  immense  malarious 
disease,  there  was  no  death. 

Subsequently  to  1861  it  appears  that  scattered  cases  of  yellow  fever 
occurred  among  the  shipping  and  in  the  town  every  year  ;  in  1866  there 
was  an  outbreak  among  the  white  troops.  In  eight  weeks  16  deaths  oc- 
curred among  72  men,  or  22  per  cent.' 

Some  important  lessons  are  di'awn  from  the  medical  history  of  this  sta- 
tion. It  has  been  shown  that  even  in  a  highly  malarious  country  yellow 
fever  may  be  evaded  by  change  of  ground,  although  the  men  are  obliged 
to  encamp  on  a  swamp.  Another  remarkable  point  is  the  very  small  mor- 
tality attending  the  paroxysmal  fevers.  It  would  be  very  interesting  to 
know  the  future  history  of  such  men,  but  it  cannot  be  doubted  that  the 
lessened  mortality  since  former  years  must  be  owing  to  better  treat- 
ment. 

The  extent  of  malarious  disease  shows  how  desirable  it  is  to  avoid  send- 
ing white  troops  to  Demerara. 

In  French  Guiana,  Dr.  Laure,  besides  malarious  fevers,  describes 
typhoid  fever  to  have  occurred  for  some  short  time  after  the  arrival  of 
French  poUtical  prisoners  after  the  coujj  d'etat  of  1851.  It  then  disap- 
peared. 

'  A  full  inquiry  was  made  into  this  outbreak ;  it  was,  as  so  frequently  happens, 
localized,  for  the  troops  were  suffering  severely,  while  the  health  officer  for  the  port 
(Dr.  Scott)  states  in  his  evidence  (Report  of  the  Commissioners  appointed  to  Inquire 
into  the  Outbreak  of  Yellow  Fever  at  Demerara  in  18(j6,  p.  25)  that  the  cases  in  town 
were  "very  few"  at  the  time.  The  barracks  were  badly  circumstanced  in  various 
ways,  particularly  in  having  removal  of  sewage  on  a  trench  system,  into  which  the 
latrines  opened,  and  which  trenches  were  intended  to  be  kept  clean  by  flushing ;  they 
were,  however,  in  a  veiy  foul  state,  and  were  merely  open  cesspools  ;  and  the  evidence 
of  Surgeon-Major  Hutton  (Report,  p.  87)  clearly  points  out  that  a  thoroi^ghly  good  sys- 
tem of  dry  removal  is  the  proper  plan  for  this  colony.  Whether  this  and  the  other 
unsanitary  conditions  gave  its  local  development  to  the  yellow  fever,  was  a  matter  of 
doubt  in  the  colony  ;  but  they  are  precisely  the  same  conditions  which  have  been  so 
frequently  seen  in  West  Indian  outbreaks  -  a  foul  soil,  and,  iu  addition,  open  cess- 
pools exposed  to  the  intense  heat  of  a  tropical  sun,  and  to  the  influence  of  a  moist 
atmosphere  and  a  moist  soil.  On  this  occasion  the  troops  were  not  removed  from  the 
barracks  until  too  late. 


316 


PRACTICAL    HYGIENE. 


Bahamas  and  Honduras. 

The  black  troops  garrison  both  those  places,  and  show  a  degree  of 
mortahty  nearly  the  same  as  in  the  other  stations,  the  amount  of  phthisis 
being  very  great.  In  1862,  at  the  Bahamas,  there  were  no  less  than 
4  deaths  from  phthisis  out  of  a  strength  of  439,-  or  at  the  rate  of  9.1  per- 
1,000  of  strength  ;  there  were  also  3  deaths  from  pneumonia  and  1  from 
l^leui'isy.  In  the  years  1859-66  the  average  deaths  from  tubercular  dis- 
eases per  1,000  men  were  11.04  yearly,  and  from  other  diseases  of  the 
lungs,  5.86  ;  out  of  100  deaths,  60  were  from  diseases  of  the  lungs.  This 
is  evidently  a  matter  for  careful  inquiry. 

At  Honduras,   among  the  black  troops,  the  deaths   from   tubercular 
cfisease,  in  1859-66,  were  4.04  per  1,007  of  strength. 


SECTION  m. 


BERMUDA. 


Usual  strength  of  garrison,  about  1,900  men.  Civil  population  (in 
1881),  13,948. 

Climate. — Hot,  equable,  and  rather  Umited. 

Temperature. — Mean  of  year,  74°  ;  hottest  month  (July),  83.5°  ;  coldest 
month  (February),  64.5°  ;  amplitude  of  yearly  fluctuation,  19°.  Kelative 
humidity  about  74  per  cent. 

The  sanitary  condition  was  formerly  very  bad  ;  there  were  no  sewers, 
and  no  efficient  dry  method  of  removal.  Now  matters  are  much  improved, 
and  in  1875  the  health  of  the  troops  was  reported  excellent.  Rain-water 
is  used  for  drinking. 

Diseases  of  the  Troops. 


Loss  of  Strength  per  1,000  per  annum. 

Loss  of  Service  per  1,000  per  annum. 

Years. 

Total 
Deaths. 

Deaths  from 
Disease. 

Invaliding. 

Admissions. 

Mean  Daily 
Sick. 

Days  in 

Hospital  to 

each  Sick 

Man. 

1817-36 

1837-46 

28.8 
35.5 
26.02 

169.54 

8.55 

15.04 

8.96 

9.62 

.... 

168.83 
5.70 

8. 61 

20.6 

2'l.92 
20.45 
29.89 

768 
1080 
764.3 

716.5 
637.1 
696.0 

39.54 

35.39 
32.62 
40.15 

.... 

1861-70  (10  years)  . . 
1864  (highest ;  yellow 

fever  year) 

1860  (lowest) 

1865-74  (10  years)  . . 
1870-79  (10  years)  . . 
1880 

15 

18.27 
18.69 
21.11 

This  history  of  the  West  Indies  may  be  applied  to  Bermuda,  though, 
with  the  excei^tion  of  yellow  fever  years,  it  never  showed  the  great  mor- 
tality of  the  West  Indies.  There  is  no  great  amount  of  paroxysmal  fevers  ; 
in  ten  years  (1837-46)  there  were  only  29  admissions  out  of  an  aggregate 
strength  of  11,224  men.  In  ten  years  (1870-79)  there  were  only  15  ad- 
missions out  of  18,974,  or  at  the  rate  of  0.8  per  1,000. 

Yellow  fever  has  prevailed  seven  times  in  this  country — viz.,  in  1819, 
1837,  1843,  1847,  1853,  1856,  and  1864. 


FOEEIGN    SEE  VICE.  317 

The  history  of  the  yellow  fever  in  1864  is  given  in  detail  by  Dr. 
Barrow, ' 

The  total  mortality  was  14  officers,  173  men,  5  women,  and  4  children. 
The  deaths  to  strength  were,  among  the  officers,  189,  and  among  the  men, 
149  per  1,000.  The  officers'  mortality  was  owing  to  a  large  number  of 
deaths  among  the  medical  officers. 

The  town  of  St.  George's,  in  Bermuda,  presents  every  local  condition 
for  the  spread  of  yellow  fever  ;  the  town  is  quite  unsewered  ;  badly  sup- 
plied with  water  ;  badly  built. 

"Dandy  fever,"  or  break-bone  (Dengue),  has  prevailed  several  times. 

"  Continued  fevers  "  (no  doubt  in  part  typhoid)  have  always  prevailed 
more  or  less  at  Bermuda.  In  the  ten  years  (1837-46.)  they  gave  1,004  ad- 
missions out  of  11,-224  men,  or  88  per  1,000  of  strength,  being  much 
greater  than  at  home.  In  ten  years  (1870-79)  there  were  884  admissions 
out  of  18,974,  or  47  per  1,000  ;  in  1880  the  ratio  was  42.6. 

In  1859  there  were  only  11  cases  of  "  continued  fever  "  out  of  1,074 
men  ;  but  in  1860  "continued  fever"  prevailed  severely  (209  cases  in  1,052 
men).  It  was  of  a  mild  type,  and  caused  little  mortahty.  It  was  probably 
not  typhoid,  but  its  nature  has  not  been  definitely  determined.  It  pre- 
vailed in  September,  October,  and  November.  It  is  said  that  the  drainage 
was  defective  at  Hamilton. 

In  1866  there  was  decided  typhoid  fever,  and  a  considerable  mortality. 
In  1875  there  were  5  admissions  recorded  and  1  death  in  1,902  men.  In 
1880,  27  admissions  and  6  deaths. 

Formerly  tuberculous  diseases  caused  a  considerable  mortality.  In  the 
years  1817-36,  diseases  of  the  lungs  gave  a  mortality  of  no  less  than  8.7 
per  1,000  of  strength.  In  1837-46,  the  lung  diseases  gave  a  yearly  mor- 
tality of  8.3  per  1,000  of  strength.  Of  late  years  the  amount  has  decreased. 
The  admissions  and  deaths  respectively  were  10.5  and  2.6  in  the  seven 
years  (1859-65).  In  1870  the  deaths  from  phthisis  were  1.57,  and  in  1871 
no  less  than  5.19  per  1,000  of  strength  ;  in  1875  they  were  1.58. 

Diarrhoea  and  dysentery  were  also  formerly  very  common,  but  of  late' 
years  there  has  been  a  great  decrease.     Diseases  of  the  eyes  are  common. 

There  has  always  been  much  intemperance,  and  a  large  number  of 
deaths  from  delirium  tremens.  This  was  the  case  even  in  1866  ;  there 
were  no  less  than  5  deaths  out  of  a  total  of  28. 

Venereal  diseases  have  averaged  from  55  to  80  per  1,000  of  strength. 

In  considering  the  sanitary  measures  to  be  adopted  at  Bermuda,  it 
would  seem  that  drainage  and  ventilation  are  still  most  defective,  and  that 
means  should  be  taken  to  check  intemperance.  If  yellow  fever  occurs,  the 
measures  should  be  the  same  as  in  the  West  Indies. 


SECTION  IV. 

NORTH  AMERICAN  STATIONS. 

Sub-Section  I. — Canada.^ 

The  usual  garrison  used  to  be  from  3,000  in  profound  peace  to  10,000 
or  12,000  in  disturbed  times.  In  1871  the  troops  were  withdrawn  from 
Canada  and  concentrated  at  Halifax. 

'  Army  Medical  Report,  vol.  v. ,  p.  290. 

^  For  an  excellent  account  of  the  Canadian  stations,  see  Sir  W.  Muir's  Report  in  the 
Army  Medical  Report  for  1862,  p.  375. 


318  PRACTICAL   HYGIENE. 

Lower  Canada. 
Chief  Stations— 1.   ^ue&ec  (62,446  inhabitants). 

Temperature. — Mean  of  year,  41°  ;  hottest  month  (July),  71.3°  ;  coldest 
(January),  11°.     Annual  fluctuation,  60.3°. 

The  undulations  of  temperature  are  enormous.  In  the  winter,  some- 
times, there  is  a  range  of  30,  40,  and  even  more  degrees  in  twenty-four 
hours,  from  the  alternation  of  northerly  and  southerly  winds.  In  one  case 
the  thermometer  fell  70°  in  twelve  hours.  The  mercury  is  sometimes 
frozen. 

The  mean  tempei'ature  of  the  three  summer  months  is  69°  ;  winter 
months,  12.8°.     The  climate  is  "extreme"  and  variable. 

Hain. — About  36  to  40  inches.  The  air  is  dry  in  the  summer,  and  again 
in  the  depth  of  winter. 

Ban-acks. — Built  on  lower  Silurian  rocks.  No  ague  is  known,  though 
the  lower  town  is  damp. 

Amount  of  cubic  space  small.  Casemates  in  citadel  very  bad,  damp,  ill 
ventilated,  ill  lighted. 

2.  Montreal  (140,862  inhabitants). 

Temperature. — Mean  of  year,  44.6°  ;  hottest  month  (July),  73.1°  ;  coldest 
(January),  14.5°.  Annual  fluctuation,  58.6°.  The  undulations  are  very 
gi'eat,  though  not  so  great  as  at  Quebec. 

Mean  of  the  three  summer  months,  70.8°  ;  of  the  three  winter  months, 
17.2°. 

Rain. — 36  to  44  inches. 

Barracks. — Bad  ;  very  much  overcrowded. 

In  Lower  Canada  are  also  many  smaller  stations. 

Upper  Canada. 
Chief  Stations — 1.   Toronto  (86,455  inhabitants). 

Temperature. — Mean  of  year,  44.3°  ;  hottest  month  (July),  66.8° ;  cold- 
est (February),  23.1°.     Difference,  43.7°.     Great  undulations. 

Rain. — 31.5  inches. 

The  town  stands  on  ground  originally  marshy.  The  new  barracks  are 
built  on  limestone  rocks  of  Silurian  age.  Average  cubic  space  only  350. 
Drainage  bad.  , 

Intermittent  fevers  among  the  civil  population  ;  not  very  prevalent 
among  the  troops. 

2.  Kingston  (14,093  inhabitants). 

Temperature. — Mean  of  year,  45.8°. 
Malarious. 

London,  Hamilton,  and  several  smaller  stations — Fort  George,  Amherst- 
berg,  etc. — were  also  occupied  at  one  time. 

Diseases  of  the  Civil  Inhabitants. 

Formerly  ague  was  prevalent  in  Upper  Canada,  especially  in  Kingston  ; 
it  is  now  much  less.  At  Montreal  ague  used  to  be  seen  ;  now  is  much  less 
frequent.     It  prevails  from  May  to  October,  and  is  worst  in  August. 


FOREIGlSr    SERVICE. 


319 


If  the  summer  isothermal  of  65°  be  the  northern  limit  of  malaria,  both 
Quebec  and  Montreal  are  within  the  limit ;  yet  the  winter  is  too  severe, 
and  the  period  of  hot  weather  too  short,  to  cause  much  development  of 
malaria. 

The  climate  is  in  both  provinces  very  healthy,  and  has  been  so  from  the 
earliest  records,  though,  when  the  country  was  first  settled,  there  was  much 
scurvy. 

T}'phoid  is  sometimes  seen.  Typhus  has  been  often  carried  in  emigrant 
ships,  but  has  not  spread,  or  at  least  has  soon  died  out.  Cholera  has  pre- 
vailed.    Yellow  fever  dies  out.     ConsumjDtion  is  decidedly  infrequent. 

Acute  pulmonary  diseases  used  to  be  considered  the  prevalent  com- 
plaints, but  it  is  doubtful  whether  they  are  much  more  common  than  else- 
where. 


Diseases  of  the  Troops. 


1,097 


Tears  1817-36  (20  years). — Admissions  per  1,000  of  strength 
deaths,  16.1  (without  violent  deaths). 

Years  1837-46  (10  years). — -Yearly  admissions  per  1,000  of  strength, 
982;  average  daily  sick  per  1,000  of  strength,  39.1;  mortahty  (violent 
deaths  excluded),  13  ;  mortahty  with  violent  deaths,  17.42. 

The  mortality  was  made  up  in  part  of — fever,  2.13  ;  lung  disease,  7.44; 
stomach  and  bowels  disease,  1.11  ;  brain  disease,  1.28.  Nearly  two-thirds 
of  the  fevers  are  returned  as  "  common  continued,"  probably  typhoid. 

Venereal  admissions,  117  per  1,000. 

Erysipelas  was  epidemic  at  Quebec,  Montreal,  and  Toronto  in  1841 ;  at 
Montreal  in  1842,  from  bad  sanitary  conditions. 

The  foUowing  table  shows  the  mean  of  the  later  years  : — 


Loss  of  Strength,  per  1,000. 

Loss  of  Service  per  1,000. 

Years. 

By  total 
Deaths. 

By  Deaths 

from 

Disea.se. 

By  In- 
validing. 

Admis- 
sions. 

Mean 
Daily 
Sick. 

Days  in 

Hospital 

to  each 

Sick  man. 

1861-70  (10  years) 
1871  

9.01 
9.55 

5.87 

15.9 
17.6 

646.9 

679.8 

30.36 
33.15 

17.14 

17.8 

Influence  of  Age  on  Mortality. 


Years. 

Under  30. 

20-24. 

25-29. 

30-34. 

35-39. 

40  and  over. 

1861-70  (10  years) . 

3.47 

6.01       9.80 

11.13 

17.66 

20.23 

These  numbers  show,  what  indeed  is  apparent  in  all  the  records,  that 
Canada  is  a  very  healthy  station. 

The  amount  of  phthisis  was  always  smaller  than  on  home  service,  and 
regiments  of  the  Guards  proceeding  from  London  to  Canada  had  on  two 
occasions  a  marked  diminution  in  phthisical  disease. 

In  this  respect,  also,  Canada  contrasted  formerly  -vrith  the  West  Indies, 


320  PRACTICAL    HYGIENE. 

but  of  late  years  the  decline  of  phthisis  in  the  AYest  Indies  has  lessened 
the  superiority  of  Canada. 

The  comparatively  small  amoimt  of  phthisis  was  remarkable,  as  the 
troops  were  at  times  very  much  crowded  in  barracks.  Latterly  they  had 
the  home  allowance  of  space  (600  cubic  feet). 

In  the  later  years  phthisis  declined  considerably  with  improved  barrack 
accommodation. 

In  the  20  years,  1817-36,  the  annual  admissions  were  6.5,  and  the 
deaths  4.22,  per  1,000  of  strength. 

In  the  years  1859-65  the  admissions  from  the  whole  tubercular  class 
were  8.3,  and  the  deaths  were  1.67,  per  1,000  of  strength.'  It  is  curious 
to  observe  that  this  diminution  was  coincident  with  a  similar  change  at 
home.''  The  acute  lung  affections,  pneumonia,  and  acute  bronchitis,  ap- 
pear formerly  to  have  been  rather  more  prevalent  in  Canada  than  they 
were  in  later  years. 

The  following  table  gives  the  mean  and  extremes  for  8  years  (1859-66) : — 

Per  1.000  of  Strength. 

Admissions.  Deaths. 

Pneumonia— Mean 12.24  0.8576 

Highest 15.33  1.996 

Lowest 7.91  0.411 

Acute  bronchitis— Mean 42.67  0.309 

Highest 49.79  0.719 

Lowest 28.48  0.092 

Average  of  the  mean  of  both 27.45  0.5833 

If  this  table  is  compared  with  the  similarly  constructed  table  (at  page 
283),  showing  the  prevalence  of  these  diseases  at  home,  it  appears  that 
both  pneumonia  and  acute  bronchitis  were  rather  more  fatal  in  Canada. 
Both  together  gave  a  mortality  of  .868  per  1,000  at  home,  and  1.166  per 
1,000  in  Canada.  The  admissions  from  pneumonia  were  also  higher,  but 
those  from  acute  bronchitis  were  one-third  less  than  at  home,  showing 
that  the  common  catarrhal  affections  were  less  frequent  in  Canada.  On 
the  whole,  however,  the  influence  of  the  severe  climate  and  the  exposure 
on  guard  in  Canada  produced  less  effect  than  might  have  been  anticipated. 

"Continued  fevers"  (probably  enteric)  almost  yearly  gave  some  mor- 
tality ;  the  mean  being  about  .6  per  1,000  of  strength.  This  was  actually 
more  than  on  home  service,  and  dej^ended  probably  on  the  difficulties  con- 
nected with  drainage.  A  good  dry  system  is  the  only  plan  which  can  be 
depended  on  in  Canada. 

The  great  healthiness  of  Canada  in  part  probably  depends  on  the  fact, 
that  the  extreme  cold  in  winter  lessens  or  pi'events  decomposition  of  ani- 
mal matter  and  the  giving  off  of  efHuvia  ;  hence,  in  spite  of  bad  drainage 


'  Still  the  lung  complaints  were  higher  than  they  ought  to  have  been.  Sir  William 
Muir  (Army  Med.  Eeport,  vol.  viii.,  p.  56),  after  detailing  the  measures  taken  by  him 
to  improve  the  barrack  accommodation,  says,  "I  cannot  help  thinking  that  the  large 
number  of  men  treated  and  invalided  for  chest  disease,  during  the  five  years  I  hav« 
been  on  this  command,  bears  a  close  relationship  to  this  impure  state  of  barrack  air." 

'In  contrasting  the  consumptive  invalidity  at  Gibraltar,  Bermuda,  and  Canada,  the 
Reporters  of  1839  (Army  Med.  Report)  remark,  that  the  returns  "  afford  another  inter- 
esting proof  how  little  the  tendency  to  consumption  is  increased  either  by  intensity  of 
cold  or  sudden  atmospherical  vicissitudes."  See  also  the  remarks  on  Phthisis  in  India 
at  a  subsequent  page.     * 


FOEElGIf    SERVICE.  321 

and  deficient  water,  there  is  no  very  great  amount  of  fever.  In  the  hot 
summer,  the  life  is  an  open-air  one.  Even  in  winter  the  dry  cold  peiTaits 
a  good  deal  of  exercise  to  be  taken. 

The  amount  of  drunkenness  and  delirium  tremens  in  Canada  used  to 
be  great.  In  1863  no  less  than  9  out  of  96  deaths,  or  nearly  one-tentk, 
were  caused  by  delirium  tremens.  Violent  deaths  also  are  usually  large, 
drowning  giving  the  largest  proportion 

The  sickness  and  mortality  of  Nova  Scotia  and  Newfoundland  are  al- 
most identical  with  Canada,  and  they  are  now  included  in  the  returns 
under  the  one  head  of  "Dominion  of  Canada."  Both  stations  have  always 
been  considered  very  healthy.  There  is  some  typhoid  fever  at  Halifax,  and 
at  both  places  there  was  formerly  much  diinking,  but  that  is  now  less.  In 
British  Columbia,  where  there  is  a  small  garrison  of  100  to  150,  the  health 
is  also  extremelv  good. 


SECTION  V. 

APRICAN   STATIONS. 

Sub-Sectiox  L — St.  Helena. 

Garrison,  200.     In  1880  only  194.     Civil  population  (in  1881),  5,059. 

Untd  comparatively  recently  this  small  island  was  garrisoned  by  a  local 
corps  (St.  Helena  Regiment),  which  has  now  been  disbanded. 

The  island  has  always  been  healthy  ;  seated  in  the  trade- winds,  there 
is  a  tolerably  constant  breeze  from  southeast.  The  average  mortality  in 
the  years  1859-66  was  9.75,  or  -without  violent  deaths,  7.85.  In  1867  the 
mortality  from  disease  was  only  5.24  In  1875  almost  the  same,  viz.,  5.41. 
There  is  very  httle  malarious  disease  (about  50  to  60  admissions  per 
1,000  of  strength),  but  there  has  frequently  been  a  good  many  cases  of 
*'  continued  fever,"  and  dysentery  and  diarrhoea  are  usual  diseases.  For- 
merly there  appears  to  have  been  much  phthisis,  but  this  is  now  much 
less,  gi^^ing  another  instance  of  the  decline  of  this  disease,  as  in  so  many 
other  stations. 

In  the  years  1837-46,  the  admissions  from  tubercular  diseases  aver- 
aged 21  per  1,000  per  annum,  and  the  deaths  5.45.  In  the  years  1859-66 
the  admissions  from  tubercular  diseases  were  6.6  ;  and  the  deaths  1.66  per 
1,000.  In  1867  there  were  no  admissions.  The  health  of  the  troops  would 
have  been  even  better  if  the  causes  of  the  continued  fever  and  dysentery 
could  have  been  discovered  and  removed,  and  if  the  amount  of  di-unken- 
ness  had  been  less.  The  returns  from  St.  Helena  are  now  combined 
with  those  from  the  Cape  of  Good  Hope. 

Sub-Section  IL — West  Coast  of  Africa.' 

The  principal  stations  are  Sierra  Leone  and  Cape-Coast  Castle. 

The  station  of  Gambia  has  now  been  given  up,  and  troops  are  no  longer 
stationed  regularly  at  Lagos  (500  miles  from  Cape-Coast  Castle,  and  occupied 
in  1861).  In  1875  SieiTa  Leone,  Cape-Coast,  and  Accra  were  occupied,  and 
Elmina  for  a  short  time,  and  since  then  the  two  first  stations  have  been 

'  For  a  very  good  account  of  the  topography  of  the  Gold  Coast,  see  Dr.  R.  Clarke's 
paper  in  the  Transactions  Epid.  Society,  vol.  i. 
Vo:..  II.— ai 


322  PRACTICAL    HYGIENE. 

alone  garrisoned.  No  white  troops  are  employed,  except  during  war-time, 
as  in  the  Ashanti  campaign  of  1873. 

Sierra  Leone. 

Strength  of  garrison,  300  to  500  black  troops,  with  a  few  European 
officers  and  non-commissioned  officers.  Civil  jDopulation  (in  1872),  37,089. 
Hot  season  from  May  to  the  middle  of  November  ;  Harmattan  wind  in 
December  ;  soil,  red  sandstone  and  clay,  veiy  ferruginous.  Thei-e  are  ex- 
tensive mangrove  swamps  to  N.  and  S.  Water  very  pure.  The  spring  in 
the  barrack  square  contains  only  3  to  4  grains  per  gallon  of  solids. 

This  station  had  formerly  the  reputation  of  the  most  unhealthy  station 
of  the  army.     Nor  was  this  undeserved. 

From  1817  to  1837  (twenty  years)  there  were  yearly  among  the  troops — 

Admissions 2,978  per  1,000 

Deaths 483 

At  the  same  time,  about  17  per  cent,  of  the  whole  white  population  died 
annually. 

The  chief  diseases  were  malarious  fevers,  which  caused  much  sickness, 
but  no  great  mortahty  ;  and  yellow  fever,  which  caused  an  immense  mor- 
tality.    Dysentery,  chiefly  scorbutic,  was  also  very  fatal. 

The  causes  of  this  great  mortality  were  simple  enough.  The  station 
was  looked  upon  as  a  place  of  punishment,  and  disorderly  men,  men  sen- 
tenced for  crimes,  or  whom  it  was  wished  to  get  rid  of,  were  drafted  to 
Sierra  Leone.  They  were  there  very  much  overcrowded  in  barracks,  which 
were  placed  in  the  lower  part  of  the  town.  They  were  fed  largely  on  salt 
meat ;  and  being  for  the  most  part  men  of  desperate  character,  and  without 
hope,  they  were  highly  intemperate,  and  led,  in  all  ways,  lives  of  the  utmost 
disorder.  They  considered  themselves,  in  fact,  under  sentence  of  death, 
and  did  their  best  to  rapidly  carry  oiit  the  sentence. 

Eventually,  all  the  white  troops  were  removed,  and  the  place  has  since 
been  garrisoned  by  one  of  the  West  Indian  regiments.  Of  late  years,  the 
total  white  population  of  Sierra  Leone  (civil  and  military)  has  not  been 
more  than  from  100  to  200  persons. 

The  great  sickness  and  mortality  being  attributable,  as  in  so  many  other 
eases,  chiefly  to  local  causes  and  individual  faults,  of  late  years  Europeans 
have  been  comparatively  healthy  ;  although  from  time  to  time  fatal  epi- 
demics of  yellow  fever  occur.  They  are,  however,  less  frequent  and  less 
fatal  than  formerly.  The  position  of  the  barracks  has  been  altered,  and 
the  food  is  much  better.  One  measure  which  is  supposed  to  have  improved 
the  health  of  the  place,  is  allowing  a  species  of  grass  (Bahama  grass)  to 
grow  in  the  streets.  The  occupiers  of  the  adjacent  houses  are  obliged  to 
keep  it  cut  short,  and  in  good  order. 

During  the  four  years,  1863-66,  there  died  8  white  non-commissioned 
officers,  in  the  whole  command  of  the  West  Coast,  out  of  an  average  strength 
of  25,  or  at  an  annual  rate  of  80  per  1,000  of  strength.  Three  of 'the  8  deaths 
Avere  from  liver  disease,  two  from  delirium  tremens,  two  fi'om  fevers,  and 
one  from  dysentery.  In  1867  two  sergeants  died,  out  of  15  white  men — one 
from  apoplexy,  one  fi'om  dQlirium  tremens. 

Among  the  black  troops  serving  in  Sierra  Leone  and  the  Gold  Coast, 
the  returns  of  the  ten  years  (1861-70)  give  1,283  admissions  and  22.49 
deaths  per  1,000.     In  1871  the  deaths  were  15.63  per  1,000  from  disease. 


FOREIGN    SERVICE.  823 

In  ten  years  (1870-79)  the  admissions  were  1640.5  and  the  deaths  25.07 
per  1,000.  1873  was  the  year  of  the  last  Ashanti  war.  In  1880  the  admis- 
sions were  1565.7  and  the  deaths  22.47,  of  which  20.86  were  from  disease. 
These  numbers  are  for  the  whole  West  African  command.  Among  the 
causes  of  death,  tubercular  diseases  hold  the  first  place,  amounting  to  7.05 
per  1,000  of  strength.  In  1862  phthisis  amounted  to  no  less  than  12.6  per 
1,000  of  strength,  and  constituted  43.7  per  cent,  of  all  deaths  from  disease. 
There  were  also  9.46  per  1,000  of  strength  deaths  from  pneumonia.  In 
1863  the  deaths  from  phthisis  were  9.3  per  1,000  of  strength,  and  made  up 
36.3  per  cent,  of  the  total  deaths.  In  1867  the  tubercular  deaths  per  1,000 
of  strength  were  17.71  in  Sierra  Leone,  15.87  at  the  Gambia,  and  12.58  at 
the  Gold  Coast  and  Lagos  together.  In  1880  the  total  rate  for  the  com- 
mand was  11.23  per  1,000.  It  seems  clear,  indeed,  that  in  all  the  stations 
of  the  West  Indian  corps  (black  troops),  the  amount  of  phthisis  is  great ; 
in  fact,  the  state  of  health  generally  of  these  regiments  requires  looking 
into,  as  in  the  West  Indies. 

In  1862  there  were  only  five  cases  of  intermittent,  and  eighteen  of  re- 
mittent fever  among  317  negroes.  In  1880  the  number  was  404  out  of 
623. 

In  1861  some  of  the  troops  from  Sierra  Leone  and  the  Gambia  were 
employed  up  the  Gambia  against  the  Mandingoes,  and  also  against  the  chiefs 
of  Quiat.  In  1863  and  1864,  and  again  in  1<'^73,  Ashanti  wars  prevailed. 
All  these  wars  added  to  the  sickness  and  mortahty,  so  that  these  years  are 
not  fair  examples  of  the  influence  of  the  climate. 

Gambia. 

No  troops  have  been  quartered  here  of  late  years,  and  it  has  been  in 
contemplation  to  abandon  the  station.  It  is  much  more  malarious  than 
any  of  the  others.  The  drinking  water  is  bad  ;  all  barrack  and  sewage 
arrangements  are  imperfect.  Yellow  fever  from  time  to  time  is  very  destruc- 
tive. In  1859  two  out  of  four  European  sergeants,  and  in  1860  three 
medical  officers,  died  of  yellow  fever.  Among  the  black  troops  in  1859-65, 
the  admissions  were  1169.8  and  the  deaths  29.97  per  1,000  of  strength. 

As  at  Sierra  Leone,  phthisis  and  other  diseases  of  the  lungs  caused  a 
large  mortality  among  the  negroes.  In  1861  phthisis  gave  five  deaths  out 
of  a  strength  of  421,  or  at  the  rate  of  11.6  per  1,000  strength  ;  and  pneu- 
monia gave  four  deaths,  and  acute  bronchitis  three,  or  (together)  at  the 
rate  of  16.24  per  1,000  of  strength.  Phthisis,  pneumonia,  and  bronchitis 
gave  nearly  60  per  cent,  of  all  deaths  from  disease.  This  was  higher  than 
in  previous  years ;  but  in  1862  phthisis  gave  14.35  deaths  per  1,000  of 
strength,  and  constituted  75  per  cent,  of  the  whole  number  of  deaths. 
There  was,  however,  no  pneumonia  or  bronchitis  in  that  year.  In  1856 
the  tubercular  class  gave  9.53  deaths  per  1,000.  In  1863,  however,  there 
were  no  deaths  from  phthisis.  Although  the  period  of  observation  is  short, 
it  can  hardly  be  doubted  that  here,  as  elsewhere  in  the  stations  occupied 
by  the  West  Indian  regiments,  some  causes  influencing  the  lungs  prejudi- 
cially are  everywhere  in  action.  It  is  probably  to  be  found  in  bad  ventila- 
tion of  the  barracks. 

Among  the  few  white  residents  at  the  Gambia,  diarrhoea,  dysentery,  and 
dyspepsia  appear  to  be  common.  These,  in  part,  arise  from  the  bad  water ; 
in  part  from  dietetic  errors  (especially  excess  in  quantity),  and  want  of 
exercise  and  attention  to  ordinary  hygienic  rules. 


324  PRACTICAL    IIYGIEXE. 

Cape-Coast  Castle  {Gold  Coast). 

Garrison,  300  to  400  (black  troops). 

This  station  has  always  been  considered  the  most  healthy  of  the  three 
principal  places.  It  is  not  so  malarious  as  even  Sierra  Leone,  and  much 
less  so  than  the  Gambia,  and  has  been  much  less  frequently  attacked  "svith 
yellow  fever.  Dysentery  and  dyspepsia  are  common  diseases  among  the 
white  residents.  Among  the  black  troops  the  prevalence  of  phthisis, 
pneumonia,  and  bronchitis  is  marked,  though  less  so,  perhaps,  than  at  the 
other  two  stations. 

One  peculiarity  of  the  station  was  the  prevalence  of  dracunculus.  This 
was  much  less  common  at  SieiTa  Leone,  and  at  the  Gambia.  It  appears  to 
have  lessened  considerably  in  later  years,  but  there  is  no  definite  informa- 
tion now  to  be  obtained  from  the  A.  M.  D.  Reports. 

Hygiene  on  the  West  Coast. 

There  is  no  doubt  that  attention  to  hygienic  rules  will  do  much  to  les- 
sen the  sickness  and  mortahty  of  this  dreaded  climate.  In  fact,  here  as 
elsewhere,  men  have  been  contented  to  lay  their  own  misdeeds  on  the 
chmate.  Malaria  has,  of  course,  to  be  met  by  the  constant  use  of  quinine 
diu'ing  the  whole  period  of  service.  The  other  rules  are  summed  ujd  in 
the  following  quotation  from  Dr.  Eobeii;  Clarke's  paper,'  and  when  we 
reflect  that  this  extract  expresses  the  opinion  of  a  most  competent  judge 
on  the  etiect  of  cUmate,  we  must  allow  that,  not  only  for  the  West  Coast, 
but  for  the  West  Indies,  and  for  India,  Dr.  Clarke's  oj^inions  on  the  exag- 
geration of  the  effect  of  the  sun's  rays  and  exposiu-e  to  night  aii',  and  his 
statement  of  the  necessity  of  exercise,  are  full  of  instruction  : — 

"  Good  health  may  generally  be  enjoyed  by  judicious  attention  to  a  few 
simple  rules.  In  the  foremost  rank  should  be  put  temperance,  with  regular 
and  industrious  habits.  European  residents  on  the  Gold  Coast  are  too 
often  satisfied  with  wearing  apparel  suited  to  the  climate,  overlooking  the 
fact  that  exercise  in  the  open  air  is  just  as  necessary  to  preserve  health 
there  as  it  is  in  Europe.  Many  of  them  likewise  entertain  an  impression 
that  the  sun's  rays  are  hurtful,  whereas  in  nine  cases  of  ten  the  mischief  is 
done,  not  by  the  sun's  rays,  but  by  habits  of  personal  economy.  Feehng 
sadly  the  wearisome  sameness  of  hfe  on  this  part  of  the  coast,  recoui'se  is 
too  frequently  had  to  stimulants,  instead  of  resorting  to  inexhausting  em- 
ployments, the  only  safe  and  effectual  remedy  against  an  evil  fi-aught  with 
such  lamentable  consequences.  Eiu'opeans  also  bestow  too  little  attention 
on  ventilation,  far  more  harm  being  done  by  close  and  imj)ure  air  during 
the  night  than  is  ever  brought  about  by  exposure  to  the  night  air. 

"Much  of  the  suffering  is  occasioned  by  over-feeding." ^ 

'  Trans,  of  the  Epidem.  Soc,  vol.  i.,  pp.  123,  124. 

*  Considerable  interest  in  this  part  of  the  work  was  roused  by  the  occurrence  of  the 
Ashanti  war  of  1873,  for  an  admirable  account  of  which  see  the  Army  Medical  Reports, 
vol.  XV.,  where  Sir  Anthony  D.  Home  gives  a  full  medical  history  of  the  operations 
carried  on.  The  excellent  hygienic  arrangements  enabled  the  arduous  work  of  the  ex- 
pedition to  be  accomplished  with  a  comparatively  small  loss.  But  the  few  casualties  in 
action,  compared  with  the  deaths  by  disease,  show  by  contrast  how  much  more  deadly 
were  the  forces  of  nature  than  those  of  the  enemy  :  26  officers  died,  of  whom  only  five 
were  killed  or  died  of  wounds;  13  men  were  kiUed  (white  troops),  while  40  died  of 
disease  ;  of  the  West  Indian  troops  (black)  only  1  was  killed,  while  41  died  of  disease. 
For  analysis  of  soil  of  Gold  Coast,  see  Army  Med.  Reports,  vol.  xiv.,  p.  264  ;  and  for 
some  account  of  the  drinking-water,  see  paper  by  Dr.  J.  D.  Fleming,  in  vols.  xiv.  and 

XV. 


foreig:jt  service. 


325 


Sub- Section  HI. — Cape  op  Good  Hope. 

Garrison,  about  3,000  men. 

The  chief  stations  are  Cape  Town  (about  45,000  inhabitants),  Graham's 
Town,  King  William's  Town,  Port  Elizabeth,  Algoa  Bay,  and  several  small 
frontier  stations.  At  Natal  there  is  also  a  small  force.  The  chmate  is 
almost  everywhere  good  ;  the  temperature  is  neither  extreme  nor  very 
variable ;  the  movement  of  air  is  considerable. 

At  Cape  Town  the  mean  annual  temperature  is  67°,  with  a  mean  annual 
ransfe  of  about  38°. 


Years. 

Total  Deaths. 

Admissions. 

Mean  dally  Sick. 

Days  in 

Hospital  to 

each  Sick 

Man. 

1860-69  (10  years) 

10.87 
9.72 

973 
906 

50.24 
43.85 

18.83 

1870-77  (8  years) ' 

17.88 

The  statistics  of  later  years  are  complicated  by  the  casualities  of  war, 
included  killed  and  wounded  in  action  and  a  great  excess  of  fever.  Ehm- 
inating  these,  we  have  the  following  ratios  per  1,000  : — 


Total 

Admissions. 


1870-77    (8    years    of 

peace) !       906 

1878-80    (3    years    of 

war) 900 


Wounds  and 
Injuries. 


131 
103 


Admissions 

for  Disease 

only 


775 
797 


Continued 
Fever. 


39 
159 


Paroxysmal 
Fever. 


28 
38 


Admissions 

for  Disease, 

excluding 

Fevers. 


708 
600 


Deaths  per  1,000  of  Strength. 


Years. 

Total 

Wounds  and 

Injuries  and 

Killed  in 

Action. 

Disease 
only. 

Continued 
Fever. 

Paroxysmal 
Fever. 

Deaths  from 

Disease, 

excluding 

Fevers. 

1870-77  (8  years) 

1878-80  (3  years) 

9.72 
50.43 

1.94 

28.98 

7.78 
21.45 

0.50 
11.16 

0.24 
1.13 

7.04 
9.18 

As  regards  the  admissions,  which  in  total  number  appear  Httle  if  at  all 
influenced  by  war,  it  is  clear  that  the  diminution  which  might  have  been 
expected  in  consequence  of  sanitary  improvements  was  chiefly  arrested  by 
the  great  number  of  cases  of  continued  fever,  which  occurred  during  the 
period  of  hostilities.  In  times  of  peace  there  is  but  little  fever,  and  a  small 
and  decreasing  mortality.  Thus,  in  1856-66,  the  death-rate  was  1.25  per 
1,000,  in  1870-77  only  0.50,— while  in  1878-80  it  was  no  less  than  11.16  ; 
in  all  these  cases  the  deaths  are  almost  invariably  enteric.  Parox^'smal 
fevers,  arising  in  the  station  itself,  are  very  uncommon,  the  worst  year  in 
the  period  1870-77  being  1874,  when  these  diseases  appeared  among  troops 


^  Including  the  detachment  at  St.  Helena. 


326  PRACTICAL    HYGIENE. 

from  the  Mamitius,  where  it  had  undoubtedly  been  contracted.  During  the 
period  of  hostilities  there  -was  an  increase  both  in  admissions  and  deaths 
from  that  cause.  Although  the  net  admissions  (after  eliminating  wounds 
and  injuries  and  fevers)  are  less  in  the  later  period  (1878-80)  than  in  the 
earher  (1870-77),  as  shown  in  the  preceding  table,  yet  the  death-rate  is 
higher.  This  is  almost  entu-ely  due  to  diseases  of  the  digestive  system, 
mostly  dysentery  and  diarrhoea.  These  were  more  common  formerly 
than  they  are  now  in  ordinai-y  years  ;  in  many  cases,  especially  in  the 
small  fi'ontier  stations,  they  were  clearly  owing  to  bad  water. 

Ophthalmia  has  prevailed  rather  largely,  especiaDy  in  some  years  ; 
there  is  a  good  deal  of  dust  in  many  parts  of  the  colony,  and  it  has  been 
attributed  to  this  ;  the  disease  is  probably  the  specific  ophthalmia  (gray 
granulations),  and  is  propagated  by  contagion.  "\\Tiether  it  had  its  origin 
in  any  catarrhal  condition  produced  by  the  wind  and  dust,  and  then  be- 
came contagious,  is  one  of  those  moot  points  which  cannot  yet  be  an- 
swered. 

The  Cape  has  always  been  noted  for  the  numerous  cases  of  muscular 
rheumatism.  Articular  rheumatism  is  not  particularly  common.  There  is 
also  much  cardiac  disease.  The  prevalence  of  this  afiection  has  been  attrib- 
uted to  the  exposiu'e  and  rapid  marches  in  hill  districts  during  the  Kaflfir 
wars.     In  1863  there  was,  however,  less  rheumatism  than  usual. 

Taking  the  yeai's  1859-66  as  expressing  tolerably  fau'ly  the  eflfect,  per  se, 
of  the  station,  we  find  that  the  whole  colony  gave  18.3  admissions  and  1.90 
death  per  1,000  of  strenglh  from  diseases  of  the  circulator}'  organs.  In 
1869-77  the  admissions  were  13.5  and  the  deaths  1.47  ;  in  1878-80  they 
were  20.3  and  1.25  respectively. 

Dr.  Lawson '  has  contributed  a  valuable  paper  on  this  subject.  He 
finds  the  death-rate  from  diseases  of  the  organs  of  circulation  (mean  of 
seven  yeai's,  1859-65)  at  1.91  per  1,000  of  strength.  This  is  higher  than 
at  any  other  foreign  station,  as  's^•ill  be  seen  from  the  table  copied  by  Dr. 
Lawson. 

Mortality  from  Diseases  of  the  Circulatory  Organs. 

Ratio  per  1,000  Ratio  per  1.0001                        Ratio  per  1,000 

of  Strength.  of  Strength.                                of  Strength. 

Cape  of  Good  Hope,  1.91    Bombay 0.80    Malta 0.53 

New  Zealand 1.18    Bengal 0.86     Gibraltar 0.70 

Austraha 1.72     South  China  ....    1.16  '  Bei-muda 1.25 

Mauritius 0.53    West  Indies  ....    1  02    Nova  Scotia 0.84 

St.  Helena 0.31    Jamaica 0.85    Canada 1.19 

Ceylon 1.11    Ionia  0.84    Home 0.93 

Madras 1.12  , 

This  table  shows  an  extreme  diversity,  hardly  to  be  reconciled  with 
differences  of  climate  or  duties.  In  the  years  1869-74  the  death-rate  was 
1.68,  and  was  exceeded  by  that  of  the  Mauritius,  2.29,  and  that  of  Madras, 
1.99.  In  1875  the  rate  at  the  Cape  was  only  1.45,  while  Ceylon  showed 
3.87,  BeiTQuda  2  63,  and  Madras  2.05  ;  Mauritius  returning  no  death.  In 
the  eight  rears  (1870-77)  the  rate  at  the  Cape  was  1.62  ;  and  in  the  years 
1878-80  it  was  1.25. 

Scui-vy  foi-merh"  prevailed  much  at  the  Cape,  particularly  in  the  Kaffir 
wars,  and  may  have  had  something  to  do  with  the  prevalence  of  dysentery. 

'  Army  Medical  Report,  vol.  v.,  p.  3B8. 


FOREIGN"    SERVICE.  327 

Venereal  diseases  have  of  late  years  been  veiy  common.  The  average 
admissions  from  "enthetic"  diseases  in  1859-66  were  248.5,  and  in  1867 
they  were  438.3  per  1,000  of  strength  in  the  whole  colony.  In  Cape  Town 
alone,  wjiere  facilities  for  promiscuous  intercourse  are  greater,  they  were 
even  more  numerous. '  Much  diminution  has  taken  place  in  recent  years. 
In  the  ten  years,  1871-80,  the  ratio  for  syphihs,  both  primary  and  secon- 
dary, was  only  102,  and  for  gonorrhoea  80. 

The  Cape  has  always  been  considered  a  kind  of  sanitarium  for  India. 
Its  coolness  and  the  rapid  movement  of  the  air,  the  brightness  and  clear- 
ness of  the  atmosphere,  and  the  freedom  from  malaria,  prc-bably  cause  its 
salubrity.  It  has  been  supposed  that  it  might  be  well  to  send  troops  to 
the  Ctfpe  for  two  or  .three  years  before  sending  them  on  to  India.  This 
plan  has  never  been  periectly  tried  ;  but  in  the  case  of  regiments  sent  on 
hui'riedly  to  India  on  emergency,  it  has  been  said  that  the  men  did  not 
bear  the  Indian  chmate  well.  Probably  they  were  placed  under  unfavor- 
able conditions,  and  the  question  is  still  uncertain. 

As  a  convalescent  place  for  troops  who  have  been  quartered  in  a  mala- 
rious district  it  is  excellent." 


SECTION    VI. 
MAURITIUS. 

Grarrison,  about  800  to  500  men.     Civil  population  (in  1879),  359,988. 

Mauritius  in  the  eastern  has  been  often  compared  with  Jamaica  in  the 
western  seas.  The  geographical'  position  as  respects  the  equator  is  not 
veiy  dissimilar ;  the  mean  annual  temperature  (80°  Fahr.)  is  almost  the 
same  ;  the  fluctuations  and  undulations  are  more  considerable,  but  still  are 
not  excessive  ;  the  humidity  of  air  is  nearly  the  same,  or  perhaps  a  Httle 
less  ;  the  rainfall  (66  to  76  inches)  is  almost  the  same  ;  and  the  physical 
formation  is  really  not  very  dissimilar.  Yet,  with  all  these  points  of  simi- 
larity in  climatic  conditions,  the  diseases  are  very  different. 

Malarious  fever  was  formerly  not  nearly  so  frequent  as  in  Jamaica,  and 
true  yellow  fevei-  is  quite  unknown  ;  Maui'itius,  therefore,  has  never  shown 
those  epochs  of  great  mortality  which  the  West  Indies  have  had.  Hepatic 
diseases,  on  the  other  hand,  which  are  so  'uncommon  in  the  West  Indies, 
are  very  common  in  the  Mauritius.  For  example,  in  1859  there  were  47 
cases  of  acute  and  chronic  hepatitis  in  1,254  men,  while  in  Jamaica  there 
was  one  case  out  of  807  men.  In  1860  there  were  31  admissions  from 
acute  hepatitis  out  of  1,886  men  ;  in  Jamaica  there  was  not  a  single  case. 
In  1862  there  were  12  cases  of  acute,  11  of  chronic  hepatitis,  and  72  cases 
of  hepatic  congestion,  out  of  2,049  men  ;  in  Jamaica,  in  the  same  year, 
there  was  only  1  case  of  acute  hepatitis  out  of  702  men.  This  has  al- 
ways been  marked ;  is  it  owing  to  an  eiTor  in  diagnosis  or  to  differences  in 
diet  ?  It  can  scarcely  be  attributed  to  any  difference  in  chmate.  In  1868 
the  difference  was  less  marked,  but  was  stOl  evident.  In  later  years,  how- 
ever, there  has  been  considerable  diminution  :  in  1872  there  were  only  4 
cases  of  hepatitis,  and  in  1873  only  2.  Since  that  year  no  detailed  statis- 
tics have  been  published,  but  it  is  mentioned  incidentally  that  there  were 
3  cases  in  1880,  out  of  a  strength  of  358. 

^  Army  Med.  Depart.  Report,  vol.  viii  ,  p.  548. 

"  See  effect  on  th.e  59tli  Regiment  iu  the  Army  Medical  Report  for  1859,  p.  99. 


328  PRACTICAL    HYGIENE. 

In  1866-67  a  very  severe  epidemic  fever  prevailed  in  the  Mauritius, 
which  offers  many  points  of  interest.  As  ah'eady  noted,  the  Mauritius  has 
till  lately  been  considered  to  be  comparatively  free  from  malaria.  All  the 
older  writers  state  this,  and  it  is  apparent  from  all  the  statistical  retiu'ns. 
Deputy  Inspector-General  Dr.  Francis  Reid,  in  a  report'  in  1867,  mentions 
that  he  had  served  ten  years  in  the  Mauritius,  and  had  looked  over  the 
records  of  the  troops  for  twenty-four  j'ears.  He  found  some  records  of 
intermittents,  but  he  traced  all  these  to  foreign  sources,  viz.,  troops  com- 
ing from  India,  China,  or  Ceylon,  and  presenting  cases  of  relapses. 

For  the  first  time,  in  the  latter  months  of  1866  and  the  commencement 
of  1867,  malarious  fevers  of  undoubted  local  growth  aj)j)eared  on  the 
western  side  of  the  island. 

The  causes  of  this  development  were  traced  by  Dr.  Eeid,  and  also  by 
Sui-geon -Major  Small  and  Assistant  Surgeon  W.  H.  T.  Power,  in  some 
very  careful  RejDorts.''  During  some  years  a  large  amount  of  forest  land 
had  been  cleared,  and  there  had  been  much  upturning  of  the  soil ;  coin- 
cidently  the  rainfall  lessened,  and  the  rivers  became  far  less  in  volume. 
At  the  same  time,  there  was  a  large  increase  of  population ;  a  great  defile- 
ment of  the  ground  in  the  neighborhood  of  villages  and  towns,  so  that  in 
various  parts  of  the  island  there  was  a  constant  drainage  down  of  filth  of 
all  kinds  (vegetable  and  animal)  into  a  loose  soil  of  slight  dej^th,  resting 
on  impermeable  rock,  which  forms  a  great  deal  of  the  western  seaboard. 
In  1866-67  there  occurred  an  unusually  hot  season,  and  again  a  deficient 
rainfall.  This  seems  to  have  brought  into  active  operation  the  conditions 
which  had  been  gradually  increasing  in  intensity  for  some  years.  The 
development  of  the  malaria  was  not  so  much  on  the  regular  marshy  ground 
as  on  the  loose  contaminated  soil  ah-eady  noticed. 

That  the  fever  which  in  1866-67  became  so  general  was  of  malarious 
type,  is  proved  by  a  large  amount  of  evidence  on  the  spot  from  both 
mihtary  and  civil  practitioners,  and  from  the  fact  that  many  soldiers  re- 
turned to  England  and  had  at  home  relapses  of  decided  paroxysmal  fevers. 
Dr.  Maclean  also  stated  that  he  had  seldom  seen  spleens  so  enlarged  as 
among  the  invalids  from  this  fever  who  arrived  at  Netley. 

But  in  some  respects  this  fever  presented  characters  difi'erent  from 
common  paroxysmal  fevers.  There  was  no  very  great  mortality  among 
the  troops,  but  it  was  excessively  fatal  among  the  inhabitants  of  Poi-t 
Louis  and  many  other  towns  and  villages.  It  also  lasted  for  many  months, 
and  was  attended  in  many  cases  with  symptoms  not  common  in  ordinary 
paroxysmal  fevers,  viz. ,  with  yellowness  of  the  skin  and  with  decided  re- 
lapses, closely  resembHng  in  these  respects  the  common  relapsing  fever. 
Mixed  up  with  it  also  was  decided  t;)i3hoid  fever.  The  question  whether 
the  great  bulk  of  the  epidemic  was  a  jDurely  paroxysmal  or  malarious  fever, 
with  an  indej)endent  subordinate  outbreak  of  tv'phoid  fever,  or  whether 
it  was  a  composite  affection  like  the  "  typho-malarial  fever"  of  the  Ameri- 
can war,  ^  or  was  mixed  up  with  the  contagious  "Indian  jail  fever  "im- 
ported by  CooUes,  is  not  a  matter  very  easy  to  decide.  The  officers  best 
qualified  to  judge  (Drs.  Reid,  Small,  and    Power)  looked  upon  it    as  a 


'  Letter  to  the  Director-General,  February,  1867. 

^  Animal  Report  on  the  District  Prisons  Hospitals  (in  1867,  Mauritius,  1868).  On 
the  Malarial  Epidemic  Fever  of  the  Mauritius,  Army  Med.  Depart.  Report,  vol.  viii., 
p.  442. 

^  As  descrihed  by  Woodward,  Camp  Diseases  of  the  United  States  Armies,  by  J.  J. 
Woodward,  M.D.,  Philadelphia,  1863,  p.  77. 


FOEEIGN    SERVICE. 


329 


purely  malarious  disease,  and  expressed  themselves  very  strongly  on  this 
point. ' 

This  much  seems  certain,  that  in  various  parts  of  the  island  the  loose, 
porous,  shallow  soil  had  been  gradually  becoming  more  and  more  impure 
with  vegetable  matters,  and  in  some  cases  with  animal  excreta  ;  that  there 
had  been  a  gradual  diminution  of  the  subsoil  water,  and  that  this  reached 
its  maximum  in  1866,  when  the  rains  failed,  and  the  hot  season  was  pro- 
longed. There  coincided,  then,  an  unusual  impurity  of  soil,  lowered  sub- 
soil water,  consequent  increased  access  of  air,  and  heightened  temperature. 
Under  these  conditions,  a  usually  non-malarious  soil  gave  rise  to  an  epi- 
demic fever,  which  was  characterized  (chiefly,  at  any  rate)  by  the  symptoms 
referred  to  the  action-  of  marsh  miasmata,  and  was  cm-able  by  quinine. 
The  admissions  for  paroxysmal  fevers  alone  were,  in  1875,  585.5  per  1,000, 
and  in  1869-75  (live  years)  722.3  per  1,000  as  a  mean.  In  later  years  the 
type  has  been  distinctly  paroxysmal,  the  large  majority  of  cases  being  re- 
turned as  ague.  The  mean  admissions  per  1,000  for  six  years,  1875-80, 
were  970,  with  a  maximum  of  1,557  in  1879. 


Per  1,000  of  Strength. 


Loss  of  Strength. 

Loss  of  Service. 

Years. 

Deaths  (all 
Cau.ses). 

Deaths  from 
Disease. 

Invaliding. 

Admissions. 

Mean  Daily 
Sick. 

,    Days  in 
Hospital  to 
each  Sick 
Man. 

1817-36  

30.5 

20.17 

18.97 

17.89 

5.67 

2."83 

44.15 
48.03 
79.32 

1,249.0 
1,056.5 
1,419.4 
2,181.7 
2,203.9 

68.0 

53.58 
70.36 
98.53 

20.0 

1861-70  (10  years)  . . 
1865-74  (10  years)  . . 
1875-80  (6  years)  . . 
1880 

13.76 
11.65 
16.36 

In  the  Mauritius,  as  in  Jamaica,  a  "  continued  fever "  is  not  uncom- 
mon ;  this  is  now  being  returned  in  part  as  typhoid.^  It  has  occasionally 
been  imported.  There  are  fevers  vaguely  named  "bilious  remittent," 
"Bombay  fever,"  "  Coolie  fever,"  etc.  The  last  term  denotes  the  communi- 
cable fever  so  common  in  the  jaUs  in  the  Bengal  Px-esidency.  It  prevailed 
in  the  jails  in  the  Mauritius  in  1863  and^  1864,  among  the  Hindoos.  The 
"Bombay  fever"  is  probably  typhoid.  Dysentery  and  diarrhoea  have 
largely  prevailed,  but  are  now  becoming  less  frequent.  In  this  respect 
Jamaica  now  contrasts  very  favorably  with  the  Mauritius ;  thus,  in  1860, 
there  were  altogether  213  admissions  per  1,000  of  dysentery  and  diar- 
rhoea; and  6.8  deaths  per  1,000  ;  in  Jamaica,  in  the  same  year,  there  was 
not  a  single  admission  from  dysentery,  and  only  19  from  diarrhoea,  among 
594  men,  and  no  death.     Cholera  has  prevailed  five  times — first  in  1819  ; 


'  The  two  latter  gentlemen  say,  op.  cit. ,  p.  453 — "It  was  entirely  of  malarious 
origin,  and  in  every  form,  we  might  say.  perfectly  curable  by  administration  of  qui- 
nine in  large  doses."  These  observers  entirely  deny  that  it  had  any  contagious  prop- 
erties. 

Dr.  Reid  had  no  doubt  of  the  frequent  occurrence  of  typhoid  for  many  years. 
He  mentioned  an  interesting  fact,  viz.,  that  patients  with  true  enteric  fever  were  also 
aSected  with  the  malarious  epidemic  fever  ;  this  latter  was,  however,  easily  curable 
by  quinine,  but  the  typhoid  fever,  which  was  also  present,  was  quite  unaffected. 


330  PRACTICAL    HYGIENE. 

not  afterward  till  1854  ;  then  again  in  1856,  1859,  and  1861.  (It  appears 
to  have  been  imported  in  all  these  cases.)  Formerly  there  was  a  large 
mortality  from  lung  diseases  ;  now,  as  in  Jamaica,  this  entry  is  much  less, 
not  more  than  half  that  of  former  davs.  The  deaths  from  phthisis  per 
1,000  of  strength  were,  in  1860,  0.521  fin  1861,  1.03  ;  in  1862,  1.94  (but  in 
this  year  11  men  were  invalided  for  phthisis) ;  and  in  1863,  2  ;  in  1875  no 
death  was  recorded.  Venereal  (enthetic)  diseases  formerly  gave  about 
110  to  130  admissions  per  1,000  of  strength,  but  they  are  now  greatly 
diminished.  Ophthalmia  prevails  moderately ;  to  nothing  like  the  same 
extent  as  at  the  Cape. 

In  1873  (the  last  year  of  detailed  statistics)  there  were  8  admissions  for 
diarrhoea  and  none  for  dysentery  in  Jamaica  ;  in  Mauritius  there  were  29 
for  diarrhcea  and  16  for  dysentery  and  2  deaths,  out  of  a  strength  of  441. 


SECTION  vn. 

CEYLON.  1 

Garrison,  800  to  1,000  white  troops  ;  and  about  100  gun-lascars  (black). 
Population,  2,758,166  (in  1881),  including  about  5,000  Europeans.  The 
stations  for  the  white  troops  are  chiefly  GaUe,  Colombo,  Kandy,  and  Trin- 
comalee,  with  a  convalescent  station  at  Newera  ElHa  (6,200  feet  above  sea- 
level).    The  black  troops  are  more  scattered,  at  Badulla,  Pultan,  Jaffna,  etc. 

Geology. — A  considerable  part  of  the  island  is  composed  of  granite, 
gneiss,  and  hornblende  gTanite  rocks ;  these  have  become  greatly  weathered 
and  decomposed,  and  form  masses  of  a  conglomex-ate  called  "  cabook," 
■which  is  clayey  like  the  laterite  of  India,  and  is  used  for  budding.  The 
soil  is  derived  from  the  debris  of  the  granite  ;  is  said  to  absorb  and  retain 
water  eagerly.     In  some  parts,  as  at  Kandy,  there  is  ciTstalline  limestone. 

Climate. — This  differs,  of  course,  exceedingly  at  different  elevations. 
At  Colombo,  sea-level,  the  climate  is  warm,  equable,  and  limited.  Mean 
annual  temperature  about  81°.  Mean  temperature  —  April,  82.70°; 
Januar}^  78.19°  ;  amplitude  of  the  yearly  fluctuation  =  4.51°.  Api-il  and 
May  are  the  hottest  months  ;  January  and  December  the  coldest.  Amount 
of  rain  about  74  inches  ;  the  greatest  amount  falls  in  May  w^th  the  S.W. 
monsoon  (about  13  to  14  inches) ;  and  again  in  October  and  November 
with  the  N.E.  monsoon  (about  10  to  12  inches)  in  each  month.  Eain, 
however,  falls  in  every  month,  the, smallest  amount  being  in  February  and 
March.  The  heaviest  yearly  fall  ever  noted  was  120  inches.  The  relative 
humidity  is  about  80  per  cent,  of  saturation.  The  S.W.  monsoon  blows 
from  May  to  Sejotember,  and  the  N.E.  monsoon  during  the  remainder  of 
the  year,  being  unsteady  and  rather  diverted  from  its  course  (long-shore 
■wind)  in  February  and  March.  The  mean  horizontal  movement  during 
the  year  1872  was  125  miles  ;  in  1870  it  was  139  miles,  or  rather  under  6 
miles  an  hour. 

At  Kandy  (72  miles  from  Colombo,  1,676  feet  above  sea-level),  the 
mean  temperature  is  less,  3°  to  5°  ;  the  air  is  still  absolutely  humid, 
though  relatively  rather  dry.  At  9.30  a.m.  the  mean  annual  dew-point  is 
70.4°,  and  at  3.30  p.m.  it  is  71.54°.  This  corresponds  to  8.11  and  8.42 
grains  in  n  cubit  foot  of  air ;  as  the  mean  temperature  at  these  times  is 
76.37  and  79.27,  the  mean  annual  relative  humidity  of  the  air  at  9.30  a.m. 


'  For  a  full  account,  see  Sir  E.  Tennant's  Ceylon. 


FOREIGN    SERVICE.  331 

and  3.30  p.m.  is  71  and  63  per  cent,  of  saturation.  The  heat  is  oppressive, 
as  Kandy  Ues  in  a  hollow,  as  in  the  bottom  of  a  cup. 

At  Newera  EUia  (48  miles  from  Kandy,  6,21U  feet  high)  is  a  large 
table-land  where,  since  1828,  some  Europeans  have  been  stationed  ;  the 
chmate  is  European,  and  at  times  wintry  ;  the  thermometer  has  been  as 
low  as  29°,  and  white  frosts  may  occur  in  the  early  morning  in  the  coldest 
months.     The  mean  annual  temperature  is  about  59°.' 

In  the  dry  season  (January  to  May)  the  thermometer's  daily  range  is 
excessive  ;  the  thermometer  may  stand  at  29°  at  daybreak,  and  at  8  a.m. 
reach  62°  ;  at  mid-day  it  will  mark  70°  to  74°,  and  then  fall  to  50°  at  dark. 
In  one  day  the  range  has  been  from  27°  to  74°  =  47°.  The  air  is  very  dry, 
the  difference  between^  the  dry  and  wet  bulbs  being  sometimes  15°.  As- 
suming the  dry  bulb  to  mark  70°,  this  will  give  a  relative  humidity  of  only 
38  per  cent,  of  saturation  ;  the  barometer  stands  at  about  24.25  inches. 
Although  the  diurnal  range  of  temperature  is  thus  so  great,  it  is  equable 
from  day  to  day. 

Such  a  climate,  with  its  bright  sun  and  rarefied  air,  an  almost  constant 
breeze,  and  an  immense  evaporating  force,  seems  to  give  us,  at  'this  period, 
the  very  beau  ideal  of  a  mountain  climate. 

In  the  wet  season  (May  or  June  to  November)  all  these  conditions  are 
reversed.  The  mean  thermometer  of  twenty-four  hours  is  about  59°  ;  and 
the  range  is  only  from  56°  at  daybreak  to  62°  at  mid-day  ;  during  the 
height  of  the  monsoon,  thei*e  are  about  30  inches  of  rainfall,  and  some- 
times as  much  as  70  ;  the  air  is  often  almost  saturated.  The  mean  of  three 
years  (1870-72)  gives  no  less  than  94^  inches.^ 

Two  more  striking  climatic  differences  than  between  January  and  June 
can  hardly  be  conceived,  yet  it  is  said  Newera  EUia  is  equally  healthy  in 
the  wet  as  in  the  dry  season  ;  the  human  frame  seems  to  accommodate 
itself  to  these  great  vicissitudes  without  difficulty.  The  most  unhealthy 
times  are  at  the  changes  of  the  monsoons. 

Although  there  is  some  moist  and  even  marshy  ground  near  the  sta- 
tion, ague  is  not  common,  though  it  is  seen  ;  the  temperature  is  too  low 
in  the  dry  season,  and  the  fall  of  rain  too  gl'eat  in  the  wet.  Typhoid  fever 
is  seen,  and  may  be  combined  with  periodic  fever.  ^  It  is  said  that  dys- 
pepsia, hepatic  affections,  and  neiwous  affections  are  much  benefited  ; 
phthisis  is  so  to  some  extent,  but,  it  would  appear,  scarcely  so  much  as 
European  experience  would  have  led  us  to  expect  ;  rheumatism  does  not 
do  well,  nor,  it  is  said,  chronic  dysentery  ;  but  it  would  be  very  desirable 
to  test  this  point,  as  well  as  that  of  the  influence  on  phthisis,  carefully. 
The  so-called  "hill  diarrhoea"  of  India  prevailed  in  1865,  though  before 
this  it  is  unknown.  Dysentery  has  sometimes  prevailed,  and  is  caused  in 
some  cases  by  bad  water  (Massy), 

The  son  of  Newera  EUia  is  chiefly  decomposed  gneiss  ;  it  is  described 
by  Dr.  Massy  as  being  as  hygroscopic  as  a  sponge  ;  the  contents  of  cess- 
pools easily  traverse  it,  and  the  removal  of  excreta  demands  great  care. 

The  neighboring  Horton  Hills  are  said  to  be  even  better  than  Newera 
EUia  itself.  Probably,  in  the  whole  of  Hindustan,  a  better  sanitary  station 
does  not  exist.  It  is  inferior,  if  it  be  inferior,  only  to  the  Neilgherries, 
and  one  or  two  of  the  best  Himalayan  stations. 

'  Many  of  these  facts  are  from  an  excellent  Report  by  Assistant-Surgeon  R.  A. 
Allan,  as  well  as  from  Sir  E.  Tennant's  book. 

'^  Since  1873  all  meteorological  information  about  Ceylon  has  been  dropped  out  of  the 
Army  Medical  Reports. 

^  Massy,  in  Army  Med.  Reports,  vol.  viii. ,  p.  499. 


332 


PKACTICAL    HYGIENE. 


Sickness  and  Mortalitif  of  Europeans  per  1,000  of  Strength. 


Years. 

Deaths. 

Admissions. 

Mean  Daily 
Sick. 

Duration  of 

Sickness. 

1860-69  (10  years) 

23.75 
17.72 
16.45 

1,424.9 

1,112.6 

976.4 

66.52 
52.86 

16.6  days. 

1869-74  (6  years) 

1875-80  (6  years) 

20.00    " 

Influence  of  Age  on  Mortality. 


1864-73 


Under  20|    20  and 
years,      under  35. 


5.79 


15.89 


25  and    |    30  and 
under  30.  under  35. 


28.81 


26.50 


35  and 
under  40. 


50.25 


40  and 
over. 


173.91 


Among  the  black  troops,  now  reduced  to  about  100  altogether,  in 
Ceylon  (1860-69)  the  admissions  averaged  1,011,  and  the  deaths  15.17,  per 
1,000  of  strength.  In  1870  the  total  mortality  was  9.44  (and  in  1880, 
11.63)  per  1,000.  The  chief  causes  of  admissions  were  paroxysmal  fevers, 
and  of  deaths,  cholera,  dysentery,  and  paroxysmal  fevers.  "  Continued 
fever  "  also  figures  among  the  returns,  but  was  less  common  in  the  later 
years.  The  average  number  constantly  sick  was  about  32,  and  the  dura- 
tion of  the  cases  10  or  11  days. 

In  Ceylon,  therefore,  the  black  troops  were  healthier  than  the  white, 
contrasting  in  this  remarkably  with  the  West  Indies. 

In  conclusion,  it  may  be  said  that  much  sanitary  work  still  remains  to 
be  done  in  Ceylon  before  the  state  of  the  white  troops  can  be  considered 
satisfactory.  * 

SECTION  VIII. 


INDIA. 

About  50,000  Europeans  are  now  (1880)  quartered  in  India,  and  there 
is  in  addition  a  large  native  army.  In  this  place  the  Europeans  will  be 
chiefly  referred  to,  as  it  would  require  a  large  work  to  consider  properly 
the  health  of  the  native  troops.  ^ 

The  50,000  Europeans  are  thus  distributed  : — About  31,000  are  sei-ving 
in  the  Bengal  Presidency,  which  includes  Bengal  proper,  the  Northwest 
Provinces,  the  Punjab,  arid  the  Trans-Indus  stations.     About  10,000  are 


'  In  1876  the  death-rate  was  only  7.43,  but  this  was  exceptional ;  in  1880  it  was  25, 
the  great  excess  being  due  to  dysentery  in  the  Colombo  garrison. 

■^  The  general  principles  of  hygiene  are  of  course  to  be  applied  in  the  case  of  the 
natives  of  Hindustan,  and  so  far  there  is  nothing  unusual.  In  the  chapter  on  Food, 
some  of  the  articles  of  diet  have  been  referred  to ;  the  question  of  water  and  air  is  the 
same  for  all  nations,  and  other  hygienic  rules  of  clothing  or  exercise  can  be  easily  ap- 
plied to  them.  But  their  health  is  much  influenced  by  their  customs,  which  are  in 
many  races  peculiar.  The  only  proper  way  of  treating  such  a  subject  would  be  by  a 
work  on  the  hygiene  of  India  generally,  including  the  native  army  as  a  branch  of  the 
community. 


FOREIGN    SERVICE.  333 

serving  in  the  Madras  Presidency,  which  also  garrisons  some  parts  of  the 
coast  of  Burmah,  and  sends  detachments  of  native  troops  to  the  Straits  of 
Malacca.  About  9,000  are  serving  in  the  Bombay  Presidency/  The  troops 
consist  of  all  arms. 

These  men  are  serving  in  a  country  which  includes  nearly  28°  of  lat. 
and  33°  of  long.,  and  in  which  the  British  possessions  amount  to  1,470,207 
square  miles,  and  the  population  to  253,000,000.  Stretching  from  within 
8""  of  the  equator  to  13 ""  beyond  the  line  of  the  tropics,  and  embracing 
countries  of  every  elevation,  the  climate  of  Hindustan  presents  almost  every 
variety  ;  and  the  troops  serving  in  it,  and  moving  from  place  to  place,  are 
in  turn  exposed  to  remarkable  differences  of  temperature,  degrees  of  at- 
mospheric humidity,  pressure  of  air,  and  kind  and  force  of  wind,  etc. 

Watered  by  great  rivers  which  have  brought  down  from  the  high  lands 
vast  deposits  in  the  course  of  ages,  a  considerable  portion  of  the  surface  of 
the  extensive  plains  is  formed  by  alluvial  deposit,  which,  under  the  heat  of 
the  sun,  renders  vast  districts  more  or  less  malarious  ;  and  there  are  cer- 
tain parts  of  the  country  where  the  development  of  malaria  is  probably  as 
intense  as  in  any  part  of  the  world.  A  population,  in  some  places  thickly 
clustered,  in  others  greatly  scattered,  formed  of  many  races  and  speaking 
many  tongues,  and  with  remarkably  diverse  customs,  inhabits  the  country, 
and  indirectly  affects  very  greatly  the  health  of  the  Europeans. 

Cantoned  over  this  country,  the  soldiers  are  also  subjected  to  the 
special  influences  of  their  barrack  life,  and  to  the  peculiar  habits  which 
tropical  service  produces. 

We  can  divide  the  causes  which  act  on  the  European  force  into  four 
subsections — 

1.  The  country  and  climate. 

2.  The  diseases  of  the  natives. 

3.  The  special  hygienic  conditions  under  which  the  soldier  is  placed, 

4.  The  service  and  the  individual  habits  of  the  soldier. 


Sub-Section  I. — The  Country  and  Climate. 

The  geological  structure  and  the  meteorological  conditions  are,  of 
course,  extremely  various,  and  it  is  impossible  to  do  more  than  glance  at 
a  few  of  the  chief  points. 

1.  Soil' — There  is  almost  every  variety  of  geological  structure.  In  the 
northwest,  the  vast  chain  of  the  Himalayas  is  composed  of  high  peaks  of 
granite  and  gneiss  ;  while  lower  down  is  gneiss  and  slate,  and  then  sand- 
stone and  diluvial  detritus.  Stretching  from  Cape  Comorin  almost  to 
Guzerat,  come  the  great  Western  Ghauts,  formed  chiefly  of  granite,  with 
volcanic  rocks  around  ;  and  then,  stretching  from  these,  come  the  Vindhya 
and  Satpoora  Mountains,  which  are  chiefly  volcanic,  and  enclose  the  two 
great  basins  of  the  Taptee  and  Nerbudda  rivers.  Joining  on  to  the  Vind- 
hya, come  the  Aravalli  Hills,  stretching  toward  Delhi,  and  having  at  their 
highest  point  Mount  Aboo,  which  is  probably  destined  to  become  the  great 
health  resort  of  that  part  of  India, 

'  For  brevity,  it  is  customary  to  speak  of  serving  in  Bengal,  Bombay,  or  Madras, 
when  speaking  of  the  Presidency,  so  that  these  names  are  sometimes  applied  to  the 
cities,  sometimes  to  the  presidencies  ;  but  a  little  care  will  always  distinguish  which  is 
meant. 

'^  See  Carter's  Summary  of  the  Geology  of  India,  in  the  Journal  of  the  Bombay  Asi 
atic  Society's  Transactions,  1853. 


334  PRACTICAL    HYGIENE. 

On  the  east  side,  the  lower  chain  of  the  Eastern  Ghauts  slopes  into  the 
table-land  of  the  Deccan  ;  and  at  the  junction  of  the  Eastern  and  Western 
Ghauts  come  the  Neilgherry  Hills,  fi'om  8,000  to  9,000  feet  above  sea-level, 
and  formed  of  granite,  syenite,  hornblende,  and  gneiss.  But  to  enumer- 
ate all  the  Indian  mountains  would  be  impossible. 

Speaking  in  very  general  terms,  the  soil  of  many  of  the  plains  may  be 
classed  under  four  great  headings. 

(a)  Alluvial  soil,  brought  down  by  the  great  rivers  Ganges,  Indus, 
Brahmapootra,  rivers  of  Nerbudda,  Guzerat,  etc.  It  is  supposed  that 
about  one-third  of  all  Hindustan  is  composed  of  this  alluvium,  which  is 
chiefly  siliceous,  with  some  alumina  and  iron.  At  points  it  is  very  stift' 
with  clay — as  in  some  parts  of  the  Punjab,  in  Scinde,  and  in  some  portion 
of  Lower  Bengal.  Underneath  the  alluvial  soil  lies,  in  many  places,  the 
so-called  clayey  laterite.  Many  of  the  stations  in  Bengal  are  j)laced  on 
alluvial  soil. 

This  alluvial  soil,  especially  when,  not  far  from  the  surface,  clayey  lat- 
erite is  found,  is  often  malarious  ;  sometimes  it  is  moist  only  a  foot  or  two 
from  the  surface  ;  and,  if  not  covered  by  vegetation,  is  extremely  hot. 

As  a  rule,  troops  should  not  be  located  on  it.  Whatever  be  done  to  the 
spot  itself — and  much  good  may  be  done  by  efficient  draining — the  influ- 
ences of  the  surrounding  country  cannot  be  obviated.  Europeans  can 
never  be  entirely  free  from  the  influences  of  malaria.  There  is  but  one 
perfect  remedy ;  to  lessen  the  force  in  the  plains  to  the  smallest  number 
consistent  with  military  conditions,  and  to  place  the  rest  of  the  men  on 
the  higher  lands. 

Somewhat  difiei'ent  from  the  alluvial  is  the  soil  of  certain  districts,  such 
as  the  vast  Runn  of  Cutch,  which  have  been  the  beds  of  inland  seas,  and 
now  form  immense  level  marshy  tracks,  which  are  extremely  malarious. 
The  Runn  of  Cutch  contains  7,000  square  miles  of  such  country. 

(b)  The  so-called  "regur,"  or  "cotton  soil,"  formed  by  disintegrated 
basalt  and  trap,  stretches  down  from  Bundelcund  nearly  to  the  south  of 
the  peninsula,  and  spreads  over  the  table-land  of  Mysore,  and  is  common 
in  the  Deccan.  It  is  often,  but  not  always,  dark  in  color.  It  contains 
little  vegetable  organic  matter  (1.5  to  2.5  per  cent.),  and  is  chiefly  made 
up  of  sand  (70  to  80  per  cent.),  carbonate  of  lime  (10  to  20  per  cent),  and 
a  little  alumina.  It  is  very  absorbent  of  water,  and  is  generally  thought 
unhealthy.  It  is  not  so  malarious  as  the  alluvium,  but  attacks  of  cholera 
have  been  supposed  to  be  particularly  frequent  over  this  soil. 

(c)  Red  soil  from  disintegration  of  granite.  This  is  sometimes  loamy, 
at  other  times  clayey,  especially  where  felspar  is  abundant.  The  clay  is 
often  very  stifi". 

(d)  Calcareous  and  other  soils  scattered  over  the  surface,  or  lying  be- 
neath the  alluvium  or  cotton  soil.  There  are,  in  many  parts  of  India,  large 
masses  of  calcareous  (carbonate  of  lime)  conglomerate,  which  is  called 
kunkur.  It  is  much  used  in  Bengal  for  pavements,  footpaths,  and  roads 
generally. 

In  Behar,  and  some  other  places,  the  soil  contains  large  quantities  of 
nitre,  and  many  of  the  sand  plains  are  largely  impregnated  with  salts. 

2.  Temperature. — There  is  an  immense  variety  of  temperature.  Toward 
the  south,  and  on  the  sea-coast,  the  climate  is  often  equable  and  uniform. 
The  amphtudes  of  the  annual  and  diurnal  fluctuations  are  small,  and  in 
some  places,  especially  those  which  lie  somewhat  out  of  the  force  of  the 
southwest  monsoon,  the  climate  is  perhaps  the  most  equable  in  the  world. 

At  some  stations  on  the  southern  coast,  the  temperature  of  the  sun'g 


FOEEIGN    SEEVICE. 


335 


zenitli  is  lower  than  at  the  declination,  in  consequence  of  the  occurrence  of 
clouds  and  rain,  brought  up  by  the  southwest  monsoon. 

In  the  interior,  on  the  plateaux  of  low  elevation,  the  temperature  is 
greater,  and  the  yearly  and  diui-nal  fluctuations  are  more  mai'ked.  On  the 
hill  stations  (6,000  to  8,000  feet  above  sea-level),  the  mean  temperature  is 
much  less  ;  the  fluctuations  are  sometimes  great,  sometimes  inconsiderable. 

The  influence  of  winds  is  very  great  on  the  temperature  ;  the  sea  winds 
lowering  it,  hot  land  winds  raising  it  greatly. 

The  temperature  in  the  sun's  rays  ranges  as  high  as  166°  or  170°,  but 
the  mean  sun  rays'  temperature  is,  with  great  differences  in  different  places, 
between  130°  and  160°  at  the  hottest  time  of  the  year. 

The  air  temperature  of  a  few  of  the  principal  stations  is  subjoined, 
merely  to  give  an  idea'  of  the  amount  of  heat  in  different  parts  of  the  coun- 
try. ^     Those  of  the  hill  stations  are  given  under  the  proper  headings. 

Mean  Temperature  and  Height,  above  Seor-level,  of  some  of  the  larger 

Stations.  , 


^ 

J^ 

„ 

<0 

Months. 

—  > 

a  8J 

§1 
4.^ 

I 

si 

§ 

^• 

02 

Mi 

.  o 

o  >> 

o  > 

1 

o 

■§ 

00 

■s  1 

of  5 

03  i> 

aJi 

X3 

5- 

|i 

■SB 

ii 

S 
o 

■3-2 

o 

o 

o 

o 

o 

o 

o 

o 

Mean  of  year 

82 
70 

73 

54 

74 
52 

82 
76 

76 
69 

80 

74 

78 
72 

74 

January 

72 

February 

75 

60 

55 

78 

73 

76 

75 

75 

March 

83 
88 

68 

77 

65 

75 

80 

84 

79 
79 

80   ■ 
83 

79 
83 

78 

April 

81 

May 

89 

86 

88 

87 

82 

86 

85 

78 

June  

87 
85 

89 

87 

91 
91 

88 
85 

77 
77 

83 
81 

81 

77 

75 

July 

73 

August 

85 

86 

88 

85 

75 

81 

76 

72 

September     

85 

83 

84 

84 

76 

80 

77 

74 

October 

84 

76 

73 

82 

75 

82 

79 

74 

November 

78 

61 

64 

79 

73 

79 

76 

72 

December 

73 

55 

56 

76 

71 

76 

73 

70 

Amplitude  of  yearly  fluctuation  1 

(difference    between    hottest  V 

19 

35 

39 

12 

13 

12 

13 

11 

The  increase  and  the  amplitude  of  the  yearly  fluctuation  is  thus  seen  as 
we  pass  to  the  north,  and  ascend  above  sea-level. 

In  several  places  there  are  great  undulations  of  temperature  from  hot 
land  winds,  or  from  sea  or  shore  breezes,  or  from  mountain  currents, 
which  give  to  the  place  local  peculiarities  of  temperature. 

To  get  the  same  mean  annual  temperatui-e  as  in  England,  it  would  be 
necessary  that  9,500  feet  be  ascended  in  places  south  of  lat.  20°  ;  between 


'  These  are  taken  from  Mr.  Glaisher's  very  excellent  report  in  the  Indian  Sanitary 
Commission,  which  must  be  consulted  for  fuller  details.  Very  full  meteorological 
returns  are  now  being  given  in  the  Reports  of  the  Sanitary  Commissioners  for  the 
three  presidencies,  and  these  will  ultimately  supersede  Mr.  Glaisher's  tables. 


336 


PEACTICAL   HYGIENE. 


lat.  20°  and  26°,  9,000  feet ;  between  lat.  26°  and  30°,  8,700  feet ;  and 
north  of  lat.  80°,  8,500  feet. 

The  mean  monthly  temperatures  ■would,  however,  at  such  elevations, 
differ  somewhat  from  those  of  England.  Speaking  generally,  an  elevation 
of  5,000  to  6,000  feet  will  give  over  the  whole  of  India  a  mean  annual  tem- 
perature about  10°  higher  than  that  of  England,  and  with  a  rather  smaller 
range. 

j\Ii-.  Glaisher  has  calculated  that  in  the  cold  months  the  decrease  of 
temperatui'e  is  1.05°  for  each  300  feet  of  ascent,  but  increases  from  March 
to  August  to  4.5°,  and  then  gradually  declines.  These  results  are  not  ac- 
cordant with  the  results  of  balloon  ascents  in  this  climate. 

Humidity, — The  humidity  of  different  parts  of  India  varies  extremely  ; 
there  ai'e  chmates  of  extreme  humidity — either  fiat,  hot  plains,  like  Lower 
Scinde,  where,  without  rain,  the  hot  air  is  frequent!}^  almost  saturated,  and 
may  contain  10  or  11  grains  of  vapor  in  a  cubic  foot ;  or  mountain  ranges 
like  Dodabetta,  in  Madras,  8,640  feet  above  sea-level,  where  during  the 
rainy  season  the  aii'  is  also  almost  saturated  ;  a  copious  rain,  at  certain 
times  of  the  year,  may  make  the  air  excessively  moist,  as  on  the  Malabar 
coast,  the  coast  of  Tenasserim,  or  on  the  Khasyah  Hills,  where  the  south- 
west monsoon  parts  with  its  vapors  in  enormous  c^uantities. 

On  the  other  hand,  on  the  elevated  table-land  of  the  interior,  and  on  the 
hot  i^lains  of  Northwest  India,  during  the  dry  season,  or  in  the  places 
exposed  to  the  land  winds  at  any  part,  the  air  is  excessively  dry.  In  the 
Deccan  the  annual  average  of  the  relative  humidity  is  only  55  per  cent,  of 
saturation  (S^'kes).  IVIr.  Glaisher  has  given  the  humidity  of  many  places. 
A  few  stations  are  here  given  : — 

Mean  Humidity  per  cent. 


. 

i 

•6 

so 

a 
c 
5 

g 

1 

3 
1 

g 

f 
g 

% 

c 

"1 
a 

i 

^ 

fa 

n 

n 

s 

P4 

n 

02 

04 

M 

n 

Mean  maximum 

81 

79 

85 

94 

84 

73 

76 

84 

79 

80 

84 

"      minimum 

59 

61 

67 

44 

54 

41 

40 

40 

42 

48 

43 

Yearly  mean   

68 

73 

73 

69 

67 

55 

56 

54 

53 

62 

64 

The  mean  relative  humidity  at  Greenwich  is  82,  varying  from  89  in 
December  and  January  to  76  in  July.  Calcutta,  therefore,  with  a  mean 
yearly  humidity  of  68  per  cent,  of  satm-ation,  is,  as  far  as  relative  humidity 
{i.e.,  evaporating  power)  goes,  less  moist  than  England,  and  the  evapo- 
rating power  is  also  increased  by  the  higher  temperature. 

Rain. — The  amount  of  rain  and  the  period  of  fall  varj^  exceedingly  in 
the  different  places.     It  is  chiefly  regulated  by  the  monsoons. 

When  the  southwest  monsoon,  loaded  with  vapor,  first  strikes  on  high 
land,  as  on  the  Westei'n  Ghauts,  on  the  Malabar  coast,  or  on  the  mountains 
of  Tenasserim,  and  especially  on  the  mountains  of  the  Khasyah  Hills,  at 
some  points  of  which  it  meets  with  a  still  colder  air,  a  deluge  of  rain 
falls  ;  as,  for  example,  at  Cannanore  (Malabar),  121  inches ;  Mahableshwur, 
253  inches  ;  Moulmein  (Tenasserim),  180  inches  ;  CherraiDoonjee  (Khasyah 
Hills),  600  inches.  On  the  other  hand,  even  in  places  near  the  sea,  if 
there  is  no  high  land,  and  the  temperature  is  high,  scarcely  any  rain  falls  ; 


rOEEIGN    SEKVICE. 


337 


as  in  Aden,  on  the  soutli  coast  of  Arabia,  or  at  Kota,  in  Scinde,  wliere  the 
amount  is  only  1.8  annually,  or  Kurrachee,  where  the  yearly  average  is 
only  4.6  inches.  Or  in  inland  districts,  the  southwest  monsoon,  having 
lost  most  of  its  water  as  it  passed  over  the  hills,  may  be  comparatively  dry, 
as  at  Nusserabad,  where  only  15.8  inches  fall  per  annum,  or  Peshawur, 
where  there  are  13. 7  inches  annually. 

The  yearly  amount  of  rain  in  some  of  the  principal  stations  is — 


Average. 

Calcutta 56.8 

Madras 50 

Bombay 72.7 

Bengal  Presidency — 

Dinapore 31.1 

Berhampore 49.8 

Benares 37.4 

Ghazeepore 41.4 

Azimghur. 40 

Agra 27.9 

Delhi 25.1 

Meerut 18 


Average 

Punjab 56.6 

Madras  Presidency — 

BeUary •  21.7 

Bangalore 35 

Trinchinopoly 30.6 

Secunderabad 34.6 

Bombay  Presidency — 

Belgaum 51.5 

Poonah 27.6 

Neemuch 34.1 

Kamptee 21.8 


Winds. — The  general  winds  of  India  are  the  northeast  monsoon,  which 
is,  in  fact,  the  great  northeast  trade-wind,  and  the  southwest  monsoon,  a 
wind  caused  by  the  aspiration  of  the  hot  earth  of  the  continent  of  Asia, 
when  the  sun  is  at  its  northern  declination.  During  part  of  the  year 
(May  to  August)  the  southwest  monsoon  forces  back  the  trade-wind  or 
throws  it  up,  for  at  great  altitudes  the  northeast  monsoon  blows  through 
the  whole  year,  and  the  southwest  monsoon  is  below  it.  But,  in  addition, 
there  are  an  immense  number  of  local  winds,  which  are  caused  by  the 
effect  of  hills  on  the  monsoons,  or  are  cold  currents  from  hills,  or  sea 
breezes,  or  shore  winds  caused  by  the  contact  of  sea  breezes  and  other 
winds,  or  by  the  first  feeble  action  of  the  southwest  monsoon  before  it  has 
completely  driven  back  the  northeast  trade.  The  southwest  monsoon  is 
in  most  of  its  course  loaded  with  vajDor ;  the  northeast  is,  on  the  contrary, 
a  colder  and  drier  wind,  except  when  at  certain  times  of  the  year,  in  pass- 
ing over  the  Indian  Ocean,  it  takes  up  some  waier,  and  reaches  the  Coro- 
mandel  coast  and  Ceylon  as  a  moist  and  rain-carrying  wind. 

The  hot  land-winds  are  caused  by  both  the  southwest  monsoon,  after 
it  has  parted  with  its  moisture  and  got  warmed  by  the  hot  central  plains, 
and  the  northeast  monsoon  ;  the  temperature  is  very  great,  and  the  rela- 
tive humidity  very  small,  the  difference  between  the  dry  and  the  wet  bulb 
being  sometimes  15°  to  25°  Fahr. 

Fressure  of  the  Air. — On  this  point  little  need  be  said.  The  barome- 
ter is  very  steady  at  most  sea-coast  stations,  with  regular  diumal  oscilla- 
tions, chiefly  caused  by  alteration  in  humidity.  An  elevation  of  5,000  feet 
lowers  the  barometer  to  nearly  26  inches. 

Electricity. — On  this  point  few,  if  any,  experiments  have  been  made  ; 
the  air  is  extremely  charged  with  electricity,  especially  in  the  dry  sea- 
son, and  the  dust-storms  are  attended  with  marked  disturbance  of  the 
electrometer. ' 

'  See  Baddeley's  Whirlwinds  and  Dust  Storms  of  India  (1860)  for  a  very  good  ac- 
count of  these  singular  storms. 
Vol.  n.~22 


338  PKACTICAL    HYGIENE. 

Effects  of  Climate. — The  estimation  of  the  effects  of  such  various 
climates  is  a  task  of  great  difficulty.  Long-coutinuecl  high  temperature, 
alternations  of  great  atmospheric  dryness  and  moisture,  rapidly  moving 
and  perhajDs  dry  and  hot  air,  are  common  conditions  at  many  stations  ;  at 
others,  great  heat  during  part  of  the  year  is  followed  by  weather  so  cold 
that  even  in  England  it  would  be  thought  keen.  When  to  these  influ- 
ences the  development  of  malaria  is  added,  enough  has  been  said  to  show 
that,  a  priori,  we  can  feel  certain  that  the  natives  of  temperate  climates 
wiU  not  support  such  a  climate  without  influence  on  health,  and  the  selec- 
tion of  healthy  spots  for  troops  is  a  matter  of  the  greatest  moment  as 
affects  both  health  and  comfort.  This  much  being  said,  it  must  at  the 
same  time  be  asserted  that,  malaria  excepted,  the  influences  of  climate  are 
not  the  chief  causes  of  sickness. 

The  location  of  troops  should  be  governed  by  two  or  three  condi- 
tions— 1.  Military  necessities ;  2.  Convenience  ;  3.  Conditions  of  health. 
The  second  of  these  conditions  is,  however,  a  mere  question  of  administra- 
tion ;  every  place  can  be  made  convenient  in  these  days  of  railway  and 
easy  locomotion.  Military  necessity  and  health  are  the  only  real  consid- 
erations which  should  guide  our  choice.  The  \dtal  military  points  must 
be  held  with  the  necessary  forces,  and  then  the  whole  of  the  remaining 
troops  can  be  located  on  the  most  healthy  spots. 

These  spots  cannot  be  in  the  plains.  Let  any  one  look  at  a  geological 
map  of  India,  and  see  the  vast  tract  of  alluvial  soil  which  stretches  from 
the  loose  soil  of  Calcutta,  formed  by  the  deposit  of  a  tidal  estuary,  up  past 
Cawnpore,  Delhi,  to  the  vast  plains  of  the  Punjab,  Scinde,  and  Beloochis- 
tan.  The  whole  of  that  space  is  more  or  less  malarious,  and  will  continue 
to  be  so  until,  in  the  course  of  centuries,  it  is  brought  into  complete 
tillage,  drained,  and  cultivated.  Moreover,  heat  alone  without  malaria  tells 
upon  the  European  frame,  lessens  the  amount  of  respiration  and  circula- 
tion, and  lowers  digestive  power. 

In  looking  for  healthy  spots,  where  temperature  is  less  tropical,  and 
malarious  exhalations  less  abundant,  there  are  only  two  classes  of  localities 
which  can  be  chosen — sea-side  places  and  highlands. 

Sea-side  Places. — The  advantages  of  a  locahty  of  this  kind  are  the 
reduction  in  temperature  caused  by  the  expanse  of  water,  the  absence  of 
excessive  dryness  of  the  air,  and  the  frequent  occurrence  of  breezes  from 
the  sea.  All  these  advantages  may  be  counteracted  by  the  other  features 
of  the  place ;  by  a  damp  alluvial  soil,  bad  water,  etc. 

It  does  not  appear  that  many  eligible  places  have  yet  been  found,  and 
as  a  substitute  in  Bengal,  the  Europeans  from  Calcutta  sometimes  live  on 
board  a  steamer  anchored  oft'  the  Sandheads,  thus  literally  carrying  out  a 
suggestion  of  Lind  in  the  West  Indies  a  century  ago. 

In  the  Bay  of  Bengal,  Waltair,  in  the  northern  division  of  Madras,  is 
one  of  the  best.'  Cape  Calimere  (28  miles  south  of  Nagapatam)  also  ap- 
pears to  have  many  advantages  (Macpherson).  On  the  opposite  coast, 
Cape  Negrais,  on  the  Burmese  coast,  was  pointed  out  as  long  ago  as  1825, 
by  Sii*  Ranald  Martin,  as  a  good  marine  sanitarium,  and  Amherst  in  Tenas- 
serim,  and  some  of  the  islands  down  the  coast  toward  Mergui,  ai-e  beauti- 
ful spots  for  such  a  purpose,  being,  howevei-,  unfortunately,  at  a  great 
distance  fi'om  the  large  mihtary  stations,  and  not  being  well  suppHed  with 
food. 

On  the  Bombay  side,  at  Sedashagur  or  Beitkul  Bay,  between  Mangalore 

'  Evidence  of  Dr.  Maclean  in  India  Report,  p.  139. 


FOREIGN    SERVICE.  339 

and  Goa,  a  spur  of  tlie  Western  Ghauts  projects  into  the  sea  for  upward 
of  a  mile,  and  forms  an  admirable  sea-coast  sanitarium  (Macpherson). 

All  these  sea-coast  stations  seem  adapted  for  organic  visceral  affections 
and  dysentery,  but  they  are  not  so  well  calculated  for  permanent  stations 
for  healthy  men.     Probably  they  are  rather  sanitaria  than  stations. 

Highlands. — The  location  of  troops  on  the  hills  or  on  elevated  table- 
lands has  long  been  considered  by  the  best  army  medical  officers  as  the 
most  important  sanitary  measure  which  can  be  adopted.  Not  only  does 
such  a  location  improve  greatly  the  vigor  of  the  men,  who  on  the  hill 
stations  preserve  the  healthy,  ruddy  hue  of  the  Eurojaean,  but  it  prevents 
many  diseases.  If  properly  selected,  the  vast  class  of  malarious  diseases 
disappears  ;  hver  diseases  are  less  common,  and  bowel  complaints,  in  some 
stations  at  any  rate,  are  neither  so  frequent  nor  so  violent.  Digestion  and 
blood  nutrition  are  greatly  improved.  Moreover,  a  proper  degree  of  ex- 
ercise can  be  taken,  and  the  best  personal  hygienic  rules  easily  observed. 

Indian  surgeons  appear,  however,  to  think  the  hill  stations  not  adapted 
for  cardiac  and  respiratory  complaints ;  it  is  possible  that  this  objection  is 
theoretical.  The  latest  European  experience  is  to  the  effect  that  phthisis 
is  singularly  benefited  by  even  moderate,  still  more  perhaps  by  great  ele- 
vation ;  that  ansemia  and  faulty  blood  nutrition  are  cured  by  high  positions 
with  great  rapidity,  and  that  if  the  elevation  be  not  too  great  (perhaps  not 
over  3,000  feet)  even  chronic  heart  diseases  are  improved.  In  some  of  the 
hill  stations  of  India  bowel  complaints  were  formerly  so  frequent  as  to  give 
rise  to  the  term  "hill  diarrhoea."  The  elevation  was  credited  with  an  ef- 
fect which  it  never  produced,  for,  not  to  speak  of  other  parts  of  the  world, 
there  are  stations  in  India  itself  (Darjeeling,  for  examj^le)  as  high  as  any 
other,  where  the  so-called  hill  diarrhoea  was  unknown.  At  Newera  Ellia, 
in  Ceylon,  too,  if  the  simple  condition  of  mountain  elevation  could  have 
produced  diarrhoea,  it  would  have  been  present.  The  cause  of  the  hill 
diarrhoea  was  certainly,  in  many  stations,  unwholesome  drinking-water  ; 
whether  or  not  this  was  the  case  in  all  is  uncertain.  Some  of  the  hill 
stations  are  said  not  to  be  adapted  for  rheumatic  cases  ;  in  other  instances 
(as  at  Subathoo)  rheumatism  is  much  benefited.  From  reading  the  reports 
from  these  stations,  it  is  more  probable  that  damp  barracks,  and  not  the 
station,  have  been  in  some  cases  the  cause  of  the  rheumatism. 

But  it  must  be  noticed  that  the  evidence  given  before  the  Indian  Sani- 
tary Commission  shows,  on  all  or  almost  all  hill  stations,  a  most  lamentable 
want  of  the  commonest  sanitary  appliances.  At  great  expense  men  are 
sent  tip  to  the  hills,  where  eveiything  is,  or  was,  left  undone  which  could 
make  that  expense  profitable.  It  appeared  to  be  thought  sufficient  to  as- 
cend 6,000  feet  to  abandon  all  the  most  obvious  sanitary  rules,  without 
which  no  place  can  be  healthy. 

Admitting,  as  a  point  now  amply  proved,  that  stations  of  elevation  are 
the  proper  localities  for  all  troops  not  detained  in  the  plains  by  imperative 
mihtary  reasons,  the  following  questions  are  still  not  completely  an- 
swered : — ■ 

1.  What  amount  of  elevation  is  the  best  ?  We  have  seen  that  to  reduce 
the  temperature  to  the  EngHsh  mean,  5,000  to  6,000  feet  must  on  an  aver- 
age be  ascended.  But  then  such  an  elevation  brings  with  it  certain  incon- 
veniences, viz.,  in  some  stations  much  rain  and  even  fog  at  certain  times  of 
the  year,  and  cold  winds.  However  unpleasant  this  may  be,  it  yet  seems 
clear,  from  the  experience  of  Newera  Ellia,  in  Ceylon,  that  damp  and  cold 
are  not  hurtful.  But  it  must  also  be  said  that,  with  a  proper  selection,  dry 
localities  can  be  found  at  this  elevation. 


340  PRACTICAL    HYGIENE. 

From  3,000  to  4,000  feet  have  been  recommencled,  especially  to  avoid 
the  conditious  just  mentioned.  Whether  places  of  this  height  are  equal 
in  salubrity  to  the  colder  and  liigher  points  is  uncertain. 

Even  at  6,000  feet  there  may  be  marsh  land,  though  it  is  not  very  mala- 
rious. Malarious  fever  has  been  known  during  the  rains  at  Kussowlie 
(6,400  feet),  and  Subathoo  (4,000),  and  other  Himalayan  stations.  Malaria 
may,  however,  drift  up  valleys  to  a  great  height,'  but,  apart  from  this,  it 
seems  likely  that  5,000  feet,  and  probably  4,000,  will  perfectly  secure  fi'om 
malaria.     Probably,  indeed,  a  less  height  will  be  found  effectual 

At  no  point  do  hot  land-winds  occiu",  or  at  any  rate  endure,  at  above 
4,000  feet.  On  the  whole,  it  would  appear  probable  that  the  best  locahties 
are  above  5,000  feet,  but  below  7,000. 

2.  What  stations  are  the  best — the  tojjs  of  solitary  hills,  si:)urs  of  high 
mountains,  or  elevated  table-lands  ? 

Ranald  Martin  has  called  especial  attention  to  the  solitary  hills,  rising 
as  they  do  sometimes  from  an  ahnost  level  plain  to  2,000  and  3,000  feet. 
Such  mountain  islands  seem  especially  adapted  for  troops  if  there  is  suffi- 
cient space  at  the  top.  They  are  free  from  ravines  conducting  cold  air 
from  higher  land,  and  are  often  less  rainy  than  the  spurs  of  loftier  hills. 

The  spurs  of  the  Himalayas,  however,  present  many  eligible  spots,  and 
so  do  some  table-lands.  And  perhaps,  on  the  whole,  if  the  elevation  is 
sufficient,  it  is  not  a  matter  of  much  importance  which  of  these  formations 
is  chosen  ;  other  circumstances,  viz.,  purity  of  water,  space,  ease  of  access, 
and  supplies,  etc.,  will  generally  decide. 

In  choosing  hill  stations,  the  pomts  discussed  in  the  chapter  on  Soils 
should  be  carefully  considered,  and  it  is  alwa^'s  desirable  to  have  a  trial 
for  a  year  or  two  before  the  station  is  permanently  fixed. 

In  all  the  presidencies  of  India  elevated  spots  where  troops  can  be  can- 
toned exist  in  abundance.^  The  follo-oing  table,  coj^ied  from  Dr.  ^Macj^her- 
son's  work,  gives  some  of  the  principal  hill  stations.  Fresh  stations  are, 
however,  being  constantly  discovered,  and  it  seems  now  certain  that  there 
is  scarcely  any  important  strategical  point  without  an  elevated  site  near  it. 

Near  Nynee  Tal,  in  Kumaon,  are  Almorah  (5,500  feet)  apd  Hawalbagh 
(4,000  feet),  both  well  spoken  of.  Kunawai-  (5,000  or  6,000  feet),  in  the  val- 
ley of  the  Sutlej,  has  a  delicious  climate  ;  and  Chini  (about  100  miles  from 
Simla)  is  a  most  desirable  spot. 

Passing  down  from  the  northwest  toward  Calcutta,  Dr.  M'Clellan  found 
elevated  land  within  100  miles  of  Allahabad  ;  and  in  the  south  there  are  the 
Travancore  Mountains,  with  numerous  good  sites. 

If,  then,  the  mass  of  the  troops  are  cantoned  on  elevated  places,  the  dis- 
advantages of  climate  are  almost  removed.  The  Indian  Sanitary  Commis- 
sioners recommended  that  one-third  of  the  force  shaU  be  in  the  hills,  and 

'  It  has  drifted  up  even  to  the  summits  of  the  Neilgherries,  7,000  or  8,000  feet. — In- 
dian Sanitary  Report,  Mr.  Elliott's  Evidence,  vol.  i  ,  p.  250. 

-  See  the  evidence  in  the  Indian  Sanitary  Report  (vol.  i.)  of  Sir  R.  Martin,  Mr.  El- 
liott, Dr.  Maclean,  Dr.  Alexander  Grant,  Mr.  Montgomery  Martin,  and  others.  Also 
most  instructive  reports  by  Mr.  Macpherson,  Indian  Report,  vol.  ii.,  p.  622;  and  by  Dr. 
Alexander  Grant,  Indian  Annals.  On  the  location  of  troops  reference  may  also  be 
made  to  the  late  Surgeon-General  Dr.  Beatson's  very  decided  opinion  on  the  necessity 
of  placing  on  the  hiUs  all  the  men  who  can  be  spared  from  the  military  posts  in  the 
plains.  No  more  valuable  opinion  could  be  given  on  such  a  point  than  that  of  an  offi- 
cer who  had  the  largest  possible  experience,  and  the  best  opportunities  of  forming  a 
correct  judgment.  (See  his  Report  in  the  Army  Med.  Report,  vol.  viii.,  p.  847.)  Sir 
William  Muir  also  urged  this  point,  and  the  result  is  that  gradually  more  and  more 
troops  are  being  located  on  the  hills. 


rOKEIGN    SERVICE. 


341 


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342  PRACTICAL    HYGIENE. 

that  enfeebled  men  and  recruits  especially  shall  be  sent  there.  But  it  is  to 
be  hoiked  that  not  only  one-third,  but  a  large  majority  of  the  ti'oops  will 
eventually  be  placed  there. 

Sub-Section  IL — Diseases  of  the  Natives. 

It  is  impossible  that  Europeans  can  be  perfectly  isolated  from  the 
nations  among  whom  they  serve  ;  they  have  suffered  from  the  pestilential 
diseases  of  the  Hindus,  but  still  it  is  wonderful  that  they  have  not  suffered 
more.  Cholera  is  the  chief  disease,  which,  arising  in  the  native  population, 
scourges  their  conquerors.  Some  fevers  also,  relapsing  fever,  perhaps  a 
"febris  icterodes,"  or  bilious  remittent,  which  has  attacked  Europeans, 
have  had  theii-  origin,  or  at  any  rate  their  conditions  of  spread,  in  the 
dense  populations  of  native  cities.  Happily,  the  Black  Death  (the  Maha 
mmTce,  or  Pali  plague)  has  never  yet  sj^read  to  the  troops,  and  has  indeed 
been  confined  within  narrow  hmits.  Still  these  pestilences  among  the 
native  population  are  an  ever-present  menace  to  Europeans,  and,  as  in  the 
case  of  cholera,  may  pass  to  them  at  any  time.  Cholera,  certainly,  wiU 
never  be  extiqoated  until  attacked  in  its  strongholds,  among  the  miserable 
dwellings  which  make  so  large  a  part  of  every  Oriental  city.  In  1867  there 
were  some  cases  among  the  troops  of  the  contagious  fever  which  has 
caused  so  much  mortality  in  many  of  the  Bengal  jails.  The  exact  influence 
on  Europeans  of  the  customs  and  modes  of  hfe  of  the  natives  of  India  has 
not  been  made  an  object  of  sj^ecial  study,  but  it  cannot  be  inconsiderable. 
In  many  places  the  EurojDeans  and  the  natives  ai-e  in  close  neighborhood, 
and  the  air  at  all  times,  and  often  the  water,  must  be  influenced  by  the 
social  life  of  the  native  races.  •  The  proximity  to  large  cities  or  bazaars  is 
indeed  often  alluded  to  by  army  officers  as  influencing  the  health  of  their 
men  ;  it  would  be  veiw  interesting  to  know  the  precise  effect.  The  sani- 
tary condition  of  almost  all  the  large  native  towns,  and  the  sanitary  habits 
of  the  country  j)eople,  are  as  bad  as  can  be.  Bad  water,  fetid  au-,  want  of 
sewage  removal,  and  j^ersonal  habits  of  uncleanliness,  abound  everywhere. 
The  Report  of  the  Lidia  Sanitaiy  Commission,  and  the  activity  of  the 
Indian  officials  in  the  Sanitaiy  Departments,  are  now  beginning  a  series 
of  changes  in  this  respect,  which  will  probably  change,  in  toto,  the  medical 
histoiy  of  India. 

Sub-Sectiox  HI, — Special  Hygiexic  Conditions. 

The  special  hygienic  conditions  (apart  fi-om  locality)  under  which  the 
soldier  serves  in  India  have  been  the  main  causes  of  excess  of  disease. 
This  subject  has  received  a  searching  inciuiry  from  the  Sanitary  Commis- 
sioners.' They  declare — and  after  reading  the  Station  Eejiorts  and  the 
evidence  given  before  them,  no  one  will  doubt  the  assertion— that  while 
malaiia,  extremes  of  temperatui-e,  moisture,  and  variability  of  tempera- 
ture cause  a  cerfain  amount  of  sickness,  "there  are  other  causes  of  a  very 
active  kind  connected  with  stations,  barracks,  hospitals,  and  the  habits  of 
the  men,  of  the  same  nature  as  those  which  are  known  in  colder  chmates 
to  occasion  attacks  of  those  very  diseases  from  which  the  Indian  anny 
suffer  so  severely." 

And  the  Commissioners  enumerate  a  list  of  causes  connected  with  un- 

'  Eeport  of  tlie  Commissioners  on  the  Sanitary  State  of  the  Army  in  India,  1863. 
Report,  p.  79,  published  in  1864  in  small  bxilk. 


FOEEIGJSr    SERVICE.  ^  343 

healthy  stations,  bad  barracks,  overcrowding,  impure  air  and  water,  bad 
drainage,  imperfect  ablution,  inferior  rations  and  cooking,  etc. 

In  fact,  no  doubt  can  exist  in  the  minds  of  all  who  have  studied  the 
subject  that  these  form  the  most  potent  class  of  causes  which  affect  health. 

Sub-Section  IV. — Habits  aito  Customs  of  the  Tkoops. 

The  habits  of  the  men  and  the  customs  of  service  were,  however,  also 
great  causes  of  diseases,  and  are  stiU  so  to  some  extent. 

The  men  were,  as  a  rule,  intemperate,  great  smokers,  and  indisposed 
for  exertion.  It  has,  indeed,  been  pointed  out  with  truth,  that  in  propor- 
tion to  their  amount  of  exercise  the  men  were  much  overfed,  and  some 
diseases  of  the  hver  appear  to  result  directly  from  this  simple  condition. 

The  want  of  exercise  is  not  always  the  fault  of  the  men.  The  early 
morning  hours,  and  often  the  evening,  are  occupied  with  parades  ;  in  the 
period  between,  the  men  used  to  be  confined  to  barracks,  and  are  still 
sometimes  so.  Here,  hstless,  unoccupied,  and  devoured  with  ennui,  they 
passed  the  weary  day,  lying  down  perhajDS  for  hours  daily,  or  lounging  on 
chairs  smoking. 

This  forced  confinement  to  barracks  is  indeed  an  evil  often  greater  than 
that  it  is  intended  to  remove.  To  prevent  men  fi'om  passing  out  into  the 
sun  they  are  compelled  to  remain  in  a  hot,  often  ill-ventilated  room,  worse 
for  health  than  the  intensest  rays  of  the  sun,'  that  scape-goat  of  almost 
every  fault  and  vice  of  Indian  hfe. 

All  these  causes  have  been  summed  up  by  Miss  Nightingale  in  some  of 
those  telling  sentences  which  have  done  more  than  anything  else  to  force 
attention  to  these  vital  questions.^ 

Of  late  years  a  great  change  has  taken  place  in  the  habits  of  the  men — 
more  open-air  exercises  of  all  kinds ;  and  in  the  cooler  stations  athletic 

^ c 

'  The  late  Dr.  Parkes  writes — "  I  shall  never  forget  the  sufferings  of  the  men  in  the 
old  barracks  at  Madras.  We  arrived  there  from  Moulmein,  where  the  men  had  never 
been  confined  to  barracks,  and  where,  during  two  hot  seasons,  no  injury  had  resulted 
from  allowing  them  to  go  out  when  they  liked.  On  arrival  at  Madras,  in  accordance 
with  invariable  custom,  the  men  were  confined  to  barracks.  They  lay  all  day  on  their 
beds,  reeking  with  perspiration  ;  the  place  was  so  small  and  ventilation  so  bad,  that 
the  heat  was  perfectly  intolerable  in  the  barracks,  though  the  sun's  rays  were  quite 
bearable.  The  sufferings  were  extreme.  When  the  afternoon  came,  more  injury  had 
been  done  by  the  hot  and  impure  air  than  exposure  to  the  sun's  rays  could  have  caused. 

"  At  Moulmein,  in  Tenasserim,  at  one  time,  two  European  regiments  served  to- 
gether. The  barracks  of  each  were  perfectly  healthy ;  the  food  and  duties  were  the 
same  ;  yet  one  showed  a  sick-list  and  mortality  always  much  greater  than  the  other. 
Serving  in  the  station  shortly  afterward,  I  was  so  struck  by  this  difference  that  I  went 
over  all  the  returns  and  reports  in  the  staff-surgeon's  office  to  make  out  the  cause  ;  the 
only  difference  I  could  detect  was,  that  in  the  sickly  regiment  the  men  were  confined 
to  barracks,  in  the  other  they  were  allowed  to  go  about  as  they  pleased.  Many  years 
afterward,  I  met  with  a  medical  ofiicer  who  had  served  in  the  sickly  regiment,  and 
learned  from  him  that  he  had  always  considered  the  confinement  to  barracks,  and  the 
want  of  exercise,  and  the  impure  air  breathed  by  that  system  almost  night  and  day,  to 
have  been  the  cause  of  a  disparity  so  striking.  No  one  would  recommend  imprudent 
exposure  to  the  sun ;  men  may  be  trusted  to  avoid  its  intensest  rays  ;  but  to  reduce 
men  to  enforced  idleness  for  many  hours,  and  to  confine  them  in  the  small  space  of  a 
barrack-room,  is  not  the  way  of  meeting  the  evil."  (On  this  point  see  also  Dr.  Clark's 
observations  on  want  of  exercise  as  compared  with  exposure  to  the  sun  on  the  West 
Coast  of  Africa. )  On  this  point,  as  in  many  others,  the  statements  of  Dr.  Kenneth 
Mackinnon  are  deserving  of  great  attention.  His  remarks  on  the  desirability  of  exer- 
cise, even  in  the  trying  climate  of  Tirhoot,  in  Bengal,  are  very  striking.  (A  Treatise  on 
Public  Health,  by  Kenneth  Mackinnon,  M.D.,  Cawnpore,  1848,  pp.  27  and  145.)  He 
strongly  recommended  open  sheds  and  gj^mnasia,  and  these  are  now  being  adopted. 

^  How  People  may  Live  and  not  Die  in  India,  by  Florence  Nightingale,  1863. 


344  PEACTICAL    HYGIENE. 

sports  and  cricket  have  been  encouraged  ;  in  some  of  the  hill  stations  the 
troops  have  been  emploj-ed  in  making  roads  and  pubhc  works,  and  the 
practice  of  trades  has  been  promoted.  Were  the  troops  chiefly  on  the 
hUls,  as  much  exercise  as  at  home  would  be  possible,  and  the  men  would 
preserve  their  Eurojiean  vigor  and  apiiearance.  But  even  in  the  plains 
exercise  is  necessary,  and  if  it  be  taken  at  the  proper  times  [i.e.,  with 
avoidance  of  the  thi-ee  or  foui'  hottest  hours),  and  with  proper  precautions, 
such  as  keeping  the  head  and  spine  well  covered  and  cool,  putting  on  after 
profuse  sweating  dry  and  thin  mixed  cotton  and  woollen  undei'clothes, 
and  protecting  the  loins  and  abdomen  with  a  silk  or  flannel  sash,  and 
avoiding  stimulants  before  and  dining  the  exercise,  all  men  wotdd  be 
benefited  even  by  very  great  exercise. 

The  pale,  feeble  appearance  of  persons  who  keep  much  in  the  darkened 
houses  is  really  owing  more  to  the  absence  of  light  and  to  the  unhealthy 
and  sedentary  life  than  to  the  efiect  of  the  climate. 

The  subject  of  clothing  has  been  already  referred  to.  In  Algeiia,  as  in 
India,  much  good  has  been  ascribed  to  the  use  of  very  large  flannel  belts, 
which  the  French  suspend  fi-om  the  shoulder.s,  a  plan  better  adapted  for 
comfort  than  the  so-called  cholera  belts  of  India. 

"With  i-egard  especiallv'  to  diet,  two  points  must  be  considered  : — 

1.  What  amount  of  food  should  be  taken  ?  In  India,  as  in  all  parts  of 
the  world,  food  should  be  taken  in  proportion  to  the  mechanical  work  done 
by  the  body,  and  to  the  equivalent  of  mechanical  energy,  viz.,  animal  heat. 

High  temperature,  as  lessening  the  loss  of  the  body  heat,  must,  p?'o 
tanto,  lessen  the  need  of  food  to  supply  the  temperature  ;  and  it  has  been 
supposed  that  the  diet  of  men  in  cold  countries  (Ai'ctic  regions)  and  in  hot, 
contrasted  remai-kably  in  respect  of  the  amount  of  carboniferous  food 
taken  by  each.  But  although  it  is  certain  that  large  quantities  of  meat 
and  fat  are  taken  by  men  hving  in  or  aniAing  in  cold  countries,  it  is  now 
kiiown  that  the  natives  of  some  of  the  hottest  jDarts  of  the  world  take  im- 
mense quantities  of  both  fats  and  starches.  In  fact,  both  these  substances 
are  taken  to  supply  mechanical  energy  directly,  as  well  as  animal  heat.  It 
is  not,  in  fact,  yet  known  what  amount  of  lessening  of  food,  or  what  kind 
of  lessening,  the  increased  heat  of  the  tropics  demands,  or  whether  any  is 
demanded,  for  exact  experiments  are  wanting.  Our  best  guide  at  present 
for  the  quantity  of  food  to  be  taken  in  the  tropics,  is  to  apportion  it  to  the 
amount  of  mechanical  work  done,  as  in  temperate  climates.  In  India,  as 
elsewhere,  it  must  be  in  balance  with  exercise.  The  points  then  to  be  con- 
sidered are  the  amounts  of  daily  food  and  of  daily  exercise,  and  by  means 
of  the  tables  formerh'  given,  and  by  knowing  the  habits  of  the  men,  little 
difficulty  will  be  found  in  determining  the  proper  ration  quantity'  of  food 
with  accuracy. 

In  considering  the  amount  of  food,  it  must  be  remembered  that  the 
soldier  almost  always  buys  additional  food,  and  often  eats  much  more  than 
his  ration.  Some  years  ago  Dr.  Macnamara  found  the  troops  in  Bengal 
taking  no  less  than  76  ounces  of  food  (i.e.,  water-containing  food),  while 
the  regulation  ration  was  only  52  ounces,  so  that  these  men  were  largely 
over-feeding.  And  Dr.  Dempster  '  states  that  the  majority  of  the  recruits 
from  Scotland  and  England  eat  in  the  hot  weather  in  India  much  more 
animal  food  than  in  the  coldest  seasons  in  then-  native  countries." 

'  Indian  Sanitary  Report — Evidence. 

-  Colonel  Sykes  long  ago  directed  particular  attention  to  this  point,  stating  with  per- 
fect truth  that  the  soldier  in  India  is  over-stimulated  by  food  and  drink,  and  under- 
stimulated  by  bodily  and  mental  exercise. 


FOREIGN   SERVICE.  345 

It  would  therefore  seem  that  illness  may  arise  in  India  from  excess  of 
food,  but  it  is  not  the  regulation  ration  which  produces  it,  but  the  addi- 
tional purchased  food,  which  is  often  of  bad  quality,  or  the  extreme  idleness 
of  the  men,  in  which  case  even  the  regulation  ration  is  too  much.  The  only 
remedy  is  instruction  of  the  men  in  what  is  good  for  them,  and  no  men  are 
so  stupid  as  not  to  perceive  what  is  best  for  theii'  own  comfort  and  happi- 
ness when  it  is  once  pointed  out  to  them. 

In  addition,  the  soldier  in  India  had  till  very  lately  the  spiiit  ration 
(now  lessened  to  one-half),  which  has  the  effect  of  lessening  the  power  of 
apj)ropriation  of  food,  though  not  always  the  appetite,  and  thus  indu-ectly 
may  cause  over-feeding. 

2.  Admitting  (till  better  obseiwations  are  made)  that  men  in  the  tropics, 
undergoing  as  much  exertion  as  at  home,  will  demand  as  much  food,  and 
in  the  same  proportions,  as  far  as  the  four  classes  of  aliment  ai'e  concerned 
(and  all  physiological  evidence  goes  to  show  that  this  must  be  the  case, 
and  that  not  external  temperatiu-e,  per  se,  but  the  work  of  the  body,  is  the 
chief  measure  of  food),  the  next  question  is,  whether  the  different  articles 
of  the  diet  should  be  altered  ;  whether,  for  example,  the  same  amount  of 
nitrogen  being  given,  it  should  be  contained  in  vegetable  or  animal  food  ? 

It  has  been  stated  by  several  of  the  best  observers  in  the  tropics  that 
those  who  eat  largely  of  animal  food  are  less  healthy  than  those  who  take 
more  vegetable  food  ;  and  Friedel,  in  his  work  on  China,  has  again  directed 
attention  to  the  fact '  that  the  amount  of  digestive  and  hepatic  disease  is 
much  greater  among  the  Enghsh  than  among  any  other  European  settlers 
in  China.  But  whether  this  is  o'ttdng  to  excessive  animal  food,  or  excess 
generally  in  all  food,  and  to  too  much  wine,  beer,  and  spirits,  is  not  certain. 
The  diet  is  probably  too  rich  as  a  whole. 

Supposing  meat  is  taken  in  proper  but  not  excessive  quantity  with 
farinaceous  food,  as  at  home,  is  it  less  healthy  than  a  cjuantity  of  vegetable 
food  containing  an  equivalent  amount  of  nitrogen?  On  this  point  strict 
scientific  evidence  has  not  been  produced.  With  regard  to  excess  of  ani- 
mal food  there  is  no  doubt ;  but  animal  food  in  moderation  has  not  been 
shown  to  be  more  active  in  causing  liver  complaints  in  India  than  at  home. 

Considering,  indeed,  how  important  it  is,  when  the  digestive  organs 
have  been  accustomed  to  one  sort  of  diet,  not  to  change  it  suddenly  and 
completely,  it  seems  very  doubtful  whether  it  would  be  desirable  for  the 
Eui'ojDean  arriving  in  India  at  once  to  give  up  all  previous  habits,  and  to 
commence  an  entii'ely  different  kind  of  diet. 

It  is  possible,  however,  that  the  meat  standard  of  England  might  be 
somewhat  reduced,  and  the  bread,  flour,  and  legiiminosge  increased.  This 
is  not  the  opinion,  however,  of  some  of  those  who  have  lately  paid  particular 
attention  to  Indian  rations  (Dr.  C.  A.  Gordon  and  Dr.  Inglis),"  and  who 
believe  that  the  amount  of  meat  is  even  too  small. 

It  has  often  been  said  that  Europeans  in  India  should  imitate  the 
natives  in  their  food,  but  this  opinion  is  based  on  a  misconception.  The 
use  of  ages  has  accustomed  the  Hindu  to  the  custom  of  taking  large  quan- 
tities of  rice,  with  pulses  or  corn  ;  put  a  European  on  this  diet,  and  he 
could  not  at  first  digest  it ;  the  very  bulk  would  be  too  much  for  him.  The 
Hindu,  with  this  diet,  is  obliged  to  take  large  quantities  of  condiments 
(peppers,  etc.).  The  Eru-opean  who  did  the  same  would  produce  acute 
gastric  catarrh  and  hepatic  congestion  in  a  very  short  time  ;  in  fact,  as 

'  Already  noticed  as  regards  India  and  the  Mauritius. 
^  Op.  cit.  and  Army  Medical  Report,  vol.  v.,  p.  880. 


346 


PRACTICAL    HYGIENE. 


already  stated,  one  great  fault  of  the  diet  of  Europeans  arriving  in  India  is 
too  great  use  of  tliis  part  of  the  native  diet. 

Tn-o  points  about  the  diet  of  India  seem  quite  clear.  One  is,  that  spirits 
are  most  hurtful,  and  that  even  wine  and  beer  must  be  taken  in  gi-eat 
moderation.  Of  the  two  beverages,  hght  wines  (clarets),  which  are  now 
happily  coming  into  use  in  India  for  the  officers,  are  the  best.  For  the 
men  good  beer  should  be  provided,  but  it  is  important  to  teach  the  men 
moderation.  The  allowance  per  man  per  diem  should  never  be  more  than 
a  quart,  and  men  would  find  themselves  healthier  with  a  single  pint  per 
day.  But  it  would  seem  probable  that,  especially  in  the  hot  stations  and 
seasons,  entire  abstinence  should  be  the  rule,  and  that  infusions  of  tea  and 
coffee  are  the  best  beverages.' 

The  other  point  is,  that  in  the  tropics  there  is  perhaps  even  a  greater 
tendency  to  scurv}'  than  at  home  ;  the  use  of  fruits,  then,  is  of  great  im- 
portance, and,  whenever  practicable,  the  gi'owth  of  fi'uit  trees  should  be 
encoiu'aged  in  the  neighborhood  of  stations.  In  some  stations  (IVIooltan) 
lime-juice  has  been  issued  with  the  greatest  benefit  when  vegetables  were 
scarce. 

Health  of  the  Troops. 

India  presents  in  many  respects  the  same  history  as  our  other  tropical 
possessions.  In  former  years  there  was  a  lai'ge  mortality  among  Europe- 
ans, attributed  usually  to  the  climate,  instead  of  being  put  down  to  its 
proper  causes,  viz.,  a  reckless  mode  of  Hving  amidst  the  most  insanitaiy 
conditions.  As  years  have  passed,  the  same  gradual  improvement  has 
occurred  in  India  as  in  the  West  Indies.  Habits  have  improved,  and  the 
conditions  of  life  have  been  slowly  altered  for  the  better.  This  change 
has  been  going  on  for  yeai's,  and  there  has  been  an  astonishing  progress 
since  the  mutiny.  Much,  no  doubt,  remains  to  be  done,  but  the  fall  in 
mortality  and  in  sickness  has  been  so  marked  in  all  the  Presidencies,  as  to 
lead  us  to  hojie  that  in  a  few  more  years  the  Indian  semdce  mil,  like  the 
West  Indian,  be  almost  as  healthy  as  the  home  service.  It  may  seem  rash 
to  anticipate  sucli  a  result,  but  an  improvement  as  great  has  already  taken 
place,  for  the  mortaUty  even  now  has  faUeu  one-half,  compared  with  that 
of  thirty  years  ago.     The  following  table  shows  this  : — 


Earlier  Years. — MortaUty  of  Europeans  per  1,000  of  Strength. 

Years  and  Authorities.* 

Bengal 
Presidency. 

Bombay 
Presidency. 

Madras 
Presidency. 

1845-54  (Chevers) 

63.38 
79.20 

74.10 

60.20 
61.10 

66.00 

59.20 

1838-56   (Queen's  troops  alone 
— Balfour) 

62.90 

1806-56       (Company's      troops 
alone — Indian  Sanitary  Com- 
missioners)   

63.50 

'  The  drinks  which  the  private  soldier  often  bnjs  in  the  bazaars  in  India  are  of  the 
worst  description ;  arrack  mixed  with  cayenne  and  other  pungent  substances,  or  fer- 
mented toddy  mixed  with  peppers  and  narcotics,  or  drugged  beer,  are  common  drinks. 
It  would  be  easy  to  put  a  stop  to  this  by  legislative  enactment. 

-  The  chief  statistics  of  the  forces  in  India  are  contained  in — 

1.  Numerous  scattered  papers  in  the  various  Indian  medical  periodicals  for  the  last 
forty  years,  referring  chiefly  to  the  health  of  one  presidency  or  of  regiments  or  forces 
occupying  small  districts. 

2.  Summaries  of  the  whole,  by  Colonel  Sykes  (for  twenty  years  ending  1847,  Sta- 


FOEEIGIS"    SERVICE. 


347 


In  1812-16,  in  the  Bengal  Presidency,  the  deaths  averaged  96.5  per 
1,000  ;  in  the  Bombay  Presidency,  in  1819-20,  the  deaths  were  80  per 
1,000. 

The  above  mean  mortality  includes  every  loss  ;  in  some  years  it  was,  of 
course,  greater,  in  some  less ;  but  on  the  whole  large  every  year,  with  a 
few  exceptions,  tiU  the  year  1856.  After  the  mutiny,  about  the  year  1860, 
the  sanitary  improvements  and  the  gTeater  care  of  the  troops  which  had 
been  gradually  taking  place  received  an  immense  impulse.  The  results 
are  shown  below. 

Later  Years. — Mortality  of  Europeans  per  \000  of  Strength. 


Bengal 
Presidency. 

Madras 
Presidency. 

Bombay 
Presidency, 

Total 
Mortality. 

Total 
Mortality. 

Total 
Mortality. 

1860-9  (10  years— Balfour),     . 
1870-79  (10  years— .^.i/.X*.  RcvortsV 
1880,1 

31-27 
20-17 
29-26 

22-53 
18-97 
10-51 

22-58 
16-37 
25*10 

Causes  of  Sickness  and  Death. 
The  causes  of  diseases  and  deaths  of  Europeans  are  given  in' the  following 
table.2    I)uring  the  period  of  ten  years  there  was  a  good  deal  of  cholera  in 
the  years  1872  and  1875,  1876,  1878,  1879,  as  well  as  in  1880. 

Admissions  and  Deaths  per  1000  of  Strength. 


Bengal. 

Madras. 

Boinl)ay. 

Causes. 

1870-79.-. 

1880. 

1870-79. 

1880. 

1870-79. 

1880. 

Adm. 

Died. 

Adm. 

Died. 

Adm. 

Died. 

Adm. 

Died. 

Adm. 

Died. 

Adm. 

Died. 

Cholera, 

6-3 

3-2 

6-8 

4-9 

3-6 

1-5 

0-1 

0-1 

2-1 

1-5 

Paroxvsmalfevers 

453-8 

1-3 

645-2 

2-5 

119-5 

0-3 

346-6 

0-3 

546-2 

1-0 

975-4 

.3-5 

Continued  fevers 

164-1 

2-4 

160-6 

3-5 

132-8 

1-6 

104-0 

1-2 

132-8 

1-9 

148-9 

4-0 

Eruptive  fevers  ) 
(including      [ 

3-7 

0-1 

0-6 

-.. 

1-2 

0-1 

0-8 

... 

A '4 

0-05 

1-0 

0-1. 

Dengue),     .  ) 

Hheumatism, 

49-4 

0-02 

39-5 

0-03 

35-5 

0-OS 

31-8 

... 

39-1 

0-05 

39-4 

0-3 

Syphilis,       ■  . 

90-8 

0-11 

1211 

r... 

105-7 

0-15 

132-9 

0-1 

89  1 

0-08 

115-2 

0-1 

Phthisis,  Scro 
fula,  &c. , 

■'! 

9-0 

1-6 

7-5 

1-8 

10-5 

1-6 

7-3 

0-9 

8-3 

1-55 

6-7 

3-5 

Eespiratory, 

) 

58-3 

1-1 

51-1 

2-1 

42-0 

0-5 

35-0 

0-7 

42-6 

0-1 

58-0 

2-3 

Circulatory, 

20-0 

1-3 

14-6 

0-8 

18-9 

1-7 

17-8 

1-2 

13-5 

1-0 

12-2 

0-5 

Nervous, 

20-1 

2-2 

21-9 

3-8 

18-6 

2-0 

15-0 

1-6 

15  9 

2-1 

14-9 

4-0 

iiye,      . 

20-6 

•  .. 

16-3 

•  •• 

18-2 

16-1 

... 

20-7 

16-7 

... 

Digestive, 

235-1 

5-4 

256-2 

6-2 

328-5 

6-1 

231-3 

2-8 

220-2 

3-8 

266-0 

5-1 

Drinary, 

118-2 

0-3 

136-8 

0-2 

88-5 

0-2 

131-3 

0-1 

98-2 

0-2 

131-0 

0-5 

Injuries      and ) 
poisons,       t  1 

96-0 

V6 

92-1 

R-0 

104-0 

2-1 

'98-8 

1-4 

99-6 

1-8 

110-3 

2-4 

All  .other  causes, 

94-5 

0-3 

192-7 

0-4 

195-2 

1-0 

201-2 

0-1 

172-7 

1-1 

222-2 

0-8 

Total, 

1439-9 

25-0 

1763-0 

29-2 

1226-918-9 

1370-0 

10-5 

1503-4 

16-0 

2117-9 

■25-1 

1  Including 

deaths  of  invalids 

2  Arn 

ly  Me 

dical  I 

!,eport 

s,  vol. 

xii.  t 

0  xxii. 

tisticalJournal,  vol.  x.) ;  Sir  Ranald  Martin  anfluence  of  Tropical  Climates,  2d  edition) ; 
Mr.  Ewart  (Vital  Statistics  of  European  and  Native  Armies,  1859)  ;  Drs.  Waring  and 
Norman  Chevers  (Indian  Annals,  1858-1862) ;  and  as  far  as  oflBcers  and  civilians  are 
concerned,  by  Col.  Henderson  (Asiatic  Researches,  vol.  xx.),  and  Mr.  Hugh  Macpherson. 
3.  Official  documents,  the  most  important  of  which  are  contained  in  the  Indian 


348 


PRACTICAL    HYGIENE. 


The  following  table  shows  the  distribution  of  mortality  according  to 
age:— 

Deaths  per  1,000  of  Strength  at  the  Ages  named. 


All  India. 

Under  20 
years. 

20  and 
under  25. 

25  and 
under  30. 

30  and 
under  33. 

35  and 
under  40. 

40  and 
upward. 

18C0-69  (10  years— Balfour) ' 

1870-79(10  years) 

1880 

9.25 

6.65 

10.59 

17.59 
14.79 
23.17 

24.63 
16.95 
21.70 

34.17 
22.14 
26.56 

44.13 
28.17 
25.59 

60.88 
52.01 
45.50 

If  these  numbers  are  compared  with  those  of  men  serving  at  home,  it 
will  be  seen  that  the  mortality  at  every  period  is  greater  in  India.  If  the 
average  for  the  corresponding  years  in  England  be  multiiDlied  by  three,  the 
result  comes  close  to  the  average  Indian  numbers  in  the  earlier  years,  al- 
though the  proportion  is  not  quite  the  same  in  the  later.  In  the  period 
1870-79  the  ratio  between  the  ages  20-30  is  nearly  three  times  the  home 
ratio,  while  in  1880  it  was  about  four  times.  At  the  ages  above  30  the 
rate  in  India  is  distinctly  diminishing. 

These  facts  are  an  argument  against  the  \aew  that  age,  per  se,  increases 
the  total  mortahty  fastei'than  it  does  at  home  ;  and  the  statistics  of  officers 
confirm  the  inference  drawn  from  the  argument.  The  mortality  of  the 
members  of  the  Mihtary  and  Medical  Funds  in  Madras  and  Bengal  has  been 
carefully  determined  by  actuaries,  and  the  following  table  proves  that 
mortality  among  officers  does  not  increase  with  age  in  anything  like  the 
proportion  it  does  among  non-commissioned  officers  and  privates.  The 
large  mortality  in  the  earlier  ages  is  owing  to  the  statistics  running  back  to 
long  periods,  when  the  deaths  were  more  numerous. 

Mortality  in  Officers  (in  Service  Fund)  according  to  Age, ^  per  1,000  of 

respective  Ages. 


Under 
20. 

29 
12 

20-25. 

25-30. 

30-35. 

35-40. 

40-45.- 

Madras  Military  Fund,  1808-57. .  . 

Bengal  Military  Fund 

Madras  Medical  Fund,  1807-66.. . . 

32.6 
22.3 
14.2 

31.6 
24.5 
35.1 

32 

27.5 

34.1 

29.4 

29 

33.4 

28.4 
28.9 
34.1 

The  mortality  among  officers  of  30  to  35  years  of  age  was,  therefore, 
nearly  the  same  as  among  privates,  but  at  35  to  45  it  was  very  much  less. 

Sanitary  Report ;  in  the  yearly  Army  Medical  Department  Reports  since  1860;  in  the 
various  Reports  of  the  Sanitary  Commissioners  in  the  three  Presidencies,  in  the  invalu- 
able Returns  of  the  late  Dr.  Bryden,  and  in  the  Municipal  and  other  Official  Reports 
sent  in  from  towns  or  districts.  At  present  the  most  valuable  information  is  being 
collected  and  published  in  India  of  the  health  not  only  of  the  European  and  native 
armies,  but  of  the  civil  population ;  and  records  of  population  and  of  births  and  deaths 
are  now  systematically  made.  For  the  first  time  the  Indian  Government  is  gradually 
obtaining  a  view  of  the  state  of  health  of  the  numerous  nations  it  controls. 

The  Reports  from  Bengal  (Annual  Reports  of  the  Sanitary  Commissioner  with  the 
Government  of  India)  and  those  from  Madras  and  Bombay  are  models  of  their  kind, 
and  must  have  a  great  effect  on  the  healtli  of  the  inhabitants  of  all  India.  The  inior- 
mation  given  in  these  excellent  Reports  is  so  copious  that  it  is  impossible  to  give  any 
adequate  account  of  it  in  this  short  chapter.     Only  the  most  striking  points  are  noticed. 

'  Copied  from  the  Report  for  1871  of  the  Sanitary  Commissioner  (Dr.  Cornish)  for 
Madras,  1872,  p.  7. 


FORETGIS"    SERVICE. 


349 


Mere  climatic  conditions,  acting  more  and  more  as  age  advances,  can  there- 
fore not  account  for  the  gi'eater  mortality  of  the  private  soldier,  for  they 
would  act  equally  on  the  officer.  No  doubt  the  officer  had  a  more  frequent 
furlough  to  England ;  but  would  this  be  capable  of  giving  him  such  an  ad- 
vantage ?  We  must  conclude  that  other  conditions  apart  from,  or  at  any 
rate  superadded  to,  climate,  must  give  rise  to  the  large  mortahty  of  the 
piivate  soldiers. 

Moyiality  according  to  Service. 

The  question  can  be  further  considered  by  taking  into  account  the  effect 
of  service.  The  following  table  from  Dr.  Bryden  shows  the  effect  of  ser- 
vice for  three  years  at  the  different  ages  : — 

Death-rate  per  1,000  in  the  European  Army  of  Bengal,  excluding  Cholera. 


Under  20 
years  of  age. 

20-24. 

25-29. 

30  and  over. 

Whole  army  of  1865-70 

First  vear  of  service 

7.61 

12.93 

3.95 

2.87 

13.67 

24.87 

15.84 

9.92 

17.41 
39.32 

23.08 
17.64 

29.94 
47.08 

Second  year  of  seiwice 

Third  year  of  service 

35.61 

27.77 

This  table  brings  out  veiy  forcibly  the  gi'eat  mortality  of  the  first  year 
of  service  at  all  ages  ;  the  older  men  suffer  as  much  as  the  younger  ;  the 
mortality  falls  during  the  second  year  of  seiwice,  and  in  the  thuxl  is  below 
the  mean  mortality  of  the  army  at  large.  To  determine  how  far  this  is 
GAving  to  climate,  we  must  analyze  the  causes  of  this  mortality.  The  careful 
statistics  of  Dr.  Bryden  enable  us  to  answer  this  point  with  some  accuracy.' 

Deaths  in  the  first  Two  Tears  of  Indian  Service  and  the  Death-rates  at 
different  Ages  (1871-75).' 


Died  per 

1,000  of  Strength  in  the  Biennial  Period. 

Under  24.3 

25-99. 

30-34. 

35  and 
upward. 

Cholera 

5.34 
2.10 
9.77 
2.11 
1.80 
1.8S 
2.10 
0.15 
6.00 

5.87 
3.84 
10.16 
2.71 
3.39 
5.42 
1.58 
2.26 
7.00 

4.77 
1.27 
1.59 
4.77 
3.82 
4.45 
3.82 
3.82 
8.27 

13.86 

Remittent  and  continued  fevers 

Enteric  fever     

3.73 
0.53 

Apoplexv 

12.26 

Dvsenterj  and  diarrhoea 

11.20 

Hepatitis 

Phtliisis  pulmonalis = ". . . 

Heart  diseases 

12.26 
8.. 53 
9.06 

All  other  causes , 

22.39 

All  causes    

31.25 
25.91 

42.23 
36.36 

36.58 
31.81 

93.82 

All  causes,  excluding  cholera . . . 

79.96 

^  See  Appendix  C,  in  Bengal  Sanitary  Report  for  1870,  p.  255  et  seq.,  and  for  1871, 
p.  213  ;  also  Tital  Statistics  of  India,  vol.  v.  Dr.  Bryden's  Statistics,  as  given  in  the 
Reports  of  the  Sanitarv  Commissioner  with  the  Government  of  India,  and  in  the  sepa- 
rate Blue  Books  (Vital  Statistics  of  the  Bengal  Presidency.  1870  and  1878),  are  so  much 
more  complete  than  any  other,  that  they  have  rendered  obsolete  all  tlie  older  records. 
Dr.  Corni.sh's  Statistics^  as  contained  in  the  Madras  Sanitary  Reports  are  also  most 
valuable.  -  Vital  Statistics  of  India  (Bryden),  1878,  vol.  v.,  p.  56. 

3  The  niunber  of  soldiers  under  20  is  now  very  small,  little  over  2  per  cent. 


350  PRACTICAL    HYGIENE. 

100  Deaths  made  up  at  different  Periods  of  Residence  in  India  (1871-76).' 


Disease. 

1st  Year. 

2d  Year. 

In  first  four 
Years. 

5th,  fith, 
and  Tth 
Years. 

Above  the 
7th  Year. 

Above  the 
10th  Year. 

Enteric  fever 

32.9 
10.1 
12.7 

7.7 
9.6 
8.9 
5.3 
4.1 
1.2 

7.5 

16.8 

17.6 

9.7 

10.9 

10.4 

8.3 

7.5 

4.1 

3.7 

11.0 

22.2 
14.0 
11.8 
9.0 
9.0 
7.8 
5.8 
4.4 
2.1 

13.9 

5.2 
18.9 
11.9 

8.1 
10.1 

7.3 
11.2 

5.9 

6.1 

15.3 

0.9 
16.0 
10.3 

8.2 
13.3 

6.0 
16.2 

6.8 
5.2 

17.1 

0.5 

Hepatitis 

15.7 

Heat-apoplexj 

Phthisis 

9.5 

7.8 

Dvsenterv 

13.7 

Other  fevers 

4.6 

Heart  disease 

17.6 

Eespiratory   diseases . . . 

Suicidal  deaths 

All  other  causes  (exclud- 
ing cholera,  small-pox, 
and  accidents) 

6.6 
6.1 

17.9 

Total 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

Tliese  tables  are  instructive  on  several  points : — 

1.  As  regards  fever :  the  most  serious  mortality  is  from  enteric  fever, 
■^vliicli  attacks  the  young  soldier,  especially  in  his  earhest  term  of  service. 
The  mean  mortality  below  30  years  of  age  is,  in  round  numbers,  10  per 
1,000  of  strength,  from  30  to  35  less  than  one-s-i.rfh  of  that  proportion,  and 
above  35  only  one-thirtieth.  "With  reference  to  length  of  service,  the  first 
year  in  India  shows  that  about  33  per  cent,  of  the  total  deaths  are  due  to 
enteric  fever,  and  in  the  first  four  years  22  per  cent.  ;  from  the  fifth  to  the 
seventh  the  proportion  is  reduced  to  5  per  cent.,  while  after  7  years  it  is 
merely  fractional.     The  other  fevers  show  much  less  difference. 

2.  Heai-apoplexy. — This  formidable  disease  is  most  severe  in  the  earlier 
years,  and  attacks  especially  the  old  soldier :  the  mortality  above  35  years 
of  age  is  12^  per  1,000,  six  times  the  ratio  below  24,  and  five  times  that 
below  30. 

8.  Dysentery  and  diarrhoea  are  more  fatal  to  old  soldiers,  and  in  the 
later  years  of  service. 

4.  The  same  is  very  markedly  the  case  with  hepatitis,  which  is  markedly 
a  disease  of  deterioration.  -. 

5.  Phthisis  is  rather  more  fatal  in  the  earhest  years  of  service,  but  (in 
the  period  1871-75)  shows  most  mortahty  among  the  older  soldiers.  This, 
however,  does  not  appear  to  be  uniformly  the  case,  if  we  compai'e  previous 
years. 

6.  Heart  diseases  show,  as  might  be  expected,  an  increasing  mortality 
with  age  and  length  of  residence  in  India. 

The  most  dangerous  disease,  therefore,  which  young  newly  amved 
soldiers  have  to  face  in  India  is  (putting  aside  cholera  for  the  present) 
enteric  fever ;  next  to  that,  but  at  a  considerable  distance,  dysentery  and 
diarrhoea.  These  diseases,  but  most  esi^ecially  enteric  fever,  are  so  com- 
pletely under  the  control  of  sanitaiw  measures  that  their  continuance  is  a 
slur  upon  the  application  of  our  sanitaiw  knowledge.  There  is  no  reason 
to  beheve  that  proper  preventive  means  should  be  less  successful  in  India 
than  at  home.     For  old  soldier.s,  that  is,  men  over  30  years  of  age,  newly 

'  From  Bryden's  Vital  Statistics  of  India,  vol.  v. ,  1878. 


FOEEIGN    SERVICE.  351 

arrived  in  India,  the  diseases  to  be  feared  are  heat-apoplexy,  dysentery, 
hepatitis,  and  heart  disease,  all  diseases  of  deterioration,  and  favored  and 
aggravated  by  intemperate  habits.  With  careful  medical  selection  of  men 
much  might  be  prevented,  and  hygienic  precautions,  such  as  free  ventila- 
tion against  heat-apoplexy,  might  do  a  great  deal  toward  a  diminution  of 
the  mortality.  But  drinking  habits  are  the  most  dangerous  enemy  the 
soldier,  particularly  as  he  advances  in  years,  has  to  contend  with.  The 
abolition  of  the  sale  of  spirits  to  European  soldiers,  either  in  canteens  or 
elsewhere,  would  be  a  great  advantage. 

Troops  should  be  stationed  in  the  hills  as  much  as  possible,  so  as  to 
remove  them  from  the  influences  of  excessive  heat,  malaria,  and  choleraic 
poison,  and  also  it  might  be  hoped  to  some  extent  fi'om  enteric  fevers. 
More  efforts  ought  to  be  made  to  provide  employment  and  recreation  for 
the  trooiDS,  who  suffer  greatly  from  enforced  idleness,  ennui,  and  the  foul 
air  of  their  barrack  rooms,  to  which  they  are  still  too  much  confined  for 
fear  of  exposure  to  the  sun.  Undue  exposure  is  unadvisable,  but  it  may 
be  safely  said  that  its  consequences  are  smaller  evils  than  those  undoubt 
edly  arising  from  the  mistaken  steps  taken  for  their  prevention. 

The  men  ought  also  to  be  spared  as  much  as  possible  from  unnecessary 
night  duty. 

As  regards  age  of  arrival  in  India,  men  cannot  now  be  sent  out  under 
20  years  of  age,  for,  as  they  are  not  taken  into  the  army  before  19,  their 
preliminary  training  will  not  be  over  before  that  age  :  there  is  also  now  an 
order  against  it.  Above  that  age  the  younger  they  go  the  better.  For 
the  first  3^ears,  if  protected  from  enteric  fever,  cholera,  and  dysentery 
(which  is  quite  possible),  their  health  will  be  as  good  as,  if  not  better  than, 
at  home.  It  seems  pretty  clear,  on  the  other  hand,  that  men  ought  not  to 
remain  beyond  30  years  of  age,  if  possible,  unless  they  are  non-commis- 
sioned officers  :  the  best  period  would  appear  to  be  between  21  and  28 
years.  After  30  years  of  age  the  private  soldier  is  an  old  man  in  India 
(Bryden,  Roberts),  and  this  is  partly  due  *to  the  work  he  has  had  to  do 
(particularly  night  guards — Roberts),  but  also  very  largely  to  habits  of 
drinking.  When  we  find,  as  in  the  army  of  Bengal,  30,000  men  yielding 
10,000  cases  of  drunkenness  in  the  year,  we  cannot  but  consider  it  a  de- 
plorable condition  of  things,  knowing  as  we  do  what  a  large  amount  of 
unrecorded  excess  this  represents. 

Cholera  in  the  Bengal  Presidency.^ 

During  Miy  years  (from  1818  to  1867)  the  mean  annual  mortality  from 
cholera  per  1,000  of  European  strength  in  Bengal  was  no  less  than  9.4. 
It  was  the  gi-eat  cause  of  variation  in  the  percentage  of  mortality  from 
year  to  year.  The  cholera  mortality  was  not  owing,  as  might  have  been 
supposed,  to  service  in  the  stations  in  Bengal  proper  (the  so-called  en- 
demic home  of  cholera),  for  the  mean  mortality  in  Bengal  proper  was 
below  that  of  the  Punjab,  where  cholera  is  occasional,  i.e.,  prevails  only  at 
certain  seasons  and  in  certain  years.  If  we  compare  Bengal  pro23er  with 
two  other  military  districts,  Agra  (with  Central  India)  and  the  Punjab, 
two  facts  come  out  very  clearly — (1)  That  in  Bengal  proj)er  the  mortaUty 
is  more  steady,  but  on  an  average  of  years  is  lower  than  in  the  other  two 
districts,    where   the   mean   mortality  is   heightened   by  occasional  tre- 

'  The  statistics  referred  to  in  this  section  are  those  given  by  Bryden  in  his  valuable 
Reports  (Vital  Statistics  of  the  Bengal  Presidency,  1870  and  1878),  and  Appendices 
from  Dr.  Cuningham's  Annual  Report. 


352 


PRACTICAL    HYGIENE. 


mendous  outbreaks  unknown  in  cholera's  endemic  home  ;  (2)  that  in 
Bengal  proper  the  Sepoy  mortality  is  higher  than  in  Europeans,  while  m 
the  other  stations  it  is  much  lower.' 

Ihblc  to  shoiv  the  Mortality  from  Cholera  per  1,000  of  Strength  in  Euro- 
peans and  Sepoys. 


Tears. 

Bengal  Proper. 

Agra  and  Central  India. 

Punjab, 

Europeans. 

Sepoys. 

Europeans. 

Sepoys. 

Europeans. 

Sepoys. 

1861 

18G3    

6.51 
6.11 
3.17 
2.50 
6.40 
1.90 
2.50 
5.34 
0.53 
1.00 
0.51 
1.01 
0.53 
0.50 

2!  49 

6.38 
5.44 
4.25 
6.40 
9.20 
7.03 
3.50 
2.51 
4.43 
3.03 
1.25 
2.70 
2.76 
4.74 
2.76 
2.01 

41.21 
26.90 
3.82 
0.62 
7.20 
0.23 
3.30 
3.36 
30.18 
0.47 
0.24 
4.75 
0.97 

5.57 
0.25 

0.25 

1.3 

0.4 

Z.l 

0.9' 
0.16 
7.25 

. . .  .* 

i.05 
0.26 
1.57 

36.10 

12.74 

0.13 

0.06 

0.14 

20.7*0 

16.86 

13.86 

0.09 

2.27 
4.48 

6.88 
3.99 

186;}            

0  90 

18i)4 

0.09 

1865 

1866 

1867     

3.9 

1868 

1869 

7.33 

1870  

1871 

1872 

2.80 

1873 

1874 

b!67 

1875           

1.50 

1876 

1.80 

Means    

2.12 

4.27 

7.46 

1.01 

5.63 

1.83 

This  table  is  most  instructive,  and  proves  beyond  doubt  that  while 
cholera  has  never  (until  lately)  been  absent  from  Europeans  in  Bengal 
proper  ^  (the  endemic  home),  it  has  never  attained  the  destructive  preva- 
lence which  occvLTS  in  Central  India  and  the  Punjab,  where  it  is  sometimes 
entirely  absent  for  years,  and  yet  the  severity  of  the  outbreak,  when  it 
does  occur,  makes  the  mean  Punjab  and  Central  India  cholera  mortality 
of  sixteen  years  far  greater  than  the  cholera  mortality  of  Bengal  proper. 

Among  Sepoys  the  mortality  in  Bengal  proper  is  actually  greater 
than  in  Evu-opeans,  while  it  is  far  less  in  the  UpjDer  Provinces,  and  in 
some  outbreaks  (as  in  Central  India  in  1861)  the  Europeans  have  suffered 
frightfully,  while  the  Sepoys  have  been  scarcely  touched. 

"What,  then,  is  the  cause  that  while  in  Bengal  proper,  where  the  condi- 
tions of  cholera  always  exist,  the  mortahty  should  be  comparatively  low, 
there  should  be  such  teiTible  outbreaks  in  up-country  stations  where 
cholera  is  only  a  visitor,  and  why  should  these  outbreaks  affect  the  Eu- 

'  It  has  been  wrongly  stated  that  the  excessive  mortality  from  cholera  of  Eu- 
ropeans in  the  Bengal  Presidency  is  an  effect  of  race  ;  the  statistics  of  Bengal  proper 
(as  shown  in  the  next  table)  and  of  the  Madras  Presidency  entirely  disprove  this.  In 
the  Madras  Presidency  in  1860-66,  the  annual  European  cholera  mortality  was  3.1  per 
1,000  of  strength,  and  the  Sepoy  mortality  was  3.07,  or  virtually  the  same. 

'  Since  1876  the  ratio  of  deaths  from  cholera  among  European  troops  has  been  very 
small  in  the  Presidency  division  (including  Bengal  proper) : — 

1877 0.49  per  1,000. 

1878 0.97   " 

1879 nil.    " 

1880 nil.   '« 


rOEEIGN    SERVICE. 


353 


ropeans  so  particularly  ?  To  answer  this  question  we  may  select  a  few  of 
the  worst  stations  in  Upper  India,  and  see  what  the  mortality  was  in  the 
epidemics  of  1861-62-67-69-72-75-76. 


Mortality 

per  1,000  of  European  Strength  in 

different  Epidemics. 

1861. 

1863. 

1867. 

1869. 

1872. 

1875. 

1876. 

Meerut 

Mean  Meer. 
Peshawur  . . 

Agra 

Morar 

34.32 
245.63 

56.'56  - 
137.43 

15.70 

49.93 

49.24 

42.5 

37.25 

70.30 
50.49 
92.93 

ii.52 

7.04 
120.14 

82.89 

32.62 
86.87 
21.53 
15.57 
17.05 

7.35 

1.90 

•17.05 

23.06 

This  table  shows  that  the  outbreaks  are  very  variable  in  intensity ;  a 
station  may  be  quite  free  from  cholera  in  one  epidemic  and  suffer  fright- 
fully in  another.  In  Agra,  in  1861-62,  there  were  seven  outbreaks  ;  in 
1867  and  1869  there  was  no  case,  though  the  disease  was  all  round. 

If  we  analyze  the  station  statistics  themselves,  the  remarkable  fact 
comes  out  that  some  of  the  severest  outbreaks  involved  only  a  portion  of 
the  Europeans. 

At  Meerut,  in  1867,  while  the  3d  Buffs  were  Hterally  more  than  deci- 
mated, the  Hussars  and  Sepoys  were  as  healthy  as  if  they  had  been  in 
England. 

These  facts  show  that  the  hypothesis  of  an  epidemic  influence  pro- 
duced by  something  floating  in  the  air  is  incredible,  and  for  such  a  partial 
distribution  as  is  shown  above  would  be  impossible.  If  these  figures  prove 
anything,  it  is  that  the  causes  of  the  tremendous  loss  in  these  stations  is 
not  a  generally  diffused  cause,  but  a  well-marked  local  development,  hav- 
ing narrow  Hmits,  and  sometimes  involving  only  a  single  barrack. 

The  figures  also  show  that  the  supposition  that  the  difference  in  mor- 
tality between  the  Europeans  and  Sepoys  is  owing  to  difference  of  social 
habits  (especially  as  regards  latrine  arrangements)  is  unhkely,  for  different 
bodies  of  Europeans  in  the  same  station  suffer  as  diversely  as  Europeans 
and  Sepoys. 

The  localizing  conditions,  which  give  the  intense  spread  to  what  is,  no 
doubt,  an  imported  agent,  must  be  referable  to  either  soU,  water,  air,  or 
food.  Faulty  latrine  arrangements,  if  they  exist,  must  act  through  one  or 
other  of  these  media,  poisoning  the  ground,  or  air,  or  water.  The  inquuy 
into  the  local  spread  of  cholera,  if  concentrated  on  the  locaHty,  and  car- 
ried to  the  exhaustion  of  every  possible  factor,  must  surely  solve  this 
problem.  It  is  as  in  typhoid  fever  at  home,  where  everything  often  seems 
a  mystery  vuitil  a  minute  search  is  made,  and  then  what  seemed  inexpli- 
cable is  found  to  be  simple. 

But,  without  waiting  for  the  solution  of  the  cause  of  these  localizations 
of  cholera,  the  fact  of  the  localization  points  out  preventive  measures 
which,  as  a  matter  of  reasonable  precaution,  ought  to  be  taken  in  every 
barrack  in  Upper  India  where  these  great  outbreaks  have  occurred.  These 
measures  should  be  adopted  on  the  ground  of  removing  every  possible 
local  cause,  even  though  the  particular  precaution  may  not  have  been 
proved  to  be  necessary. 

1.  The  influence  of  the  ground  should  be  excluded  by  the  most 
thorough  paving  and  cementing  everywhere,  and  by  carefvil  examination 
Vol.  n.— 33 


354  PRACTICAL    HYGIENE. 

and  cleansing  under  every  floor.     When  possible  ground  floors  should  not 
be  occupied  as  sleeping  rooms. 

2.  A  fresh-water  supply  should  be  obtained  at  any  cost,  be  from  an  un- 
doubted source,  and  be  kept  solely  for  the  use  of  the  barrack.  During 
an  epidemic  all  water  should  be  boiled  before  use,  or,  better  still,  distilled. 

3.  The  cooking  arrangements  should  be  entii-ely  remodelled,  and  the 
supply  of  every  article  of  food  carefully  considered. 

■4.  The  latrine  arrangements  should  be  remodelled,  the  places  changed, 
and  the  system  at  every  point  scrutinized  to  see  if  soil,  aii-,  or  water  can 
in  any  waV  be  contaminated  by  percolation  or  emanation. 

If,  after  adoi:)ting  these  measures,  and  carrying  them  out  fairly  in  their 
integritv.  an  outbreak  still  occurs,  this  cannot  throw  doubt  on  the  con-ect- 
ness  of  the  view  which  attaches  so  much  weight  to  localization;  it  will 
only  show  that  we  have  not  solved  the  problem  of  the  localizing  agency, 
and  if  no  other  local  sanitary  measures  can  be  adopted  the  baiTack  should 
altogether  be  abandoned.     But  this  will  hardly  be  found  to  be  necessary. 

With  regard  to  Mean  Meer,  which  has  suffered  so  severely  and  so  often 
from  cholera,  it  is  a  very  important  fact  that  enteric  fever  has  from  time 
to  time  prevailed  at  that  station,  as  in  1860-69-70.  In  the  two  latter  years 
a  careful  examination  of  the  water  supply  was  made  by  Surgeon-Major 
Skeen,  of  the  85th  Eegiment,  who  formerly  gave  e^-idence  on  the  point, 
that  in  both  these  years  the  water  was  the  medium  of  introduction. 
The  fact  of  typhoid*  fever  being  thus  introduced  by  well-water  (tempo- 
rarily used  in  the  absence  of  canal- water),  the  chemical  analysis  showing 
fecaf  imioreguation  of  this  well-water,  and  the  existence  of  sources  of 
fecal  contamination  of  water,  all  seem  strongly  to  indicate  that  cholera 
evacuations  would  also,  in  all  probability,  pass  into  the  water,  and  might 
account  for  the  fearful  outbreaks  at  Mean  Meer.  At  any  rate,  there  can 
be  no  doubt  that  means  should  be  taken  to  entirely  close  the  wells,  which 
are  occasionally  used,  and  if  the  canal-water  which  is  ordinarily  used  does 
not  give  a  suiKcient  supply  at  all  times  of  the  year,  that  a  fresh  source 
should  be  brought  down  at  any  cost.  The  strong  facts  given  by  Dr.  De 
Eenzy  respecting  Peshawui'  prove  that  the  same  course  should  be  adopted 
in  that  station.  These  measures  are  imperatively  demanded  as  a  matter 
of  precaution,  and  no  theoretical  arguments  that  the  water  is  not  to  blame 
ought  to  be  allowed  to  ovenide  them.  The  dimintition  of  cholera  at  Cal- 
cutta among  Europeans  since  the  introduction  of  a  pure  water  supply  and 
improved  drainage  is  very  encouraging  for  the  strenuous  apphcation  of 
local  measures. 

Phlhisis  in  India. 

The  amount  of  phthisis  in  India  is  a  highly  interesting  question,  and 
in  the  table  on  page  355  the  admissions,  deaths,  and  invaliding  from  this 
cause  are  given  for  successive  periods. 

How  regularly  the  causes  of  phthisis  must  be  acting  is  seen  in  the 
fact  that  in  four  years,  1863-66,  74  men  died  from  phthisis  in  the  Bombay 
Presidency,  and  73  in  the  Madras  Presidency,  the  mean  number  of  troops 
being  in  each  case  almost  precisely  the  same  (12,119  and  12,512).  In  the 
next  four  years,  with  a  smaller  number  of  troops,  53  and  55  died  in  the 
two  presidencies.  The  means  of  deaths  (for  18  years)  and  invaliding 
(12  years)  are  practically  identical  for  Madras  and  Bombay  as  shown 
above.  In  the  Bengal  Presidency  the  deaths  are  higher,  but  the  invalid- 
ing is  less,  so  that  the  slight  difference  is  compensated.  More  men  died, 
and  fewer  were  sent  away.. 


FOREIGN"    SERVICE. 

Phthisis,  including  Haemoptysis,  per  1,000  of  Strength. 


355 


02 

.2 

< 

H 

03 
ft 

Is 
1— 1 

02  -Ti 

3  ^ 

Bengai^ 

4  years— (1863-66) 

4  years— (1867-70). 

6  years— (1869-74) 

6  years— (1875-80) 

Bombay. 

4  years— (1863-66) 

4  years— (1867-70) 

6  years— (1869-74) 

6  years— (1875-80) 

Madbas. 

4  years     (1863  66) 

4  years— (1867-70) 

6  years     (1869  74) 

6  years— (1875-80) 

Means,  18  years  (1863-80) 

Bengal 

Bombay  ...'... 

Madras 

7.5 
10.1 
10.1 

7.8 

7.7 

9.2 

10.0 

6.7 

11.5 
11.9 
13.0 

8.1 

8.7 

8.2 

10.8 

1.71 
1.75 

1.87 
1.48 

1.52 
1.23 
1.67 
1.25 

1.46 
1.34 
1.62 
1.37 

1.68 
1.40 
1.44 

2.73 
3.64 

3.28 
3.58 

3.66 
4.74 

.... 

2.97 
3.74 
3.73 

4..4A 

5.39 

4.81 

4.81 

5.11 

6.07 

4.64 
5.08 
5.02 

The  table  seems  to  show  clearly  that  the  immense  range  and  variation 
of  climates  in  which  the  troops  serve  in  India  produce  no  effect  whatever 
on  the  production  of  phthisis  ;  and  this  inference  is  again  strengthened  by 
the  fact  that  the  mortality  in  Bengal  from  phthisis  is  precisely  the  same  as 
in  Canada  (1.71  per  1,000).  The  means  for  12  years  (1869-80)  were— 
Bengal,  1.37  ;  all  India,  1.30;  Canada,  1.37. 

If  the  Indian  mortaUty  and  invaliding  are  compared  with  the  table  al- 
ready given  of  phthisis  in  the  home  army,  it  will  be  seen  that  there  is  de- 
cidedly less  phthisis  in  India.  The  mortality  is  less,  and  the  invahding 
is  far  below.  There  can  be  no  doubt,  then,  that  the  causes  of  phthisis  are 
less  active  in  India  than  at  home ;  and  if  these  causes  are  not  cHmatic, 
must  the  difference  not  be  found  in  the  larger  breathing  space  and  greater 
lateral  separation  men  have  in  India  ? 

It  would  be  interesting  to  have  some  certain  statistics  of  the  amount 
of  phthisis  in  former  years,  when  men  were  more  crowded  ;  Ewart  '^  gives 
the  deaths  in  the  Bengal  Presidency,  from  1812  to  1831,  as  2.6  per  1,000 
of  strength,  and  from  1832  to  1851-52,  as  1.8  per  1,000.  In  the  Bombay 
Presidency,  from  1803  to  1827,  they  were  1.6,  and  from  1828  to  1852,  1.4 
per  1,000.  Ewart  thinks  this  indicates  a  large  decrease,  but  doubts  whether 
this  may  not  be  owing  to  more  accurate  diagnosis.  The  table  just  given 
shows,  however,  that  in  Bombay  at  any  rate  the  deaths  in  the  years  1863- 

1  1871-74  and  1877-78  omitted.     ^  vital  Statistics  of  the  Armies  in  India,  1859,  p.  164 

3 


356  PRACTICAL    HYGIENE. 

80  -were  as  gi-eat  as  in  1828-52,  In  Bengal  there  is  a  diminution,  but  it  is 
very  slight.  In  the  early  period,  however,  there  may  have  been  less  invalid- 
ing. In  the  absence  of  reliable  statistics,  the  question  of  the  relative  amount 
of  phthisis  now  and  formerly  seems  impossible  to  be  answered. 

With  respect  to  the  cure  and  prevention  of  phthisis,  it  seems  a  great 
pity  to  send  phthisical  invalids  to  England,  where  they  die  at  Netley,  or 
are  cast  out  to  die  miserably  among  the  cixil  population,  when  in  the 
Himalayas  thei-e  are  elevated  localities  which  must  be  pai-ticularly  adapted 
for  the  successful  treatment  of  consumption.  "When  means  of  communica- 
tion are  imjiroved,  it  is  possible  that  we  may  see  phthisical  invahds  going 
fi'om  Europe  to  the  high  peaks  of  the  Himalayas,  and  why  should  not  the 
European  soldier,  who  is  actually  in  India,  benefit  by  the  mountain  ranges? 
A  phthisical  sanitarixun,  at  an  altitude  of  10,000  feet,  would  be  likely  to 
ciu-e  the  disease  in  many  cases,  if  it  were  diagnosed  early,  and  then  if  the 
men  were  afterward  kept  on  the  lower  hill  stations,  they  would  probably 
become  perfectly  strong.  To  send  these  men  home  to  England,  is  con- 
demning them  to  almost  certain  death.  Formerly  the  distance  in  India 
would  have  been  fatal  to  such  a  plan,  but  now,  by  proper  arrangements, 
even  weakly  men  could  be  brought  from  all  pai'ts  of  India.  Dr.  Hermann 
Weber,  who  has  paid  great  attention  to  the  effect  of  altitude  on  phthisis, 
holds  very  decided  views  as  to  the  beneficial  effect  of  such  an  arrangement, 
and  has  akeady  urged  this  point  on  the  attention  of  the  authorities. 

The  other  diseases  of  the  lungs  ai-e  not  unknown  in  India.  Pneumonia 
gives  a  mortality  in  Bengal  of  about  0.5  per  1,000  of  strength,  or  a  little  less 
than  at  home  (=  0.571)  ;  while  in  the  other  two  presidencies  it  is  not  half 
this  amount.  Acute  bronchitis  also  causes  in  aU  the  presidencies  a  mor- 
tahty  almost  precisely  the  same  as  at  home  (0.27  and  0.285  per  1,000). 

Lof^s  of  Service — Euroj^ean  Troops. 

The  admissions  and  mean  daily  sick  have  been  ah'eady  given. 

As  compared  with  home  service,  a  larger  number  of  admissions,  a  greater 
daily  number  of  sick,  and  a  shorter  duration  of  cases  and  a  larger  mortahty, 
indicate  not  only  more  sickness,  but  the  presence  of  veiy  rapid  mortal  dis- 
eases, which  shorten  the  mean  duration  of  all  cases. 

The  chief  causes  of  admissions  are  "  pai-oxysmal  and  continued  fevers," 
venereal  disease,  dysenteiy,  rheumatism,  integumentaiy  diseases,  and 
digestive  affections  (not  hepatitis).  Hepatitis  and  cholera  cause  few  admis- 
sions, but  a  large  mortahty. 

It  is  most  satisfactory  to  find  that  the  sickness  and  mortality  are  both 
rapidly  falhng,  owing  to  the  energetic  means  now  being  adopted  by  the 
Government,  and  to  the  increased  sanitary  powers  and  improved  cvu'ative 
means  of  the  medical  officers. 

The  prevalence  of  venereal  disease  demands  as  much  attention  in  India 
as  in  England,  but  the  preventive  measures  will  be  much  easier.  Police 
regulations  and  proper  surveillance  are  now  being  enforced,  and  Lock  hos- 
pitals are  established  in  many  places. 

Invaliding  of  European  Troops. 

For  some  years  back  the  invaliding  statistics  of  Bengal  have  been  given 
"with  great  care  by  the  late  Dr.  Bryden.'     The  invaliding  ratio,  from  all 

'  Vital  Statistics  of  the  Bengal  Presidency,  1870  and  1878  ;  and  Reports  of  the  San- 
itary Commissioner  (Dr.  Cuningham)  with  the  Government  of  India.  Reference  must 
be  made  to  these  elaborate  reports  for  the  full  details. 


FOREIGN    SERVICE. 


357 


causes,  in  the  Bengal  European  army,  varied  in  ten  years  (1861-70)  from 
28.09  to  53.98  per  1,000  of  strength,  the  mean  being  38.9  ;  and  in  the  next 
ten  yeai-s  (1871-80)  from  29.88  to  47.14,  the  mean  being  40.6. 
Iq  the  Bengal  army  the  ratios  were  per  1,000  strength — 

Tears.  Under  25.  25  to  30.       30  and  upward. 

1865-70 26.55  39.74  78.34 

1871-75 24.60  85.92  58.17 


Army  of  India. 


Tears.                        Under  25. 
1871-75..'. 25.84 


25  to  34.       35  and  upward. 
37.07  91.34 


Bryden  remarks  that  there  is  but  little  change  in  the  invaliding  rate 
from  25  to  34  years  of  age,  and  he  therefore  puts  the  ten  yeai's  in  one 
class. 

The  hivahding  is  high  during  the  eaiiy  years  ei  service,  as  shown  by 
the  following  table  : — 

Invaliding  per  cent,  of  the  total  Livaliding  at  the  different  Periods  of 
Indian  Service,  1871-75. 


1st  and  2d  years 28.5 

3d  and  4th     "     22.3 


1-4 

5-7 
above     7 


48.1 

23.2 

28.7 

100.0 


The  chief  causes  of  invaliding  are  phthisis,  heart  affections,  hepatitis, 
and  general  debilit}' ,  and  the  following  table,  calculated  from  Bryden,  shows 
the  ratio  of  these  classes  (1871-75)  : — 


CMef  Causes  for  Invaliding. 

1  to  4  Tears. 

5  to  7  Tears. 

Above  7  Tears. 

Phthisis 

11 
15 
15 
15 

9 
10 
17 
20 

6 

Heart  affections 

6 

Hepatitis 

16 

General  debility 

29 

Per   cent,  of  total  invaliding  at 
each  period 

56 

56 

57 

The  total  invaliding  is  made  up  of  those  sent  home  for  dischai-ge  and 
for  change  of  air.  From  about  30  to  60  per  cent,  of  all  invalids  are  in  the 
latter  category.  In  the  ten  years,  1870-79,  the  mean  number  of  invalids 
sent  home  was  42.44,  and  those  finally  discharged  were  16.08  per  1,000  of 
strength.  Those  sent  home  for  change  were  thus  62  per  cent,  of  the  whole. 
In  1880,  29.88  per  1,000  were  sent  home  and  21.40  dischai'ged,  the  per- 
centage sent  home  for  change  being  thus  only  28^. 


358  PRACTICAL    HYGIENE. 

Mortality  of  Naiive  Troops. 

Colonel  Sykes  gives  the  moi-tality  for  1825-44  as  18  per  1,000  of  strength 
for  all  India  ■  and  for  Bengal,  17.9 ';  Bombay,  12.9  ;  Madras,  20.95. 

In  Madras,  from  1842  to  1858,  the  average  was  18  per  1,000  (Macpher- 
son),  of  which  6  jDer  1,000  each  year  were  deaths  from  cholera. 

Ewart  gives  the  following  numbers  per  1,000  of  strength — Bengal 
(1826-1852),  13.9  ;  Bombay  (1803-1854),  15.8  ;  Madras  (1827-1852),  17.5. 

Taking  successive  quinquennial  jDeriods,  there  has  been  a  slight  pro- 
gressive decrease  in  mortahty,  but  this  is  less  marked  than  in  Eui'opeans. 

The  excess  of  mortahty  is  chiefly  due  to  cholera,  dysenteiy,  and  fever. 

In  Bengal,  m  the  years  1861-67,  the  annual  mortality  per  1,000  of  men 
present  with  the  regiments  was  14.57.  In  Madras  the  average  mortality  in 
six  years,  1860-66,  was  12.6, 

The  following  table  gives  the  mortality  of  native  troops  per  1,000  of 
strength  for  the  period  1867-76,  fi-om  Bryden's  tables  : — 

3Iortality  of  Sej^oys  (1867-76)  per  1,000  of  Strength. 

Diseases.  Bengal. 

Cholera 2.12 

Fevers 2.84 

Heat-apoplexy 0.22 

Dysentery  and  diarrhoea 2.01 

Hepatitis 0.15 

Spleen  diseases 0.28 

Respiratory  diseases 2.57 

Heart  disease 0.20 

Phthisis  pulmonaHs 0. 77 

Dropsy 0.09 

Scui-\y 0.14 

Atrophy  and  anaemia 0.52 

All  other  causes 1.19 

Violent  deaths 0.74 

Total  deaths 13.84 

Deaths,  excluding  cholera 11.72 

Total  deaths,  including  those  in  absence 17.25 


SECTION  IX. 
CHINA. 

Hong-Kong. 

Although  the  English  have  occupied  Canton,  Tientsin  in  the  north,  and 
several  other  places,  yet,  as  their  occupation  has  been  only  temporary,  it 
seems  unnecessary  to  describe  any  other  station  than  Hong-Kong. 

Garrison  of  Hong-Kong  about  1,000,  but  differing  considerably  accord- 
ing to  the  state  of  affairs  in  China. 


rOEEIGN    SEETICE.  359 

The  island  is  27  miles  in  circumference,  10  long,  and  8  broad  at  its 
widest  part. 

Geology. — The  kills  are  for  the  most  part  of  granite  and  syenite,  more 
or  less  weathered.  In  some  parts  it  is  disintegrated  to  a  great  extent,  and 
clayey  beds  (laterite)  are  formed,  in  which  granite  boulders  may  be  em- 
bedded. Victoria,  the  chief  town,  stands  on  this  disintegi'ated  granite.  As 
in  all  other  cases,  this  weathered  and  clayey  granite  is  said  to  be  veiy  ab- 
sorbent of  water,  and,  especially  in  the  wet  season,  is  considered  veiy  un- 
healthy. 

Climate. — Mean  annual  temperature,  73°  Fahr.  ;  hottest  month  (July), 
86.25°  ;  coldest  month  (Januaiy),  52.75°  ;  amplitude  of  the  yearly  fluctua- 
tions, 33.5°. 

The  humidity  is  considerable — about  80  per  cent,  of  saturation,  as  an 
average. 

The  N.E.  monsoon  blows  from  November  to  April ;  it  is  cold,  dry,  and 
is  usually  considered  healthy  and  bracing  ;  but  if  persons  who  have  suffered 
from  malaria  are  much  exposed  to  it,  it  reinduces  the  paroxysm.  The  S.  W. 
monsoon  blows  from  May  to  October  ;  it  is  hot  and  damp,  and  is  consid- 
ered eneiwating  and  relaxing.  The  difference  in  the  thermometer  between 
the  two  monsoons  has  been  said  to  be  as  much  as  46^,  but  this  seems  ex- 
cessive. 

The  rainfall  is  about  90  to  100  inches  \dih.  the  S.W.  monsoon. 

In  addition  to  Victoria,  there  are  two  or  three  other  stations  which  have 
been  occupied  as  sanitaria,  viz.,  Stanley,  seated  on  a  peninsula  on  the  south 
end  of  the  island,  and  about  100  feet  above  the  sea ;  and  Sarivan,  5  miles 
east  of  Victoria.  Neither  station  seems  to  have  answered  ;  the  barracks  are 
very  bad  at  Stanley,  and  ai'e  exposed  too  much  to  the  N.E.  monsoon,  which, 
at  certain  times,  is  cold  and  wintry  ;  during  the  S.  W.  monsoon  it  is  healthy. 
Sarivan  has  always  been  unhealthy,  probably  from  the  neighborhood  of 
rice-fields.  Since  the  close  of  the  last  wai*  a  portion  of  the  mainland.  Cow- 
loon,  opposite  Victoria,  has  been  ceded,  and  has  been  occupied  by  troops. 
It  is  said  not  to  be,  however,  even  so  healthy  as  Hong-Kong,'  but  there  are 
differences  of  opinion  on  this  point. 

Hong-Kong  has  never,  it  is  said,  been  considered  healthy  by  the  Chi- 
nese. The  chief  causes  of  unhealthiness  appear  to  be  the  moist  laterite  and 
weathered  granite,  and  the  numerous  rice-fields.  Indeed,  to  the  latter 
cause  is  ascribed  by  some  (Smart) '  the  gi'eat  unhealthiness,  especially 
when  the  rice-fields  ai'e  drving  in  October,  November,  and  December. 

Local  causes  of  unhealthiness  existed  till  very  lately  in  Victoria.  In 
building  the  baiTacks  the  felspar  clay  was  too  much  cut  into,  and,  in  addi- 
tion, the  access  of  air  was  impeded  by  the  proximity  of  the  hills.  The 
S.W.  monsoon  was  entirely  shut  out.  Till  lately  sewerage  was  very  de- 
fective. 

Owing  probably  to  these  climatic  and  local  causes,  for  many  years  after 
its  occupation  in  1842,  Hong-Kong  was  excessively  unhealthy.  Malarious 
fevers  were  extremely  common,  and  not  only  so,  but  it  is  now  kno"v\-n  that 
typhoid  fever  has  always  prevailed  there  (Becher  and  Smart).  Dysentery 
has  been  extremely  severe,  and  has  assumed  the  peculiar  foi-m  of  lientery. 
This  was  noticed  in  the  first  China  war,  and  appears,  more  or  less,  to  have 

'  See  Eeport  of  Surgeon  Snell,  Army  Medical  Eeport,  vol.  v.,  p.  360,  for  the  causes 
of  tlie  unhealthiness  of  Cowloon. 

■  Transactions  of  the  Epid.  Soc,  vol.  i.,  p.  191.  This  paper  should  be  consulted 
for  an  excellent  aceouut  of  Hong-Kong,  and  of  the  diseases  among  sailors  especially. 


360  PRACTICAL    HYGIENE. 

continued  since.  In  addition  to  these  diseases?  phthisis  appears  to  have 
been  frequent. 

For  some  years  there  were  such  frequent  wars  in  China,  that  the  exact 
amount  of  sickness  and  mortality,  due  to  the  cHmate  of  Hong-Kong,  could 
not  be  well  determined.  But  it  is  becoming  much  healthier  than  in  former 
years,  owing  to  the  gradual  improvement  in  sanitary  matters  which  goes  on 
from  year  to  year.  In  1865  there  was,  however,  much  sickness,  owing  ap- 
parently to  overcrowdiag  and  to  bad  accommodation. 

In  the  "  Statistical  Reports,"  the  ti'oops  serving  in  Hong-Kong,  Cowloon, 
Canton,  Shanghai,  and  the  Straits  settlements,  are  classed  together,  so  that 
the  influence  of  Hong-Kong  per  se  can  only  be  partially  known. 

In  the  years  1859-66,  which  include  years  of  war,  the  admissions  in 
South  China  averaged  2,131,  and  the  deaths  56.25,  or,  exclusive  of  \iolent 
deaths,  52.63  per  1,000  of  strength,  and  there  was  in  addition  a  large  in- 
vahding.  Paroxysmal  fevers  gave  609  admissions  and  7.77  deaths;  con- 
tinued fevers,  25.25  admissions  and  4.17  deaths;  and  dysentery  and 
diarrhoea,  249  admissions  and  16.3  deaths  per  1,000.  In  later  years  the 
mortality  was  less;  in  1869-70,  it  was  16.02,  and  in  1871  only  5.82  per 
1,000  of  strength,  and  of  these  only  3.88  was  from  disease.  In  the  five 
years,  1871-75,  it  was  11.73  ;  and  in  1876-80  it  was  8.61,  giving  for  the  ten 
years  a  mean  of  10.17.  This  contrasts  very  favorably  with  the  mean  of  the 
previous  ten  years  (1861-70),  which  was  39.84,  or  nearly  four  times  as 
great.  It  is  evident  that  the  causes  of  sickness  and  mortality  are  now 
being  brought  under  control. ' 

'  Atistralia  and  New  Zealand  — The  withdrawal  of  the  troops  from  these  colonies 
renders  it  unnecessary  to  give  any  statistical  details. 


CHAPTER   V. 

SERVICE  ON  BOARD  SHIP.' 

Servicb  on  board  ship  must  be  divided  into  three  sections,  corresponding 
to  three  different  kinds  of  service. 

1.  Transport  ships,  for  the  conveyance  of  healthy  soldiers,  their  wives 
and  children,  from  place  to  place,  or  for  conveying  small  parties  of  troops 
in  charge  of  convicts. 

2.  Transports  for  conveyance  of  sick  from  an  army  in  the  field  to  an 
hospital  in  rear,  or  fi'om  a  foreign  station  to  a  sanitarium,  or  home.  Al- 
though the  term  is  a  httle  odd,  it  is  convenient  to  call  these  ships  Sick- 
Transports. 

3.  Hospital  ships,  intended  for  the  reception  and  treatment  of  the  sick. 

SECTION  I. 

TRANSPORTS  FOR  HEALTHY  TROOPS. « 

The  use  of  Government  transports  has  very  much  altered  the  duty  of 
medical  ofiicers  on  board.  The  transports  are  really  men-of-war,  i.e.,  ofl&- 
cered  by  the  Royal  Navy  and  under  naval  regulations.  The  medical  officer 
of  troops  has  therefore  nothing  to  do  with  the  vessel  and  its  arrangements. 
If  hired  transports  are  used,  the  "Queen's  Regulations"  (1881)  (section  17, 
Movement  of  Troops  by  Sea),  and  the  "  Medical  Regulations  "  (Part  I.,  sec- 
tion iii.,  sub-section  iii.  ;  Part  IL,  section  vi.,  sub-section  x.  ;  Part  V.,  sec- 
tion vii.),  have  to  be  carried  out. 

SECTION  n. 

TRANSPORTS   FOR  SICK  TROOPS. 

No  specific  regulations  are  laid  down  with  respect  to  these  hired  ships, 
but  it  would  be  very  desirable  to  have  some  set  rules  with  respect  to  space, 
diet,  and  fittings.  Invalids  are  now  carried  from  India  and  the  Colonies 
in  Government  transports  ;   occasionally  hired  transports  are  used.     At 

'  See  Rattray's  paper  read  to  the  Medico-Chirurgical  Society  in  1872  ;  also  the  last 
edition  of  this  work  ;  and  Naval  Hygiene,  by  Professor  Macdonald,  R.N.,  M.D.,  F.R.S. 
(Smith,  Elder  &  Co.),  1881. 

■^  The  following  note  is  given  in  the  Queen's  Regulations,  1881,  p.  372  :  *'  A  Troop- 
Ship  is  one  of  Her  Majesty's  ships  commissioned  as  a  troop-ship.  A  Transport  is  a  ship 
wholly  engaged  for  the  Government  service  on  monthly  hire,  or  a  ship  wholly  engaged 
by  the  Government  to  execute  a  special  troop  service,  though  not  hired  by  the  month. 
A  Troop  Freight  Ship  is  a  ship  in  which  conveyance  is  engaged  by  Government  for 
troops,  but  which  is  not  wholly  at  the  disposal  of  the  Government." 


362  PRACTICAL    HYGIENE. 

present  the  diet  of  invalids  on  boai*d  the  hired  transports  is  not  good.  In 
respect  of  fittings,  the  use  of  swinging  cots  for  feeble  men  and  well- 
aiTanged  closets  for  dysenteric  cases  are  very  important.  So  also  with 
the  cooking  ;  the  coarse  ship  cooking  is  a  great  trial  to  many  patients.  If 
there  is  need  of  Government  transports  for  healthy  men,  the  necessity  is 
still  gi-eater  for  sick  men. 

As  far  as  possible,  the  sick  should  be  treated  on  deck  in  fine  weather,  a 
good  a\vning  and  a  comfortable  part  of  the  deck  being  appropriated  to 
them.  I  believe  that  it  would  be  a  good  plan  not  to  send  home  officers  and 
sick  men  in  the  same  shij),  but  to  have  officers'  ships,  so  as  to  give  up  the 
poop  to  the  men  in  the  ships  which  carried  them.  This  di\ision  will  be  a 
gain  to  both. 

In  time  of  war,  sick-transports  are  largely  used  to  cany  troops  to  hos- 
pitals in  the  rear.  For  this  purpose  good  roomy  steamers  must  be  chosen. 
For  economy's  sake,  they  will  generally  be  large,  and  probably  with  two 
decks  ;  they  should  never  have  more,  and  indeed  a  single  deck  is  better. 
But  if  with  two  decks,  each  sjDace  should  be  separately  ventilated  by  tubes, 
so  as,  as  far  as  possible,  to  prevent  passage  of  foul  air  from  the  lower  to 
the  upper  deck.  All  the  worst  cases  should  be  on  the  ujDper  deck,  esjDe- 
cially  surgical  cases. 

Tlie  decks  of  these  vessels  should  be  as  clear  as  possible,  so  that  men 
can  be  treated  on  deck.  An  aj^paratus  should  be  arranged  for  hoisting 
men  on  deck  from  below. 

It  has  been  proposed  to  fit  these  ships  with  iron  bedsteads,  and  no 
doubt  this  gives  the  men  more  space  ;  but  a  better  plan  still  would  prob- 
ably be  to  have  short  iron  rods,  to  which  every  cot  could  be  suspended. 
The  sick  men  might  be  carried  in  then-  cots  on  board,  and  ogain  removed. 
If  the  rods  are  made  about  14  inches  high,  and  bent  in  at  the  top  so  as  to 
form  a  hook,  a  cot  is  hung  easily,  and  will  swing.  There  is  space  enough 
below  to  put  a  close-stool  or  pan  under  the  man  without  stirring  him,  if  a 
flap  is  left  open  in  the  canvas,  and  a  hole  left  in  the  thin  mattress. 

Fixed  berths  are  not  so  good,  but  some  must  be  provided.  Some  cots 
can  swing  fi'om  the  top,  and  some  men  can  be  in  hammocks.  Probably 
eveiy  sick-transport  should  have  all  these,  viz.,  iron  bedsteads  at  some 
points  fastened  to  the  deck,  iron  standards  for  swinging  cots,  cots  swinging 
from  the  roof,  lew  berths,  and  hammocks. 

In  these  sick-transports  the  kits  and  clothes  must  be  stowed  away  ;  and 
as  they  are  often  veiy  dirty  and  offensive,  and  sometimes  cany  the  poison 
of  typhus  and  other  diseases,  the  place  where  they  are  put  should  be  con- 
stantly fumigated  with  nitrous  and  sulphurous  acid  alternately.  Eobert 
Jackson  mentions  that  dirty  clothes  and  bedding  may  be  soon  washed 
sweet  by  mixing  oatmeal  with  salt  water. 

Directly  a  sick-transport  has  landed  the  sick,  the  whole  place  should  be 
thoroughly  washed  and  scraped,  then  the  walls  and  ceiling  should  be  lime- 
washed,  and  the  between-decks  constantly  fumigated  till  the  veiy  moment 
when  fresh  sick  embark. 

SECTION  m. 

HOSPITAL  SHIPS. 

These  are  ships  intended  for  the  reception  and  treatment  of  the  sick — 
floating  hospitals,  in  short.  Whenever  operations  are  undertaken  along  a 
sea-board,  and  especially  when  a  force  is  moving,  and  places  for  fixed  hos- 


SERVICE    OlS"   BOARD    SHIP.  363 

pitals  cannot  be  assigned,  they  are  indispensable.  They  at  once  relieTe  the 
army  from  a  veiy  heavy  encumbrance,  and,  by  prompt  attendance  M'hich  can 
be  given  to  the  sick,  save  many  lives.  They  should  always  be  organized  at 
the  commencement  of  a  campaign.  In  the  Abyssinian  war  three  hospital 
ships  were  used.  Then-  fitting  out  was  carefully  superintended  by  Deputy 
Inspector-General  Dr.  Massy,  and  appears  to  have  answered  admirably.  A 
full  account  of  one  of  these  ships  (Queen  of  the  South)  was  given  by  the 
late  Staff-Surgeon  Charteris,  to  which  reference  may  be  made.  The  ven- 
tilation, as  shown  by  the  amount  of  carbonic  acid  (0.708  per  1,000  volumes), 
was  very  good.  The  supei-ficial  space  between  decks  per  man  was  on  the 
night  of  the  experiment  154  feet,  and  the  cubic  space  no  less  than  1,076. 
During  the  Ashanti  war  (1873-74)  the  Hne-of-battle  ship  Tictor  Emanuel 
was  used  as  an  hospital  ship,  and  was  most  successful.  A  very  full  and 
detailed  account  of  it  is  given  by  the  late  Brigade-Surgeon  T.  M.  Bleckley, 
C.B.,  in  medical  charge.'  The  floor-space  per  head  was  generally  about  50 
square  feet,  and  the  cubic  space  about  480,  although  it  was  originally  in- 
tended to  be  less.  Hospital  ships  were  also  used  during  the  Egyptian 
campaign  of  1882. 

However  convenient,  and  indeed  necessary,  they  are,  it  must  be  clearly 
understood  that  they  are  not  equal  to  an  hospital  on  shore.  It  is  impossible 
to  ventilate  and  clean  them  thoroughly.  The  space  is  small  between  decks. 
The  wood  gets  impregnated  with  effluvia,  and  even  sometimes  the  bilge  is 
contaminated.  Dr.  Becher,  late  pathologist  in  China,  stated  that  even  in 
the  very  best  of  the  hosiDitals  used  there,  it  was  C[uite  clear  that  in  every 
wound  there  was  evidence  of  a  slight  gangrenous  tendency.  In  fact,  it  is 
perhajDS  impossible  to  prevent  this,  except  by  the  freest  ventilation  and  the 
most  vigorous  antiseptic  treatment. 

The  principle  of  separation  should  be  carried  out  in  these  ships — one 
ship  for  wounded  men,  another  for  fevers,  a  third  for  mised  cases  ;  or  if 
this  cannot  be  done,  separate  decks  should  be  assigned  for  wounded  men 
and  fever  cases.  In  fine  weather  the  sick  should  be  treated  on  deck  under 
awnings.  The  between-decks  must  be  thoroughly  ventilated,  and  all  meas- 
ures of  fumigation,  frecj^uent  lime-washing,  etc.,  must  be  constantly  em- 
ployed. Charcoal,  also,  in  substance  should  be  largely  used.  Warming  by 
stoves  must  be  used  in  damp  and  cold  weather,  and,  if  so,  advantage  should 
be  taken  of  this  source  of  heat,  and  of  all  lights,  to  improve  ventilation. 

Ships  of  one  deck  are  better  than  two  ;  but  as  they  will  hold  a  very 
small  number  of  sick,  two  decks  are  commonly  used.  But  not  more 
than  two  decks  should  be  used  ;  and  if  there  be  a  third  or  orlop  deck,  it 
should  be  kept  for  stores.  Sometimes,  if  there  are  two  decks,  the  upper 
deck  is  used  for  officers  and  the  lower  for  troops,  but  the  reverse  an-ange- 
ment  should  be  adopted. 

The  ventilation  of  the  between-decks,  in  addition  to  Edmond's  plan, 
should  be  carried  on  by  tubes,  which,  if  the  central  shaft  is  acting,  will  be 
all  inlets,  and  can  be  so  arranged  as  to  cause  good  distribution  of  the  au'. 

The  fittings  of  an  hospital  ship  should  be  as  few  and  simple  as  possible, 
and  invariably  of  u-on.  Tables  should  be  small,  and  on  thin  iron  legs. 
Swinging  cots  are  indispensable  for  wounded  men,  and  the  appliances  for 
the  receiring  and  removing  the  excreta  of  dysenteric  and  febrile  patients 
must  be  carefully  attended  to.  Berths  should  not  be  of  wood,  but  of  iron 
bars,  which  are  much  more  easily  laid  bare  and  cleaned. 

The  supply  of  distilled  drinking-water  should  be  as  large  as  possible, 

'  Army  IMedical  Reports,  vol.  xv.,  p.  260. 


364  PRACTICAL    HYGIENE. 

and  a  good  distilling  apparatus  should  be  on  board,  whether  the  vessel  be 
a  steamer  or  not. 

The  laundiy  arrangements  are  most  important,  and  it  would  be  a  good 
plan,  on  a  large  expedition,  to  have  a  smaU  ship  converted  entirely  into  a 
laundry.  It  would  not  only  wash  for  the  sick,  but  for  the  healthy  men  also 
So  also  a  separate  ship  for  a  bakery  is  an  important  point,  so  as  to  have  no 
baking  on  boai'd  the  hospital  ship. 

On  board  the  hospital  ship  there  should  be  constant  fumigation  ;  lime- 
washing,  whenever  any  part  of  the  hospital  can  be  cleaned  for  a  day  or  two, 
and,  in  fact,  every  other  preclution  taken  which  can  be  thought  of  to  make 
the  floating  hospital  equ^y  clean,  dry,  well  aiirated  and  pure  as  an  hospital 
on  shore. 

On  board  hospital  ships  it  is  often  easy  to  arrange  for  sea-bathing  and 
douching ;  it  should  never  be  forgotten  what  important  curative  means 
these  are. 

In  case  pyeemia  and  erysipelas,  or  hospital  gangrene  occur,  the  cases 
must  be  treated  on  deck,  no  matter  how  bad  the  weather  may  be.  Good 
awnings  to  protect  from  wind  and  rain  can  be  put  up. 

If  cows  or  goats  are  kept  on  board  to  supply  milk,  their  stalls  must  be 
kept  thoroughly  cleaned.  But  generally  it  is  better  to  obtain  milk  from 
the  shore. 


CHAPTER  VI. 

WAR. 

The  trade  of  tlie  soldier  is  war.  For  war  he  is  selected,  maintained,  and 
taught.  As  a  force  at  the  command  of  a  government,  the  army  is  also 
an  agent  for  maintaining  public  order  ;  but  this  is  a  minor  object,  and  only 
occasionally  called  for,  when  the  civil  power  is  incompetent. 

In  theory,  an  army  should  be  so  trained  for  war  as  to  be  ready  to  take 
the  field  at  literally  a  moment's  notice.  The  various  parts  composing  it 
should  be  so  organized  that,  almost  as  quickly  as  the  telegram  flies,  they 
can  be  brought  together  at  any  point,  prompt  to  commence  those  combined 
actions  by  which  a  body  of  men  are  moved,  fed,  clothed,  kept  supplied  with 
munitions  of  war,  maintained  in  health,  or  cui'ed  if  sick,  and  ready  to  un- 
dertake all  the  engineering,  mechanical,  and  strategical  and  tactical  move- 
ments which  constitute  the  art  of  war. 

That  an  organization  so  perfect  shall  be  carried  out,  it  is  necessary  that 
all  its  parts  shall  be  equally  efficient ;  if  one  fails,  the  whole  machine  breaks 
down.  The  strength  of  a  chain  is  the  strength  of  its  weakest  link,  and  this 
may  be  said  with  equal  truth  of  an  army.  Commissariat,  transport,  medical, 
and  engineering  appliances  are  as  essential  as  the  arts  of  tactics  and  strategy. 
It  is  a  narrow  and  a  dangerous  view  which  sees  in  war  merely  the  move- 
ments of  the  soldier,  without  recognizing  the  less  seen  agencies  which  in- 
sure that  the  soldier  shall  be  armed,  fed,  clothed,  healthy,  and  vigorous. 

During  peace  the  soldier  is  trained  for  war.  What  is  meant  by  training 
for  war?  Not  merely  that  the  soldier  shall  be  taught  to  use  his  weapons 
with  effect,  and  to  act  his  part  in  that  machine,  where  something  of  mechani- 
cal accuracy  is  imprinted  on  human  beings,  but  that  he  shall  also  know  how 
to  meet  and  individually  cope  with  the  various  conditions  of  war,  which 
differ  so  much  from  those  of  peace. 

It  is  in  the  nature  of  war  to  reinduce  a  sort  of  barbarism.  The  arts 
and  apphances  of  peace,  which  tend,  almost  without  our  care,  to  shelter, 
and  clothe,  and  feed  us,  disappear.  The  man  reverts  in  part  to  his  pristine 
condition,  and  often  must  minister  as  he  best  may  to  his  own  wants.  No 
doubt  the  State  wdll  aid  him  in  this  ;  but  it  is  impossible  to  do  so  as  com- 
pletely as  in  peace.  Often,  indeed,  an  army  in  war  has  maintained  itself 
in  complete  independence  of  its  base  of  supplies,  and  in  almost  every  cam- 
paign there  is  more  or  less  of  this  independence  of  action. 

In  peace,  the  soldier,  as  far  as  clothing,  feeding,  shelter,  and  cleanliness 
are  concerned,  is  almost  reduced  to  the  condition  of  a  passive  agent.  Every- 
thing is  done  for  him,  and  all  the  appliances  of  science  are  brought  into 
play  to  save  labor  and  to  lessen  cost.  Is  this  the  proper  plan?  Looking 
to  the  conditions  of  war,  ought  not  a  soldier  to  be  considered  in  the  light 
of  an  emigrant,  who  may  suddenly  be  called  upon  to  quit  the  appliances 


366  '  PKACTICAL    HYGIENE. 

of  civilized  life,  and  who  must  depend  on  himself  and  his  own  powers  for 
the  means  of  comfort,  and  even  subsistence  ? 

There  is  a  general  impression  that  the  English  soldier,  when  placed  in 
unaccustomed  circumstances,  can  do  nothing  for  himself,  and  is  helpless. 
If  so,  it  is  not  the  fault  of  the  man,  but  of  the  system  which  reduces  him 
to  such  a  state.  That  it  is  not  the  fault  of  the  man  is  shown  by  the  fact 
that,  however  helpless  the  English  soldier  may  appear  to  be  in  the  first 
campaign,  he  subsequently  becomes  as  clever  in  pro\iding  for  himself  as  any 
man.  The  Crimean  war  did  not  perhaps  last  long  enough  to  show  this, 
but  the  Peninsular  war  proved  it.  The  soldier  there  learned  to  cook,  to 
bouse  himself,  to  shelter  himself  from  the  weather  when  he  had  no  house, 
to  keep  himself  clean,  and  to  mend  and  make  his  clothes.  Was  it  not  the 
power  of  doing  these  things,  as  well  as  the  mere  knowledge  of  movements 
and  arms,  which  made  the  Duke  of  Wellington  say  that  his  army  could  go 
anywhere  and  do  anything  ?  And  the  wars  at  the  Cape  and  in  New  Zea- 
land have  shown  that  the  present  race  of  soldiers,  when  removed  from  the 
appliances  of  civilized  life,  have  not  lost  this  power  of  adaptation. 

The  English  soldier  is  not  helpless  ;  he  is  simj^ly  untrained  in  these 
things,  and  so  long  as  he  is  untrained,  however  perfect  he  may  be  in  drill 
and  manoeuvre,  he  is  not  fit  for  war.  The  campaign  itseK  should  not  be 
his  tutor  ;  it  must  be  in  the  mimic  campaigns  of  peace,  in  which  the  stern 
realities  of  war  are  imitated,  that  the  soldier  must  be  trained.  Our  j^res- 
ent  field-days  represent  the  very  acme  and  culminating  point  of  war — the 
few  bright  moments  when  the  long  marches  and  the  wearisome  guards  are 
rewarded  by  the  wild  excitement  of  battle  ;  but  the  more  common  condi- 
tions of  the  campaign  ought  also  to  find  their  parallel.  Since  the  Crimean 
war  much  has  been  done  to  instruct  the  soldier  in  the  minor  arts  of  war. 
The  establishment  of  camps  has  to  some  extent  familiarized  him  with  tent 
life  ;  the  flying  columns  which  go  out  from  Aldershot  show  him  something 
of  the  life  of  the  bivouac,  and  the  training  in  cooking  which  Lord  Herbert 
ordered  is  teaching  him  how  to  prepare  his  food.  The  Autumn  Manoeu- 
vres have  extended  this  system,  and  are  now  making  him  familiar  with  the 
chief  conditions  of  the  life  in  campaigns. 

A  campaign  can  never  be  successful  unless  the  men  are  healthy.  How 
are  men  to  be  trained  so  as  to  start  in  a  campaign  in  a  healthy  condition, 
and  to  be  able  to  bear  the  manifold  trials  of  war  ?  The  answer  may  be 
given  under  three  heads — 

1.  Preparation  for  war  dui'ing  peace. 

2.  Enby  on  war. 

3.  Actual  service  in  war. 


SECTION  I. 
PREPARATION  FOR  WAR  DURING  PEACE. 

The  various  conditions  of  war,  which  are  different  from  those  of  peace, 
are — 

1.  Exposure  to  the  Weather. — It  is  a  constant  observation  that  men  who 
have  led  out-door  lives  are  far  more  healthy  in  war  than  men  whose  occu- 
pations have  kept  them  in  houses.  The  soldier's  life  should  be,  therefore, 
an  out-door  one.  This  can  only  be  done  properly  by  keeping  him  in  tents 
during  the  summer.  It  would  be  well,  in  fact,  to  tent  the  whole  army 
from  the  middle  of  May  to  the  end  of  September  every  year.     The  expense 


WAR.  367 

sliould  be  looked  on  as  a  necessary  part  of  tlie  military  establishments. 
Wooden  huts  are  too  like  ordinary  barracks.  As  the  soldier  has  often  to 
sleep  out  in  war,  he  should  be  accustomed  to  this  also  in  peace — warm 
summer  nights  being  first  selected  to  train  him.  It  will  soon  be  found 
that  he  will  very  soon  acquire  the  power  of  resistance  to  cold.  This  plan 
will  also  test  the  utility  of  his  clothes. '  It  has  been  found  by  experiment 
that,  by  careful  training,  even  delicate  persons  can  bear-sleeping  out  at 
night,  even  in  tolerably  cold  weather,  without  injury,  provided  there  be  no 
rain.  At  the  latter  end  of  the  summer,  it  would  be  well  to  expose  the 
men  even  to  rainy  nights,  theii-  clothes  being  adapted  for  this  by  the  sup- 
ply of  waterproofs  ;  and  in  the  very  useful  Autumn  Manoeuvres  this  plan 
might  be  tried  with  advantage. 

At  the  same  time,  it  is  important  to  have  the  men  raised  off  the  gTound, 
both  when  in  tent  and  lying  in  the  open  air,  in  all  countries  where  the 
ground  may  be  moist,  or  cools  rapidly  during  the  night.  A  very  useful 
field  hammock  has  been  invented  by  Captain  M'Quire  ;  it  consists  of  a 
strong  woollen  material,  wdiich  is  suspended  on  two  sticks  by  means  of 
guide-ropes.     It  makes  a  comfortable  bed,  and  keeps  the  body  very  warm. 

It  may  be  thought  that  training  of  this  kind  is  needless,  and  that  it 
may  be  left  to  the  campaign  to  accustom  the  men  to  exposure,  but  this  is 
not  the  case  ;  a  number  of  men  are  rendered  inefficient  at  the  commence- 
ment of  a  campaign  simply  by  the  unaccustomed  exposui-e. 

2.  Tent  and  Gamp  Life."" — The  pitching,  striking,  and  cleansing  of 
tents ;  the  digging  trenches  round  the  tents,  and  providing  for  general 
surface  drainage  ;  the  arrangement  of  the  interior  of  the  tent,  etc.,  should 
all  be  carefully  taught.  So  also  the  camp  life  of  the  campagin  should  be 
closely  imitated,  and  the  rules  of  conservancy  most  strictly  canied  out  as 
a  means  simply  of  teaching  what  will  be  of  such  importance  in  war,^ 

3.  Cooking  of  Food. — No  doubt,  in  future  wars  all  governments  will 
endeavor  to  supply  prepared  and  cooked  food,  so  as  to  lessen  the  cost  of 
transport  and  the  labor  of  the  soldier.  But  as  this  cannot  always  be  de- 
pended upon,  the  soldier  must  be  trained  to  cook  his  ordinary  rations. 
This  should  not  be  done  for  him  ;  he  ought  to  do  it  himself  merely  with 
the  appliances  he  would  have  in  war,  viz.,  his  camp-kettle,  canteen,  and  tin 
plate. 

At  the  commencement  of  a  campaign  many  men  lose  flesh  and  strength, 
or  suffer  from  diarrhoea,  from  the  food  being  badly  cooked  and  indigest- 
ible. 

In  the  Peninsular  war  the  men  became  admirable  cooks.  At  first  very- 
large  camp-kettles,  intended  for  half  a  company,  were  used,  and  were  car- 
ried on  horses.  Th'ey  did  not  answer,  and  the  men  left  them  behind. 
Afterward  smaller  camp-kettles  were  supplied,  one  for  each  mess  of  six  or 
eight.     Luscombe  mentions  that  the  supply  of  salt  was  found  to  be  a  very 


'  In  reference  to  what  was  said  of  the  great  importance  of  a  liood  to  the  great-coat 
for  men  who  sleep  out  at  night,  an  old  observation  of  Donald  Monro  is  of  interest.  He 
states  that  in  1760  the  greater  health  enjoyed  by  the  Austrian  Hussars  over  the  other 
troops  was  owing  to  the  half-boots,  and  the  large  cloaks  with  hoods  carried  by  these 
men.     (On  the  Means  of  Preserving  the  Health  of  the  Army,  2d  edit.,  1780,  p.  7.) 

^  Reference  may  be  made  for  fuller  details  to  some  excellent  treatises  on  camps  pub- 
lished in  Germany  and  Russia,  especially  by  Dr.  Roth  (Das  Zeltlager  auf  der  Lockstad- 
ter  Heide  in  Holstein,  1866)  and  by  Dr.  Heyfelder  (Das  Lager  auf  der  Krasnoe-Selo, 
1868). 

^  Reference  has  already  been  made  to  the  very  useful  Soldier's  Pocket  Book,  by  Sir 
Garnet  (now  Lord)  Wolseley,  which  gives  full  details  on  all  these  points. 


368  PRACTICAL    HYGIENE. 

important  point ;  he  says  he  had  no  idea  of  the  value  of  this  condiment 
till  he  saw  the  wa}'  in  which  the  men  saved  every  little  particle  ;  without  it, 
in  fact,  animal  and  even  vegetable  food  is  unsavory. 

In  the  French  army  on  service  8  or  10  men  form  a  corporal's  detachment 
or  escouade.  They  have  between  them  one  kettle  and  cover  (marvnte, 
weight  1.7  kilog.),  one  large  bowl  (grande  gameUe,  weight  1  kilog.), 
and  one  large  drinking  vessel  (grand  bidon,  weight  1.5  kilog.)  Each  man 
has  for  his  personal  use  a  small  bowl  (petite  gamelle)  and  a  small  drinking 
vessel  (petit  bidon).  They  are  all  of  tinned  iron.  All  these  vessels  are  car- 
ried by  the  men,  the  lai-ger  vessels  being  taken  in  turn  by  the  men  of 
the  mess. 

It  may  be  concluded  with  regard  to  this  very  important  matter  of 
cooking  utensils,  that  a  man  should  have  a  small  but  very  strong  canteen, 
made  of  unsoldered  tin,  and  with  a  good  deep  lid,  with  a  handle  which 
may  serve  as  a  frying-j^an  or  second  vessel,  as  well  as  a  cover.  The  shape 
of  the  canteen  should  be  long  and  flat,  and  not  deeper  than  is  necessary' 
for  cooking,  so  that  it  may  be  easily  carried.  Then  all  the  other  vessels, 
the  camp-kettles  for  each  mess,  and  the  large  water- vessels,  should  be  car- 
ried for  the  men.  They  should  be  made  of  thin  steel,  which  is  very  light 
for  its  strength,  very  durable,  and  is  not  acted  on  by  the  food. 

The  diiferent  kinds  of  camp  cooking  to  be  taught  are  stewing,  boihng, 
and  making  soup,  making  tea  and  coffee,  cooking  preserved  vegetables, 
making  cakes  of  flour,  and  oatmeal  poiTidge. 

Reference  has  already  been  made  to  the  great  importance  of  not  keep- 
ing men  too  long  without  food.  By  a  little  arrangement  men  can  alwaj's 
carry  food,  and  the  proper  organization  of  supplies  and  regimental  trans- 
port would  always  enable  a  commanding  officer  to  have  some  food  for  his 
men.  In  almost  all  marches  with  large  bodies  of  men,  and  in  many  ac- 
tions, thei'e  are  long  periods  of  inaction  during  which  men  could  eat  food 
which  has  been  already  cooked.  The  effect  of  this  upon  their  strength, 
endurance,  and  even  courage,  is  remarkable.  Some  instances  have  been 
related  by  officers  in  which  failures  resulted  entirely  from  the  exhaustion 
of  the  men  produced  by  want  of  food.  Surely  it  is  useless  to  supply  am- 
munition for  guns  if  the  men  who  are  to  work  have  no  supply  of  energy 
issued  also  to  them. 

4.  Water  Supply. — As  impure  water  is  a  great  cause  of  sickness  in 
war,  the  soldier  should  be  taught  how  to  recognize  impurity,  and  how 
to  use  the  simple  methods  of  purification  wdth  charcoal,  alum,  tea,  boil- 
ing, etc. 

5.  Mending  Clothes. — Every  soldier  carries  a  hold-all,  but  many  cannot 
use  it  properly.  It  may  be  suggested  whether,  in  the  workshops  which 
are  now  being  established,  it  would  not  be  well  to  let  every  recruit  have  a 
month's  practice  in  repairing  clothes,  and  especially  boots  ;  simple  plans 
of  repair  being  selected  if  it  be  possible. 

6.  Cleanliness.— Jn  war  a  source  of  disease  is  the  want  of  cleanliness. 
Very  soon  the  person  and  clothes  get  covered  with  lice  ;  aU  the  garments, 
outer  as  well  as  under,  get  impregnated  with  sweat,  and  become  very  filthy. 
The  best  generals  have  always  been  ver}'  careful  on  this  point,  and  have 
had  frequent  washing  parades.  As  washing  clothes  is  really  an  art,  the 
soldier  should  be  taught  to  do  it,  not  by  machinery,  but  in  the  rude  fash- 
ion he  must  practise  during  war.  Clothes  can  be  partially  cleaned  by 
drying  and  beating. 

The  hair  should  be  cut  short.  In  the  absence  of  water  for  washing, 
the  best  plan  is  the  small-tooth  comb,  to  keep  the  hair  free  from  vermin, 


WAE.  369 

and  it  may  be  a  question  whether  one  should  not  be  supphed  to  every 
soldier. 

Washing  the  whole  body  in  cold  water,  whenever  it  can  be  done,  is  not 
only  bracing  and  invigorating,  but  strengthens  it  against  vicissitudes  of 
weather,  and  against  dysentery.' 


SECTION  n. 

ENTRY    ON   WAR. 

When  actual  war  commences  some  further  steps  become  necessary. 

All  experience  shows  that  men  under  twenty  or  twenty-one  years  of  age 
cannot  bear  the  fatigues  of  war.^  If  possible,  then,  all  men  below  twenty- 
one,  or  at  any  rate  below  twenty,  should  be  held  back  from  the  campaign, 
and  formed  into  depots,  whence  they  may  be  drafted  for  active  service  on 
occasion.  Of  course,  every  means  should  be  taken  during  their  service  at 
the  depots  to  strengthen  and  harden  them. 

All  weakly  men  should  also  be  held  back,  and  every  man  thus  retained 
should  come  under  the  surgeon's  superintendence,  not  in  hospital,  but 
while  doing  his  duty. 

The  men  who  are  about  to  enter  on  the  campaign  should  at  once  com- 
mence a  more  severe  training.  If  there  be  time  to  do  it,  this  should  be 
carried  to  an  extent  even  greater  than  will  be  demanded  in  war,  in  the 
manner  of  the  Romans,  who  trained  their  soldiers  so  severely  in  peace  that 
war  was  a  rehef.  Footsoreness  is  very  common  at  the  commencement  of 
a  campaign,  and  often  gives  great  trouble. 

Certain  changes  in  the  food  of  the  men  should  be  made. 

The  exertions  of  war,  bodily  and  mental,  are  often  very  great,  and  de- 
mand an  increased  quantity  of  food,  especially  in  the  nitrogenous  and  fatty 
elements  ;  an  increased  amount  of  meat  and  bread,  with  the  addition  of  fat 
bacon,  cheese,  and  peas  or  beans,  should  be  given,  so  as  to  bring  the  daily 
amount  of  nitrogen  to  375  or  400  grains,  and  of  carbon  to  5,000  grains 
daily.  During  the  war  every  effort  should  be  made  to  get  bread  and  flour 
supplied  in  lieu  of  biscuit,  and  to  supply  red  wine.  As  one  of  the  perils 
of  war  is  the  occurrence  of  scurvy,  the  supply  of  fresh  vegetables  should 
be  increased ;  if  these  at  all  fail  during  the  campaign,  the  preserved  vege- 
tables must  be  issued,  and  the  other  precautions  taken.  Considering  the 
benefit  apparently  derived  in  Captain  Cook's  voyages  from  wort  made  from 
malt,  it  might  be  worth  while  to  try  the  efifect  of  introducing  this  as  a 
beverage  ;  it  can  be  readily  made. 

Donald  Monro  mentions  that  at  Bremen,  in  1762,  when  no  vegetables 
could  be  got,  and  fresh  meat  was  dear,  and  scurvy  broke  out,  infusion  of 
horse-radish  was  found  to  be  useful.     Spruce  beer  was  also  used. 

'  Both  Donald  Monro  and  Lind  notice  this. 

°  The  examples  are  numerous,  but  the  following  are  often  quoted :  In  1805  the 
French  army  broke  up  at  Boulogne,  and  marched  400  leagues  (French)  to  fight  at  Aus- 
terlitz ;  the  youngest  soldier  was  twenty-two  years  old  ;  they  left  scarcely  any  sick  or 
wounded  en  route.  In  1809  the  French  marched  from  the  German  provinces  to  Vienna  ; 
not  half  the  army  were  aged  twenty  years ;  the  hospitals  were  filled  with  sick.  In 
1813  and  1814  the  despatches  of  Napoleon  are  filled  with  complaints  of  the  "boys" 
who  were  sent  him  ;  he  said—"  I  must  have  grown  men  ;  boys  serve  only  to  encumber 
the  hospitals  and  roadsides." 

You  II. -24 


370  PRACTICAL    HYGIENE. 

SECTION  m. 

ACTUAL   WAE.i 

Experience  has  shown  in  hundreds  of  campaigns  that  there  is  a  large 
amount  of  sickness.  The  almost  universality  of  this  proves  that,  -u-ith 
eveiy  care,  the  conditions  of  war  are  unfavorable  to  health.  The  strenu- 
ous exertions,  the  broken  rest,  the  exposui-e  to  cold  and  wet,  the  scanty, 
ill-cooked,  or  unwholesome  food,  the  bad  water,  and  the  foul  and  over- 
crowded camps  and  tents,  accoimt  for  the  amount  of  disease. 

The  amount  of  illness  varies  with  the  nature  of  the  campaign  and  the 
genius  of  the  commander. 

If  the  records  can  be  tnisted,  it  would  seem  that  the  English  have  been 
more  unhealthy  than  the  French  in  theii-  wars,  but  there  is  no  great  trust 
to  be  placed  in  wai'  statistics.  In  the  Peninsula  the  mean  daily  number  of 
sick  was  never  below  12  per  cent,  except  for  a  short  time,  in  the  lines  of 
Torres  Yedras,  when  it  fell  to  9  or  10.  Sometimes  it  amounted  to  15,  20, 
or  25  per  cent.  In  the  Crimea  the  immense  sickness  of  the  first  winter  is 
but  too  well  remembered. 

Army  Medical  Regulations. 

Before  an  army  takes  the  field,  the  Du-ector-General  may  appoint  a 
medical  officer  to  act  as  Field-Inspector  under  the  principal  medical  offi- 
cer, but  not  to  act  as  sanitaiy  officer.  The  Dii-ector-General  prepares  lists 
of  all  medicines,  stores,  etc.  The  amount  of  transport  and  of  stores  is  laid 
down. 

The  Director-General  also,  on  requirement  by  the  War  Office,  gives  an 
account  of  everything  in  the  proposed  scene  of  operations  which  may  affect 
the  health  of  the  men.  He  appoints  a  sanitary  officer  to  be  attached  to 
the  Quartermaster-General's  department.     He  issues  instructions  to  the 

■  Sanitary  Rules  of  the  Romans  during  War. — Vegetius  (De  Re  Militari,  lib.  iii., 
cap.  2)  says  the  Romans  took  great  care  that  the  men  should  be  well  supplied  with, 
good  water,  good  provisions,  firewood,  sufficient  quantity  of  wine,  vinegar,  and  salt. 
They  endeavored  to  keep  their  armies  in  good  health  by  due  attention — 

1.  To  situation  ;  avoiding  marshes  and  dry  uncovered  ground  in  summer ;  in  hav- 
ing tents,  frequently  changing  camps  in  summer  and  autumn. 

2.  To  the  water  ;  for  bad  water  was  considered  to  be  very  productive  of  diseases. 

3.  To  the  seasons ;  not  exposing  men  to  heat.  In  winter,  taking  particular  care 
that  the  men  never  were  in  want  of  firewood  or  of  clothing. 

4.  To  food  and  medicine  ;  the  officers  saw  that  the  men  had  their  regular  meals, 
and  were  well  looked  after  by  the  commissariat. 

5.  To  exercise  ;  by  keeping  the  troops  during  the  day-time  in  constant  exercise  ;  in 
dry  weather  in  the  open  air ;  in  time  of  rain  or  snow  under  cover ;  for  exercise  was 
believed  to  do  a  great  deal  more  for  the  preservation  of  health  than  the  art  of  physic. 

The  Prsefectus-Castrorum  (Quartermaster-General),  an  officer  of  high  rank  in  the 
Roman  army,  looked  after  the  sick,  and  provided  everything  required  by  the  surgeons. 
Both  Livy  and  Tacitus  mention  that  the  commanding  officers  used  to  visit  the  sick  and 
wounded  soldiers,  to  inquire  if  they  were  well  taken  care  of.  The  great  health  of  the 
Roman  soldiers  was  evidently  owing  to  their  great  temperance  ;  their  excellent  warm 
tents  made  of  hides  ;  their  carefully  kept  camps  ;  the  warm  war  dress  or  sagum,  and 
their  constant  exercise. 

Rules  of  the  Macedonians. — The  only  notice  of  the  means  by  which  Alexander  the 
Great  preserved  so  wonderfully  the  health  of  his  small  army  seems  to  be  a  statement 
that  he  frequently  changed  his  encamping  grounds  (Quintus  Curtius,  lib.  v.,  132).  This 
great  soldier  must  certainly  have  been  acquainted  with  the  art  of  Hygiene. 


WAR.  371 

principal  medical  officer  and  sanitary  officer  on  aU  matters  connected  with 
rations,  clothing,  shelter,  precautions  for  preventing  disease,  etc. 

The  sanitary  officer  inspects  all  proposed  encamping  ground,  quarters, 
etc.,  and  supervises  the  sanitary  arrangements  of  all  camps,  towns,  hos- 
pitals, etc.  The  principal  medical  officer  advises  the  Commander  of  the 
Forces  on  all  matters  affecting  health,  such  as  rations,  shelter,  clothing, 
etc.,  and  may,  with  the  sanction  of  the  Commander  of  the  Forces,  issue 
instructions  on  such  matters  to  the  medical  officers. 

The  sanitary  officer  inspects  the  camp  daily  ;  accompanies  the  Quarter- 
master-General on  the  march,  and  gives  his  advice  on  all  sanitary  points. 
He  is  suppKed  with  information  to  aid  him  in  his  work  from  all  principal 
medical  officers  of  general  hospitals,  divisions,  and  brigades  in  the  field. 
He  transmits  a  weekly  sanitary  report  to  the  principal  medical  officer. 

Causes  of  Sickness  and  Mortality  in  War. 

The  chief  causes  of  sickness  and  mortality  in  the  English  army  have 
been  in  order  of  fatality — ■ 

1.  Diseases  arising  from  improper  and  insufficient  food,  viz.,  general 
feebleness  and  increased  liability  to  malarious  fevers,  dysentery,  diarrhoea, 
etc.,  and  production  of  scurv^^  and  scorbutic  dysentery. 

2.  Malarious  disease  from  unhealthy  sites. 

3.  Catarrhs,  bronchitis,  pleurisy,  pneumonia,  rheumatism,  dysentery  (?), 
produced  by  inclemencies  of  weather. 

4.  Spotted  typhus,  kept  up  and  spread  (if  not  produced)  by  overcrowd- 
ing and  uncleanliness. 

5.  Contagious  dysentery,  arising  from  foul  camps  and  latrines. 

6.  Enteric  and  perhaps  other  fevers,  produced  by  foul  camps. 

7.  Exhaustion  and  debility,  produced  by  excessive  fatigue — a  very  great 
predisposing  cause  of  almost  all  other  diseases. 

8.  Cholera,  in  India  especially. 

9.  Yellow  fever  in  the  West  Lidian  and  West  African  campaigns. 

10.  Plague  in  Egypt. 

11.  The  exanthemata  occasionally. 

12.  Ophthalmia. 

13.  Venereal  diseases. 

Of  these  diseases  the  most  fatal  have  been  scorbutic  dysentery  and 
typhus.  It  is  indeed  curious  to  see  how  invariably  in  all  wars  the  scor- 
butic taint  occiu's,  and  frequently  in  how  early  a  period  of  the  campaign  it 
can  be  detected.  There  almost  seems  to  be  something  in  the  fatigues 
and  anxieties  of  war  which  assists  its  development.  It  frequently  compli- 
cates every  other  disease,  impresses  on  them  a  peculiar  character,  and 
renders  them  very  intractable  to  treatment.  This  is  the  case  with  dysen- 
tery, enteric  fever,  malarious  fever,  and  spotted  typhus.  With  the  last 
disease,  especially,  it  has  intimate  relations,  and  contributes  apparently  to 
its  propagation  by  rendering  the  frame  more  easily  attacked  by  the  specific 
poison. 

One  of  the  most  important  preventive  measures  to  be  adopted  in  war 
is  the  prophylactic  treatment  of  scurvy.  But  with  a  full  knowledge  of 
this,  the  disease  cannot  always  be  avoided.  The  Federal  Americans  were 
fully  aware  of  the  necessity  of  combating  it,  and  made  immense  effi>rts  to 
do  so.  They  did  not  succeed,  and  so  marked  and  so  general  was  the  scor- 
butic taint  in  their  army,  that  its  combinations  with  enteric  fever  and  ma- 
laria have  been  looked  upon  as  new  diseases. 


372  PRACTICAL    HYGIENE. 

If  scurvy  could  be  prevented,  every  other  war  disease  oup;lit  to  be 
comparatively  trifling.  Inflammations  from  exjDosure,  exhaustion  from 
fatigue,  and  gastro-intestinal  affections  from  improper  food  and  atmos- 
pheiic  vicissitudes,  would  stiU  occur ;  but  the  ravages  of  typhus,  enteric 
fever,  malaria,  and  dyse^itery  ought  to  be  trifling,  and  easily  jDrevented. 

To  prevent  sciu'vy,  then,  is  one  of  the  most  imj)ortant  measures. 

If  scurvy  be  absent,  typhus  fever  is  readily  treated  ;  isolation  and  the 
fi-eest  ventilation  are  certain  to  stoj)  it.  The  only  great  danger  would  be 
in  a  besieged  and  crowded  fortress.  In  such  a  place  it  may  be  beyond 
control,  but  early  recognition  and  prompt  isolation,  as  far  as  it  can  be 
done,  and  as  free  ventilation  as  possible,  may  perhaps  stop  it.  It  is  in 
such  cases  that  we  should  freely  use  the  nitrous  acid  fumes  and  other  dis- 
infectant vaj^ors. 

Enteric  (typhoid)  fever  and  contagious  dysentery,  in  the  same  way, 
ought  with  certainty  to  be  pi-evented  in  a  camp.  Recent  experience,  how- 
ever, in  Affghanistan,  South  Africa,  and  Egypt  has  shown  what  ravages 
enteric  fever  can  make,  and  how  rapidly  it  is  generated  and  spread  among 
troops  in  campaign.  This  is  certainly  due  to  the  neglect  of  proper  hy- 
gienic measures.  The  first  case  even  should  make  us  take  urgent  meas- 
ures for  the  cleansing  of  latrines,  or,  better  still,  the  closing  of  all  the  old 
and  the  opening  of  fresh  ones.  But  the  best  plan  of  all  is  to  shift  the 
encamping  ground,  and  we  should  remember  the  old  Roman  maxim,  based 
doubtless  on  observation  of  typhoid  fevers,  that  this  must  be  done  more 
often  in  the  autumn. 

The  exanthemata,  measles,  and  scarlet  fever  sometimes  spread  largely 
through  an  army  ;  the  only  plan  is  to  separate  all  cases,  and  send  them 
one  day's  march  on  the  flank  of  the  army,  if  it  can  be  done,  not  in  the 
direction  of  the  line  of  suj^plies. 

Plague  probably,  demands  the  same  measures  as  typhus. 

The  measures  for  cholera  have  been  already  sufficiently  noted. 

The  diseases  of  exposure  can  hardly  be  avoided,  but  may  be  lessened 
by  warm  clothes  and  waterpx'oof  outer  coverings.  Flannel  should  be  used 
next  the  skin  all  over  the  trunk  and  extremities,  and  is  indispensable. 
One  of  the  most  important  means  to  enable  troops  to  stand  inclemencies 
of  weather,  and  indeed  all  fatigues,  is  hot  food.  Coffee  and  tea  are  the 
best,  and  hot  spirits  and  water,  though  useful  as  an  occasional  measure, 
are  much  inferior,  if  indeed  they  do  any  good  at  all  apart  from  the 
warmth.  But  the  supply  of  hot  food  in  war  should  be  carefully  attended 
to,  especially  in  the  case  of  breakfast,  after  which  men  will  undergo 
without  harm  great  exposure  and  fatigue. 

It  is  unnecessary  to  enter  at  greater  length  into  the  measures  to  pre- 
vent the  diseases  of  war,  for  the  proper  plans  have  been  all  enumerated 
previously.  We  may  conclude  only  that  much  can  be  done  to  prevent 
disease,  but  we  must  also  remember  that  the  course  of  campaigns  some- 
times is  too  violent  and  overpowering  for  our  efforts,  and  that  wars,  like 
revolutions,  will  never  be  made  with  rose-water. 

Recapitulation  of  the  Duties  of  a  Sanitary  Officer  during  War. 

To  go  forward  with  the  officers  of  the  Quartermaster-General's  depart- 
ment, to  choose  the  camping  ground  ;  arrange  for  surface  drainage  ;  if 
necessarily  in  a  malarious  place,  make  use  of  all  obstacles,  as  hills,  trees, 
etc.,  to  throw  off  the  malaria  from  the  tents  ;  place  the  tents  with  the 
openings  from  the  malarious  quarter.     If  possible,  never  take  low  hiUs 


WAV..  373 

(100  to  250  feet)  above  marshy  j)lains.  Arrange  for  the  water  supply,  and 
for  the  seiTice  of  the  men,  animals,  and  Avashing.  As  soon  as  possilDle  fix 
the  sites  for  the  latrines  ;  have  them  dug  out,  and  make  di-y  paths  to 
them.  As  soon  as  the  tents  are  pitched  visit  the  whole  camp,  and  see  that 
the  external  ventilation  is  not  blocked  in  any  "way,  and  that  the  tents  are 
as  far  off  each  other  as  can  be  permitted.  Assign  their  work  to  the  scaven- 
gers, and  mark  out  the  places  of  deposit  for  refiise.  It  is  of  the  greatest 
importance  that  all  refuse  should  be  immediately  and  completely  de- 
stroyed by  fire.  The  destruction  of  the  stools  of  enteric,  dysenteric,  and 
choleraic  patients  by  the  same  means  would  probably  prove  a  most  impor- 
tant jprecaution.  The  daily  insiDection  should  include  all  these  points,  as 
well  as  the  inspection  of  the  food  and  cooking  and  of  the  slaughter-houses. 
If  the  camp  be  a  large  one,  a  certain  portion  should  be  selected  ever)'  day 
for  the  careful  inspection  of  the  individual  tents,  but  it  should  be  made 
in  no  certain  order,  that  the  men  may  not  prepare  specially  for  the 
inspection. 

A  set  of  rules  should  be  drawn  up  for  the  men,  pointing  out  the  neces- 
sity of  ventilation,  cleanhness  of  their  persons,  tents,  and  ground  around 
them,  and  ordering  the  measures  which  are  to  be  adopted.  This  will  have 
to  be  promulgated  by  the  general  in  command. 

In  the  daily  work,  a  certain  order  and  routine  should  be  followed,  so 
that  nothing  shall  be  overlooked. 

The  sanitary  officer  of  a  large  camp  can  never  perform  his  duties  with- 
out the  most  uni'emitting  support  from  the  medical  officers  attached  to 
regiments,  who  are  the  sanitary  officers  of  their  respective  coi-ps.  Not 
only  must  they  inspect  theii*  own  regimental  camps,  but  by  an  immediate 
report  to  the  sanitary  olficer  of  any  disease  which  can  possibly  be  traced 
to  some  camp  impurity,  they  should  render  it  possible  for  the  commencing 
evil,  of  whatever  kind,  to  be  detected  and  checked. 

As  early  as  possible  every  morning  the  number  of  men  reported  sick 
from  each  regiment  should  be  made  knoT\-n,  and  a  calculation  made  of  sick 
to  strength,  and  then,  if  any  regiment  showed  any  excess  of  sick,  the  san- 
itary state  of  its  cam]D  should  be  specially  and  thoroughly  investigated. 

Hospitals  in  War.^ 

"With  an  ai'my  in  the  field,  hospitals  are  of  several  kinds. 

1.  The  principal  General  Hospital  at  the  base  of  operations. 

2.  The  intermediate  Hospitals,  di\-ided  into — 

a.  The  Field  Hospitals  stationed  at  the  base  or  on  the  line  of  com- 

munication. 

b.  The   Field  Hospitals   proper,  which  move  with   the  corps,  and 

include  the  dressing  stations  and  regimental  stations. 
The  old  regimental  hospital  is  now  definitely  aboHshed,  but  medical 
and  surgical  assistance  is  j^rovided  by  a  medical  officer  with  one  or  two 
attendants,  accompanied  by  bearers,  with  stretchers  when  required,  as  in 

'  Sir  James  M'Grigor,  in  tlie  Peninsula,  established  divisional  hospitals  in  front, 
and  convalescent  hospitals  in  the  rear,  where  the  men  were  received  eji  route  to  the 
d:pot.  Although  he  does  not  describe  his  system  fully  in  lais  paper  in  the  Medico- 
Chirurgical  Transactions  (vol.  vi.),  it  is  evident  from  his  Autobiography  that  his  con- 
stant practice  was  to  send  off  the  sick  as  soon  as  possible.  This  is  shown  by  his  narra- 
tive of  the  retreat  from  Burgos,  when  he  saved  Lord  Wellington  from  the  mortification 
of  abandoning  his  sick  and  wounded  to  the  enemy.  Professor  Longmore,  in  his  most 
instructive  work  on  Transport,  has  detailed  at  length  the  means  of  transport  of  the 
sick  and  wounded,  and  other  important  matters  of  the  kind. 


oii  niACTICAL    IIYGIEXE. 

action  in  the  field.  The  sick  are  treated  in  the  field  hospitals  first,  and 
then  passed  on  to  the  intermediate  hospitals  in  rear,  which  are  again  evac- 
uated, as  occasion  requires,  bj  transfer  of  patients  to  the  principal  general 
hospital  at  the  base.  This  last  will  be  in  a  convenient  station  on  the 
frontier,  or,  in  case  of  an  insular  nation  Hke  ourselves,  on  some  sea-coast 
easily  accessible.  It  is  fi'om  it  that  men  will  ultimately  be  invalided  home 
if  unfit  for  further  service. 

For  each  army  coi-ps  (of  nominally  36,000  men)  25  field  hospitals  are 
appointed — 12  to  move  with  the  coi-ps,  and  13  to  be  stationed  at  the  base 
and  along  the  lines  of  commnnication ' — each  is  equipped  for  200  sick, 
and  may  be  divided  into  half  hospitals  for  100  each,  if  necessary.  Slight 
cases  would  be  treated  in  the  field  hospitals,  but  all  cases  likely  to  take 
any  time  should  be  sent  to  the  rear  of  operations  as  soon  as  possible. 
Cases  of  fever  (typhus  and  enteric)  ought  to  be  removed  as  soon  as  possi- 
ble far  from  the  field  force.  It  is  of  great  importance  that  they  should 
not  be  put  near  surgical  cases,  which  ought  to  be  kept  sepai-ate,  or  mixed 
only  with  non-communicable  diseases.  This  (the  separation  of  fever  fi-om 
surgical  cases)  was  a  Peninsular  nile  of  Sir  James  M'Grigor,  and  should 
never  be  forgotten.     Ophthalmic  cases  ought  also  to  be  isolated. 

The  hospitals  in  rear  may  be  at  some  distance,  but  connected  either 
with  a  railway  or  by  water  carriage.  It  is  of  gi-eat  importance  to  keep 
continually  sending  patients  from  the  division  and  general  hospitals  wdth 
the  army  to  the  hospitals  in  rear.  It  is  not  only  to  keep  the  hospitals  in 
front  empty  for  emergencies,  and  to  facilitate  all  movements  of  the  army, 
but  it  has  a  great  effect  on  the  aiTay  itself.  A  great  hospital  full  of  sick 
is  a  disheartening  spectacle,  and  often  damps  the  spirits  of  the  bravest 
men.  The  whole  army  is  higher  in  hope  and  spiirits  when  the  sick  are 
removed,  as  was  shown  remarkably  by  the  Austrian  experience  of  1859. 
The  sick  themselves  are  greatly  benefited  by  the  removal ;  the  change  of 
scene,  of  air,  of  ideas,  has  itself  a  man-ellous  effect,  and  this  is  another 
great  reason  for  constantly  evacuating  the  sick  from  the  hospitals  in  front. 

The  men  who  are  rejDorted  for  hospital  in  war  must  be  dirided  into 
several  classes — 

1.  Slightly  wounded  should  be  treated  in  the  field  or  intermediate 
hospitals,  and  then  returned  to  duty. 

2.  Severely  wounded  at  first  in  the  field  hospitals,  then  sent  to  the  inter- 
mediate hospital,  and  then  to  the  rear,  as  convalescence  is  alwaj's  long. 

3.  SHght  colds,  diarrhcea,  etc.,  treated  in  the  field  hospitals. 

4.  Severer  colds,  bronchitis,  pleurisy,  pneumonia,  dysenter}^,  etc.,  should 
be  sent  at  once  to  the  intermediate  hospital,  and  then  to  the  rear  as  soon  as 
they  can  move  with  safety. 

5.  Typhus  iever  at  once  to  the  hosjDitals  in  rear,  if  possible  without  en- 
tering the  field  hospitals. 

6.  Enteric  cases,  also,  should  be  sent  to  the  rear,  and,  in  fact,  all  severe 
cases.  The  field  hospitals  should  be  always  almost  empty,  and  ready  for 
emergencies. 

These  hospitals  in  rear  may  be  even  two  or  three  days'  journey  off,  if 
conveyance  be  by  water,  or  one  or  two  days  if  by  rail.  Sick  and  wounded 
men  bear  movement  wonderfully  well,  with  proper  appliances,  and  are 
often  indeed  benefited.^ 


'  For  full  details  of  the  new  hospital  organization  in  the  field,  see  Professor  Long- 
more's  work,  Gunshot  Injuries  (1877),  sec.  ix.,  chap.  1. 

-  On  this  and  other  points  of  the  like  kind,  see  Keport  on  Hygiene,  in  the  Army 
Medical  Report  for  1862,  pp.  349,  350. 


WAE.  375 

The  proper  position  for  the  hospitals  at  the  base  of  operations  must 
be  fixed  by  the  commander  of  the  forces  at  the  commencement  of  the  cam- 
paign, as  he  alone  will  know  what  point  will  be  the  base  of  supphes,  and  it 
is  of  importance  to  have  these  great  hospitals  near  the  large  stores  which 
are  collected  for  the  campaign. 

It  seems  now  quite  clear  that  these  hospitals  should  not  be  the  ordinary 
buildings  of  the  country  adapted  as  hospitals.  Such  a  measure  seldom  suc- 
ceeds, and  the  mere  adaptation  is  expensive,  though  pi'obably  always  im- 
perfect. '  Churches  should  never  be  taken,  as  they  are  not  only  cold,  but 
often  damp,  and  there  are  often  exhalations  from  vaults. 

The  French,  Austrian,  and  American  experience  is  in  favor  of  having 
the  hospitals  in  rear  made  of  tents  or  wooden  huts.  The  huts  are  perhaps 
the  best,  especially  if  the  winter  be  cold.  They  were  very  largely  used  by 
the  Federal  Americans,  who  gave  up  entirely  converting  old  buildings  into 
hospitals.  The  best  huts  which  were  used  in  the  Eussian  war  of  1854-56 
were  those  erected  at  Renkioi  from  Mr.  Brunei's  design  ;  each  held  fifty 
men  in  four  rows.  This  plan,  however,  is  not  so  good  a  one  as  having  only 
two  rows  of  beds.  Hammond  ^  states  that  in  the  American  war  the  best 
size  has  been  found  to  be  a  ward  for  fifty  men  with  two  rows  of  beds ; 
length  of  ward,  175  feet ;  width,  25  ;  height,  14  feet ;  superficial  area  per 
man,  87  feet ;  cubic  space  per  man,  1,200  feet.  Ventilation  was  by  the  ridge, 
an  opening  10  inches  wide,  running  the  whole  length,  and  by  openings  be- 
low, which  could  be  more  or  less  closed  by  sliding  doors.  Some  of  the 
American  hospitals  held  from  2,000  to  2,800  beds.^  It  is  probable,  however, 
that  smaller  wards  (for  25  men)  would  be  better. 

An  hospital  constructed  of  such  huts  can  be  of  any  size,  but  there  must 
be  several  kitchens  and  lau^jdries  if  it  be  very  large.  If  space  permit,  how- 
ever, it  seems  desirable  to  have  rather  a  collection  of  smaller  hospitals  of 
500  beds  each,  separated  by  half  a  mile  of  distance,  than  one  large  hospital. 

The  arrangement  of  the  huts  must  be  made  according  to  the  pi-inciples 
already  laid  down.     Dr.  Hammond  writes  thus  of  these  hospitals  : — 

"  It  will,  perhaps,  not  be  out  of  place  again  to  insist  on  the  great  advan- 
tages of  these  temporary  field  hospitals  over  those  located  in  permanent 
buildings  in.  towns.  Nothing  is  better  for  the  sick  and  wounded,  winter 
and  summer,  than  a  tent  or  a  ridge-ventilated  hut.  The  experience  gained 
during  the  present  war  establishes  this  point  beyond  the  possibHity  of  a 
doubt.  Cases  of  erysipelas  or  of  hospital  gangrene  occurring  in  the  old 
buildings,  which  were  at  one  time  unavoidably  used  as  hospitals,  but  which 
are  now  almost  displaced  for  the  ridge-ventUated  pavilions,  immediately 
commenced  to  get  well  as  soon  as  removed  to  the  tents.  But  in  one  in- 
stance that  has  come  to  my  knowledge  has  hospital  gangrene  originated  in 
a  wooden  pavilion  hospital,  and  in  no  instance,  as  far  as  I  am  aware,  in  a 
tent.  Hospital  gangi-ene  has  been  exceedingly  rare  in  all  our  hospitals,  but 
two  or  three  hundred  cases  occurring  among  the  many  wounded,  amount- 
ing to  over  100,000  of  the  loyal  and  rebel  tfoops,  which  have  been  treated 
in  them.    Again,  wounds  heal  more  rapidly  in  them,  for  the  reason  that  the 

'  Donald  Monro  says  that,  in  1769,  the  houses  in  Germany  taken  for  the  sick  were 
improved  by  taking  away  the  stoves  and  putting  in  open  fire-places.  In  the  Peninsula, 
the  Duke  of  Wellington  appeared  to  have  a  dread  of  fever  attacking  the  army.  Liis- 
combe  tells  us  that  the  Duke  asked  the  principal  medical  officer  every  day  as  to  the 
appearance  of  fever.  He  also  improved  the  hospitals  by  ordering  open  fire-places.' — 
Luscombe,  p.  6.  ^  On  Hygiene,  p.  355. 

°  See  Report  on  Hygiene,  in  the  Army  Medical  Eeport  for  1862,  p.  345  et  seq.,  for 
a  fuller  description. 


376  PRACTICAL    HYGIENE. 

full  benefit  of  the  fresh  air  and  the  light  are  obtained.     Even  in  fractui-es 
the  beneficial  effects  are  to  be  remarked."  ' 

Baron  Larrey,  in  his  useful  work,'  describes  the  plans  adopted  by  the 
French  in  the  Italian  war  of  1859.  At  Constantinople,  during  the  Crimean 
war,  the  French  were  apparently  very  well  instaUed  ;  the  best  buildings  in 
Constantinople  were  assigned  to  them,  and  they  were  an-anged  with  all  the 
accuracy  of  organization  which  distinguishes  the  French.  The  results  were 
not,  however,  favorable,  especially  in  the  spring  of  185G,  when  typhus 
spread  through  many  of  the  hospitals,  and  caused  great  mortality.'  Taught 
by  this  experience,  in  the  Italian  war  of  1859  the  French  distributed  theu- 
sick  in  small  hospitals  whenever  they  could  find  a  building,  and  in  this  way 
the  extension  of  the  specific  diseases  was  entirely  stopped. 

In  the  great  Franco-Prussian  war  of  1870-71,  the  Germans  made  great 
use  of  temporary  hospitals,  and  distributed  their  sick  and  wounded  over 
almost  the  whole  of  Germany.  The  plans  were  very  similar  to  those  used 
in  the  Crimean  and  American  wars.  In  some  of  the  large  cities,  as  at  Ber- 
lin, immense  hospitals,  with  railways  and  every  apphance,  were  fitted  up. 
The  expeiience  as  regards  hospital  gangrene  and  erysipelas  was  favorable, 
but  there  were  many  cases  of  pyaemia  in  some  of  these  hospitals. 

To  sum  up,  the  hygiene  of  field  hospitals  in  war  (the  rules  are  derived 
fi'om  our  own  Crimean  experience,  and  that  of  the  wars  which  have  taken 
place  since)  is  as  follows  : — The  field,  including  the  intermediate,  hospitals 
to  be  made  of  tents  ;  the  tents  being  well  constructed,  of  good  size,  thor- 
oughly ventilated,  the  flaps  being  able  to  be  raised  so  as  almost,  if  desu-ed, 
to  make  the  tent  into  an  awning.  The  most  convenient  and  best  ai'e  the 
hospital  marquees  of  the  new  pattern,  except  for  their  considerable  weight. 
The  new  double  circular  tents  will  now  be  used«in  all  probability  :  they  are 
a  great  improvement  on  the  old  bell-tent,  and  lighter  than  the  marquee. 
Each  weighs  100  ft  dry,  and  four  patients  are  put  in  a  tent.  For  opera- 
ting purposes,  the  central  pole  can  be  removed  and  a  tripod  support  sub- 
stituted, so  as  to  leave  the  centre  free. 

The  ground  round  the  tents  to  be  thoroughly  drained,  kept  very  clean, 
and  replaced  from  time  to  time.  The  tent  floor  to  be  covered  with  clean, 
and,  if  possible,  dried  earth,  or  charcoal,  and  to  be  then  covered  mth  a 
waterproof  cloth,  or  boarded,  if  the  camp  be  one  of  position.  In  either 
case  the  greatest  care  must  be  taken  that  the  ground  does  not  get  soaked 
and  filthy.  Eveiy  now  and  then  (if  possible  every  ten  days  or  so)  the  tents 
should  be  shifted  a  httle. 

If  it  can  be  done,  the  sick  should  be  raised  off  the  ground.  Iron  bed- 
steads are  cumbrous,  but  small  ii-on  pegs  stuck  in  the  ground  might  carry 
a  sort  of  cot  or  hammock.  The  advantage  of  a  plan  of  this  kind  is  that 
by  means  of  holes  in  the  sacking  wounded  men  can  have  the  close-stool 
without  much  movement.  For  fever  cases  it  permits  a  free  movement  of 
air  under  the  patient. 

'  On  Hygiene,  p.  397.  -  Notice  sur  I'Hygiene  des  H.'pitaux  Militaires,  1862. 

^  Larrey  mentions  some  striking  instances  of  the  effects  of  overcrowding.  At  Rami- 
Tchifflick,'the  hospital  was  fixed  for  900  by  the  surgeon  in  charge,  who  allowed  no 
more  ;  it  remained  healthy.  His  successor  increased  the  beds  to  1,200  and  then  to  1,400. 
Typhus  became  most  severe,  and  spared  no  one  {ni  injirmiers,  ni  sceurs,  ni  medemu). 
In  the  hospital  at  Pera  there  was  the  same  mistake  and  the  same  results.  Typhus 
caused  50  per  cent,  of  the  deaths.  At  the  hospital  of  the  Fcole  Militaire  no  crowding 
was  permitted,  and  typhus  caused  only  10  per  cent,  of  the  deaths.  In  the  French  am- 
bulances in  the  Crimea  the  same  facts  were  noticed.  Double  and  treble  numbers  were 
crowded  into  some,  and  they  were  ravaged  by  typhus ;  others  were  not  allowed  to  be 
crowded,  and  had  little  typhus. 


WAR.  377 

The  stationary  general  hospitals  in  rear  slionld  be  of  tents  or  wooden 
huts,  but  never  of  convei-ted  buildings,  or  of  hospitals  used  by  other  na- 
tions. Here,  of  course,  iron  bedsteads,  and  all  the  appurtenances  of  a 
regular  hospital,  are  brought  into  play. 

^\nienever  practicable,  the  rear  hospital  should  have  water-closets  and 
sewers.  At  Kenkioi,  in  Turkey,  IVIr.  Brunei  supphed  square  wooden  sew- 
ers about  fifteen  inches  to  the  side  ;  they  were  tarred  inside,  and  acted 
most  admirably,  without  leakage,  for  fifteen  months,  till  the  end  of  the 
war.  The  water-closets  (Jenuing's  simple  siphon),  arranged  with  a  small 
water-box  below  the  cistern  to  economize  water,  never  got  out  of  order, 
and,  in  fact,  the  drainage  of  the  hospital  was  Hterally  perfect.  Dr.  Parkes 
had  little  doubt  such  weU-tarred  wooden  sewers  would  last  two  or  thi'ee 
years. 

Thei-e  is  one  danger  about  wooden  hospitals,  viz.,  that  of  fii-e.  The 
huts  should,  therefore,  on  this  gTound  alone,  be  widely  separated  ;  each 
hut  should  have,  about  ten  feet  from  it,  an  iron  box  for  refuse.  Wooden 
boxes  do  not  answer,  as  in  the  winter  hve  cinders  get  thi'own  in,  and  there 
is  danger  of  fire.  These  boxes  should  be  emptied  eveiy  morning  by  the 
scavengers,  and  the  contents  burned  as  soon  as  possible.  Water  must  be 
laid  on  into  every  ward. 

The  arrangement  of  the  buildings  is  a  simple  matter,  but  must  partly 
be  determined  by  the  ground.  Long  open  lines  are  the  best.  An  hospi- 
tal of  this  kind,  completely  prepared  in  England,  can  be  put  up  at  a  very 
rapid  rate,'  supposing  there  be  no  great  amount  of  earth-work,  and  that 
the  supply  of  water  and  of  outlet  for  sewage  be  convenient.  So  that,  if 
commenced  at  once  at  the  beginning  of  a  campaign,  accommodation  would 
soon  be  provided. 

Circumstances  may  of  course  render  it  necessary  to  take  existing  build- 
ings for  hospital  purposes,  but  it  ought  always  to  be  remembered  that  it  is 
running  a  very  great  risk,  and  nothing  but  rigid  necessity  ought  to  sanc- 
tion it. 

Laundry  Establishment. 

This  part  of  an  hospital  must  be  organized  as  early  and  as  perfectly  as 
possible.  The  different  parts  must  be  sent  out  from  England,  viz.,  boiler, 
drying-closet,  washing-machines,  and  wringing-machines.  The  washing  in 
war  can  never  be  properly  done  by  the  people  among  whom  the  war  is  car- 
ried on.  Every  appliance  to  save  labor  must  be  used,  and  after  calcula- 
ting what  amount  of  laundry  work  has  to  be  done  for  a  presumed  number 
of  sick,  just  twice  the  amount  of  apparatus  should  be  sent  out,  partly  to 
insure  against  breakage,  partly  to  meet  moments  of  gi*eat  pressui-e.  The 
drying-closet,  especially,  is  a  most  important  part  of  the  laundry,  as  its  heat 
can  be  used  to  disinfect. 

'  The  hospital  at  Renkioi,  in  Turkey,  in  the  Crimean  vrar,  was  made  of  such  large 
huts  (50  men  in  each)  that  its  rapidity  of  erection  is  no  guide  to  others  ;  yet  it  was  mar- 
vellously soon  put  up.  The  first  beam  was  laid  on  May  24,  185.5  ;  on  July  12th  it  was 
reported  ready  for  800  sick,  every  ward  having  water  laid  on,  baths  and  closets,  and 
an  iron  kitchen  and  laundry  being  also  ready  ;  on  August  11th  it  was  ready  for  500, 
and  on  December  4th  for  1,000  sick.  In  January,  1856,  it  was  ready  for  1,500  sick,  and 
in  a  short  time  more  2,200  could  have  been  received.  The  number  of  English  artisans 
was  only  forty,  but  we  had  native  workmen,  and  if  we  had  had  eighty  English  arti- 
sans it  would  have  been  ready  for  1,000  sick  in  three  months.  Smaller  huts  could 
be  put  up  in  much  less  time  if  the  ground  requires  no  terracing. 


378  PRACTICAL    HYGIENE. 


Amount  of  Hospital  Accommodation. 

This  must  not  be  less  than  for  25  per  cent,  of  the  force,  with  reserve 
tents  in  rear  in  case  of  need. 

Cemeteries  in  war  must  be  as  far  removed  as  possible  ;  the  graves  dug 
deep,  and  peat  charcoal  thrown  iu  if  it  can  be  prociu-ed.  Lime  is  gener- 
ally used  instead,  but  is  not  quite  so  good.  If  charcoal  cannot  be  got,  Hme 
must  be  used.  If  the  army  is  warring  on  the  sea-coast,  burial  in  the  sea 
might  be  employed.  But  cremation  would  be  best,  and  forms  of  ambula- 
tory furnaces  have  been  proposed. 

Sanitary  Duties  connected  unth  a  War  Hosjntal. 

In  addition  to  the  usual  sanitary  duties  of  an  hospital,  there  are  one  or 
two  points  which  require  particular  attention  in  the  field. 

The  first  of  these  is  the  possible  conveyance  of  disease  by  the  exceed- 
ingly dirty  clothes,  which  may  perhaps  have  been  worn  for  weeks  even 
without  removal,  in  the  hard  times  of  war.  Typhus,  especiaUy,  can  be 
carried  in  this  way. 

To  provide  for  this,  every  hospital  should  have  a  tent  or  building  for 
the  reception  of  the  clothes  ;  here  they  should  be  sorted,  freely  exposed  to 
ah',  and  the  dirty  flannels  or  other  filthy  clothes  picked  out.  Some  of 
these  are  so  bad  that  they  should  at  once  be  burnt,  and  the  principal  medi- 
cal officer,  at  the  beginning  of  a  camj)aign,  should  have  authority  given 
him  to  do  this,  and  to  replace  the  articles  from  the  public  store. 

The  articles  which  are  not  so  bad  should  be  cleansed.  The  cleansing 
is  best  done  in  the  following  way  : — If  the  hospital  have  a  laundry  and  dry- 
ing-closet, they  should  be  put  first  in  the  drying-closet  for  an  houi',  and 
the  heat  carried  to  220°  Fahr.  Then  they  should  be  transferred  into  the 
fumigation  box  ;  this  is  simply  a  tin-hned  box  or  large  chest.  The  clothes 
are  put  in  this,  and  sulphur  placed  above  them  is  set  on  fire,  care  being 
taken  not  to  burn  the  clothes  ;  or  nitrous  acid  fumes  should  be  used. 
After  an  hour's  detention  in  the  fumigating  box,  they  should  be  removed 
to  the  soaking  tubs.  These  are  large  tubs  with  pure  water,  put  in  a  shed 
or  tent  outside  the  laundry.  A  little  chloride  of  lime  can  be  added  to  the 
water.  They  should  soak  here  for  twenty-foiu'  hours,  and  then  go  into  the 
laimdry  and  be  washed  as  usual.  This  plan,  and  especiaUy  the  heating  and 
fumigation,  will  also  kill  Hce,  which  often  swarm  in  such  numbers. 

Another  point  of  importance  is  to  bathe  the  men  as  soon  as  possible. 
The  baths  of  a  war  hospital  at  the  base  of  operations  should  be  on  a  large 
scale,  and  the  means  for  getting  hot  water  equally  large.  The  men's 
heads,  if  lousy,  should  be  Avashed  with  a  little  weak  carbohc  acid,  which 
kills  the  hce  at  once.  The  smell  is  not  agreeable,  but  that  is  not  of  real 
consequence. 

In  a  war  hospital,  also,  the  use  of  charcoal  in  the  wards,  antiseptic 
dressings,  the  employment  of  disinfectants  of  all  kinds,  is  more  necessary 
than  in  a  common  hosj)ital. 

As  a  matter  of  diet,  there  should  be  a  large  use  in  the  diet  of  antiscor- 
butic food,  vegetables,  etc.,  and  antiscorbutic  drinks  should  be  in  every 
ward,  to  be  taken  ad  libitum — citric  acid  and  sugar,  cream  of  tartar,  etc. 
The  bread  must  be  very  good,  and  of  the  finest  flour,  for  the  dysenteric 
cases. 


WAE.  379 


Siegei 


The  sanitary  duties  during  sieges  are  often  difficult.  "Water  is  often 
scarce,  disposal  of  sevrage  not  easy,  and  the  usual  modes  of  disposal  of  the 
dead  cannot,  perhaps,  be  made  use  of.  If  sewage  is  not  Tvashed  a^vay,  and 
if  there  is  no  convenient  plan  of  removing  it  by  hand,  it  must  be  burnt. 
Mixing  it  "m.th  guxipowder  may  be  adopted  if  there  is  no  straw  or  other 
combustible  material  to  put  with  it. 

If  food  threaten  to  run  short,  the  medical  officer  should  remember  how 
easily  Dr.  Morgan's  process  of  salting  meat  can  be  apphed,  and  in  this  way 
cattle  or  horses  which  are  killed  for  want  of  forage,  or  are  shot  in  action, 
can  be  preserved.  For  sieges,  as  vegetables  ai-e  sure  to  fall  shori,  a  very 
ample  supply  of  lemon-juice  and  of  citric  acid,  citrates,  and  cream  of  tartao: 
should  be  laid  in  and  distributed  largely. 

One  other  point  should  be  brought  to  the  notice  of  the  general  in  com- 
mand. In  times  of  pressui'e,  every  man  who  can  be  dischai'ged  from  the 
hospital  is  sent  to  the  front.  This  cannot  always  be  avoided.  But  when 
there  is  less  pressure,  the  men  should  go  from  the  rear  hospitals  to  a  de- 
pot, and  while  there  should  still  be  considered  under  medical  ti-eatment, 
so  that  they  may  not  too  soon  be  subjected  to  the  hardships  of  war.  They 
should,  in  fact,  be  subjected  again  to  a  sort  of  training,  as  if  they  were  just 
entering  on  the  war.  If  this  is  not  done,  a  number  of  sickly  or  half-cured 
men  get  into  the  ranks,  who  may  break  down  in  a  moment  of  emergency, 
and  cause  gi'eat  difficulty  to  the  general  in  command.  Some  officers  think 
that  a  man  should  either  be  in  hospital  or  at  his  full  duty  ;  this  seems  a 
misapprehension  both  of  the  facts  and  of  the  best  way  of  meeting  them. 
To  transfer  a  man  just  cured,  fi'om  the  comforts  of  a  hospital  at  once  to 
the  fi'ont,  is  to  inin  great  danger.  A  depot,  which  should  be  a  sort  of 
convalescent  hospital,  though  not  under  that  term,  is  the  proper  place 
to  thoroughly  strengthen  the  man  just  recovered  for  the  arduous  work 
before  him. 


APPENDIX  A. 


STANDAED  SOLUTIONS  FOE  VOLUMETEIC  ANALYSIS. 

1.  For  Clilorine. 

(a)  Silver  Nitrate  Solution. 

4788  grammes  of  silver  nitrate  in  1  litre  of  distilled  water. 
1  CC.  of  solution  =  1.00  miDigramme  of  chlorine. 

"  "  =1.51  "  of  ammonium  chloride. 

"  "  =  1.65  "  of  sodium  chloride. 

"  "  =  2.10  milligrammes  of  potassium  chloride. 

This  solution  may  be  standardized  with    a  solution  of  pure   sodium 
chloride,  1.648  to  the  litre,  1  CC.  of  which  equals  1  mgm.  of  chlorine. 

(6)  Potassium  Monochromate  Solution. — 50  gi-ammes  of  potassium  mono- 
chromate  are  dissolved  in  one  litre  of  distilled  water.  Solution  of 
nitrate  of  silver  is  added  until  a  permanent  red  precipitate  is 
formed,  which  is  allowed  to  settle. 

2.  Hardness. 

(a)  Soap  Solution. 

Dissolve  some  soft  soap  (pharmacopoeial)  in  diluted  spirit,  and  graduate 
by  means  of  this  barytic  solution. 

Nitrate  of  barium 0.26  gramme. 

Distilled  water 1  litre. 

2.2  CC.s  (or  22  measuj-es)  of  standard  soap  solution  produce  a  per- 
manent lather  with  50  CC.s  of  the  the  above  solution. 
1  measure  (=  y\  CC.)  of  soap  solution  =  0.00025  gm.  =  0.25  mgm.  of 

calcium  carbonate. 
Con-ection  for  lather  =  —  2  measures  of  soap. 
Short  factors  (when  50  CC.s  of  water  are  taken  for  experiment). 
For  degi-ees  of  Clark's  scale  (1 :  70.000)    =  0.35. 
"       Metrical  "     (1  :  100,000)  =  0.50. 

(6)  A  weaker  solution,  each  measure  (^-^  CC.)  of  which  is  equal  to  0.07 
mgm.  of  CaC03  is  sometimes  used.  The  correction  for  lather  would 
be  7  measm-es  of  soap.  The  corrected  number  of  measures,  divided 
by  10.  gives  the  hardness  in  Clark's  scale  directly,  or  multiplied  b}' 
0.14  the  degrees  on  the  metrical  scale. 


APPENDIX.  381 

3.  Solutions  required  for  the  determination  of  Oxidizable  Matter  m  Water. 

(a)  Permanganate  Solution. 

0.395  of  potassium  permanganate  in  1  litre  of  water. 

100  CC.s  are  exactly  decolorized  by  100  CC.s  of  oxalic  acid  solution  (c). 
(See  No.  7.) 

1  CC  of  permanganate  solution  used  with  acid  yields  0. 10  milligramme 
of  oxygen. 

1  CC.  of  permanganate  solution  used  with  alkali  yields  0,06  milligramme 
of  oxygen. 

1  CC.  of  permanganate  solution  exactly  oxidizes  0.2875  mgm.  nitrous 
acid  (NO J. 

1  CC.  of  permanganate  solution  exactly  oxidizes  0.2125  mgm.  hydro- 
gen sulphide  (H„S). 

1  CC.  of  permanganate  solution  exactly  oxidizes  0.7000  mgm.  iron  (Fe). 

0.9000  "  ferrous 
oxide  (FeO). 

(b)  Potassium  Iodide  Solution. — A  10   per  cent,  solution   of  the  pure 

potassium  iodide,  reciystallized  from  alcohol. 

(c)  Dilute  Sulphuric  Acid. — One  volume  of  pure  sulphuric  acid  is  mixed 

with  tlu'ee  volumes  of  distilled  water,  and  permanganate  solution 
dropped  in  until  the  whole  retains  a  very  faint  pink  tint,  after 
warming  to  80°  F.  for  foiu-  hours. 

(d)  Sodium  Hyposulphite. — One  gramme  of  crystallized  sodium  hyposul- 

phite dissolved  in  1  htre  of  water. 

(e)  Starch  Solution. — One  gramme  of  starch  to  be  intimately  mixed  with 

\  litre  of  distilled  water,  the  whole  boiled  briskly  for  five  minutes, 
filtered,  and  allowed  to  settle. 

4  Solutions  for  determination  of  Free  and  Albuminoid  Ammonia. 

(a)  Ammonium  Chloride  Solution  for  JSesslerizing. 

0.315  gTamme  cf  ammonium  chloride  in  1  litre  of  water. 
This  is  the  strong  solution. 
*  Take  100  CC.s  of  this  solution  and  dilute  to  1  litre. 

This  is  the  standard  solution. 
1  CC.=  0.01  milhgramme  of  ammonia  (NHJ  or  0.0082  mgm.  of 
nitrogen. 

(&)  Nessler's  Solution. — Dissolve  35  grammes  of  potassium  iodide  in 
100  CC.s'  of  distilled  water.  Dissolve  17  grammes  of  mercuric 
chloride  in  300  CC.s  of  distilled  water  ;  warm  if  necessarj',  and 
allow  to  cool.  Add  the  mercuric  solution  to  the  iodide  solution 
until  a  perceptible  permanent  precipitate  is  produced.  Then 
dilute  with  a  20  per  cent,  sodium  hydrate  solution  (caustic  soda) 
up  to  1,000  CC.s  (1  litre) :  add  mercuric  chloride  solution  until  a 
permanent  precipitate  again  forms  ;  allow  precipitate  to  settle,  and 
then  decant  off  the  clear  solution. 

(e)  Sodium  Carbonate  (sometimes  requu'ed  for  free  ammonia,  but  not 
usually  needed). — A  20  percent,  solution  of  recently  ignited  pure 
sodium  carbonate. 


382  PRACTICAL    HYGIENE. 

(d)  Alkaline  Potassium  Permanganate  Solution  (for  Albuminoid  Ammonia), 

— Dissolve  200  grammes  of  potassium  liydrate  and  8  gi-ammes  of 
pure  potassium  peiTuanganate  in  1,100  CC.s  of  distilled  water,  and 
bod  the  solution  rapidly  till  concentrated  to  1,000  CC.s. 

(e)  Distilled  Water  free  from  Ammonia. — The  S.  P.  A.  recommend  boiUng 

ordinaiy  distilled  water  with  1  per  1,000  of  pure  ignited  sodium  car- 
bonate. If  the  water  is  distilled  with  a  little  phosphoric  acid  (as 
recommended  by  Xotter),  it  comes  over  quite  free.  Test  with  a 
little  Nessler's  solution. 

5.  Be-agentsfor  the  determination  of  Nitric  Acid  in  Nitrates. 
(a)  Jletallic  Aluminum. — As  thin  fod. 

(6)  Solution  of  Sodium  Hydrate. — Dissolve  100  grammes  of  solid  sodium 
hydi'ate  in  1  litre  of  distilled  water.  "\Mien  cold,  introduce  a  strip 
of  about  100  square  centimetres,  say  15  square  inches,  of  aluminum 
foil,  previously  heated  to  just  short  of  redness,  wi-apped  round  a 
glass  rod  ;  when  the  aluminum  is  dissolved,  boil  the  solution  briskly 
in  a  porcelain  basin  until  about  one-third  of  its  volume  has  evapo- 
rated ;  allow  it  to  cool,  and  make  it  up  to  its  original  volume  with 
water  free  from  ammonia.  The  solution  must  be  tested  by  a  blank 
exjDeriment  to  prove  the  absence  of  nitrates. 

(c)  Cojyper  Sulphate  Solution. — Dissolve  30  gi-ammes  of  pure  copper  sul- 

phate in  1  litre  of  distilled  water. 

(d)  Metallic  Zinc,  pure. — As  thin  foil.     This  should  be  kept  in  a  dry  at- 

mosphere, so  as  to  be  preserved  as  far  as  possible  from  oxidation. 
To  make  the  icet  Copper  Zinc  copjple. — Put  into  a  flask  or  bottle  a  piece 
of  clean  zinc  foil,  and  cover  it  with  the  copjoer  solution  (c) :  aUow 
the  foil  to  remain  until  it  is  well  covered  with  a  firmly  adheiing 
black  deposit  of  copper.  (If  left  too  long  the  deposit  may  peel  off 
in  washing.)  Pour  off  the  solution  (which  may  be  kept  for  further 
use),  and  wash  the  conjoined  metals  with  distilled  water.  The 
coj^ple  is  now  ready  for  Use.  About  one  square  decimetre  (=^  of  a 
square  inch)  should  be  used  for  every  200  CC.s  of  a  water  containing 
5  parts  or  under  of  nitric  acid  in  100,000,  For  waters  richer  in 
nitrates  more  will  be  required. 

(e)  Standard  Solution  of  Anunonium  Chloride  {see  4:  {a)).  ' 
(/)  Nessler's  Solution  {see  4  (6)). 

6.  Re-agents  for  the  determination  of  Nitrous  Acid  in  Nitrites. 

(a)  Solution  of  Jletapheni/lenediamine. — Dissolve  5  grammes  of  metapheny- 
lenediamine  in  1  htre  of  distilled  water,  rendered  acid  with  sul- 
phuric acid.     Decolome,  if  necessary,  with  animal  charcoal 

(6)  Dilute  Sulphuric  Acid. — One  volume  of  pure  sulphuric  acid  to  two 
volumes  of  distilled  water. 

(c)  Solution  of  Potassic  Nitrite. — Dissolve  0.-406  gramme  of  pure  silver 
nitrite  in  hot  water,  and  decompose  it  with  a  slight  excess  of  potas- 
sium chloride.  After  cooling,  make  the  solution  up  to  one  litre, 
allow  the  chloride  of  silver  to  settle,  and  dilute  each  100  CC.s  of  the 
clear  supernatant  Hquid  again  to  one  litre,  1  CC,  of  this  diluted 
solution  =:  0,01  of  a  milligramme  of  X0„. 
The  nitrites  may  also  be  determined  by  the  permanganate  solution 
{see  3). 


APPENDIX.  883 

7.  For  determination  of  Phosphoric  Acid. 

One  part  of  pure  molybdic  acid  is  dissolved  in  4  parts  of  ammonia, 
sp.  gr.  0.960.  This  solution,  after  filtration,  is  poured,  with  constant 
stirring,  into  15  parts  of  nitric  acid  of  1.20  sp.  gT.  It  should  be 
kept  in  the  dark,  and  carefully  decanted  from  any  precipitate  that 
may  form. 

8.  Sulphuric  Acid  Solution  for  Carbonates  in  Water. 

Take  4.9  grammes  by  weight  of  pure  H.^SO^  and  dilute  to  1  litre. 
1  CC.  saturates  5  miUigrammes  of  calcium  carbonate. 
6.2         "  of  sodium 

9.  Alkaline  Solution  for  Acidities. 

Take  liquor  sod^  or  liquor  potassse  of  pharmacopoeial  strength,  and 

dilute  with  8  or  9  parts  of  distilled  water. 
Graduate  with  oxalic  acid  solution  {a).     [See  No.  7.) 

1  CC.  of  standard  alkaline  solution  =  6.3  mgm.  oxalic  acid. 

=  6         "      glacial  acetic  acid. 
=  9         "      lactic  acid. 
=  7.5      "      tartaric  " 
=  6.4      "      citric      " 

10.  Oxalic  Acid  Solutions. 

Solution  (a) — Take  6.3  grammes  of  crystallized  oxalic  acid,  and  dis- 
solve in  one  htre  of  water. 

10  CC.s  exactly  neutralize  10  CC.s  of  standard  alkaline  solution. 
Solution  (6) — Take  100  CC.s  of  solution  (a)  and  add  180  CC.s  of  dis- 
tilled water  ;  or,  dissolve  2.25  gTammes  of  crystallized  oxalic  acid  in 
one  litre  of  distilled  water. 
This  makes  the  solution  for  testing  the  alkalinity  of  lime  or  baryta 
water. 

1  CC.  exactly  neutralizes  1      milligramme  of  lime  (CaO.) 
2.73         "  of  baryta  BaO. 

Solution  (c) — Take  100  CC.s  of  solution  (a)  and  add  700  CC.s  of  dis- 
tilled water ;  or,  dissolve  0. 7875  gramme  of  crystaUized  oxaUc  acid 
in  one  litre  of  distilled  water. 

This  is  the  solution  for  graduating  the  permanganate. 
100  CC.s  exactly  decolorize  100  CC.s  of  permanganate  in  presence 
of  sulphuric  acid. 

11.  Copper  Solution  (Fehling's)  for  Sugars. 

Take  of  pure  copper  sulphate 34.64  grammes.  |  2){ssoZt;e    < 

"      distilled  water 200  CC.s.  [ 

Take  also  of  tartrate  of  sodium  and  potassium,  173     grammes.  )  nvgoQ/yg 
Solution  of  caustic  soda  (or  caustic  potash)  . .   480  CC.s.  .| 

Mix  the  two  solutions  slowly,  and  dilute  with  distilled  water  to  one  htre. 
1  CC.  is  reduced  by  5      milligrammes  of  either  glucose  or  inverted  sugar. 
1  CC.  "  6.67  "  of  lactin  (or  milk  sugar). 

12.  Iodine  Solution  for  Hxjdrogen  Sulphide. 

Dissolve  6.35  grammes  of  iodine  in  1  litre  of  distilled  water  by  the  aid 
of  a  little  potassium  iodide. 

1  CC.=  0.85  milligramme  of  H^S. 


384  PRACTICAL    HYGIENE. 

If  a  litre  of  water  be  taken  for  examination,  the  short  factor  for  cubic 
inches  per  gallon  is  0.1G4. 

Starch  is  used  as  the  indicator. 

13.  Solution  of  Iron  for  Colorimetric  Test. 

Dissolve  one  gramme  of  pure  iron  wire  in  nitro-hydrochloric  acid  ; 
precipitate  the  feme  oxide  ■^-ith  ammonia  ;  wash  the  precipitate  ;  dis- 
solve in  a  Httle  hydrochloric  acid,  and  dilute  to  1  htre. 

1  CC.  =  1  milligramme  of  u'on. 

This  is  the  strong  solution. 

For  use  it  is  diluted  1  to  100,  so  that 

1  CC.  =  0.01    milligramme  of  metallic  iron. 
ICC.  =  0.027  "  of  iron  phosphate. 

14.  Dilute  Acid  Solutions  are  generally  1  part  of  acid  to  9  of  distilled  ■water. 

unless  otherwise  specified. 

15.  Qualitative  Solutions,  and,  generally,  solutions  that  ai-e  not  titrated  or 

graduated,  are  saturated,  unless  otherwise  specified. 

16.  Brucine  Solution  (for  Nitric  Acid). — 1  gramme  of  brucine  to  1  htre  of 

distilled  water. 

17.  Solution  of  Potassium  Iodide  and  Starch  (for  Nitrous  Acid). 

Potassium  iodide  1   gramme,   starch  20  grammes,  water  500  CC.s. 

Make  the  starch,  filter  when  cold,   and   then  add  the  potassium 

iodide. 
This  mixture  does  not  keep  well,  and  must  be  made  fresh  from  time 

to  time  ;  or,  the  solutions  3  (6)  and  3  (e)  may  be  used  instead. 

18.  Solution   of  Gold   Chloride    (for   Oridizahle   Matter   in   "Water). — One 

gramme  of  gold  chloride  dissolved  in  1  litre  of  water. 

19.  Solution  of  Cochineal  (for  Acidities  or  Alkalinities). — Take  5  grammes  of 

cochineal,  bruised  in  a  mortar,  add  25  CC.s  of  S2:)irit  of  wine  and 
500  CC.s  of  distilled  water  ;  filter.  This  solution  is  ajDt  to  become  a 
Httle  acid. 

20.  Phenol-Phthaleine    Solution    (for   Acidities    or    Alkalinities). — Take    5 

gi'ammes  of  the  phenol-phthaleine,  and  dissolve,  "nith  the  aid  of  25 
CC.s  of  spii'it  of  wine,  in  500  CC.s  of  distilled  water. 

21.  Use  of  Sikes'  Hygrometer,  for  ascertaining  the  strength  of  spmts. 

A  sample  of  the  spirits  to  be  tested  is  poiu-ed  into  a  trial  glass,  and  the 
temperature  ascertained  by  means  of  a  thermometer  in  the  usual  way.  The 
hydrometer  is  taken,  and  one  of  the  weights  is  attached  to  the  stem  below 
the  ball ;  it  is  then  pressed  down  to  the  0  on  the  stem.  If  the  right  weight 
has  been  selected  it  will  float  up  to  one  of  the  divisions  on  the  stem.  The 
number  on  the  stem  is  then  read  off  and  added  to  the  number  on  the 
iveight ;  the  sum  is  called  the  indication.  The  book  of  tables  is  then  opened 
at  the  temperature  fii-st  found,  and  the  indication  looked  for  in  one  of  the 
columns ;  opposite  it  will  be  found  the  strength  of  the  spirits  over  or  under 


APPENDIX.  385 

proof.  If  at  the  temperature  60°  F.  the  indication  is  58.8,  then  opposite 
this  will  be  found  zero,  that  is,  the  spuit  is  the  exact  strength  of  proof.  If 
the  indication  is  50,  then  opposite  that  is  12.8,  or  the  spirit  is  12.8  over 
proof;  if  the  indication  is  70,  then  opposite  is  18.9,  or  the  spirit  is  18.9 
under  proof.  The  meaning  of  these  expressions  is — (1)  If  the  spirit  be 
12.8  over  proof,  then,  in  order  to  reduce  it  to  pi-oof,  12.8  gallons  of  water 
must  be  added  to  100  gallons  of  the  spirit ;  the  resulting  mixture  will  be 
proof  ;  (2)  if  the  spirit  be  18.9  under  proof,  this  means  that  100  gallons 
contain  only  as  much  alcohol  as  89.1  {i.e.,  100-18.9)  of  proof  spirit;  to 
raise  it  to  proof  it  would  have  to  be  mixed  with  an  equal  quantity  of  spirit 

as  much  above  proof  as  it  is  below  it,  so  that '- — — '—  =  100. 

The  "  Adulteration  of  Food  and  Drugs  Amendment  Act,"  1879,  allows 
brandy,  whiskey,  or  rum  to  be  25  degrees  under  proof;  equal  to  42.6  per 
cent,  of  absolute  alcohol,  volume  in  volume,  or  34.1  per  cent,  of  weight  in 
volume.  This  gives  a  sj)ecific  gTavity  of  .947.  Gin  is  allowed  to  be  35 
degrees  tmder  proof,  equal  to  36.9  per  cent,  volume  in  volume,  or  29.5  per 
cent,  weight  in  volume  of  absolute  alcohol.  This  gives  a  specific  gi'avity  of 
.956.  Proof  spirit  contains  56.8  volume  in  volume,  or  45.4  weight  in  vol- 
ume of  absolute  alcohol,  sp.  gr.  .920.  The  presence  of  sugar  or  extractives 
renders  the  use  of  the  hydi-ometer  fallacious  imless  the  spirit  is  distilled 
off. 


APPENDIX  B. 


METEICAL  WEIGHTS  AND  IVIEASTJEES. 

a.  Length. 

1  Metre  =  39.37    English  inches  =  3.28  feet. 

1  Decimetre  =    3.94         "  "        =  (4  inches  nearly). 

1  Centimetre  =    0.39         "  "        =  (y%  inch  nearly). 

1  MiUimetre  =    0.039       "  "         =  (gV  inch  nearly). 

N.B. — The  Latin  prefix  indicates  division. 

The  Greek      "  "        multiphcation. 

1  Kilometre  —  1,000  metres  =  1,094  yards  =  fth  mile  (nearly). 
1  IVIile  (EngUsh)  i=  1,609  metres,  or  1.609  kilometre. 

h.  Area. 

1  Square  Metre  =  10.76      sq.  feet      —  1,542  sq.  inches. 

1  Square  Centimetre  =    0.154    sq.  inch     =  tj  sq.  inch  (nearly). 

1  Square  Millimetre  =    0.0015         "  =  e io        "     (nearly). 

100  Square  Metres  =  1  are         =      119.7  square  yards. 

100  Ares  r=  1  hectare  =  11967.0      "         "  =  2.47  acres. 

100  Hectares  =  1  square  kilometre  =  247  acres  =  0.386  sq.  mile. 
Vol.  II.— 25 


386 


PRACTICAL    HYGIENE. 


c.   Capacity. 

1  Decimetre  cubed  =  1  litre  =  1,000  cubic  centimetres  =  61  cubic 

inches  =  35.3  ounces  =  0.22  gallon. 
1  Cubic  centimetre  =  0.061  cubic  inch. 
1  Cubic  inch  =  16.4    cubic  centimetres. 

28.35  Cubic  centimetres  =  1.733  cubic  inch  =  1  ounce. 
1,000,000  Cubic  centimetres  =  1,000  litres  =  1  cubic  metre  =  1  stere  = 
35.3  cubic  feet. 


d.  Weight. 

1  Cubic  centimetre  of  distilled  water  at  4**  C.  (39.2°  F.)  weighs  1  gramme. 

1  Gramme         =  15.432  grains. 

1  Decierramme  =    1.543  grain   (=  1^  gi-ain  nearly). 

0.154      "      (=  T7  gi'ain  nearly). 

0.015       "      (=  -^  grain  nearly). 
1,000  gi'ammes  =  15,432  grains  =  2.2 lb  auozr.  =35.3 


Centigi-amme  = 
^Milligramme  = 
Kilogramme  = 

ounces. 
French  livre  and  German ^wn^i  = 
The  German  loth  = 

1  ib  avoir.   =  453.5  grammes. 
1  ton  avoir.  =  1,018  kilogrammes. 


500  grammes= 1.1  ft)  =  17.6  ounces. 
16|-      "        =  ^  ounce  nearly. 


APPENDIX  C. 


THERMOMETEK  SCALES. 

Centigrade         _         Reaumur         _         Fahrenheit — 32 
5  ~  4  ~  9 


Centigrade. 

Reaumur. 

Fahrenheit. 

Mercury  freezes  at 

-40°.0 

-17.7 

0.0 

4.0 

10.2 

15.5 

25.8 

38.5 

78.3 

100.0 

360.0 

-32°.  0 

-14.2 

0.0 

3.2 

8.2 

12.4 

20.6 

30.0 

62.7 

80.0 

288.0 

-40.0 

Zero  of  Fahrenheit 

0.0 

Water  freezes  at 

32  0 

Water  at  its  maximum  density  at 

Mean  temperatiu'e  of  London 

39.2 
50.4 

Mean  temperature  for  specific  gravities,  etc. 
Mean  temperature  of  Calcutta 

60.0 
82.0 

Mean  tempei-ature  of  the  human  body . . . 
Alcohol  boils  at 

98.4 
173.0 

Water  boils  at 

212.0 

Mercury  boils  at 

680.0 

APPENDIX. 


387 


APPENDIX  D. 


BAEO^ilETEK  SCALES. 

Standard  pressure  =  760  millimetres  =  29.922  inclies. 

30     inches  =  762 

29.5      "  =  749 

29         "  =  Idl 

28.5      "  =  724 

28        "  =  711 

1      inch  =    25.4 


APPENDIX  E. 


1.  Table  showing  the  daily  yield  of  Water  from  a  Eooficith  varying  Eainfalls.^ 


Area  of  House,  10  by  20  feet,  or  200  square  feet. 


Mean  fiainfalL 

Loss  from 
Evaporation. 

Requisite 
capacity  of  Tank. 

Mean  daily  yield 
of  Water. 

Mean  d  lily  yield 
of  Water  in 
wettest  year. 

Mean  daily  yield 
of  Water  in 
driest  year. 

Inclies. 

Per  cent. 

Cubic  feet. 

Gallons. 

Gallons. 

Gallons, 

20 

25 

100 

4.3 

6.7 

3.2 

25 

20 

135 

5.7 

7.5 

3.9 

30 

20 

145 

6.8 

9.4 

45 

35 

20 

155 

7.9 

11.0 

5.0 

40 

15 

165 

9.7 

13.1 

7.2 

45 

15 

170 

10.9 

14.2 

8.6 

For  any   other  size  of  roof  or  amount  of  rainfall,  the  numbers  will  be 
proportional. 

2.   Tables  showing  the  Distribution  of  Positive  and  Negative  Errors,  accord- 
ing to  Number  of  Events. 


■  (a)  1  Event. 

Chances. 

1  positive 1 

1  negative 1 


Total 2 


(&)  2  Events. 

Chances. 

2  positive 1 

1  positive,  1  negative 2 

2  neo-ative 1 


Total 


1  From  a  paper  by  H.    So^erby-Wallis,  F.M.S.,  on  Rainfall  Collection,  Transac- 
tions of  the  Sanitary  Institute  of  Great  Britain,  vol.  i.,  1880  (Croydon  Congress),  p.  213. 


388 


PEACTICAL    HYGIENE. 


(c)  3  Events. 

Chances. 

3  positive 1 

2  positive,  1  negative 3 

1  positive,  2  negative 3 

3  negative 1 

Total 8 


{d)  4  Events. 

Chances. 

4  positive 1 

3  positive,  1  negative 4 

2  positive,  2  negative 6 

1  positive,  3  negative 4 

4  negative 1 

Total 16 


(e)  10  Events. 
Chances. 


10  positive 1 

9  positive,  1  negative 10 

8  positive,  2  negative 45 

7  positive,  3  negative 120 

6  positive,  4  negative 210 

5  positive,  5  negative 252 

Carry  forward 638 


Brought  forward  ....  638 

4  positive,  6  negative 210 

3  jDositive,  7  negative 120 

2  positive,  8  negative 45 

1  positive,  9  negative .    10 

10  negative 1 


Total 1,024 


In  each  case  the  number  of  chances  correspond  to  the  coefficients  of  a 
binomial  whose  exponent  is  the  number  of  events.  Thus,  with  1  event  we 
have  {a  +  hy  =  a  +  h ;  with  2  events  we  have  {a  +  by  —  a"  +2a6  +  h\  and 
so  on. 


AMERICAN   APPENDIX 


TO 


PARKES'   HYGIENE 


INTRODUCTION. 


The  fundamental  principles  of  hygiene  underlying  all  measures  aimed  at 
the  improvement  of  the  health  of  mankind  so  carefully  brought  out  in 
the  preceding  pages  are,  of  course,  apphcable  to  all  countries,  chmates, 
and  habits  of  living ;  but  there  is  very  much  that  is  of  a  practical  nature, 
apphcable  to  England  and  English  ■n-ays  which  it  would  be  impossible  to 
follow  in  the  United  States,  where  existing  conditions  of  chmate,  govern- 
ment, density,  and  movement  of  j)opulation  are  so  totally  different.  For 
this  reason  it  has  been  thought  best  to  supplement  the  theoretical  part  of 
the  treatise  bearing  Dr.  Parkes'  name  by  a  short  sketch  of  American  prac- 
tice in  matters  relating  to  pubhc  health,  and  the  progress  that  has  been 
made  in  sanitary  science -during  the  last  few  years. 

Although  for  many  years  a  department  for  the  study  of  subjects  relat- 
ing to  State  medicine,  and  for  the  employment  of  such  methods  as  would 
tend  to  improve  the  health  of  the  nation,  has  had  its  place  in  the  internal 
policy  of  England,  it  was  not  till  the  year  1869  that  any  measures  looking 
to  the  same  results  were  inaugurated  in  America.  In  that  year  Massachu- 
setts created  a  State  board  of  health,  and  gi-aduaUy  other  States  have  fol- 
lowed her  example  till  twenty-nine  now  have  their  departments  of  health. 

The  creation  of  these  boards  of  health  has  been  the  outcome  of  a  grad- 
ually gTowing  public  recognition  of  the  need  for  concerted  action  in  the 
prevention  of  disease,  a  feeling  that  received  great  impetus  during  the 
epidemic  of  1878.  Much  of  this  interest  is,  however,  due  to  the  fact  that 
it  can  now  be  proved  that  a  large  proportion  of  the  deaths  that  occur  an- 
nually from  contagious  or  infectious  diseases  might  be  prevented,  and  the 
average  dui'ation  of  human  life  considerably  lengthened  thereby. 

As  the  education  of  the  pubhc  increased,  so  did  the  demand  for  accu- 
rate knowledge  concerning  the  causes  of  disease  and  the  methods  for  its 
prevention.  Laws  were  enacted  in  several  States  creating  boards  of  health, 
which  should  make  these  investigations,  and  the  system  was  completed 
when,  in  1879,  Congress  created  the  National  Boai'd  of  Health,  whose  duty  it 
should  be  to  make  investigations  into  the  causes  and  means  of  prevention 
of  contagious  and  infectious  diseases,  to  initiate  measures  of  national  im- 
portance, and  to  be  a  centre  of  information  for  all  matters  relating  to  pub- 
lic health.  So  valuable  has  been  the  work  of  this  Board,  during  its  short 
career  of  four  years,  that  something  more  than  a  passing  notice  seems  to 
be  merited.  The  following  sketch  of  its  history  and  work  has  been  com- 
piled from  notes  furnished  the  writer  by  Dr.  Stephen  Smith,  a  member  of 
the  Board,  to  whom  he  feels  himself  greatly  indebted  : 

"  The  National  Board  of  Health  was  the  direct  outcome  of  the  great 
yellow  fever  epidemic  of  1878,"  which,  among  other  valuable  lessons,  taught 


392  america:n^  appendix  to  parkes'  hygiene. 

the  people  that  "  there  are  pestilences  of  a  Bational  character,  which  in 
their  devastations,  know  no  municipal  or  State  limits,  and  that  in  their 
control  and  suppression  the  National  Government  should  bear  its  proper 
share." 

So  thoroughly  were  the  peoj^le  roused  to  the  necessity  of  a  department 
of  health  at  the  seat  of  the  central  government,  that  Congress,  on  assem- 
bling in  December,  at  once  appointed  Committees  on  Ejjidemic  Diseases  in 
both  Houses,  which  resulted  in  the  passage,  March  3,  1879,  of  an  Act  cre- 
ating a  National  Board  of  Health.  The  Board  was  composed  of  seven 
civilians  aj^pointed  by  the  President,  who  in  addition  detailed  officers 
from  the  Marine  Hospital  Service,  War  Dejjartment,  Navy  Department, 
and  Department  of  Justice,  to  act  as  ex-officio  members.  Owing  to  the 
nearness  of  the  several  Departments,  the  ex-officio  members,  forming,  to- 
gether with  two  of  the  appointed  members,  the  Executive  Committee,  could 
be  summoned  in  a  few  moments  to  the  rooms  of  the  Board.  "  No  emer- 
gency, however  urgent,  could,  therefore,  occur  which  it  was  not  possible 
to  meet  properly  and  timely."  The  full  committee  was  called  whenever  the 
exigencies  of  the  case  demanded  it.  The  members  of  the  Board  were  rep- 
resentative men  in  their  several  sections,  and  its  executive  committee 
brought  to  the  daily  discharge  of  duty  the  efficiency  of  a  single  hand  and 
the  wisdom  of  the  combined  experience  of  the  four  chief  executive  depart- 
ments of  the  Government. 

The  operations  of  the  Board,  under  the  Act,  were :  1,  the  collection  of 
information,  from  health  organizations  and  sanitarians,  as  to  the  best  plan 
for  a  national  public  health  organization  ;  2,  the  collection  of  information 
regarding  the  sanitary  condition  of  some  of  the  principal  cities  and  towns 
of  the  United  States  ;  3,  the  appointment  of  a  commission  to  investigate 
yellow  fever  in  the  Island  of  Cuba ;  4,  the  collection  and  collation  of  the 
sanitary  laws  of  the  United  States  and  of  the  several  States  ;  5,  an  investi- 
gation as  to  the  best  method  of  determining  the  amount  and  character  of 
the  organic  matter  in  the  air  ;  6,  an  investigation  into  the  efl'ects  of  disin- 
fectants ;  7,  an  investigation  as  to  the  composition  and  merits  of  patent 
disinfectants  ;  8,  an  investigation  regarding  the  prevalence  of  the  adulter- 
ation in  food  and  drugs  ;  9,  a  preliminary  inquiry  with  regard  to  the  dis- 
eases of  food-making  animals ;  10,  an  examination  of  the  flow  of  sewers  in 
relation  to  their  sizes  and  gradients  ;  11,  a  sanitary  survey  of  the  eastern 
coast  of  New  Jersey  bordering  on  New  York  Harbor  ;  12,  a  sanitary  survey 
of  the  city  of  Memphis ;  13,  an  inquiry  as  to  the  hygiene  of  the  mercantile 
marine  ;  14,  an  investigation  of  the  outbreak  of  diphtheria  in  Northern 
Vermont ;  15,  an  investigation  as  to  the  influence  of  various  soils  upon 
sanitation,  especially  with  regard  to  drainage  and  methods  of  disposal  of 
excreta. 

In  June,  1879,  the  Board  was  given  additional  power  by  Act  of  Con- 
gress, enabling  it  to  act  efiectively  in  case  of  a  reapjiearance  of  yellow  fever. 

The  Bulletin,  published  under  this  act,  was  recognized  as  "  one  of  the 
most  important  sanitary  periodicals  in  the  world,  as  it  contained,  not  only 
a  complete  summary  of  the  progress  of  epidemic  diseases  in  all  countries, 
and  of  the  state  of  the  public  health  of  every  city  of  the  United  States  and 
of  the  seaport  towns  of  the  world,  but  in  it  appeared  all  the  investigations 
of  the  committees  of  experts  appointed  by  the  Board." 

In  order  to  meet  the  ap2:)rehended  reappearance  of  yellow  fever,  sets  of 
rules  and  regulations  were  carefully  prepared,  one  to  be  enforced  on  rail- 
roads, another  at  seaport  quarantine,  and  the  third  for  steamboat  and  river 
travel  and  traffic.     Owing  to  the  efficient  way  in  which  these  regulations 


LNTRODUCTION.  393 

were  carried  out  "  travel  and  traffic  was  but  little  imj)eded,  where  the 
year  previously  it  was  entirely  suppressed  by  the  shot-gun  policy,  or  com- 
plete non-intercourse."  /.Ithough  the  work  of  the  National  Board  was  en- 
larged so  as  to  reach  every  threatened  community  in  the  Mississippi  Valley 
and  on  the  Gulf  Coast,  its  operations  were  strictly  limited  to  aiding  local 
and  State  authorities  in  theii-  struggle  with  the  epidemic.  The  experience 
vdth  this  epidemic  j>roved  conclusively  the  value  and  necessity  of  a  central 
health  organization  at  Washington,  and  also  that  "when  there  is  concert 
of  action  among  the  health  authorities  of  the  States  and  the  National  Board 
of  Health,  the  most  destructive  and  irrepressible  pestilence  known  cannot 
make  headway ;  but  may  not  only  be  controlled,  but  completely  sup- 
pressed." 

To  prevent  the  recurrence  of  the  epidemic,  preventive  measures  were 
adopted,  one  of  the  most  important  of  which  was  the  creation  of  insular 
refuge  stations  at  points  on  the  Atlantic  and  Gulf  coasts,  where  aU  infected 
vessels  could  be  quickly  cleaned  and  disinfected  before  they  entered  the 
harbors  of  seaport  towns.  They  were  designed  to  aid  local  quarantines 
which  had  not  the  means  to  provide  all  the  apparatus  necessary  for  the 
immediate  cleaning  of  vessels.  Of  their  value  to  the  seajDort  towns  of  the 
Gulf  and  Atlantic  coasts,  the  health  authorities  of  those  sections  bear 
the  most  positive  testimony. 

The  International  Sanitary  Conference,  held  in  Washington  early  in 
1881,  was  at  the  invitation  of  the  National  Board,  and  the  propositions 
there  agreed  upon  "  will  doubtless  be  the  basis  of  international  co-opera- 
tion to  prevent  the  Si3read  of  epidemic  diseases." 

In  1882  the  Board  organized  and  carried  out,  in  co-operation  with  State 
and  local  Boards,  a  system  of  inspection  of  emigTants,  with  a  view  to  the 
suppression  of  small-pox  which  was  being  introduced  into  the  Western 
States  by  unvaccinated  persons.  Previously  to  the  organization  of  this 
service,  severe  outbreaks  of  small-pox  were  of  almost  daily  occin-rence  in 
this  section  ;  but  when  it  was  fully  developed,  they  decreased  in  frequency 
and  soon  ceased  to  occur. 

The  circumstances  that  led  to  a  suspension  of  the  work  of  the  Board 
can  best  be  given  in  Dr.  Smith's  own  words. 

"Among  the  appropriations  set  apart  annually  by  Congress  for  the  use 
of  the  National  Board  of  Health  was  $100,000,  as  a  contingent  epidemic 
fund.  This  fund  was  to  be  used  at  the  discretion  of  the  Board,  and  with 
the  approval  of  the  Secretary  of  the  Treasury,  in  the  aid  of  local  health 
authorities,  for  the  control  and  suppression  of  epidemics.  Although  yel- 
low fever  appeared  at  one  or  two  points  in  1880  and  1881,  yet  the  Board 
was  able  to  meet  the  contingencies  which  occurred  with  its  ordinary  ap- 
propriations, and  turned  over  to  the  Treasury,  at  the  close  of  each  year, 
the  $100,000.  In  1882  the  $100,000  was,  as  usual,  set  apart  by  Congress, 
among  the  appropriations  for  the  Board,  as  a  contingent  epidemic  fund, 
but  with  the  proviso  that  it  was  to  be  used  at  the  discretion  of  the  Presi- 
dent. The  President  transferred  that  discretion  to  the  Secretary  of  the 
Treasury,  who  decided  to  confer  upon  the  Marine  Hospital  Service  (a 
branch  of  the  Navy  Department)  power  to  perform  all  of  the  required 
sanitary  work,  and  disburse  therefor  the  epidemic  fimds.  In  this  man- 
ner, the  functions  of  the  National  Board  of  Health  were,  without  legisla- 
tive action,  transferred  to  another  branch  of  the  service.  In  the  following- 
year,  1883,  the  Secretary  of  the  Treasury  made  the  same  disposition  of 
the  fund,  and  the  Marine  Hospital  Service  assumed  the  duties  imposed. 
Meanwhile  the  general  appropriations  to  the  National  Board  were  with- 


394  AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 

held,  and  on  June  2,  1883,  the  Act  of  June  2,  1879,  expu-ed.  At  the 
close,  therefore,  of  the  fourth  year  of  its  labors,  the  National  Board  of 
Health  practically  ceased  operations.  Of  the  vast  service  which  it  rendered 
to  the  country  during  its  shoi-t,  active  existence,  in  the  control  and  suppi-es- 
sion  of  epidemic  diseases,  the  health  authorities  of  the  country,  and  the 
people  of  the  Mississippi  valley,  bear  gi-ateful  testimony.  Of  the  value  of 
the  great  number  and  variety  of  investigations  into  the  obscure  origin, 
and  the  methods  of  prevention  of  pestilential  diseases  which  it  instituted, 
and,  for  the  most  part,  earned  to  their  final  determination,  scientific  men 
in  all  parts  of  the  civihzed  world  have  expressed  their  appreciation.  What- 
ever may  be  the  future  destiny  of  the  present  National  Board  of  Health,  it 
has  accomphshed  one  important  result,  viz.  :  it  has  demonstrated  the  fact 
that  there  must  be  a  permanent  department  of  public  health  in  the  gen- 
eral government." 

Although  the  existing  State  Boards  of  Health,  in  their  reports,  show,  in 
most  instances,  gi-atifying  progress,  theu'  usefiilness  is  often  seriously  in- 
terfered with,  first,  by  a  lack  of  public  recognition  of  the  importance  of 
their  work,  and  a  consequent  unwillingness  on  the  part  of  State  and  mu- 
nicipal authorities  "to  appropriate  an3i;hing  like  the  amount  of  funds 
needed  to  secure  the  canying  out  of  measures  necessary  to  secure  the  pub- 
He  health  ; "  and  second,  by  the  appointment  of  members  Avho  have  ex- 
ceedingly vague  ideas  in  regard  to  their  duties  as  health  officers.  In 
spite,  however,  of  much  that  is  discouraging,  these  boards  are  doing  much 
to  control  disease  as  well  as  collecting  data  showing  the  physical  conditions 
of  the  States  in  their  relations  to  health  and  disease,  such  as  that  relating 
to  natural  and  artificial  drainage,  water-supply,  forests,  rainfall,  climate, 
etc. 

The  relations  between  damj^ness  of  soil  and  consumption  ha\ing  been 
shown  by  Dr.  Bowditch  to  be  those  of  cause  and  efl:ect,  and  later  by  Dr. 
Buchanan,  of  London,  the  subject  of  subsoil  drainage,  and  the  consequent 
lowering  of  the  level  of  the  gTound-water,  is  being  taken  ujd  more  and 
moi*e.  Without  exception,  where  lands  have  been  reclaimed  by  embank- 
ments, or  marshes  have  been  drained,  malarial  fevers  have  decreased,  and 
the  general  health  of  the  community  has  greatly  improved.  In  ^Michigan 
the  decrease  in  malarial  fevers,  consequent  on  di-ainage,  is  estimated  at 
seventy-five  per  cent. 

Vital  statistics — though  receiving  attention  from  most  boards  of  health 
— registration  is  not  yet  sufficiently  thorough  to  allow  of  any  deductions 
being  made  from  the  returns.  The  laws  are  still  defective  in  man}'  States, 
and  acciu-ate  returns  cannot  be  expected  till  proper  and  sufficient  legisla- 
tion is  secured.  There  is  little  uniformity  in  the  method  of  publishing  the 
statistics,  and  no  system  of  registry  of  physicians  and  midwives,  by  which 
a  registrar  can  know  who  are  properly  qualified.  Many  States  seem  un- 
willing to  i3ass  any  laws  whatever  on  the  subject  of  registration.  Dr.  John 
S.  Bilhngs,  in  a  report  to  the  National  Board  of  Health,  says:  'Of  the 
twenty-three  States  which  have  had  registration  laws,  only  eight  have  pub- 
lished statistics  which  can  be  said  to  have  any  scientific  value,  and  none  of 
them  have  published  results  as  complete  as  those  attained  under  the  Eng- 
lish Registration  Acts.  It  v.-iti.  be  seen  also  that  the  supposed,  and  prob- 
ably in  most  cases  the  real,  cause  of  failure  of  these  registration  acts  in 
this  country  has  been  the  want  of  sufficient  compensation  to  the  register- 
ing officers,  and  that  the  successive  amendments  to  the  registration  acts 
that  have  been  made  in  the  States  which  have  secured  the  best  results, 
have  consisted  essentially  in  increasing  the  pay  of  the  registrars."    As  an 


INTEODUCTION".  395 

accurate  record  of  the  births,  marriages,  and  deaths  in  any  community  is 
absolutely  necessary  before  proper  measures  can  be  adopted  aiming  at  the 
jDreventiou  and  stamping  out  of  disease,  the  gradual  education  of  the 
people  to  the  need  of  sanitary  measures  will,  no  doubt,  result  in  the  en- 
actment of  the  necessary  laws. 

The  State  Boards,  acting  as  central  bodies,  have  generally  striven  to 
organize  Local  Boards  of  Health  in  the  various  cities,  towns,  and  villages 
oftheu'  States,  whose  objects  should  be  :  "1st.  The  creating  of  channels  of 
information  to  the  people  in  a  form  which  would  most  successfully  reach 
the  masses,  by  being  placed  in  the  hands  of  those  who  could  appreciate 
and  would  use  the  information.  2d,  The  formation  of  organized 
bodies  through  which  -the  statistics  in  regard  to  pubhc  health  could  be 
gathered  from  all  parts  of  the  State.  3d.  To  ascertain  the  existence  of 
preventable  causes  of  disease  in  therr  communities  and  to  destroy  these 
causes."  These  local  boards  are  increasing  in  number  year  by  year,  as  fast 
as  prejudice  is  removed  and  the  opposition  that  is  j)ersistently  offered  to 
them  in  many  towns  gives  way  before  accumulated  evidence  of  the  -pve- 
ventable  natiu'e  of  many  diseases.  In  some  of  the  States  these  boards 
have  almost  unhmited  authority  in  their  special  province,  and  gi'eat  care  is 
therefore  required  in  the  appointment  of  their  members,  so  that  no  poli- 
tical considerations  or  personal  schemes  shall  in  any  way  injure  their 
efficiency. 

Active  and  aggressive  sanitary  journalism  has  influenced  the  lay  press  to 
devote  much  space  to  the  consideration  of  subjects  relating  to  the  public 
health.  The  popular  interest  thus  awakened  has  resulted  in  the  forma- 
tion of  sanitary  associations  which  are  doing  good  work  in  educating  the 
public. 

The  first  of  these  associations  formed  in  this  country  was  the  "  Sanitaiy 
Protection  Association"  of  Newport,  E.  I,  which  following  the  plan  of  a 
similar  organization  in  Edinburgh,  was  in  its  turn  followed  by  those  of 
Lynn,  Mass.,  and  Orange,  N.  J.,  till  at  the  jijresent  time  one  hundi'ed  and 
seventy  communities  have  like  associations.  Theu'  objects,  being  about  the 
same  in  every  case,  may  best  be  given  by  an  extract  from  the  rales  of  the 
Lynn  Association.  These  state  that  the  objects  shall  be,  "  1st.  To  promote 
a  general  interest  in  sanitary  science,  and  to  dispense  among  the  people  a 
knowledge  of  the  means  of  preventing  disease.  2d.  To  secure  the  adojDtion 
by  the  city  authorities  of  the  most  effectual  methods  of  improving  the  sanitary 
conditions  of  the  city.  3d.  To  provide  its  members,  at  moderate  cost,  with 
such  skilled  inspection  as  shall  secure  the  proper  sanitary  condition  of  their 
own  premises  and  those  of  other  persons  in  whom  they  may  be  interested." 
Besides  distributing  vast  numbers  of  sanitaiy  tracts,  and  information  relat- 
ing to  pubhc  health,  the  Newport  Association,  in  1880,  offered  prizes  "  to 
the  jDcrson,  not  the  owner  of  the  house  occupied,  who  shall  put  his  or  her 
premises  in  the  most  satisfactoiy  condition,  and  keep  them  so  "  for  a  stated 
period,  and  "  to  the  house-owner  who  shall  d©  the  most  in  a  given  time, 
toward  improving  the  sanitaiy  condition  of  any  occupied  dwelling." 
Like  anything  aiming  to  improve  the  condition  of  mankind,  these  associa- 
tions encounter  many  obstacles.  Strangely  enough,  one  of  the  most 
formidable  with  which  they  have  to  contend  is  indifference  and  ignorance 
on  the  part  of  theii'  members.  The  results,  however,  that  have  been  attained 
are  such  as  to  make  it  extremely  desirable  that  other  towns  and  villages 
should  adopt  the  same  plan. 

This  sketch  would  not  be  complete  if  mention  was  not  made  of  the 
work  of  the  American  Public  Health  Association.     Beginning  with  a  very 


396  AMERICAIT    APPENDIX    TO    PAEKEs'    HYGIENE. 

small  membership  in  1872,  this  Association  has  now  growni  to  be  one  of 
the  largest  and  most  influential  of  our  national  societies.  It  was  organized 
for  the  mutual  benefit  and  co-operation  of  health  officers  and  others  who 
are  thinkers  and  workers  in  the  field  of  preventive  medicine.  Its  consti- 
tution states  that  its  objects  "  shall  be  the  advancement  of  sanitary  science 
and  the  promotion  of  organizations  and  measures  for  the  practical  applica- 
tion of  public  hygiene."  It  has  done  good  work  in  the  diffusion  of  knowl- 
edge, by  providing  an  audience  for  those  who  have  made  researches  into 
the  causes  of  diseases  and  the  best  means  of  avoiding  or  preventing  them, 
as  well  as  in  urging  upon  the  authorities  the  importance  of  sanitary  legisla- 
tion. Little  interest  was  manifested  in  its  meetings  until  the  epidemic  of 
1878,  when  the  public  became  suddenly  aware  of  the  imiooi'tance  of  its  de- 
liberations and  conclusions.  Every  subject  that  can  possibly  be  suggested 
in  the  vast  field  of  sanitary  research  receives  careful  attention,  and  the  re- 
ports and  papers  that  are  presented  at  the  meetings,  together  with  the  dis- 
cussions that  follow,  are  printed  annually,  and  form  a  series  of  volumes 
containing  not  only  much  that  is  valuable,  but  also,  it  is  to  be  regretted, 
giving  space  to  much  that  is  worthless. 

Aiming  at  the  same  general  work  of  educating  the  masses,  several  of 
the  State  Boards  of  Health  have  adojited  the  j^lau  of  holding  sanitary  con- 
ventions, or  councils,  in  various  towns  throughout  the  State,  at  intei-wals 
diu'ing  the  year,  where  topics  relating  to  State  medicine  are  freely  dis- 
cussed. In  speaking  of  the  conventions  in  that  State,  the  Secretary  of  the 
Michigan  Board  of  Health,  in  his  report  for  1882,  says:  "Their  good 
effects  are  apparent  in  the  after-results  in  the  to^mis  where  such  conven- 
tions are  held.  In  most  instances  the  citizens  are  aroiised  to  the  necessity 
of  establishing  and  maintaining  an  effective  board  of  health  ;  more  effi- 
cient measvu-es  are  taken  for  the  suppression  of  outbreaks  of  contagious  dis- 
eases ;  a  better  understanding  of  the  necessity  for  cleanhness,  good  sewer- 
age, and  good  ventilation  prevails  ;  the  relations  between  the  peoj)le  and 
the  health  authorities  are  more  cordial,  and  a  stronger  support  is  given  to 
the  health  officer  in  his  effort  to  administer  the  public  health  laws." 

Measures  for  the  control  of  contagious  diseases  have  been  introduced 
by  most  of  the  boards,  with  marked  success  in  man}'  instances.  The  cases, 
when  found,  are  immediately  isolated,  and,  if  jDOSsible,  placed  in  temj)o- 
rary  hospital  structures.  '  As  the  result  of  its  experience  in  deahng  with 
this  class  of  disease,  the  New  York  State  Board  of  Health  in  1882  distributed 
to  local  boards  through  the  State  a  circular  giving  directions  for  procedure 
in  cases  of  epidemics,  with  diagrams  for  the  erection  of  temjioraiy  hos- 
pitals. In  the  city  of  New  York  both  small-pox  and  typhus  fever  are  now 
considered  to  be  under  perfect  control.  The  methods  adopted  in  that  city 
for  deahng  with  these  scourges  is  to  isolate  a  case  as  soon  as  discovered,  dis- 
infect the  premises  where  it  has  been  found  and  closely  watch  all  susjDicious 
persons  till  the  period  of  incubation  has  jDassed.  Owing  to  these  measures 
a  threatened  epidemic  of  tjrphus  fever  last  spring  was  promptly  brought 
under  control. 

The  su^bject  of  vaccination  has  received  a  great  deal  of  attention  of  late, 
and  scarcely  a  report  from  a  board  of  health  fails  to  devote  space  to  it, 
showing  that  the  prejudice  that  still  exists  against  it  in  some  minds  is 
gradually  being  removed.  It  is  still,  however,  a  mooted  question  whether 
vaccination  should  be  made  compulsory  or  not.  Some  States,  such  as 
Illinois  and  New  York,  require  public-school  children  to  be  vaccinated  be- 
fore entrance,  and  certificates  are  given  if  the  operation  has  been  success- 
ful, without  which  a  child  cannot  enter  a  school.     Considerable  success 


IlSrTEODTJCTION.  397 

has  attended  the  methods  pursued  in  New  York  City.  The  Board  of  Health 
of  that  city  employs  a  corps  of  inspectors,  whose  duty  it  is  to  -visit  every 
tenement-house  and  public  school  twice  during  the  year,  examining  each 
child,  and  offering  free  vaccination  to  every  one  in  the  tenements.  From 
Octoi)er  1,  1874,  when  this  work  was  begun,  to  July  1,  1883,  there  have^ 
been  130,598  primary,  and  452,550  re -vaccinations,  making  a  total  of  583,- 
148  operations  performed  by  this  corps.  The  records  that  are  kept  by  the 
Department  show  that  about  ninety-five  per  cent,  of  the  primary,  and  about 
sixty  per  cent,  of  the  re-vaccinations  are  successful,  and  that  jDrotection 
from  small-pox  is  assured  in  every  case.  The  great  numbers  of  immi- 
grants that  are  constantly  passing  through  the  city  make  the  mortality  re- 
turns for  the  year  much  higher  than  they  would  otherwise  be,  as  the  cases 
of  small-jDox  are  confined  to  this  class  of  the  population,  the  older  inhabi- 
tants  that  have  been  successfully  vaccinated  experiencing  comjjlete  immu- 
nity from  the  disease. 

The  j)ollution  of  rivers  in  this  country  has  not  yet  received  the  atten- 
tion it  deserves.  Special  i-eports  have  been  made  from  time  to  time,  but 
they,  as  a  rule,  cover  only  the  case  of  the  stream  under  litigation,  when 
riparian  or  other  rights  are  infringed,  and  have  no  bearing  on  the  general 
subject. 

Food  and  di'ug  adulteration  ha*s  received  much  attention,  and  four 
States  have  passed  laws  for  its  prevention.  Nothing  more,  however,  than 
a  passing  notice  of  the  work  in  this  direction  is  necessary,  as  the  subject 
is  treated  at  length  in  one  of  the  articles  that  follow. 

Many  of  our  older  cities  have  sewerage  systems  that  seem  to  have  been 
the  result  of  chance  instead  of  prearranged  and  carefully  studied  method. 
Flat-bottomed  sewers,  covered  watercourses,  and  badly  constructed  oval 
sewers,  which  have  been  aptl}''  described  as  "  elongated  cessjDools,"  are,  in 
some  instances,  the  only  means  for  removing  the  sewage  from  the  vicinity 
of  dwellings.  Cesspools  are  still  in  use  in  many  cities,  towns,  and  vil- 
lages, but  are  fast  disappearing  under  the  vigorous  measures  of  boards 
of  health.  Too  much  cannot  be  said  against  then-  use  under  any  circum- 
stances. The  almost  depopulation  of  the  city  of  Memphis,  in  1878,  is  a  ter- 
rible example  of  the  loss  of  life  that  may  be  occasioned  by  their  use.  Much 
more  attention  is  now,  however,  being  paid  to  systematic  sewerage  ;  new 
towns  are  employing  competent  engineers  to  prepare  plans  for  its  proper 
disposal,  and  old  ones  are  seeking  advice  for  the  improvement  of  their  ex- 
isting systems.  There  has  been  some  controversy  of  late  on  the  compara- 
tive merits  of  what  are  termed  the  "  combined  "  and  "  sej^arate  "  sj^stems, 
the  former  providing  for  the  removal  of  both  sewage  and  rainfall  through 
one  set  of  pipes,  and  the  latter  requiring  a  separate  system  for  each.  No 
hard-and-fast  rules  can,  however,  be  given  for  the  emj)loyment  of  either 
system  ;  local  considerations  and  future  wants  should,  in  all  cases,  deter- 
mine the  use  of  either,  or  a  combination  of  both. 

Within  the  past  few  years  the  problem  of  how  to  remove  house  waste 
in  suburban  districts  has  been  solved  by  the  employment  of  a  system  of  sub- 
surface irrigation.  The  efficiency,  simplicity,  and  comparative  cheajDuess 
of  this  mode  of  sewage  disposal  makes  it  available  for  small  plots  of 
ground,  and  at  the  same  time  has  none  of  the  dangers  of  the  old  system 
of  leaching  cesspools. 

Although  the  condition  of  our  pubhc  schools  is  beginning  to  receive 
official  attention,  and  the 'grosser  sanitary  evils  remedied,  there  is  yet  com- 
paratively little  interest  taken  in  such  matters  by  the  public  at  large.  Much 
has  been  done,  and  is  being  done ;  but  those  who  recognize  the  evils  of 


398  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

imperfect  heating  and  ligliting,  uncomfortable  seats,  defective  plumbing 
and  ventilation,  crowded  rooms,  climbing  stairs,  badly  constructed  and 
dii'ty  closets,  impure  water,  etc.,  are  often  sadly  hampered  in  their  efforts 
at  reform  by  causes  that  are  very  well  put  by  Mr.  Warren  E.  Briggs,  in  a 
recent  report  of  the  Michigan  State  Board  of  Health,  who  classifies  them 
as  follows  :  1,  The  stereotj'ped  school-house  is  always  before  them  (the 
advocates  of  a  better  system),  and  is  usually  taken  as  a  model  for  the  new 
building  ;  2,  Local  prejudice  against  sanitary  reform — the  ancient  inhabi- 
tant classes  it  mth  all  the  modern  crazes  and  new-fangled  notions  ;  3,  Penu- 
rious and  short-sighted  economy  in  the  appropriation  of  small  sums  for 
the  construction  of  buildings  ;  4,  The  difficulty  of  obtaining  satisfactory 
data.  This  last  class  has,  in  a  great  measure,  been  removed  by  competi- 
tion for  piizes  offered  by  the  editor  of  the  Sanitary  Engineer  for  the  best 
plans  for  school  buildings,  which,  by  directing  the  attention  of  architects 
and  others  to  the  matter,  has  now  made  it  possible  to  obtain  plans  for  schools 
of  varying  size,  admirable  in  construction  and  ingenious  in  arrangement. 

Municipal  boards  of  health  have  not  been  behind,  and  in  some  instances 
have  led,  the  State  boards  in  theu-  work  of  sanitary  reform.  The  New 
York  City  Board  was  the  first  to  organize,  and  being  the  pioneer  in  muni- 
cipal hygiene  has  borne  the  brunt  of  the  battle  against  ignorance.  Its 
methods  have  been  closely  watched,  and  many  of  its  regulations  adopted 
by  other  cities. 

Another  competition,  also  originating  with  the  Sajiifary  Engineer,  was 
opened  in  December,  1878,  and  a  prize  of  $500  was  offered  "  for  the  best 
foui"  designs  for  a  house  for  workingmen,  in  which  might  be  secured  a 
proper  distribution  of  light  and  pure  air,  with  an  arrangement  of  rooms 
that  would  yield  a  rental  sufficient  to  pay  a  fair  interest  on  the  investment." 
This  competition  attracted  great  attention,  and  so  aroused  the  pubhc  to  the 
evils  of  the  then  tenement-house  system  that  "an  amendment  to  the  Tene- 
ment-House Act  was  passed  by  the  State  Legislature,  May,  1879,  limiting 
the  space  to  be  occupied  by  any  tenement-house  to  sixty-five  per  cent,  of  the 
lot  it  occupies,  requiring  all  bedrooms  to  have  windows,  with  direct  Ught 
and  air,  and  greatly  adding  to  the  j)owers  of  the  Board  of  Health  to  remedy 
abuses  in  such  buildings." 

A  very  important  move  was  made  in  1881,  when  the  State  legislature 
passed  a  law  i-equiring  the  registration  of  all  plumbers  in  New  York  and 
Brooklyn,  and  giving  the  municipal  board  of  health  the  power  to  make 
such  rules  as  it  might  think  proper  for  the  regulation  of  the  j^lumbing 
and  drainage  in  all  buildings  to  be  erected  subsequent  to  the  first  day  of 
October  of  that  year.  Plans  must  be  submitted  to  the  Board  for  ajoproval, 
and  powers  were  given  it  to  compel  compliance  with  the  rules  and  regula- 
tions by  making  the  violation  of  them  a  misdemeanor.  These  rules  _ 
embody  the  very  best  and  latest  practice  in  such  matters,  and  their  enforce- 
ment has  already  greatly  improved  the  sanitary  condition  of  the  city. 
LiSiDectors  are  employed  to  examine  periodically  each  building  in  course 
of  erection,  and  to  report  any  \'iolation  of  the  plans  submitted  to  and 
approved  by  the  Board.  From  October  1,  1881,  to  October  IG,  1883, 
plans  for  4,489  buildings  have  been  submitted.  These  figures  will  not,  of 
course,  agree  with  the  records  of  the  Building  Department,  as  they 
represent  only  those  houses  that  contain  plumbing,  and  therefore  come 
under  the  jurisdiction  of  the  Board  of  Health.  Of  these  4,489  buildings 
2,808  were  tenement-houses,  with accommodationfor  133,473  persons.  The 
beneficial  effects  of  the  "  plumbing  law "  cannot  be  accui-ately  measured 
till  the  lapse  of  several  years  has  made  the  collection  of  statistics  possible  ; 


INTEODUCTIOlSr.  399 

but  the  providing  of  over  a  quarter  of  a  million  of  people  witli  healthy 
homes  has  undoubtedly  already  improved  the  condition  of  the  city,  a 
result  that  will  be  more  and  more  apparent,  as  the  years  pass,  in  the 
gradual  lowering  of  its  death-rate. 

Following  the  lead  of  New  York,  several  other  cities  have  adopted 
similar  plumbing  laws,  the  enforcement  of  which  is,  in  every  instance, 
accompanied  with  the  like  good  results. 

In  1880  the  Health  Commissioners  of  Chicago  were  authorized  to  in- 
spect the  factories  of  that  city,  and  since  that  time  great  improvement  has 
been  made  in  their  management  and  condition,  by  preventing  injiu'ies  to 
employes  from  moving  machinery  ;  by  the  removal  of  injurious  dust  and 
vapors ;  by  providing-  proper  ventilation  for  workrooms,  and  means  of 
escape  in  case  of  fire ;  and  by  improving  the  condition  of  the  plumbing 
and  drainage. 

The  above  sketch  will,  it  is  hoped,  give  the  reader  some  idea  of  the 
work  that  has  been  done,  and  is  still  being  done,  in  this  country  in  the 
department  of  preventive  medicine.  The  success  that  has  attended  the 
labors  of  State  and  local  boards  of  health  and  of  volunteer  associations, 
especially  within  the  x^ast  few  years,  shows  a  constantly  increasing  knowl- 
edge of  sanitary  matters  among  the  people  generally,  which  every  physician 
and  scientific  man  should  strive  to  direct  in  proper  channels  by  all  the 
means  in  his  power.  There  are,  it  is  true,  some  few  individuals  who,  by 
wild  and  unwarranted  statements  of  the  dangers  to  health  from  various 
causes,  attempt  to  make  capital  by  the  excitement  they  create.  These, 
however,  together  with  those  who  still  ridicule  sanitary  reform  as  a  new- 
fangled notion,  must  surely  give  way  before  the  honest  and  legitimate 
labor  of  trained  scientists.  It  must  be  admitted  that  the  hoiizon  is  stUl 
dark  in  most  of  the  States ;  but  with  the  tremendous  strides  made  by  the 
nation  in  other  directions,  the  time  cannot  be  far  distant  when  Sanitary 
Science  shall  be  given  its  proper  place  throughout  the  length  and  breadth 
of  the  land. 

In  conclusion,  the  editor  wishes  to  express  his  obligations  to  those  who 
have  been  associated  with  him  in  the  preparation  of  this  Supplement  for 
the  articles  they  have  contributed,  and  on  which  articles  the  work  is  depen- 
dent for  its  value. 

F.  N.  0. 


WATER. 

By  EL^TTN  WALLEE,  PH.D., 

Chemist  to  the  Health  Department  of  New  York  City. 

Necessity  for  Water. — It  is  impossible  to  over-estimate  the  sanitary  im- 
portance of  water  for  the  welfare  and  comfoi-t  of  man.  For  the  preservsr 
tion  of  a  proper  degree  of  cleanUness  of  our  persons,  our  clothes,  our 
dwellings,  or  the  articles  with  which  we  have  to  come  in  contact,  it  is 
indispensable. 

As  regards  our  food,  it  must  be  remarked  that  about  73  per  cent,  of  the 
human  body  consists  of  water,  and  the  food  proper  to  nouiish  one  should 
contain  about  81.5  per  cent,  of  water.  ^Yhat  is  termed  •'  solid  food  "  con- 
tains, roughly  speaking,  from  50  to  80  per  cent,  of  water,  and  thus  to  make 
up  the  necessary  amount  of  water,  some  must  be  drunk  as  water,  or  in 
some  beverage  of  which  water  is  the  chief  constituent.  A  healthy  man 
weighing  11  stone  (154  lb)  requires  every  twenty-four  hours  about  5|- 
pints  of  water  in  some  form  or  other.  "When  the  amount  of  water  in  the 
system  is  diminished  by  about  one  per  cent,  of  the  whole,  the  sensation  of 
thirst  is  felt,  which  we  usually  allay  by  imbibing  the  needful  amount. ' 

In  brief,  water  is  a  prime  necessity  for  human  beings,  both  externally 
for  cleanliness,  and  internally  as  food. 

Sources  of  Water. — The  water  which  we  requii-e  in  our  daily  hfe  and 
avocations,  comes  to  us  more  or  less  directly  from  the  clouds,  as  rain  or 
snow. 

The  rain  water  may  be  collected  directly  as  it  falls,  or  it  may  soak  into 
the  earth  and  flow  forth  again  as  springs,  forming  eventually  ponds, 
streams,  or  rivers,  or  it  may  penetrate  deeper  and  reqmre  us  to  dig  wells 
in  which  it  may  collect. 

Our  sources  of  supply  may  therefore  be  classified  as  Kain  water.  Sur- 
face water  (including  sjOTUgs,  ponds,  streams,  rivers),  and  Well  w^aters. 

From  none  of  these  sources,  however,  can  we  obtain  water  which  is 
chemically  pure  {i.  e.,  nothing  other  than  the  compound  of  oxygen  and 
hydrogen"  known  under  that  name),  because  water  is  the  gi-eat  solvent  in 
nature  and  dissolves  some  of  eveiy  substance,  gaseous  or  solid,  with  which 
it  may  come  in  contact.  Many  of  these  substances  are  beneficial,  most 
of  them  are  harmless,  while  some  are  not  only  hurtful,  but  may  even  be 
deadly. 

Term  "  Impurity." — In  speaking  of  those  substances  dissolved  by  natm-al 
water  many  persons,  no  doubt  following  the  lead  of  chemists,  call  them  all 
•'  impurities,"  which  is  correct  in  the  sense  that  they  are  not  water  ;  while 
sanitarians  frequently  use  the  term  impurities  to  designate  only  those  sub- 


>  Church,  Plain  Words  about  Water.     Pamplilet,     London,  1877. 


WATER.  401 

stances  in  natural  waters  "wliich  are  dangerous  or  inimical  to  health.  Con- 
fusion often  results  from  the  use  of  the  term  impurity  in  these  two  different 
senses,  and  some  bridge  the  difficulty  by  calling  the  hurtful  impurities 
"  contamination  "  or  "  pollution." 

Kinds  of  Impurity. — Using  the  term  "impurity  "in  its  widest  sense, 
the  different  kinds  of  impurity  which  may  be  met  with  in  water  are  Gase- 
ous, Mineral,  and  Organic  (Vegetable  and  Animal). 

The  mineral  and  organic  impurities  may  be  dissolved  in  the  water,  or 
partly  dissolved  and  pai-tly  suspended  (still  in  solid  form).  The  particles 
suspended  may  be  in  so  finely  divided  a  condition  as  to  elude  the  eye,  and 
the  water  appear  clear  and  bright. 

Gases. — The  gases  constituting  the  air  itseK — oxygen,  nitrogen,  and 
carbonic  acid — as  well  as  those  resulting  from  electrical  disturbances  of 
the  atmosphere,  as  ammonia  and  nitric  acid,  are  all  dissolved  to  some  extent 
by  water.  Li  addition,  some  springs  and  bodies  of  water  may  contain  sul- 
phuretted hydrogen,  either  from  the  decomposition  of  the  constituents  of 
the  rocks  through  which  the  water  percolates,  or  the  action  of  organic 
matter  upon  the  sulphates  in  the  water,  or  other  gases  may  be  present,  re- 
sulting from  conditions  peculiar  to  the  locality  (the  vicinity  of  volcanoes, 
etc.).  Moreover,  in  the  vicinity  of  towns  and  manufactories,  the  air  may 
contain  various  gases  resulting  from  the  presence  of  numerous  human 
beings,  from  the  combustion  of  coal,  or  from  numerous  manufacturing 
operations,  which  impurities  wiU  be  imparted  to  the  water. 

Mineral  Matters. — The  mineral  matters  floating  in  the  air  are  washed  from 
it  by  the  rain.  After  reaching  the  earth  the  rocks  and  soil  with  which 
water  may  come  in  contact,  yield  to  it  some  of  their  mineral  constituents. 
The  salts  almost  invariably  found  in  terrestrial  water  are  carbonates,  sul- 
phates, chlorides,  silicates,  and  nitrates,  of  potassa,  soda,  lime,  magnesia, 
iron,  and  alumina.  Other  elements  may  occur  in  some  localities,  and  when 
the  amount  or  the  kinds  are  such  as  to  impart  to  the  water  a  medicinal 
value,  we  may  have  the  so-called  mineral  springs.  The  waste  waters  from 
manufacturing  operations,  which  find  their  way  into  our  ponds  and  water 
courses,  either  du'ectly  or  indirectly  by  percolation,  may  also  introduce 
mineral  matters  into  water.  Moreover,  sewage  contains  considerable  quan- 
tities of  mineral  matters  which  may  reach  our  sources  of  supply  by  similar 
channels. 

Organic  Matters. — The  water  draining  from  swamps,  from  fox'ests,  or  in 
short  from  any  places  not  destitute  of  vegetation,  always  contains  vegetable 
matters,  more  or  less  decomposed.  Moreover,  especially  in  the  neighbor- 
hood of  human  habitations  or  industries,  the  water  percolating  through 
the  soil  usually  contains  organic  matters  of  animal  origin,  which,  on  ac- 
count of  their  instability,  are  passing  through  the  changes  known  as  de- 
composition. 

Agents  of  Decomposition. — The  purest  atmosphere  is  full  of  particles  of 
organic  nature  which  are  so  small  as  to  defy  the  powers  of  the  microscope 
(Tyndall,  "On  Haze  and  Dust");  yet  many  of  these  particles  are  the  germs 
or  spores  of  organisms  (presumably  vegetable  in  their  nature),  which  are 
the  microscopical  or  ultra-microscopical  agents  of  decomposition.  Organic 
material  from  which  the  mysterious  principle  we  call  life  has  departed,  is 
the  congenial  soil  in  which  such  organisms  flourish  and  reproduce  their 
kind,  or  such  modifications  of  their  kind,  that  the  germs  of  some  of  them, 
when  introduced  into  the  human  body  by  the  air  we  breathe  or  the  water 
we  drink,  produce  disease. 

The  germs  from  the  development  of  organisms  of  this  class  in  decom- 
VOL.  II.— 26 


402  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

jDOsing  vegetable  matter,  though  not  in  all  cases  altogether  innocuous,  are 
much  less  inimical  to  human  life  than  some  of  the  agents  of  the  decom- 
IDOsition  of  animal  matters. 

Of  the  nature  of  these  germs  "we  have  very  httle  knowledge — so  little, 
indeed,  that  doubts  have  been  expressed  as  to  their  existence ;  but  the 
"  germ  theory  of  disease,"  though  but  a  theory  or  hj-pothesis,  seems  to  fit 
the  obseiTed  facts  so  completely  that  it  has  been  very  generally  accepted. 

Drink ing-Waler  and  X'isease.— Disturbances  of  the  digestive  organs, 
manifesting  themselves  as  dian-hoea  or  dysentery,  are  believed  to  have  been 
frequently  caused,  sometimes  by  the  mechanical  action  of  finely  suspended 
mineral  matter,  or  of  hme  or  magnesia  salts  in  a  drinking-water,'  more 
frequently  by  the  presence  of  considerable  amounts  of  decomposing  veg- 
etable matter.  Malarial  or  remittent  fever  is  also  believed  to  result  from 
this  cause.* 

Typhoid  fever  and  cholera  are  among  the  most  serious  forms  of  disease 
which  have  been  in  many  cases  traced  to  the  use  of  water  containing  de- 
composing animal  matters  (sewage,  etc. ),  and  in  some  cases  it  has  been 
thought  that  certain  outbreaks  of  yellow  fever,  tyj^hus,  diphtheria,  and 
tuberculosis  were  also  attributable  to  this  cause.'' 

Some  investigators,  chief  among  whom  is  Prof.  Pettenkofer,  refuse  to 
accept  this  "drinking-water  theory,"  as  it  is  called,  maintaining  the  so- 
called  "  telluric  theory,"  according  to  which  the  character  of  the  soil,  to- 
gether with  various  conditions  induced  in  it  by  meteorological  changes, 
are  the  princij^al  factors  in  producing  these  diseases.  * 

The  diseases  mentioned  have  appeared,  and  have  been  spread  in  ways 
often  only  explicable  by  the  theory  that  the  imbibition  of  water,  contamin- 
ated b}-  decomposing  organic  matter  (joerhaps  infected  by  the  discharges 
of  a  patient)  have  been  the  direct  cause  of  the  disease.^ 

It  cannot,  of  course,  be  claimed  that  contaminated  water  is  the  only 
possible  means  of  spreading  these  diseases,  or  that  some  persons  may  not 
have  such  powers  of  resistance  as  to  drink  the  infected  water  ydih  impunity ; 
some  of  the  advocates  of  the  "  telluric  theory  "  are  willing  to  go  so  far  as  to 
admit  that  the  drinking  of  contaminated  water  may  create  a  2Dredisposiiion 
to  such  diseases." 

'  Wolrfhiigel,  Wasserversorgung,  p.  77.     Leipzig,  1882. 

''Woods,  Chemical  Xews,  vi.  ,30/  ;  Smart,  National  Board  of  Health  Bulletin,  i.,  317. 

3 Nichols,  Water  Supplj',  p.  19.     New  York,  18»3. 

*  As,  regards  Typhoid  fever,  vide  Pettenkofer,  Zeits.  f.  Biol.,  1870,  abstracted  also  in 
Report  of  State  Board  of  Health  for  Massachusett.*.  for  January,  1871  (^d  Report),  p. 
112  ;  also  for  January,  1877  (8th  Report),  p.  117.  As  regards  Cholera,  vide  Pettenkofer 
and  Decaisne,  Les  Mondes,  xliv. ,  p.  587,  etc. 

*  Cases  of  remittent  fever  from  foul  cistern  water,  "in  the  absence  of  prominent 
sources  of  malarial  exhalation,  to  account  for  the  presence  of  the  disease,"  are  men- 
tioned by  Dr.  Smart  (loc.  cit. ).  Dr.  Woods  (loc.  cit  )  speaks  of  two  ships  sailing  from 
Algiers  for  France  at  the  same  time.  The  one  took  swamp  water,  and  the  crew  were 
afflicted  with  ague ;  the  other  took  upland  water,  and  had  no  illness  of  the  kind  on 
bo.ird.  Occurrences  of  tvphoid  fever  under  similar  conditions  are  reported  by  Dr.  At- 
wood  and  Dr.  Vinal.  (State  Board  of  Health  for  Massachusetts,  10th  Report  (1879), 
Supplement,  pp.  270  and  272.)  Several  similar  cases  are  quoted  by  Dr.  Chandler  (Lec- 
ture on  Water,  pp.  36-39.  pamphlet,  Albany,  1871).  and  in  the  6tli  Report  of  the  English 
Rivers  Pollution  Commission  (pp.  140-184).  In  some  of  these  cases  instances  have  been 
known  of  whole  bodies  of  persons  living  or  working  in  the  infected  district  (workmen 
in  a  factory,  etc. )  who  did  not  drink  the  water  and  escaped  the  disease,  while  some  in- 
dividuals, being  quite  at  a  distance,  who  did  drink  the  water,  were  attacked  (6th  Re- 
port, Appendices,  p.  497).  The  abandonment  of  the  infected  water  has  also  prevented 
the  spread  of  the  disease      (Millbank  Prison,  vide  6th  Report,  -p.  163.) 

®  J.  V.  Fodor,  Boden  und  Wasser.     Brunswick,  1882. 


WATER.  403 

Sewage  may,  perhaps,  generate  Typhoid  Fever,  etc. — Many  cases  liave 
occurred  in  which  typhoid  fever  at  least,  and  perhaps  cholera,  have  seemed 
to  be  generated  in  decomj)Osing  sewage,  though  this  question  is  at  present 
regarded  as  an  open  one/ 

Sewage  may  not  cause  Disease. — It  is,  however,  tmdoubtedly  time  that 
water  contaminated  with  sewage  may  be  dxnink  without  causing  any  spe- 
cific disease,  but  aside  fi'om  the  sentiment  of  disgust  which  such  a  pro- 
ceeding inspires,  it  is  evidently  in  the  highest  degi-ee  dangerous. 

A  good  water  for  household  purposes  should  have  the  following  char- 
acters : 

The  temperatui'e  should  be  at  least  ten  degrees  lower  than  that  of  the 
atmosphere,  but  it  should  not  be  much  below  45°  Fahrenheit. 

It  should  be  agreeable  to  the  palate,  having,  perhaps,  a  slight  pungency, 
from  the  presence  of  oxygen  or  carbonic  acid. 

Characteristics  of  a  Good  Water. — Water  containing  some  of  the  most 
dangerous  forms  of  decomposing  animal  matters,  may  often  be  very  pleas- 
ant to  the  taste  ;  hence  it  appears  that  the  palate  cannot  be  depended 
upon  in  judging  of  the  safety  of  a  drinking-water. 

It  should  be  fi'ee  from  odor,  even  when  warmed.  Suspended  matters 
should  not  be  present. 

The  sohds  remaining  on  evaporation  should  not  exceed  50  parts  per 
100,000  (about  30  grains  per  gallon).  Less  than  two  parts  of  organic  mat- 
ter is  regarded  as  admissible,  but  the  quahty  of  the  organic  impurity  is 
much  more  important  than  its  quantity.^ 

The  hardness  should  be  smaU.  The  exti-eme  limit  for  its  equivalent, 
carbonate  of  hme,  is  set  by  some  as  high  as  30  parts  per  100,000  (about  17^ 
grains  per  gallon). 

The  amount  of  chlorine  in  chlorides  should  be  small,  =  5  parts  per 
100,000  (3  gi-ains  per  gallon)  is  thehmit  assigned  by  some. 

The  amounts  of  ammonia  and  nitrates  should  be  quite  small,  while 
nitrites  should  be  entirely  absent. 

The  properties  of  the  different  forms  of  water  available  for  domestic 
uses  must  here  be  considered. 


Kain  Watee. 

Amount. — The  mean  annual  rainfall  for  different  portions  of  the  United 
States  may  be  thus  briefly  stated.^ 

Inclies. 

Northern  States  (East  of  the  Eocky  Mountains) 80  to  50 

Southern  States 50  to  70 

Between  the  Eocky  Mountains  and  the  Pacific  Coast  Eange 10  to  20 

San  Francisco 20  to  25 

^  Dr.  Jaccond,  after  critically  examining  the  evidence  regarding  105  cases  of  out- 
break of  typhoid  fever  (Congres  d'Hygiene,  1878,  i.,  p.  377),  concluded  that  in  45  of 
these  cases  the  evidence  was  insufficient,  in  36  there  was  evidence  that  it  had  been 
transmitted  from  patients  by  the  dejecta  and  excreta,  and  in  the  remaining  24  excre- 
me..*itious  matter  unmixed  with  the  excreta  of  persons  suffering  from  the  disease, 
seemed  to  have  generated  it  de  novo.  Vide  Braithwaite's  Retrospect,  Part  Ixxiv.  ;  also 
Brit.  Med.  Jour.,  May  27,  1876. 

-  "The  Organic  and  volatile  matter,"  or  "loss  on  ignition,"  reported  by  chemists  in 
analyses  of  water,  does  not  necessarily  represent  organic  matter  entirely.     (See  p.  424.) 

3  Taken  from  Map  of  Signal  Service  Papers,  No.  ix.,  Lieutenant  Dun  woody. 


404 

Proceeding  along  the  Pacific  Coast  northward  from  San  Francisco,  the 
rainfall  becomes  heavier,  amounting  to  between  70  and  80  inches  at  Van- 
couver Island.  Li  all  cases,  as  one  recedes  from  the  coast  the  rainfall 
diminishes.  For  New  England  and  the  Middle  States,  in  calculating  for 
public  water  supplies,  40  inches  is  taken  as  the  average.' 

One  inch  of  rain  would  amount  to  nearly  101  (gross)  tons  per  acre,^  or 
on  a  house  roof  of  say  20  x  20  ft.  area,  one  inch  of  rain  wovild*be  about 
250  gallons.  With  a  rainfall  of  40  inches  per  annum  this  wovild  amount  to 
10,000  gallons,  or  about  27  gallons  per  day. 

The  average  daily  supply  2)er  capita  in  most  of  our  northern  cities 
ranges  from  20  to  127  gallons  or  more.^ 

Source  of  Impurities  in  Rain  Water. — The  impurities  in  rain  water  are 
derived  from  the  atmosphere  through  which  the  rain  falls,  from  the  sur- 
face upon  which  it  is  received,  the  receptacles  in  which  it  may  be  stored, 
and  from  the  emanations  or  infiltrations  which  may  reach  it  when  stored. 

Atmosphere. — Air  contains  on  an  average  about  0.5  gramme  of  solid 
matter  per  1,000  cubic  metres,^  which  is  equivalent  to  a  little  over  0.2 
grain  per  1,000  cubic  feet.  The  amount,  however,  is  subject  to  very  wide 
variations.  It  is  stated  °  that  "  a  half-pint  of  rain  water  often  condenses  out 
of  3,373  cubic  feet  of  air  ;  and  thus  in  drinking  a  tumbler  of  such  water, 
impurities  which  would  only  gain  access  to  the  lungs  in  about  eight  days 
are  swallowed  at  once."  The  average  composition  of  seventy-three  differ- 
ent samples  of  rain  water,  collected  twenty-five  miles  from  London,  on  a 
specially  prepared  surface,  etc.,  may  be  here  quoted  as  representing  approxi- 
mately the  constitution  of  rain  water  faUing  in  an  open  country,  by  the 
time  it  reaches  the  earth." 

Parts  per  100,000. 

Organic  carbon 0.099 

Organic  nitrogen 0.022 

Ammonia 0.050 

Nitrogen  as  nitrates  and  nitrites 0.007 

Chlorine 0.63 

Hardness 0.62 

Total  soHds  on  evaporation 3.95 

A  set  of  examinations  conducted  under  similar  conditions  in  this  coun- 
try, might  possibly,  on  account  of  different  climatic  conditions,  show  a 
greater  degree  of  j)urity  in  the  rain  water.  The  water,  however,  would  not 
be  pure. 

If  zymotic  diseases  prevail  in  the  neighborhood,  it  is  quite  probable 
that  the  germs  of  disease  might  be  thus  washed  into  the  drinking-water. 
At  any  rate,  in  the  neighborhood  of  collections  of  houses,  or  of  manu- 
factories, or  both,  the  impurities  in  the  rain  water  from  the  air  would  no 
doubt  be  very  much  increased. 

Surfaces  for  Collection. — The  surfaces  upon  which  rain  water  is  usu- 
ally collected  are,  almost  without  exception,  the  roofs  of  our  houses. 
Whatever  the  material  of  the  roof,  the  rain  falling  upon  them  after  a  period 
of  fine  weather,  first  washes  from  them  more  or  less  of  the  dust,  excremen- 


'  J.  T.  Fanning,  Water  Supply,  Engineering,  pp.  46  and  98.     New  York,  1878. 

2  A.  H.  Church,  Plain  Words  about  Water.     London,  1877. 

^Fanning,  loc.  cit.,  p.  39. 

^Rernsen,  Report  of  National  Board  of  Health,  p.  73,  1879. 

^  (ith  Report  Rivers  Poll.  Comm.,  p.  30. 

«Loc.  cit.,  pp.  27 to  29. 


WATEE.  405 

tal  or  other,  minute  plants,  spores,  and  germs,  etc.,  which  may  have  lodged 
upon  them.  Cases  have  also  been  known  where  ignorant  or  lazy  servants 
have  emptied  slops  from  the  upper  windows  of  a  house  on  projecting  roofs 
below.  To  avoid  the  introduction  into  the  cistern  of  such  material  as 
may  be  washed  from  roofs  by  the  first  portions  of  a  rainfall,  "  cut  offs " 
have  been  invented,  some  of  them  automatic,  by  which  the  first  portions  of 
the  rain  are  run  to  waste,  and  only  the  purer  after-faU  is  turned  into  the 
cistern.     They  appear,  however,  to  be  but  httle  used.' 

Material  of  Roof  Surface. — 'The  material  of  the  roof  surface  has  a  con- 
siderable influence  on  the  character  and  quality  of  the  water.  From 
painted  roofs  it  takes  up  some  of  the  constituents  of  the  paint,  from  galvan- 
ized roo^s  some  of  the  zinc,  and  so  on.  From  shingled  or  tiled  roofs  the 
rain  may  wash  the  small  mosses  and  small  plants  which  may  have  germinated 
upon  them  ;  from  shingled  roofs  may  also  be  washed  particles  of  the  wood 
disintegrated  by  weathering,  which  are  transferred  to  the  cistern  to  decay 
there.  The  best  material  for  a  roof  on  which  the  rain  water  is  to  be  col- 
lected is  slate,  which  is  sufiiciently  smooth  to  afford  comparatively  little 
opportunity  for  the  lodgment  of  dust,  vegetable  growths,  etc. 

Cisterns:  Wood. — The  material  of  the  cistern  also  requires  considera- 
tion. Wood  cisterns  are  very  prone  to  decay,  the  inevitable  alternate  wet- 
ting and  exposure  to  air  to  which  the  sides  of  the  cistern  are  subjected  by 
the  fluctuations  of  the  water-Hne  being  especially  favorable  to  such  decay, 
the  result  being  the  introduction  of  considerable  quantities  of  dissolved 
and  suspended  matters  into  the  water. 

Lead  Linings. — Lead  hnings  are  more  readily  attacked  by  rain  water 
than  by  any  other,  and  should  never  be  used  for  cisterns.  The  solution  of 
lead  is  aided  by  dissolved  air,  by  nitrates  and  by  chlorides  in  water,  while 
it  is  obstructed,  and  often  prevented  by  the  presence  of  sulphates,  phos- 
phates, and  lime  salts,  ^  The  presence  of  more  than  three  volumes  of  car- 
bonic acid  per  100  volumes  of  water,  is  also  stated  to  prevent  the  action 
of  water  upon  lead.^  Cistern  water  contains  less  of  the  protecting  sub- 
stances, and  more  of  those  aiding  the  solution  of  lead  than  any  other. 

Cement  Linings. — Cement  hnings,  containing  as  they  do  more  or  less 
lime,  are  apt  to  render  the  water  hard,  and  on  that  account  are  objection- 
able. They  are  also  Hable  to  crack  and  allow  of  leakage  from  the  cistern, 
or  worse  stiU,  the  leakage  of  sewage  matters  into  the  cistern. 

Slate  Linings. — Slate  linings  are  not  open  to  the  objections  raised  against 
the  others,  except  that  attention  to  the  composition  of  the  cement  by 
means  of  which  the  slabs  are  joined  is  requisite.  Lead  oxides  are  often 
used  in  these  cements,  with  the  result  of  contaminating  the  water  with 
lead.' 

Location  of  Cisterns. — If  placed  above  ground,  cisterns  should  be  shel- 
tered from  the  sun,  both  in  order  to  keep  the  water  sufficiently  cool  to  be 
palatable,  and  to  retard  or  partially  prevent  any  decompositions  of  ma- 
terial which  may  gain  access  to  them.  If  below  the  surface,  especial  care 
has  to  be  used  to  prevent  the  infiltration  of  various  slops,  etc.,  which  may 
be  thrown  or  fall  upon  the  ground  near  the  house.  Contamination  in  this 
manner  is  very  frequent  with  underground  cisterns,  either  from  the  por- 
osity of  the  material  with  which  it  is  lined,  or  the  occurrence  of  cracks  in 

'  Dr.  Smart,  loc.  cit. 

^W.  S.  Saunders,  Cliem.  News,  xlv.,  p.  7. 

^Eeport  of  English  Commission  of  1851.  Graliam,  Miller,  and  Hofman,  quoted  in 
6tli  Report,  loc.  cit. ,  p.  224. 

•*  Phipson,  Chem.  News,  xl.,  1. 


406 


AMERICAN    APPENDIX    TO    PARKES     HYGIENE. 


the  cistern.  One  of  the  samples  of  cistern  water  examined  by  the  English 
Rivers  Pollution  Commission,'  was  found  by  them  "to  consist  of  sewage  of 
even  greater  strength  than  average  London  sewage  "  fi-om  this  cause. 

Sewer-gas  m  Cisterns. — Another  source  of  dangerous  impmity  in  cistern 
water  is  sometimes  the  ai-rangement  adopted  of  having  the  ovei-How  pipe  of 
the  cistern  in  communication  with  the  soil  pipe  of  the  house,  by  which  the 
noxious  gases  from  the  house  sewage  gain  access  to  the  water  and  are  ab- 
sorbed by  it. 

Other  Impurities. — Cisterns  are  often  the  resorts  of  the  rats,  mice,  cock- 
roaches, and  other  small  vermin  about  a  house,  and  the  excreta  or  dead 
bodies  of  such  vermin  are  frequently  fovmd  in  those  receptacles.  Their 
possible  presence  adds  still  another  danger  to  the  safety  of  the  water. 

A  few  of  the  numerous  analyses  of  stored  rain  water  may  be  here  quoted. 
A  few  of  them  have  been  selected  as  showing  how  impure  a  cistern  water 
may  become. 

Analyses  of  Cisteen  Water. 
Results  eocpressed  in  Parts  per  100,000. 


-S 

Sd 

^ 

.i 

o.S 
c  a 

d 

0 

Location. 

J 

o 

§ 
6 

la 

c8 

'iH 

IB 

Analyst. 

e 

< 

<^ 

w 

0 

Podehole 

5.28 
12.00 

0.00 
0.130 

.... 

3.8 
5.0 

0.9 
1.6 

Eiv.  Poll.  Comm. 

Sheffield  Barracks. 

((           i(             a 

Greaselv  . , 

126.60 
5.28 

0.730 
0.013 

6.008 

55.70 

11.5 
0.32 

i(           ((             (( 

Boston,  Mass 

W.  E.  Nichols. 

Newijort,  E.  I 

7.50 

0.0105 

0.0275 

'3.73 

0.76 

E.  Waller. 

Omaha,  Xeb 

6.70 

0.012 

0.0136 

4.03 

trace 

(( 

Cincinnati,  0 

2.68 

0.004 

0.123 

0.55 

C.  H.  Stuntz. 

(t            (( 

4.48 

0.027 

0.118 

1.97 

<(          >( 

Wilmington,  N.  C. . 

5.05 

0.002 

0.015 

.... 

0.70 

C.  W.  Dabney. 

<(               <( 

6.90 

0.016 

0.008 

0,52 

<<                           K 

Dr.  Smart  describes  the  cisterns  so  largely  used  in  New  Orleans  in  a 
report  to  the  National  Board  of  Health.^  They  are  usually  constructed  of 
cypress  wood,  the  avei-age  capacity  being  about  2,000  gallons.  "Many  are 
in  imventilated  enclosures,  rank  with  the  emanations  of  unclean  privies. 

"The  rain  water  shed  from  the  house  roof  carries  with  it  into  the  cis- 
tern the  soot  and  condensed  ammoniacal  vapors  of  coal  combustion,  the  in- 
finity of  debris,  organic  and  inorganic,  which  constitute  the  dust  of  a  lai-ge 
city,  together  with  more  massive  fragments,  as  of  dead  insects  and  decaying 
leaves,  etc.  After  a  few  days  these  various  matters  settle,  forming  a  soft, 
black  pultaceous  sediment,  and  leading  the  supernatant  hquid  comparatively 
clean  and  pure,"  etc.  The  average  rate  of  accumulation  of  sediment  is 
about  one  inch  per  annum.  An  analysis  of  the  au'-dried  mud  from  one  of 
these  cisterns  showed — 

Per  cent. 

Moisture 17.2 

Organic  and  volatile 34.0 

IMineral  matter 48.8 

'  Sixth  Report,  p.  29.     Greasely  cistern  water  in  the  tahle  appended. 
»  National  Board  of  Health  Bulletin,  i.,  317. 


WATER.  407 

On  account  of  the  numerous  sources  of  danger  to  the  purity  of  stored 
rain  water,  most  authorities  unite  in  condemning  it  for  general  household 
purposes,  though  for  laundry  purposes  alone  it  is  usually  the  best  water. 

In  Holland,  where  rain  water  is  collected  among  the  sand  dunes  at  some 
distance  from  the  cities,  and  from  those  receptacles  is  conducted  to  the  cen- 
tres of  population,  as  Amsterdam,  rain  water  is  regarded  as  the  best  form 
of  water  obtainable. ' 

The  conclusions  of  the  Rivers  Pollution  Commission  ^  regarding  rain 
water  ai^e  as  follows  : 

"  1.  Of  the  various  kinds  of  water  used  for  dietetic  and  domestic  pur- 
poses, 7'ain  ivater,  when  collected  at  a  distance  from  towns  upon  specially 
cleansed  surfaces,  and -kept  in  clean  receptacles,  contains  the  smallest  pro- 
portion of  total  sohd  impmity  ;  but  the  organic  contamination,  even  of 
such  specially  collected  water,  somewhat  exceeds  that  of  water  from  springs 
and  wells. 

"  2.  Eain  water  collected  from  the  roofs  of  houses,  and  stored  in  under- 
gTound  tanks,  is  much  more  impure  ;  it  is  often  polluted  to  a  dangerous 
extent  by  excrementitious  matters,  and  is  rarely  of  sufficient  good  quahty 
to  be  employed  for  dietetic  pui'poses  with  safety." 

Snoiv. — Snow  is  quite  as  impure  as  rain,  perhaps  in  many  cases  more 
so.  Tissandier  obtained  the  following  results  with  snow  after  it  had  been 
melted  : 

Solids  per 
100,000  parts. 

Falling  in  a  court  in  Paris 21.2 

Falling  on  towers  of  Notre  Dame 3 1.8 

Falling  in  the  open  country 10.4 

About  60  per  cent,  of  these  soKds  was  mineral  matter.  Besides  various 
mineral  salts  the  snow  also  contained  ammonium  nitrate.' 

The  amount  of  ammonia,  and  hence  probably  the  amount  of  organic 
impurities  in  snow,  has  been  found  to  vary  with  the  temperature  at  which 
it  falls,  and  the  nature  of  the  surface  on  which  it  falls.  * 

Many  hold  the  opinion  that  snow  water  is  unwholesome.  Dr.  Chas. 
Brewer,  U.  S.  A.,  speaks  of  the  Western  moimtaineers  attributing  to  the  use 
of  snow  water  the  origin  of  the  so-called  mountain  fever.  ^ 

Surface  Water. — Springs. 

Spring  water  usually  comes  to  the  surface  after  having  undergone  a 
filtration  through  a  mass  of  soil  and  rock,  compared  with  which  the  filter 
beds  used  by  water  companies  or  corporations  in  purifying  the  water  sup- 
phed  to  consumers  are  insignificant. 

The  amount  yielded  by  them  is  naturally  more  dependent  upon  the 
rainfall  of  the  district  than  upon  the  nature  of  the  geological  formation. 
The  quaUty  is,  however,  dependent  upon  the  geological  character  of  the 
rocks  through  which  the  water  has  passed.    All  of  the  mineral  constituents 

'  Congres  d'Hygiene,  1878,  ii.,  p.  100. 

2  Sixth  Report,  p.  424. 

^  Comptes  Rendus,  January,  1875. 

■^Vogel,  Akad.  d.  Wissenschaften  Miinschen,  part  I.,  1872.  Boussingault  found  in 
freshly  fallen  snow  0.178  part  of  ammonia  (per  100,000).  After  the  same  snow  had 
lain  on  a  garden  soil  for  a  day  and  a  half,  it  contained  1.034  part  (WolfEhugel,  Was- 
serversorgung,  p.  9). 

^  Vid.  Smart  Buck's  Hygiene,  ii.,  pp.  129  to  134. 


408 


AMERICAN    APPENDIX    TO    PAKKES     HYGIENE. 


of  those  rocks  are  taken  up  by  the  water  to  some  extent.  In  general  terms, 
the  older  non-calcareous  rocks — granite,  sandstones,  etc. — aftbrd  the  water 
freest  from  mineral  matters,  while  calcareous  formations  usually  give  up 
the  most  mineral  matter  to  the  water. 

A  water  is  considei'ed  usable  in  respect  to  mineral  matter  if  it  does  not 
contain  over  30  grains  of  solids  per  gaUon  (50  parts  per  100,000),  Calcar- 
eous strata  also  not  only  give  up  more  mineral  matters  to  water,  but  also, 
among  other  elements,  the  water  takes  up  considerable  quantities  of  hme 
and  magnesia,  Avliich  cause  the  "hardness"  so  objectionable  in  water, 
especially  for  washing  and  cooking. 

Character  of  Water-bearing  Strata. — The  character  of  the  material 
through  which  the  water  may  percolate  is  of  some  importance.  Rocks 
containing  many  fissiu'es  often  yield  water  of  doubtful  quahty.  The  water 
from  gi-avelly  deposits  also  is  variable  in  quality,  no  doubt  in  both  cases 
the  result  of  imperfect  filtration. 

Avoid  External  Contamination. — The  above  is  apphcable  to  the  water 
from  springs  where  there  is  no  opportunity  for  contamination  by  drainage 
fi'om  heavily  manured  fields,  or  perhaps  houses  and  barnyards.  If,  for 
instance,  a  spring  issues  near  the  base  of  a  hill  on  which  are  located  farm- 
houses with  their  accompanying  outhouses,  as  well  as  cesspools,  barn- 
yards, pigstyes,  and  the  like,  the  probabilities  of  the  contamination  of  such 
a  spring  are  very  great.  In  such  cases,  howevei',  the  dip  of  the  strata  by 
which  the  water  is  to  some  extent  guided,  might  become  a  factor  in  de- 
termining the  chances  for  or  against  the  desirability  of  the  water  for  do- 
mestic uses.  The  external  configuration  of  the  land  is  not'  always  a  guide 
as  to  the  j^robable  lay  of  the  strata  beneath. 

Constanci/  of  Flow. — Aside  from  the  question  of  the  probable  ability  of  a 
spring  to  always  meet  the  demand  which  may  be  made  upon  it,  the  con- 
stancy of  flow  in  a  spring  is  usually  a  valuable  indication.  Springs  of 
vai'iable  volume  generally  draw  their  supply  fi-om  a  near  and  limited  area, 
and  the  water  from  them  is  more  likely  to  be  contaminated  than  that  from 
those  yielding  a  more  constant  supply,  and  presumably  drawing  from  a 
larger  and  more  thoroughly  filtered  source. 

Composition  of  Spring  Waters  from  Different  Formations. 
Results  given  in  Parts  per  100,000. 


Formation. 


Granite  and  Gneiss  Rocks 

Silurian  Rocks 

Devonian  Rocks  and  old  ) 

Red  Sandstone ) 

Yoredale  and  Millstone  ) 
Grits  and  Coal  Measures  j 

Lias 

OoUtes 

Chalk 

Flu\'io-Marine,  Drift,  and ) 

Gravel ) 


25.06 


.2  « 


"a   ? 


OfC 


0.042  0.008  0.001 
0.0510.0140.001 


0.054 


21.9l'0.050 


36, 
30. 
29 


410.073 
33  0.043 
840.Q44 


61.32.0.086 


0.0120.001 
0.014  0.001 


!^S 


0.106 

0.178 

0.764 

0.393 
0.467 


0.0190.001 
0.011:0.0010.402 
0.010  0.0010.382 


0.019 


0.0010.354 


1.69 
1.84 


1.85 

2.48 
1.55 
2.45 

2.76 


3.0 

6.8 


3.85   12.0 


13.1 

30.1 
24.4 
23.6 


s  a 


15 

22 

22 

7 
35 
30 


37.6    10 


TTATEE.  409 

Contents. — Organic  matter  is  usually  present  to  some  small  extent,  but 
if  pollution  by  excrementitious  matters  is  prevented  or  excluded,  it  is 
usually  harmless. 

The  preceding  is  a  portion  of  the  table  giving  the  average  composition 
of  rmpoUuted  waters  examined  by  the  Enghsh  Eivers  Pollution  Commis- 
sion. ' 

Summary. — Spring  water,  when  siu'face  pollution  is  avoided,  is  re- 
garded as  the  best  possible  kind  of  water  for  general  domestic  uses.  "When 
the  water  reaches  its  outlet  through  a  very  permeable  stratum  (gravel  or  fis- 
sured rocks),  it  may  not  be  sufficiently  filtered  to  have  the  desii-able  quali- 
ties common  to  spiing  waters  as  a  class.  In  hmestone  regions  it  may 
also  be  too  hard  for  comfort  or  economy  in  the  household. 


SUEFACE   WaTEE. PoXDS    A>1)    STEEAilS. 

Amount — It  is  estimated  that  about  half  of  the  water  descending  upon 
the  earth  as  rain,  finds  its  way  into  the  streams.' 

Impurities  :  Mineral. — The  character  and  amoimt  of  the  mineral  impu- 
rities in  ponds  and  streams,  is  to  some  extent  dependent  upon  the  charac- 
ter and  amount  of  those  constituents  in  the  springs  which  supj^ly  them, 
and  upon  the  geological  formation  where  they  may  be.  The  amount,  how- 
ever, is  usually  smaller,  partly  because  these  sources  receive  some  of  their 
water  du-ectly  fi-om  the  rain  that  either  falls  dii-ectly  upon  their  surfaces 
or  runs  into  them  during  a  rainfall,  without  passing  through  the  ground, 
and  partly  because  the  plants  gi'owing  in  them  abstract  some  of  the  min- 
eral matters  for  theii'  own  sustenance  and  gi'owth. 

Organic. — On  the  other  hand,  the  water  in  ponds  and  streams  is  ex- 
posed to  influences  tending  to  increase  the  amounts  of  organic  matter.  The 
plants  growing  in  the  water  or  along  its  margins  afford  some  of  this  ;  the 
dust  and  leaves  borne  by  the  vdnd  contribute  to  it,  and  in  the  vicinity  of 
human  habitations  and  manufactories,  the  sewage  and  manufactui'ing  re- 
fuse work  their  way  into  them,  imperfectly  filtered  by  the  adjacent  soil, 
or  are  turned  into  them  directly  without  any  such  pai'tial  filtration. 

"Watercoui'ses  are  the  natural  drains  of  a  country,  and  hence  the  ap- 
pearance of  such  material  in  the  streams  and  rivers  is  inevitable.  Conse- 
quently the  quality  of  the  water  of  streams  is  better,  as  a  rule,  the  neai'er 
we  approach  to  the  source. 

Suspended  Impurities. — Besides  dissolved  impurities,  sui'face  waters 
naturally  contain  various  matters  in  suspension,  which  vary  in  quantity  and 
character  with  the  weather,  and  in  each  individual  case  with  the  topogi-aphy- 
of  the  country,  the  chai'acter  of  the  rocks  and  soil  of  the  water  shed,  the 
presence  of  toT\-ns,  manufactories,  etc.  As  a  sample  of  the  same  river  at 
different  times  and  different  places,  \di\\  regard  to  its  contents  in  suspended 
matters,  the  following  results  of  obseiwations  on  the  Ehine  may  be  of  in- 
terest : 

1  6tli  Eeport,  p.  131.  ^  Fanning,  loc.  cit. ,  p.  77. 


410 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


Suspended  Matter. '     (Parts  per  100,000.) 


At  Strasbui'g,  July  and  August . , . 

At  Bonn 

At  Bonn 

At  Bonn,  after  dry  Aveather 

At  Uerdingen,  after  sudden  floods 
In  Holland 


By  Weight. 

By 

Volume. 

2.00 

'  6.25 

20.50 



1.73 

78.00 

1000.00 


A  table  of  analyses  of  some  of  the  river  waters  in  the  United  States  is 
here  given.  The  increase  of  material  of  vai'ious  kinds  in  some  of  these  rivers, 
as  we  descend  the  stream,  is  noticeable. 

Rivers  in  the  United  States.     (Eesults  in  parts  per  100,000.) 


Mississippi Minneapolis,  Minn. 

Mississippi St.  Louis,  Mo. 

Mississippi  '^ . .  .  i  St.  Louis,  Mo. 
Ohio j  Cincinnati,  O. 

Louisville,  Ky. 

Evansville,  111. 

Indianapolis,  Ind. 

Nashville,  Tenn. 

Wilmington,  N.  C. 

Albany.  N.  Y. 

Poughkeepsie,  N.Y, 

Poughkeepsie,  N.Y. 

New  York,  N.  Y. 

Philadelphia,  Pa. 

FaUs,  N.  J. 

BeUeville,  N.  J. 


Ohio. 

Ohio 

White 

Cumberland. 
Cape  Fear.  .. 

Hudson 

Hudson 

Hudson  s 

Croton 

Schuylkill... 

Passaic 

Passaic 


Date. 

Is 

2  2 

"2  « 
o 

1877 
Aug.,  '73 
Aug.,  '73 

"isso" 

1880 

1880 
Sept.,  '76 
Aug.,  '81 
March,  '72 
Nov.,  '77 
Nov.,  "77 
'72  to  '82 
July.  '81 
July,  '72 
July,  '72 

240.1 
45.04 

4.2 
2.1 

'9.30 
10.40 

1.2  ■ 

1.7 

5.702 

1.678 

5.28 
7.36 

2.58 
1.95 

18.6  1. 
244.3    1. 

47.14  ., 
14.2    0 

11.7  0. 
18.6    0, 

28.0  0, 
13.80,0. 

5.6    0 
10.5    0, 

12.1  . 
10.1  I. 
7.380  0 
12.01  0 

7.86  0 
9.31  0 
I 


0.003 
0.002 


0.011    0.048 

[trace 

0.012 

0003 

0.000    0.0035 

'O.OOS    0.016 


.sg 


0.015 
0.068 


Analyst. 


...    0.0109  0.0197 
...  !0. 0109  0.0184 
3     0.001  ,0.012 
56  '0.002  ;0.012 
4.32  0.040    0.040 
470,0.049  ,0.085 


11.47 
8.22 


7.86 
6.00 


3.21 
8.6 


S.  F.  Peck^am. 
D.  V.  Dean. 

D.  V.  Dean. 
C.  H.  Stuntz. 
T.  C.  Van  Nuys. 
T.  C.  Van  Nuys. 
T.  C.  Van  Nuys. 
N.  T.  Lupton. 
W.  R.  Nichols. 
C.  F.  Chandler. 
W.  K.  Nichols. 
W.  R.  Nichols. 

E.  Waller. 

n.  Leffmann. 
H.  Wurtz. 
H.  Wurtz. 


Examinations  of  Water  from  Lakes  and  Ponds. 

(Results  given  in  parts  per  100,000.) 


Place. 

Analyst. 

Date. 

Org. 
and 

Vol. 

Mineral. 

Total 
Solids. 

Hard- 
ness. 

Lake  Michigan 

Chicago,  111 

Blaney . . 

1859 

1.81 

9.63 

11.44 

Lake  Erie 

Cleveland,  O 

Cassels. . 

Feb.,    1866 

1.10 

8.23 

9.33 

3.66 

Lake  Ontario 

Toronto,  Can 

Croft  ...  Feb.,    1878 

0.77 

11.73 

13.50 

.... 

Lower  Chain  Lakes. 

Halifax,  N.  S 

Lawson  .Sept.,  1878 

3.83 

3.49 

7.32 

Lake  Massabesic. . 

Manchester,  N.  H . . 

Hayes. . . 

June,   1869 

2.77 

1.93 

4.70 

6.84 

South  Pond  

Plvmouth,  Mass 

Nichols  . 

June,  1877 

1.40 

1.60 

3.00 

VVatuppa  Pond 

Fall  River,  Mass.. . 

Appleton 

1870 

1.43 

1.67 

3.10 

6.34 

Lake  Konomoc  .... 

New  London,  Conn. 

Nichols  . 

Dec,  1879 

1.20 

1.60 

2.80 

Artificial  Lake 

Norwich,  Conn 

Silliman. 

Jan.,    1873 

1.16 

2.0 

3.16 

6.93 

Lake  Ovvasco    

Auburn,  N.  Y 

Chandler 

1876 

1.20 

15.80 

17.00 

8.7 

Green  Lake 

Syracuse,  N.  Y 

(^handler  Jan.,    1871 

1.20 

14.14 

16.34 

Reeds  Lake 

Grand  River,  Mich . 

Kedzie  . . ,  Aug. ,  1 872 

Much. 

12.86 

Blae  Lakes 

San  Francisco,  Cal. 

Falkenau 

April,  1875 

21.0 

'  Vid.  Nicliols,  Water  Supply,  Table  vii.,  p.  57. 


2  Filtered. 


WATER.  411 

The  "  places  "  mentioned  are  those  for  which  the  water  was  either  pro- 
posed or  used  as  a  source  of  public  supply.  In  a  few  cases  the  lake  or 
pond  is  a  considerable  distance  off,  e.g.,  the  "Blue  Lakes,  San  Francisco, 
Cal.,"  are  high  up  on  the  Sierra  Nevada,  8,000  feet  above  the  level  of  the 
city. 

Purification  of  Rivers  by  Floxo. — The  question  of  the  self-purification  of 
rivers  by  their  flow  has  been  earnestly  discussed,  and  cannot  be  regarded 
as  settled  at  the  present  time.  Such  pTu-ification  would  take  place  by  the 
oxidation  of  the  dangerous  organic  material,  by  deposition  of  the  suspended 
material,  carrying  with  it  some  of  the  organic  impurities,  or  by  the  agency 
of  organisms  in  the  water,  as  fish,  water  plants,  or  the  more  minute  algce, 
some  forms  of  which^  possibly  feed  upon  or  destroy  the  as  yet  unrecog- 
nized "  somethings  "  which  cause  disease.  Dilution  of  the  water  in  its 
progress  causes  an  apparent  and  perhaps  a  real  purification. 

The  results  of  series  of  exj)eriments  made  by  the  English  Elvers  Pollu- 
tion Commission '  would  go  to  show  that  oxidation  alone  is  insufficient 
to  purify  the  water  of  a  stream  in  which  the  water  has  been  once  fouled 
by  sewage. 

Dr.  Tidy  ^  claims  that  the  rapidity  of  oxidation  depends  on,  a,  the  de- 
gree of  dilution  of  the  sewage  ;  h,  the  distance  of  the  inin  ;  c,  the  rapidity 
of  the  current ;  d,  the  temperature,  and  e,  on  certain  natural  or  physical 
conditions  :  e.g.,  if  the  bed  is  rough,  so  that  the  water  has  a  greater  op- 
portunity for  aeration,  or  there  are  numerous  locks,  weirs,  etc.,  along  it, 
which  may  produce  the  same  effect,  the  j)urification  is  more  rapidly  effected 
than  where  the  stream  flows  quietly  along.  By  arranging  the  experiment 
in  a  different  manner  to  that  of'  the  Elvers  Pollution  Commission,  he  ob- 
tained results  which  he  interpreted  as  indicating  that  the  organic  impuri- 
ties in  a  river  would  be  materially  reduced  by  oxidation  in  a  flow  of  a  few 
miles.  He  adduces  statistics  to  show  that  the  death-rate  in  towns  sup- 
plied by  river  waters  is  less  than  in  those  supplied  from  deep  wells,  and  also 
asserts  that  there  is  no  case  of  water  of  a  river,  after  receiving  sewage, 
having  caused  an  outbreak  of  disease  after  a  flow  of  ten  or  twelve  miles.  ^ 
The  subsidence  of  mineral  matter,  carrying  with  it  some  organic  impuri- 
ties, and  the  influence  of  fish,  etc.,  he  regards  as  aids  to  such  purification. 

The  influence  of  water  plants  and  organisms  as  agents  of  purification  is 
also  dwelt  upon  by  others."  Many  of  these  authorities  also  mention  that 
plants,  etc.,  remove  chlorides  and  other  mineral  constituents  from  the 
water. 

W.  E.  Nichols  ^  suggests  that  "  the  apparent  self -purification  of  rivers  is 
largely  due  to  dilution,  and  the  fact  that  a  river  seems  to  have  purified 
itself  at  a  certain  distance  below  a  point  where  it  was  certainly  polluted, 
is  no  guarantee  that  the  water  is  fit  for  domestic  use."  In  this  connection 
it  must  not  be  forgotten  that  rivers  usually  receive  large  additions  to  their 
volume  by  subterranean  infiltration,  which  is  none  the  less  real  because 
out  of  sight. 

•  Sixth  Kept.,  pp.  134-140. 

^  Journal  of  Lond.  Chem.  See,  xsxvii.,  268. 

2  An  outbreak  of  typhoid  fever  in  a  hospital  using  river  water,  where  the  disease 
was  traced  to  a  barracks  tioenty-five  miles  up  the  stream,  is  quoted  in  Mass.  State  Board 
of  Health  Eeport,  1876,  p.  284. 

<  R.  Warington,  Chem.  News,  xli.,  265  ;  E.  J.  Mills,  ib  ,  xli.,  260.  The  discussion 
between  Drs.  Frankland  and  Tidy  on  this  subject  may  be  found  in  Jour.  Lond.  Chem. 
Soc  ,  xxxvii.,  268  ;  also  Chemical  News,  xli.,  245,  and  xlii.,  113. 

^  Water  Supply,  p.  69.     New  York,  1883. 


412  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

Dilution  of  a  contaminated  river  may  render  it  difficult  or  impossible 
to  decide,  by  chemical  analysis,  that  pollution  exists,  but  we  cannot  rest 
satisfied  that  dangerous  contamination  does  not  exist  in  it  on  that  accoimt. 

Summary. — In  conclusion  it  must  be  said,  -uith  regard  to  ponds  and 
streams  as  sources  of  water  supply,  that  where  contaminating  influences 
of  cultivated  land,  manufactures,  and  house  drains,  etc.,  are  absent,  they 
are  good  sources  of  supply,  though  perhaj)s  at  times  charged  with  sus- 
pended matter,  which  should  be  removed  by  subsidence  or  filtration,  or 
both.  Ponds  and  lakes  M'here  the  water  is  stagnant  should  be  regarded 
as  suspicious  or  dangerous,  but  where  the  water  in  them  changes  fre- 
quently they  are  safe.  Rivers  and  streams  are  always  better  (as  regards 
safety  for  health)  nearer  their  sources.  After  having  once  received  sewage 
they  may  perhaps  be  safe  if  they  have  flowed  for  some  distance,  but  the 
use  of  water  fx-om  such  streams  is  not  advisable  if  any  better  supply  can 
be  obtained. 

Wells. 

Amount. — It  is  estimated  that  about  one-fourth  of  the  rainfall  of  a  dis- 
trict penetrates  into  the  ground,  and  may  be  obtained  by  shiking  wells. ' 

As  with  springs,  a  variable  supj^l}'  shows  a  near  source. 

Kinds  of  Wells. — The  ordinary  forms  of  open  wells  have  been  roughly 
classified  into  shallow  and  deep  wells,  according  as  they  are  less  or  more 
than  about  fifty  feet  in  depth.  We  may  have  also  diive  wells,  ^  made  by 
driving  a  pointed  ii'on  tube  down  into  the  gx*ound  to  any  desii-ed  depth, 
and  (what  ai'e  infrequently  used  for  household  supplies)  artesian  wells 
made  by  boring. 

Impurities :  j\[ineral. — With  regard  to  any  or  all  of  them  it  may  be  said 
that  the  mineral  impurities  are  usually  larger  than  in  the  case  of  pond  and 
river  waters,  varying  very  much  (as  in  the  case  of  springs)  with  the  geologi- 
cal formations  which  the  water  may  have  traversed ;  usually  the  deeper  the 
well  the  more  mineral  matter  it  contains. 

Organic. — Almost  all  of  them  contain  some  organic  matter.  The  or- 
ganic matter  of  a  dangerous  character  comes  from  sources  at  the  surface, 
house  drains,  manufactures,  etc.,  and  if  a  well  penetrates  below  the  influ- 
ence of  such  impui-ities,  and  infiltration  of  such  surface  waters  are  ex- 
cluded, water  of  good  (sanitary)  quality  may  be  obtained. 

There  is  a  ^\-idespread  belief  that  water  becomes  purified  by  filtration 
through  the  soil.  This  is  true,  but  not  to  the  extent  generally  supposed. 
The  purifying  power  of  the  soil  is  much  more  limited  than  is  usually  imag- 
ined, and  the  amount  of  material  to  be  destroyed,  as  well  as  the  time  nec- 
essary for  its  destruction,  are  factors  in  the  question  which  are  usually  lost 
sight  of.  A  soil  becomes  very  rapidly  saturated  with  material  of  a  danger- 
ous character  to  have  in  o\u'  drinking-water,^  and  the  unlimited  purifying 
power  with  which  it  is  generally  credited  is,  in  fact,  very  limited  after  all, 
unless  opportunity  is  affoi'ded  for  the  operation  of  what  might  be  termed 
the  regenerative  forces  of  nature. 

Distance  to  lohich  Contamination  may  reach. — Cases  occur  almost  every 
day  where  householders  wiU  triumphantly  state  that  theu-  wells  are  a  cer- 

'  Fanning,  Water  Supply,  Engineering,  p.  102. 

-  Called  in  England  •'  Abyssinian  Tveils,"  because  used  by  the  British  army  in  the 
Abyssinian  campaign. 

"  For  experiments  on  this  point,  vid.  v.  Fodor,  Boden  und  Wasser.  Brunswick, 
1883. 


WATER.  413 

tain  number  of  feet  (usually  less  than  t-^enty)  from  any  cesspool  or  drain, 
and  that  therefore  they  cannot  conceive  of  any  possible  dan<?er  to  the  qual- 
ity of  the  "water.  As  a  matter  of  fact,  polluted  water  may  travel  a  great 
distance.  In  the  cases  of  infected  T\-ells,  etc.,  hereinafter  quoted  (p.  432), 
the  "wells  "were  30,  60,  and  even  100  feet  distant  from  the  cesspools  or  privy 
vaults  through  "^'hich  the  infection  "was  communicated,  and  connection  be- 
t"ween  the  t"wo  vcas  satisfactorily  proved  in  the  case  where  the  "well  "was  100 
feet  off.  A  case  of  pollution  of  a  "well  by  gas-works  1,000  feet  distant  is 
also  on  record. '  Finally,  reference  may  be  made  to  the  Lausen  epidemic 
of  t}-phoid  fever,'  where  a  subterranean  flow  of  over  a  mile  failed  to  remove 
the  infectious  material  from  the  water. 

Organisms  may  be  carried  through  Soil. — That  organisms  can  also  pene- 
trate the  soil  to  indefinite  distances,  probably  borne  by  the  "  ground- 
water," is  strikingly  shown  by  the  experiences  in  Berlin  and  other  places 
in  Em'ope,  where  a  number  of  wells  were  visited,  about  the  same  time,  by 
numbers  of  one  of  the  numerous  forms  of  algee  fi-equently  to  be  found  in 
water  [Crenothrix  Kuhniana),  a  plant  possessing  marked  characteristics. 
Sinking  fi'esh  wells  was  of  no  use,  as  the  plant  made  its  appeai-ance  sooner 
or  later  in  all  of  them,  and  the  whole  system  of  wells  was  finally  aban- 
doned. ' 

Some  have  claimed  that  the  water  draining  from  cemeteries  is  not  dan- 
gerous.^ It  is  also  asserted  that  though  decomposing  urine  and  excre- 
ment, when  undiluted,  are  poisonous  or  deadly,  sewage  diluted  a  hundi-ed 
thousand  times  is  haiTiiless ;  ^  but  few  "will  care  to  experiment  upon  them- 
selves or  their  families  "with  any  such  dilutions,  "under  the  name  of  drink:- 
ing-water. 

Pleasant  Flavor  of  some  Contaminated  Waters. — A  treacherous  C]uality  of 
many  polluted  waters,  especially  in  the  case  of  wells,  may  be  here  noted. 
It  has  been  frec[uently  obseiwed  that  many  contaminated  waters  are  ex- 
ceedingly palatable,  often  more  soft  to  the  taste,  and  more  clear  and  spai'k- 
ling,  than  waters  which  are  free  from  contamination. 

These  jDroperties  are  not  invariably  present,  but  when  they  are,  it  is 
often  a  matter  of  gi'eat  difficulty  to  persuade  the  0"wner  of  a  well  that  con- 
tamination exists  or  is  even  possible. 

Sev:age  not  always  Fatal. — Undoubtedly,  diluted  sewage  (which  is  in 
many  cases  the  proper  term  for  the  liquid  in  some  wells)  can  be  dmnk 
without  invariably  causing  disease  ;  but,  aside  from  the  sentiments  of  dis- 
gust which  such  a  proceeding  inspires,  the  risk  of  the  generation  of  dis- 
ease, or  the  contamination  of  the  water  with  the  excreta  of  persons  affected, 
is  too  gi-eat  to  be  hazarded. 

Impervious  Strata. — If  an  impervious  stratum  intei-poses  between  the 
well-curb  and  the  water  of  the  well,  and  the  infiltration  of  sui'face  water 
is  prevented  at  the  top,  the  conditions  are  extremely  favorable  for  the 
purity  of  the  water,  which,  under  such  circumstances  has  usually  under- 
gone a  thorough  filtration.  The  weU  then  partakes  of  the  character  of  an 
artesian  well. 

Although  all  rocks  are  probably  to  some  extent  permeable  to  water, 
those  which  are  so  slightly,  so  as  to  be  classed  as  impermeable,  are  gi-anite, 

^  Fisclier,  Dingl.  Polyt.  Jour.,  ccsi.,  139. 

-Deutsche  Vierteljahr.  fur  Off,  Gesundhtspf.,  vi. ,  154.     Quoted  in  Report  Mass. 
State  Board  of  Health,  1877,  p.  124. 
2  Xichols,  Water  Supply,  p.  125. 
■*  Wolffhugel,  Wasserversorgung,  p.  27. 
*  Emmerich,  Bavr,  Akad,  d.  Wiss,,  is.,  381. 


414  AMERICAN    APPENDIX    TO    PARKES'    HYGIENE. 

serpentine,  trap,  gneiss,  mica  slate,  argillaceous  slate,  and  clays.'  Sucb 
formations  may,  however,  be  permeable,  on  account  of  the  presence  oi 
fissures  caused  by  geological  disturbances.  Fissures  are  less  likely  to 
exist  where  the  strata  are  neai'ly  horizontal,  or  have  a  sHght  inchnation, 
than  where  they  have  been  more  disturbed,  and  consequentl}'  stand  at  a 
greater  angle  to  the  horizon. 

Lay  of  Strata.  — The  position  of  the  strata  has  an  important  influence 
on  the  quality  of  the  water  in  relation  to  filtration  from  the  surface.  The 
writer  has  had  occasion  to  examine  the  water  from  numerous  wells  (diive 
wells  and  others)  sunk  on  Manhattan  Island,  the  dej^ths  varying  from  a  few 
feet  to  one  thousand  or  more,  and  has  found  that  none  of  them  could  be 
regarded  as  safe  for  household  uses.  The  strata  on  the  island  stand  at 
angles  varying  from  80°  to  90^  with  the  horizon,^  or  nearly  vertical,  and  as 
the  tendency  of  the  water  is  to  follow  the  direction  of  the  strata,  a  well 
sunk  at  one  point,  however  deep,  draws  its  supply  from  the  water  which 
has  peneti'ated  the  surface  not  very  far  off,  and  in  such  a  densely  populated 
district,  all  the  water  soaking  through  the  ground  becomes  practically  sew- 
age, and  is  in  the  highest  degree  dangerous  for  use.  London  and  Paris 
can  sink  their  artesian  wells  and  obtain  wholesome  water,  since  they  are 
situated  in  geological  basins,  and  the  water  from  those  wells  has  filtered 
into  the  water-bearing  stratum  from  considerable  distances  outside  of  the 
city  limits  ;  but  New  York  is  not  so  favorably  situated. 

Intercepting  Wells. — Most  of  the  w^ells  located  along  the  valleys  near  the 
banks  of  streams  do  not  draw  from  the  streams,  as  is  frequently  supposed, 
but  really  intercept  the  water  which  is  on  its  way  to  join  them  by  subter- 
ranean channels.  This  affords  an  explanation  of  the  fact  that  fresh  water 
can  usually  be  obtained  by  digging  along  the  sea-shore  above  high- water 
mark.  The  water  in  such  wells  may  fluctuate  in  level  in  unison  with  the  fluc- 
tuations of  the  level  of  the  body  of  water  near  which  it  is  situated,  simply 
because  the  pressure  of  the  water  in  the  stream  or  other  body  of  water  is 
communicated  to  the  feeders  supplying  it.  It  is,  however,  not  well  to 
trust  so  far  to  the  expedient  of  catching  the  water  before  it  gets  into  the 
stream,  to  expect  to  obtain  pure  water  by  sinking  a  well  close  to  the  mar- 
gin of  a  stream  which  is  seriously  polluted.  The  satui'ation  of  the  ground 
with  material  which  will  sooner  or  later  make  its  way  into  the  wells,  and 
when  there,  wUl  thoroughly  pollute  the  water,  is  sometimes  a  slow,  but 
none  the  less  sure  process. 

Sunimari/. — Of  aU  the  sources  of  water  supply,  weUs  are  the  most  ex- 
posed to  the  danger  of  contamination,  and  require  the  most  careful  watch- 
ing. 

The  depth  is  not  always  of  so  much  importance  as  the  exclusion  of  sur- 
face drainage.  The  loosely  laid  stones  around  the  sides  of  most  wells  are 
no  protection  against  percolation  of  objectionable  liquids  into  a  well,  no 
matter  what  its  depth. 

Driven  wells  are  not  much  safer  than  the  ordinary  form,  unless  they 
penetrate  an  impermeable  stratum  in  their  coui'se. 

In  locating  a  well,  cai'eful  attention  is  necessary  to  the  respective  situa- 
tions and  depths  of  the  cesspool,  the  privy  vault,  the  kitchen  drain,  and 
the  barnyard  or  stable.''  Sources  of  contamination  external  to  the  premises 
where  the  well  is  located  must  also  be  considered,  as  cemeteries,  manufac- 

'  J.  T.  Fanning,  Water  Supply,  Engineering,  p.  103. 

"  W.  W.  Mather,  Natural  History  of  Xew  York,  part  iv.,  Geology,  pp.  519  et  seq. 
2  Vid.  Report  on  Martha's  Vineyard,  Mass.  State  Board  of  Health,  1879,  Supp.,  pp. 
163-198. 


WATER. 


415 


tories,  etc.  Even  much-travelled  streets  raay  cause  some  contamination  of 
a  well  water. 

As  regards  tlie  relative  position  of  such  sources  of  contamination,  the 
character  of  the  soil,  the  lay  of  the  underlying  strata  where  that  can  be 
ascertamed,  and  other  local  conditions,  are  factors  in  the  question.  For 
instance,  it  would  be  ob-siously  dangerous  to  place  a  well  between  a  cess- 
pool and  the  sloping  margin  of  a  stream,  since  the  drainage  naturally  tends 
toward  the  stream  bed. 

In  cities  or  parts  of  towns  where  the  houses  are  close  together,  wells 
shordd  never  be  used.'  In  towns  or  villages  where  there  may  be  a  house 
every  hundred  feet  along  the  street,  the  danger  of  contamination  of  the 
well' water  is  usually  great.^  Ever  with  isolated  farm-houses,  the  quahty 
of  the  water  needs  constant  and  vigilant  attention. 

The  composition  of  sewage  in  different  cities  is  given  below  '  in  parts 
per  100,000  : 

Composition   of   Sewage. 


Total  solid  matters  in  solution . . 

Total  suspended  matters 

Organic  nitrogen 

Total  combined  nitrogen 

Ammonia 

Nitrogen  as  nitrates  and  nitrites 

Chlorine 

Phosphoric  acid 


Average  for 

Boston, 

Worcester, 

50  English 

Mass. 

Mass. 

Cities  and 
Towns. 

58.96 

25.35 

72.2 

37.34 

21.16 

44.69 

2.205 

7.728 

2.72 

1.876 

6.703 

0.036 

0.134 

0.003 

18.94 

4.17 

10.66 

1.69 

0.66 

Berlin, 
Prussia. 


78.9 
51.0 
1.23 


1.58 


Classification  of  Waters  as  regards  Quality. — The  following  classification 
of  waters  "with  respect  to  wholesomeness,  palatability,  and  general  fitness 
for  drinking  and  cooking,"  is  given  by  the  English  Eivers  Pollution  Com- 
mission :  * 

i  Spring  water.  \  Very   pala- 

Wholesome.  -<  Deep  well  water.  )       table. 

( Upland  surface  water.  )  Moderately 

j  Stored  rain  water.  )    palatable. 

I  Surface  water  from  cultivated  land.  \ 

Kiver  water  to  which  sewage  gains  access.  V  Palatable. 
Shallow  well  water.  ) 

Decided  preference  is  given  to  the  first  two. 
Most  other  authorities  adopt  essentially  the  same  view.     Wolffhugel ' 
gives  the  preference  to  pure  spring  and  well  water  (provided  the  hardness 

1  The  Eivers  Pollution  Commission  (6th  Report,  p  284)  advised  the  closing  of  all  the 
wells  in  London  but  three,  which  were  exceptionally  placed. 

2  Vid.  Fanning,  Water  Supply,  p.  139. 

s  Report  of  State  Board  of  Health  of  Massachusetts,  January,  1876,  p.  398. 

■*  Sixth  Report,  p.  129. 

*  W-isserversorgung,  p.  203.     Leipzig,  1882. 


Suspicious. 
Dangerous. 


416 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


is  not  such  as  to  be  objectionable),  gi^•ing  the  second  place  to  the  water 
from  streams  and  rivers,  the  next  to  that  from  ponds  and  lakes,  and  the 
last  place  to  rain  water.  As  regards  the  last,  he  considers  that  only  in  case 
of  urgent  necessity  should  it  be  used  for  any  other  purposes  than  for  wash- 
ing.' 

A  table  of  the  results  of  analyses  of  the  water  of  wells,  two  of  them  of 
fair  quality  and  two  much  polluted,  is  also  here  given. 


Well  Waters. 
Results  given  in  Parts  per  100,000, 


Fair. 

Polluted. 

Appearance 

Odor 

Faintly 
turbid, 
colorless. 
None. 
0.527 
None. 
0.091 
None. 
None. 
0.004 
0.0244 
0.0244 
1.874 
1.106 
1.60 
5.70 
7.30 

Clear, 

Hght 
bluish. 

Slight. 

0.877 

None. 

0.252 

None. 

0.0004 

None. 

None. 

0.0054 
19.23 

3.72 

1.50 
22.90 
24.40 

Clear, 
light  blue. 

Sweetish. 
15.114 
Trace. 
11.53 
Trace. 
0.0072 
0.0022 
0.028 
0.028 
51.7 
39.2 
44.90 
157.10 
202.00 

Turbid, 
yellowish. 

Foul. 

Chlorine  in  chlorides 

24.103 

Phosphoric  acid  in  phosphates .  . 
Nitrogen  in  nitrates  and  nitrites. 
Nitrites 

Much. 

4.035 

Much. 

Free  ammonia 

0.620 

Albuminoid  ammonia 

Oxygen  absorbed  15  minutes . . . 

Oxygen  absorbed  3  hours 

"  Hardness  " — before  boihng  . .  . 

"  Hardness  " — after  boiling 

Organic  and  volatile  matter  .... 
Mineral  matter 

0.265 

0.337 

32.019 

30.935 

59.40 

127.70 

Total  solids  on  evaporation  .... 

187.10 

Purification  of  Water. 

What  is  effected  hy  Purification. — We  cannot  expect  to  render  a  foul 
water  good  by  any  of  the  methods  here  enumerated,  but  these  processes 
may  serv^e  to  improve  a  water  unsatisfactorv'  in  some  respects  for  the  piu'- 
poses  to  which  it  may  be  desired  to  put  it. '"  They  are  seniceable  as  a  pos- 
sible though  imcertain  safeguard. 

Water  may  be  safe  for  drinking  and  other  household  pui'poses,  but  it 
may  contain  suspended  matter  rendering  it  unsightly  to  the  eye  and  harsh 
to  the  palate,  or  may  temporarily  contain  harmless  algfe  which  give  it  an 
unpleasant  odor  or  taste.  It  may  also  contain  such  considerable  quantities 
of  lime  salts  that  it  is  inconveniently  hard  for  washing  pm'poses,  not  to 
mention  the  considerable  expense  involved  in  the  destniction  of  soap, 
which  the  presence  of  much  lime  entails,  an  item  in  household  expenses 
which  is  not  always  recognized  as  preventable. 

Boiling. — Boiling  is  one  of  the  oldest  and  simplest  modes  of  improving 
the  quality  of  water.    The  effect  is  partially  (or  if  the  boiling  is  sufficiently 


'  Wasserversorgung,  p.  210.     Leipzig,  1882. 

^  Fischer,  Chemische  Technologie  des  Wassers,  p.  199. 


Brunswick,  1878. 


WATER.  417 

prolonged,  entirely)  to  destroy  many  of  the  minute  organisms  present  in 
almost  all  waters/  The  boiling  also  sets  free  the  carbonic  acid  present, 
by  the  aid  of  which  the  water  holds  many  mineral  substances  in  solution, 
chief  among  which  is  a  considerable  proportion  of  the  lime  which  makes 
it  hard. 

The  Hme  and  other  mineral  matters,  except  alkalies,  existing  in  the 
water  as  carbonates,  may  be  thus  rendered  insoluble,  and  if  the  water  is 
allowed  to  stand  a  short  time  these  matters  collect  in  flocks  and  settle  to 
the  bottom,  carrying  with  them  much  of  the  organic  impiuity,  leaving  the 
water  clear  and  bright. 

The  water,  however,  having  lost  its  dissolved  gases  by  this  process,  has 
a  somewhat  flat  taste,-  which  may  be  remedied  by  pouring  the  water  back 
and  forth  through  the  air  a  few  times. 

Settling. — Suspended  matters  may  be  completely  removed  by  simply 
allowing  the  water  to  stand  quietly  and  deposit  them.  The  kind  of  ma- 
terial constituting  the  suspended  matter,  and  its  physical  condition,  to- 
gether perhaps  with  the  character  of  the  salts  dissolved  in  the  water,  makes, 
however,  a  great  difference  in  the  rapidity  of  the  deposition.  For  example, 
the  INIississippi  River  at  New  Orleans  is  often  turbid  with  microscopic  par- 
ticles of  clay.  On  allowing  the  water  to  stand,  the  grosser  particles  settle 
in  twenty-four  houi's,  but  the  finer  pai'ticles  requu-e  several  days. "  With 
some  other  turbid  waters,  a  few  hours'  standing  is  sufficient. 

Salts  used  to  hasten  Deposition. — The  addition  of  various  salts  to  the 
water  has  a  marked  effect  in  clarifying  it  by  deposition.  A  table  of  the 
comparative  influence  of  some  of  these  salts,  arranged  so  as  to  give  ap- 
proximately the  quantities  which  have  equal  effects,  is  given  below.' 

Chloride  of  sodium  (common  salt) 4680.0 

Sodium  bicarbonate  (cooking  soda) 672.0 

Calcium  chloride 222.0 

Magnesium  chloride 182.0 

Carbonate  of  lime,  dissolved  by  cai'bonic  acid 100.0 

Cai'bonate  of  magnesia     "  "  "   81.0 

Sulphate   of  hme 136.0 

Proto-sulphate  of  iron  (green  vitriol,  copperas) 22.80 

Proto-carbonate  of  iron,  dissolved  by  carbonic  acid  . ..  17.40 

Alum 7.92 

Perchloride  of  u-on 2. 74 

Ai'mengaud  *  advises  the  use  of  sulphate  of  u'on.  Alum  has  been  re- 
commended by  numerous  authorities,"  the  proportion  to  be  added  being 
one  part  to  five  thousand  of  water,  or  about  one  ounce  to  every  forty  gal- 
lons. 

In  Canada  a  mixture  of  powdered  alum  and  borax  (three  oimces  of  each) 

'  Forster,  Verbreitung  der  cholera,  73  ;  Cliurch,  Plain  "Words,  p.  35. 

■^  Eept.  of  Dr.  Smart,  Water  Supply  of  New  Orleans  and  Mobile.  .National  Board  of 
Health,  i.,  317. 

^  Portion  of  a  table  given  by  D.  Waldie,  in  a  paper  On  the  Muddy  Waters  of  the 
Hooghly  during  the  Rainy  Season,  with  Reference  to  its  Purification,  and  to  the  Calcutta 
Water  Supply.     (Jour.  Asiatic  Soc.  of  Bengal,  xlii.,  part  ii.,  1873.) 

■*  Genie  Industriel,  1865. 

°  Paris  commission,  Dingier,  xxi. ,  110;  D'arcet,  Bull,  Sci.  Tech.,  October,  1881,  p. 
66;  Jennet,  Compt.  Rend.,  Ixi.,  598. 
Vol.  II.— 37 


418 

to  the  baiTel  of  water  of  thirty-one  and  a  half  gallons  is  used,'  -while  ferric 
chloride  (perchloride  of  ii'on)  is  recommended  by  Peligot  ^  and  Gunning.  "* 
The  latter  adds  it  in  the  propoi-tion  of  thirty-two  parts  per  million  or  one 
ounce  per  two  hundred  and  fifty  gallons,  and  to  neutralize  any  acidity,  and 
remove  any  excess  of  iron,  this  addition  is  followed  up  by  the  addition  of 
2 1  ounces  of  carbonate  of  soda  to  the  same  quantity  of  water.  This  pro- 
cess has  been  applied  by  him  on  a  large  scale  at  Rotterdam,  on  the  water 
of  the  Meuse. 

Hager  ^  asserts  that  the  addition  of  a  small  proportion  of  tannin  to 
water  not  only  kills  the  algae  present,  and  precipitates  them  from  the 
water,  but  prevents  the  communication  of  disease  by  the  drinking-water. 
After  the  addition  of  the  tannin  the  water  must  be  allowed  to  stand  some 
hours.  Langfeldt ''  recommends  for  the  destruction  and  precij)itation  of 
algfB  the  addition  of  1  part  of  citric  acid  (the  acid  of  lemon-juice)  to  2,000 
of  the  water  (1  ounce  to  about  16  gallons). 

It  may  also  be  added  that  iron  in  contact  with  water  is  asserted  by 
some  to  have  a  purifying  influence,"  and  some  recommend  the  use  of  iron 
fihngs  or  scraps  for  piuufying  waters.'  An  objection  to  this  would  be  the 
solution  of  some  of  the  iron,  which  might  in  some  cases  be  objectionable  in 
washing,  etc.  Permanganate  of  potassium  alone  or  mixed  with  lime,  or 
permanganate  of  lime  are  suggested." 

Clark's  process  for  softening  hard  water  is  one  of  the  oldest  and  best 
known  methods  of  treating  water.  It  is  believed  that,  besides  softening 
the  water,  it  improves  its  sanitary  quahty.'  It  consists  in  adding  lime- 
water  to  a  water,  by  which  means  the  carbonic  acid  holding  lime  in  solu- 
tion is  fixed,  and  both  the  added  lime  and  that  originally  present  in  the 
water  precipitate  together  as  carbonate.  For  a  water  the  hardness  of 
which  is  equivalent  to  from  20  to  30  parts  of  carbonate  of  lime  per  100,000 
(about  10  to  20  parts  of  which  is  temporary — removable  bj^  boihng),  he 
recommends  about  9  ounces  of  quick-lime  for  400  gallons  of  water,  or  1 
gallon  of  clear  lime-water  to  every  10  gallons  of  the  water  to  be  softened. 

The  addition  of  a  little  sodium  carbonate  (washing  soda)  and  boiling 
is  probably  the  most  convenient  and  efficient  mode  of  impi-oving  the  quality 
of  a  water  for  laundry  purposes  in  the  household." 

Of  these  diflferent  modes  of  treating  water  to  improve  its  quality,  boil- 
ing is  the  simplest,  if  we  take  its  efficiency  into  consideration.  The  addi- 
tion of  ferric  chloride  (perchloride  or  muriate  of  iron),  followed  by  carbon- 
ate of  soda,  or  the  addition  of  alum  alone,  or  alum  and  borax,  in  small 
quantities,  may  be  used  with  advantage.  The  use  of  permanganates, 
stronglj'  recommended  by  some  physicians  to  travellers  in  districts  where 
fevers  prevail,  is  a  very  doubtful  safeguard. ' ' 

'  Fanning,  Water  Supply  Engineering,  p.  533. 
"^  Ann.  du  Conserv.  des  Arts  et  Metiers,  v.,  60. 

'  Chemical  News,  May,  1869.  *  Biedermann's  Centralblatt,  July,  1878. 

'  Chem.  Centralblatt,  xii.,  p.  74. 

•A.  W.  Blyth,  Effect  of  Iron  Pipes,  Chem.  News,  xxx.,  211. 

''  Runge,  Technisclie  Cliem.;  Medlock,  Eng.  Pat.,  18o7  ;  Muspratt's  Chem.,  ii.,  1085. 
^Hofmann,  Dingl.,  cliii.,  62;   Schultze,  Dingl.,  cxix. ,   188,  210;  Crooke's  Chem. 
News,  xxviii.,  243.  ^  Wanklyn,  Water  Analysis. 

"•  The  relative  amounts  of  lime,  soda,  and  soap  required  to  neutralize  hardness  in 
water  has  been  given  as  follows  (6th  Report  Rivers  Poll.  Comm.,  p.  205) : 

1    cwt.  lime, 
4f     "     carbonate  soda, 
20^     ' '     soap. 
"  Wolffhiigel,  Wasserversorgung,  p.  216. 


WATER.  419 


Filtration. 


Action  of  Filters. — The  principal  effect  of  filtration  is  to  remove  the 
suspended  matter  in  the  water.  This  is  effected,  no  doubt,  to  a  great  ex- 
tent by  the  arrest  of  particles  too  large  to  pass  thi'ough  the  interstices  of 
the  filter,  also  partially  by  the  attraction  of  the  masses  in  the  filter  for 
those  in  the  water.  A  filter  will  also  often  absorb  a  portion  of  the  gases 
in  the  water,  and  thus  effect  a  removal  of  some  of  the  dissolved  matters. 
Where  the  filter  is  used  intermittently,  as  is  apt  to  be  the  case  with  most 
house  filters,  and  air  is  allowed  to  penetrate  the  filter  occasionally,  an  oxi- 
dation of  organic  material  and  aeration  of  the  water  also  may  occur  to  some 
extent.  Certain  materials  may  also  abstract  portions  of  the  dissolved  mat- 
ters from  the  water. 

Materials  used.  — Sand,  iron  sponge,  wood-charcoal  and  animal  charcoal 
(bone  black),  porous  stone,  artificial  or  natural,  as  well  as  sponge,  wool, 
and  similar  organic  materials  have  been  used  or  recommended  for  the  fil- 
tration of  water.  As  regards  the  last-named  class  of  materials,  except  as 
rough  strainers  to  remove  the  grosser  particles  which  may  be  suspended 
in  the  water,  they  are  not  serviceable,  nor  do  they  have  any  satisfactory 
effect  on  the  quaUty  of  the  water.  They  can  only  be  used  temporarily,  as 
they  will  in  a  short  time  pass  into  a  state  where  they  communicate  more 
organic  impurit}^  to  the  water  than  they  take  out. '  Combinations  of  these 
materials  sometimes,  after  treatment  with  iron  salts,  alum,  etc.,  have  been 
used. 

Sand. — Sand  filtration  is  the  nearest  imitation  of  the  ordinary  natural 
filtration  taking  place  in  the  soil.  The  sand  should  be  well  washed  and 
screened,  so  that  all  the  particles  are  approximately  of  the  same  size."  If 
different  sizes  are  used  they  should  be  disposed  in  layers,  the  larger  sized 
material  at  the  top.  The  principal  effect  of  filtration  through  a  bed  of 
sand  is  the  removal  of  suspended  impurities.  The  organic  matter  in  water 
is  removed  to  some  extent,  but  less  by  sand  than  by  other  materials  of  this 
class.  Porous  stone,  both  artificial  and  natural,  is  similar  in  its  effects  to 
sand,  but  is  cleaned  with  greater  difficulty. 

Iron  Sponge. — Iron  sponge  is  made  by  mixing  sawdust  and  iron  oxide 
(ores  or  other  forms)  and  heating  the  mixture  in  a  furnace.  A  porous 
mass  consisting  of  an  intimate  mixture  of  charcoal  and  metallic  iron  results, 
which  has  been  found  very  efficient  for  purposes  of  filtration.  ^  The  sj)onge 
removes  more  mineral  matter,  though  less  organic  matter  than  bone 
black. 

Bone  Black. — Bone  black,  or  animal  charcoal,  should  be  thoroughly 
burned  and  be  fresh  when  used  for  filtering  purposes.  The  test  applied 
by  the  workmen  in  sugar-houses  to  determine  the  quality  of  the  material 
may  be  used.  The  dry  black  when  touched  by  the  tongue  should  have 
no  taste,  but  should  adhere  persistently  to  the  tongue,  on  account  of  the 
absorption  of  the  moisture  into  the  pores.  The  black  should  Jilso  be  duU 
in  lustre. 


'  Alton,  111.,  uses  sponge.     Nichols,  Water  Supply,  p.  168. 

"^  The  best  size  for  a  sand  for  filtration  of  water  is  said  to  be  such  that  it  passes 
through  a  screen  consisting  of  32  or  33  No.  10  wires  in  six  inches.  Nichols,  Water 
Supply,  p.  155  (foot-note). 

^'Bischof,  Proc.  Roy.  Soc,  xxvi.,  p.  152;  Wigner,  The  Engineer  (London),  1879,  p. 
22  ;  6th  Report  Rivers  Poll.  Comm.,  p.  320. 


420  AMERICAN    APPEXDIX    TO    PARKEs'    HYGIENE. 

The  effect  of  this  material  is  chiefly  on  the  organic  matter  of  the 
water,  though  when  fresh  it  Avill  remove  a  not  inconsiderable  portion  of 
the  mineral  (dissolved)  matters.  This  efi'ect  ceases  to  be  pi'oduced  in 
about  a  fortnight,  though  the  absorption  of  the  organic  matter  goes  on  for 
some  time  longer,'  though  to  a  diminished  extent. 

Numerous  combinations  of  various  forms  of  carbon  (coke,  wood-char- 
coal, etc. )  have  been  used  or  j^roposed,  but  they  are  inferior  in  efficiency 
to  bone  black  in  removing  the  oi'ganic  matter  from  water.  A  form  of  fil- 
tering slabs  of  animal  charcoal  is  made  by  Atkins  &  Co.,  of  London.  The 
material  is  mixed  with  tar,  moulded  into  slabs,  and  then  burned.  For  use 
these  slabs  are  inserted  into  frames  as  A\indow  panes  are  into  their  sashes. 
In  cleaning  them  a  portion  of  the  surface  has  to  be  scraped  off.'^ 

Filters. — The  forms  of  filters  are  more  varied  than  the  materials  used  in 
them.  We  can  here  only  notice  two  classes  :  the  small  filters  attached  to  a 
tap  which  filters  the  water  as  it  is  di-awn,  and  the  larger  forms.  The  action  of 
the  first  class  is  simply  that  of  any  strainer,  removing  the  grosser  suspended 
particles  in  the  water,  \\dthout  otherwise  imj)roving  its  condition.  Taking 
into  consideration  the  amount  of  water  usually  run  through  a  tap,  and  the 
raj)idity  with  which  it  is  expected  to  run,  it  is  too  much  to  anticipate  that 
a  couple  of  ounces  of  bone  black  or  sand  will  oxidize  and  destroy  an  ap- 
jDreciable  amount  of  the  organic  matter  in  the  water.  Any  material  acting 
as  a  strainer  will  serve  the  same  purpose,  and  the  home-made  device  of 
tying  a  bag  of  flannel  or  some  similar  material  over  the  mouth  of  the 
faucet,  though  not  perhaps  so  elegant  in  appearance,  is  as  good  as  any 
other. 

A  mixture  of  bone  black  and  sand  is  the  material  most  commonly  used 
in  these  filters.  Provision  must  always  be  made  for  washing  the  filter 
after  a  certain  amount  of  use.  This  is  usually  effected  by  having  the  box 
carrying  the  filtering  material  so  arranged  that  it  can  be  readily  reversed, 
so  that  the  first  half-pint  of  water  which  runs  through  it  washes  away  the 
material  which  the  filter  has  arrested. 

Tank  Filters. — Of  filters  on  a  larger  scale,  many  different  forms  are  used. 
Some,  used  in  cisterns  or  other  receptacles  for  water  supplies,  consist  simjDly 
of  a  porous  partition  (of  brick,  porous  stone,  etc.)  between  the  supply 
pipe  of  the  tank  and  the  service  pipe  leading  from  it.  Others  consist  of  a 
box  contamiug  the  filtering  material  attached  to  the  end  of  the  service  pij^e. 
The  best  forms  of  these  last  are  those  in  which  the  water  is  admitted 
from  the  bottom  of  the  filter,  which  is  raised  a  few  inches  from  the  bottom 
of  the  tank,  so  that  the  sediment  of  the  water  may  sej)arate  out  before  the 
water  enters  the  filter,  and  also  that  the  particles  arrested  may  to  some 
extent  fall  away  from  the  filter  when  the  water  is  not  being  drawn. 

The  objection  to  all  of  these  cistern  or  tank  filters  is  that  they  are 
out  of  sight,  and  hence  often  out  of  mind,  and  are  usually  allowed  to  go 
uncleaned  long  after  their  efficiency  has  been  destroyed  by  lack  of  cleans- 
ing. The  difficulty  of  cleansing  them  also  helps  to  contribute  to  such 
neglect. 

Of  filters  which  may  be  used  to  clarify  water  for  household  sujoplies, 
when  the  water  stands  in  a  receptacle  (usually  in  the  lower  chamber  of 
the  filter)  until  it  is  drawn  upon,  it  may  be  said  that  the  simplest  form 
which  admits  of  the  ready  cleaning  or  renewal  of  the  filtering  material  is 

'  Sixth  Report  Rivers  Poll'n  Comm.,  p.  219. 

"^  For  description  of  the  manufacture,  vid.  Am.  Chem.,  v.,  801  ;  see  also  Fanning, 
"Water  Supply  Engineering,  p.  536,  and  Nichols,  Water  Supply,  p.  178. 


WATER.  421 

the  best.  It  is  a  great  advantage  to  so  arrange  the  filter  that  pure  air 
may  be  drawn  into  it  occasionally,  so  that  water  may  become  aerated  in  its 
passage  through ;  the  material  used  in  them  is  usually  a  combination  of 
two  or  more. 

A  cheap  form  of  filter,  readily  made  in  any  household,  is  exhibited  at 
the  Bethnal  Green  Museum  at  London,  and  called  the  Poor  Man's  Filter.' 
It  consists  of  a  large  earthen  flower-jDot,  the  hole  at  the  bottom  of  which  is 
stopped  with  a  cork  through  which  passes  a  glass  tube.  A  small  piece  of 
sponge  is  tied  on  to  the  upper  end  of  the  tube.  Over  this  is  laid  the  filter- 
ing material  in  layers  in  the  following  order  : 

About 

Clean  sharp  sand 1  inch. 

Gravel 2  inches. 

Bone  black 3  or  4  inches. 

Sand 1  inch. 

Gravel 2  inches. 

This  should  be  covered  to  exclude  dust. 

To  prevent  the  water  from  running  too  straight,  slips  of  glass  may  be 
laid  between  the  laj^ers  in  such  a  way  that  the  water  must  take  a  zigzag 
course  to  reach  the  bottom. 

Dr.  Smart  ^  describes  another  form.  It  consists  of  a  tin  tube  with  cloth 
tied  tightly  over  the  top  and  the  bottom.  About  three-fourths  of  its  length 
is  filled  with  bone  black,  and  the  upper  fourth  with  sand.  Ai-ound  the 
top  of  the  tube  is  a  funnel-shaped  head,  the  tube  projecting  up  into  it  so 
as  to  form  an  angular  space  in  which  the  sediment  may  collect  without 
clogging  the  filter.  The  head  also  serves  as  a  supj)ort  to  the  tube  in  the 
bucket  or  other  vessel  which  receives  the  filtered  water. 

Duration  of  Filtering  Material. — All  filters  require  cleaning,  or  better 
still,  renewal  of  the  filtering  material.  The  frequency  with  which  this  is 
required  depends  to  some  extent  on  the  character  of  the  water,  and  the 
amount  of  susj^ended  and  other  impurities  it  may  contain.  It  is  stated 
that  a  bone-black  filter  removes  some  of  the  mineral  matter  for  about  two 
weeks,  after  which  it  has  little  or  no  effect  upon  it,  though  it  will  continue 
to  absorb  organic  matter  from  the  water  for  a  considerable  j)eriod.  After 
four  months  filters  of  sand  and  wood-charcoal  were  found  to  be  useless  or 
even  foul.  Other  materials  would  probably  last  no  longer,  and  it  is  per- 
haps advisable  to  adopt,  as  a  general  rule,  that  a  filter  should  be  cleaned 
or  its  contents  renewed  at  least  every  two  mouths,  to  insure  efiicient  opera- 
tion. With  waters  containing  much  matter  in  suspension  a  more  frequent 
cleaning  may  be  advisable. 

Cleaning. — It  will  be  remembered  that  the  layers  of  the  filter  which  the 
water  first  reaches  are  naturally  the  most  foul,  and  if  the  filtering  material 
is  easily  obtained  it  would  be  advisable  to  renew  the  first  inch  or  two  of  the 
filtering  material  at  every  cleansing. 

To  clean  material  in  grains,  as  sand,  broken  bone  black,  spongy  iron, 
etc.,  it  should  be  well  agitated  in  a  wash-tub  or  some  suitable  vessel  with 
water,  and  the  turbid  water  containing  the  finer  particles  run  off,  while  the 
coarser  grains  sink  to  the  bottom  ;  this  should  be  repeated  several  times 
until  the  water  runs  off  clear, 

'  A.  H.  Chm-cli,  Plain  Words  about  Water,  p.  33. 
,  ^  National  Board  of  Health  Bulletin,  i.,  817. 


422  AMERICAN    APPENDIX    TO    PAKKES'    HYGIENE. 

"Wliere  the  filtering  material  is  in  solid  masses,  or  slabs,  cakes  of  porouw 
stone,  "plastic  coal,"  charcoal,  etc.,  the  surface  must  be  at  least  bnished 
smartly  with  a  stiff  broom,  while  a  stream  of  water  plays  over  it.  A  still 
better  way  is  to  scrape  off  the  outside  portion  of  the  slab,  to  expose  a  fresh 
surface.  After  such  cleaning,  the  material  should  be  dried  in  the  air,  that  it 
may  aerate  the  water,  when  it  may  be  restored  to  its  position  in  the 
mter. 

Small  sand  filters  may  be  cleaned  by  poiuing  through  them  a  quart  of 
water  containing  yV  oz.  permanganate  potash,  and  ^  fl.  oz.  muiiatic  acid, 
and  then  running  water  through  it  until  it  has  no  som*  taste.  In  case  this 
method  is  used,  the  vessel  containing  the  filtering  material  should  be  of 
such  a  nattu-e  that  it  will  resist  the  action  of  the  acid. 

The  bone  black  in  small  filters  may  be  cleaned  by  boiling  it  two  or 
three  times  with  watei',  draining,  and  drving. ' 

Summary. — No  treatment  of  water  by  boihng,  chemicals,  or  infiltration 
can  be  reUed  upon  to  make  a  water  absolutely  safe  for  use,  though  the 
qualit}'  may  be  improved,  and  the  risk  diminished  with  a  water  of  doubt- 
fill  quality. 

In  the  household,  boiling  is  usually  the  simplest  method  of  improving 
the  quality  of  a  water.  A  good  plan  of  procedui'e  is  to  boil  the  water,  and 
then  to  pass  it  thi'ough  a  well-aerated  filter. 

Of  filtering  materials  bone  black  removes  the  most  organic  matters, 
spongy  iron  removes  the  most  mineral  matters,  wood-chai'coal,  etc.,  is  far 
inferior  to  either,  and  sand  has  but  little  effect  except  upon  the  suspended 
matters. 

Filters  should  be  so  constructed  that  aeration  of  the  material  is  possible, 
and  they  should  be  easily  cleaned.  The  cleaning  should  be  frequent  and 
thorough. 


Chemical  Analysis  op  Watek  &kd  the  Interpretation  of  the  Resitlts. 

Taking  Samples. — In  taking  samples  of  water  to  be  sent  to  an  analyst 
for  examination,  a  glass  vessel  (demijohn,  etc.)  of  suflBcient  capacity  and 
thoroughly  cleaned  should  be  selected.  Earthen  jugs  are  often  glazed  by 
the  use  of  salt,  and  might  impari  chlorides  to  the  water  ;  then-  use  is  best 
avoided  for  this  pui'pose.  It  will  be  observed  that  very  minute  quantities 
of  some  of  the  constituents  have  to  be  determined,  and  a  fau'  amount  of  the 
water  will  therefore  be  necessaiy,  say  one  or  two  gallons.  The  sample 
should  not  be  less  than  one  gallon  (preferably  two).  The  vessel  should 
not  have  been  used  previously  for  any  liquid  which  cannot  be  thoroughly 
i-emoved  from  it.  "SVine  demijohns  are  sometimes  used  in  which  the  sedi- 
ment fi'om  the  wine  adheres  so  strongly  to  the  glass  that  rinsing  fails  to 
dislodge  it,  yet  from  those  cnists  the  water  may  absorb  enough  material 
while  in  transit  as  to  utterly  mislead  the  analyst,  should  he  not  discover  it 
in  time.  The  vessel,  after  being  thoroughly  cleaned,  should  be  rinsed  a 
few  times  with  the  water,  a  sample  of  which  is  to  be  taken.  A  gallon  or 
two  of  the  water  at  least  should  be  allowed  to  inin  to  waste  before  the 
sample  is  taken.  The  vessel  should  then  be  securely  stopped  with  a  clea7i 
new  cork,  a  smaU  air-sj)ace  being  left  between  the  surface  of  the  water  and 
the  cork,  and  the  stopper  fastened  so  that  it  cannot  be  disturbed  in  transit. 

'  Vide  A.  H.  Cliurch,  loc.  cit.,  p.  33. 


WATEE.  423 

The  sample  also  should  be  put  into  the  hands  of  the  analyst  -with  the  least 
possible  delay,  since  all  -waters,  and  especially  polluted  waters,  alter  quite 
rapidly  after  removal  from  their  sources/ 

Modes  of  reporting  Besults. — The  modes  of  reporting  the  results  of  analy- 
ses of  water  are  so  varied  as  to  be  extremely  confusing  to  those  for  whom 
the  interpretation  of  them  is  of  the  most  importance.  Some  chemists  report 
in  paiis  per  million,  some  in  parts  per  hundred  thousand,  others  again  in 
grains  jjer  imperial  (Enghsh)  gallon,  which  is  in  effect  parts  per  70,000, 
and  others  again  in  grains  per  U.  S.  gallon  of  231  cubic  inches  (English 
Winchester  gallon),  which  is,  according  to  some,  parts  per  58,318  ;  others, 
parts  per  58,327.5  ;  and  others,  parts  per  58,372.2. 

The  different  values  for  the  U.  S.  gallon  ai'e  of  but  little  importance 
where  the  quantities  estimated  are  so  small,  but  when  the  rejoort  does  not 
specify  whether  the  gallon  used  is  the  imperial  or  the  U.  S.  gallon,  it  is  a 
matter  of  some  moment.  In  this  paper  the  method  of  parts  per  hundred 
thousand  has  been  adopted. 

Organic  Impurities. — It  is  evident,  from  what  has  been  said  regarding 
the  impurities  of  water,  that  the  greatest  danger  to  be  feared  in  water  for 
domestic  uses  is  fi'om  the  organic  matter.  Yet  almost  all  the  water  used 
by  human  beings  contains  some  organic  matter,  and  it  has  been  jocularly 
remarked  that  tea  and  coffee,  or  beef  broth,  are  samples  of  water  loaded 
with  organic  matter  to  which  no  objection  is  made.  The  kind  of  organic 
matter  is  then  the  important  point. 

Decomposing  organic  matter  in  which  thrive  the  germs  (or  undiscovered 
"  somethings  ")  which  produce  disease,  is  the  dangerous  kind  of  organic 
matter,  and  the  wash  from  marsh  land,  or  still  worse,  the  drainage  and 
sewage  saturated  with  the  decomposing  refuse  of  all  kinds,  which  inevi- 
tably exists  about  human  habitations,  are  the  bearers  of  this  dangerous 
form  of  organic  matter. 

Analysis  directed  to  Characteristic  Constituents. — Since  it  is  impossible  to 
determine  absolutely  the  amount  and  cjuahty  of  the  organic  matter  which 
may  exist  in  a  water,  the  chemical  examination  is  directed  towai'd  the  de- 
tection and  estimation  of  such  constituents  as  may  be  characteristic  of  the 
hquids,  of  which  decomposing  organic  matter  forms  a  part.  A  difficulty 
meets  the  chemist  on  the  very  threshold  of  such  an  examination,  namely, 
that  the  very  compounds  which  he  would  determine  exist  also  in  per- 
fectly pure  waters  which  are  altogether  uncontaminated.  The  most, 
therefore,  that  he  can  do  is  to  determine  whether  the  amounts  of  those 
compounds  in  the  sample  of  water  submitted  to  him  are  in  excess  of  what 
might  be  properly  expected. 

Sewage  water  is  known  to  be  especially  dangerous.^  The  characteristic 
features  of  sewage  are  large  quantities  of  organic  matter,  especially  nitro- 
genous compounds,  and  the  resiLlts  of  theii*  decomposition,  carbonaceous 
matter,  ammonia,  etc. ;  mineral  matter,  which  sometimes  includes  appreci- 
able amounts  of  phosphates,  and  always  includes  considerable  quantities 
of  chlorides  and  lime  salts,  especially  sulphate  of  lime. 

Magnesia  salts  predominate  in  meat,  bread,  grain,  and  leguminous 
products,  and  are  therefore  present  in  excreta  of  those  men  and  animals 
using  such  substances  as  food;  while  hme  predominates  in  the  leaves  of 
plants,  green  vegetables,  hay,  etc.  •  The  excreta  of  herbivora  contain  con- 

'Muir,  Chemical  Ne-ws,  xxxv.,  p.  94  ;  Wanklvn,  Water  Analysis,  p.  16  ;  Chemical 
News,  XXXV.,  p.  114. 

^  See  Table  of  Composition  of  Se-vrage,  p.  415. 


424  AMERICAN    APPENDIX    TO    PARKES     HYGIENE. 

siderable  quantities  of  potash.  Hence  large  amounts  of  potash  and  mag. 
nesia  salts  are  regardecl  as  suspicious  signs  in  well  waters. ' 

Potassium  salts  are,  however,  absorbed  hy  soils  in  large  quantities,  and 
their  presence  in  small  quantities  cannot,  therefore,  be  regarded  as  indica- 
ting absence  of  such  contamination. 

The  substances  determined  in  water  as  aids  to  a  decision  regarding  its 
quality  are  one  or  more  of  the  following  :  dissolved  oxygen,  organic  car- 
bon, organic  nitrogen,  suspended  matter,  total  solids  on  evaporation, 
organic  and  volatile  matter,  ammonia  (free  and  albuminoid),  nitrogen  in 
nitrates,  nitrites,  hardness  (temporary,  permanent,  or  total),  chlorine  in 
chlorides,  oxygen  absorbed  (usually  from  permanganate  of  potassium), 
and  phosphoric  acid  in  phosphates.  Observations  may  also  be  made  on 
the  temperature,  color,  odor,  and  taste.  The  source  of  the  water,  spring, 
well,  pond,  or  river,  must  also  be  taken  into  consideration,  and  the  sur- 
roundings noted. 

Suspended  Matter. — The  determination  of  suspended  matter  is  usually 
only  roughly  ajoproximate.  It  is  usually  done  by  filtering  some  of  the 
water  through  a  weighed  paper,  and  drying  and  weighing  the  paper,  or  by 
comparing  the  weights  of  the  residues  obtained  by  evajDorating  some  of 
the  water  both  before  and  after  filtration  through  paper.  The  physical 
state  of  the  suspended  matter  is  often  of  much  more  importance  than  its 
amount.  Minute  angular  fragments  are  for  some  persons  extremely  irri- 
tating to  the  lining  membranes  of  the  bowels. 

Total  Solids. — This  is  ascertained  by  evaporating  a  measured  quantity 
of  the  watex*,  dr^dug  and  weighing  the  residue.  It  can  only  be  regarded 
as  an  approximation,  since  various  forms  of  organic  matter  are  destroyed 
or  volatihzed  off  by  such  evaporation,'^  while,  on  the  other  hand,  many  in- 
organic salts,  as  sulphate  of  lime,  retain  water  with  great  persistency. 
The  results  may  therefore  be  below  or  above  the  truth.  Unless  it  contains 
poisonous  metals,  the  amount  of  total  solids  considered  as  admissible  in  a 
water  for  domestic  use  has  been  fixed  at  about  50  parts  per  100,000  (about 
30  grains  per  U.  S.  gallon).^ 

Organic  and  Volatile  Loss  on  Ignition. — By  igniting  (heating  to  redness) 
the  residue  obtained  b}'  evaporation  (total  solids),  and  noting  the  loss  of 
weight,  the  result  to  which  the  above  names  have  been  given  is  obtained. 
As  a  means  for  determining  the  amount  of  organic  matter  in  a  water,  it  is 
altogether  unreliable.''  Besides  the  probability  already  refen-ed  to,  of  a 
loss  of  organic  matter  on  evaporation,  all  the  organic  matter  may  not  be 
driven  by  ignition,^  and  many  of  the  mineral  salts  present  may  be  decom- 
posed with  partial  loss  of  theh*  constituents  (as  carbonate  of  lime,  which 
loses  its  carbonic  acid  and  becomes  quick-hme),  or  partially  or  entirely 
volatilized  (as  potassium  chloride,  etc.).  The  indications  by  this  test  are 
therefore  of  very  Httle  value,"  and  many  chemists  omit  to  make  it  alto- 
gether. Some  chemists,  after  igniting,  add  carbonic  acid  water  or  car- 
bonate of  ammonia  solution  to  the  residue,  and  then  dry  and  weigh,  while 
others  do  not.  The  effect  of  such  addition  is  to  convert  into  carbonates 
such  of  the  mineral  bases  as  have  lost  their  carbonic  acid  or  other  acid 

'  Fischer,  Chemische  Techn.  des  'VVassers,  p.  108.     Brunswick,  1878. 
'^  Wanklyn,  Jour.  Loud.  Cliem.  Soc,  xx.,  445;  Franklaud,  ibid.,  xxi.,  79. 
'  'VVanklyn,   'Water  Analysis,   4th    ed. ,   p.    3  ;    BoUey,    Fischer,   Kubel-Tiemann, 
etc.,  etc. 

*  Wanklyn,  'Water  Analysis,  p.  21. 

*  Franklaud  &  Armstrong,  Jour.  Lend.  Chem.  Soc,  xxi.,  80. 

*  Tidy,  Jour.  Lond.  Chem.  Soc,  xxxv.,  46. 


WATEE.  425 

whicli  was  originally  combined  with  them.  The  difference  in  the  results 
is  sometimes  very  marked. 

Many  chemists,  again,  follow  the  suggestion  of  Frankland '  and  ignite 
the  evaporated  residue,  noting  the  amount  of  blackening  as  a  rough  quali- 
tative estimation  of  the  probable  amount  of  organic  matter  present.  A 
water,  however,  which  contains  considerable  quantities  of  nitrates,  and 
may  be  very  foul,  will  often  show  no  blackening  by  such  treatment,  though 
a  considerable  quantity  of  organic  matter  may  be  present,  owing  to  the 
oxidation  of  the  organic  matter  diu'ing  evaporation  or  ignition  by  the 
oxygen  given  up  by  the  nitrates. 

Dissolved  Oxygen.— ^The  determination  of  dissolved  oxygen  is  used  by 
some,  especially  by  French  chemists.  The  value  of  the  determination  as 
giving  information  of  the  quality  of  a  water  is  derived  from  the  view  that 
oxygen  is  absorbed  by  the  burning  up  (chemically  speaking)  the  dangerous 
organic  substances  present,  which  are  in  a  state  of  change.  The  oxygen 
dissolved  in  the  water  effects  this,  and  if  the  dissolved  oxygen  is  small,  it 
is  because  there  are  in  the  water  substances  which  are  taking  it  up  and 
therefore  are  presumably  hurtful,  e.g.,  the  amounts  of  dissolved  oxygen 
found  in  the  water  of  the  Seine  were  found  to  be " — 

C.  C.    per  litre  =  Cubic  ia.  per  gal. 

Before  receiving  Paris  sewage 4.34  1. 

After  receiving  Paris  sewage 1.02  0.23 

Normal  amount  (Boudet=) 9  to  9.5  2  to  2.2 

As  water  readily  takes  up  oxygen  (and  other  gases)  by  agitation,  or  even 
by  contact  with  air,  it  is  evident  that  a  determination  of  the  dissolved 
oxygen  is  of  no  value  unless  it  is  performed  on  the  spot,  as  soon  as  the 
sample  is  drawn,  and  even  then  could  be  easily  made  useless. 

The  water  of  artesian  wells,  it  is  stated,  contains  no  oxygen.^ 

0.xygen  Absorbed. — Potassium  permanganate  is  a  salt  of  deep  purpHsh 
red  color  ;  it  dissolves  in  water,  giving  it  a  strong  red  violet  tint,  and  readily 
parts  with  a  large  proportion  of  the  oxygen  it  contains,  affording  colorless 
compounds  in  the  presence  of  an  acid.  This  salt  has  been  used  in  a 
variety  of  ways  to  determine  the  amount  of  readily  oxidizable  matters 
present  in  a  water,  and  iu  that  way  to  aid  in  deciding  as  to  the  jDrobable 
amount  of  organic  matters  present. 

This  test,  as  will  be  seen,  is  the  reverse  of  the  preceding.  It  was  fii'st 
proposed  by  Forchhammer,  of  Copenhagen,  in  1850,^  and  has  been  used  with 
various  modifications  up  to  the  present  time.''  The  test  is  applied  in 
various  ways  by  different  chemists ;  some  use  an  acid,  some  an  alkaline 
solution ;  some  boil  it,  others  do  not ;  some  allow  an  excess  of  the  per- 
manganate to  act  for  certain  stated  lengths  of  time,  others  add  it  little  by 
little,  so  long  as  the  color  of  the  permanganate  is  destroyed. 

These  different  methods  will  give  very  different  results  with  the  same 
sample  of  water,  and  hence  the  results  obtained  by  one  chemist  may  not 

'Water  Analysis,  1880,  p.  14. 

■^  Assainissement  de  la  Seine,  i.,  pp.  20  and  21.  ^Ibid.,  ii.,  p.  8. 

^  Gerardin,  Comptes  Eendus,  Ixxviii,  1704. 

^  Frankland,  Water  Analysis,  p.  52.     London,  1880. 

^Vid.  W.  A.  Miller,  Journal  of  the  London  Chemical  Society,  sviii.,  117;  Tidy, 
ibid.,  XXXV.,  67;  Kubel-Tiemann,  Untersuch.  vou  Wasser,  p.  104,  Brnnswick,  1874, 
and  others. 


426  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

be  comparable  -vsith  those  obtained  by  another.  The  value  of  the  test  has 
been  seriously  questioned.' 

Value  of  Permanganate  Tes^-s.-^WolffhugeP  says:  "The  action  of 
potassium  permanganate  without  heating  is  very  incomplete  ;  even  on 
boiling  ia  alkaline  or  acid  solution,  all  the  organic  substances  are  not 
oxidized.  Moreover,  potassium  permanganate  is  not  a  sure  means  of  dis- 
infection in  the  case  of  ferments  which  are  formed. " 

The  test,  though  of  some  value,  is  by  no  means  entitled  to  the  implicit 
faith  which  has  been  j)laced  in  it  by  many,  especially  by  physicians. 

Nitrogen  Compounds. — It  has  been  said  with  regard  to  the  chemical 
examination  of  waters  for  sanitary  purposes,  that  the  chemist  does  not 
know  what  he  has  to  look  for,  and  it  is  not  surprising  that  he  finds  dif- 
ficulty in  gi^'ing  a  decision.  The  constitution  and  properties  of  the 
materies  morbi  in  a  contaminated  water  are  unknown.  It  has,  however, 
been  observed  that  (comparatively)  considerable  quantities  of  nitrogen 
exist  in  the  organic  matter  rendering  water  insalubrious. 

Organic  Nitrogen  and  Organic  Carbon. — Professor  Frankland  has  pro- 
posed the  determination  of  the  amounts  of  carbon  and  nitrogen  present 
after  evaporating  with  certain  precautions,  and  the  relative  proportions  of 
those  two  elements.  The  results  are  usually  reported  as  "Organic  Carbon" 
and  "Organic  Nitrogen."  The  ratio  of  carbon  to  nitrogen  for  animal  matter 
is  put  as  3  : 1,  while  for  vegetable  matter  it  is  given  as  8  : 1.^  The  amount 
of  carbon  obtained  is  the  measui*e  of  the  organic  matter,  and  the  proportion 
of  carbon  to  nitrogen  is  taken  as  indicating  the  character  of  the  organic 
matter.  That  the  dangerous  quahty  of  a  water  is  no  doubt  proportional  to 
the  amount  of  nitrogen  (in  combination)  it  contains  was  noted  in  1856.* 

The  process  by  which  the  organic  carbon  and  nitrogen  are  determined, 
known  as  the  "combustion  process,"  is  one  requiring  elaborate  apparatus 
and  delicate  manipulation,  to  which  is  added  considerable  risk  of  error  in 
the  most  skilful  hands,  since  the  amounts  to  be  determined  are  usually  so 
smaU.  Hence  it  is  recommended  that,  even  with  the  most  skilful  chemists, 
dujDhcate  or  even  triplicate  concordant  results  should  be  insisted  upon 
before  accepting  the  results  as  trustworthy.^ 

Products  of  Decomi^osition  of  Nitrogenous  Matter. — It  is  generally  accepted 
as  a  fact  that  the  nitrogenous  organic  matter  in  water  affords  by  the  pro- 
cess of  putrefactive  decomposition  considerable  quantities  of  ammonia, 
then  of  nitrites,  and  finally  nitrates.  By  this  it  is  not  meant  that  the 
changes  succeed  one  another  sharply,  but  that  when  water  has  taken  up 
organic  matters  in  the  fii'st  stages  of  their  decomposition,  ammonia  or  sub- 
stances readily  yielding  ammonia  (albuminoid  ammonia)  are  prominent, 
and  later  on,  probably  by  contact  with  the  soil,  nitrites  and  nitrates  assume 
prominence.^  The  change  from  ammonia  to  nitrites  and  nitrates  is  beheved 
to  be  due  to  the  action  of  an  organized  ferment  in  the  soil,'  hence  water 
containing  nitrogenous   matter  which  has  percolated  through  the   soO, 

'Frankland,  Chemical  News,  xxxix.,  70;  ibid.,  Water  Analysis,  pp.  55  and  56; 
Wanklyn,  Water  Analysis,  p.  22,  5th  London  ed. ,  1876. 

■■^  Wasserversorgung,  216.     Leipzig,  1882. 

^  Frankland,  Water  Analysis,  p.  83. 

■*  Hofmann  and  Blyth,  Report  on  Metropolitan  Water  Supply,  London,  1856. 

5  Mallet,  Supp.  No'.  19,  National  Board  of  Health  Bulletin,  May,  1882. 

^  Trommsdorf,  Fres.  Zts.  Analyt.  Chem.,  ix.,  165.;  Boudet,  Assainissement  de  la 
Seine,  ii. ,  5,  1876  ;  Sixth  Report  River  Poll.  Comm.,  p.  12. 

'  Houzeau,  Comptes  Rendus,  Ixxxiii.,  525  ;  Schloesing&  Munz,  ibid.,  Ixxxiv.,  301 ; 
Boussingault ;  Warington,  Jour.  Lond.  Chem.  Soc,  i.,  74,  1878;  Storer,  Am.  Jour. 
Sci.  and  Arts,  xv. ,  June,  1878  ;  etc. ,  etc. 


WATEE.  427 

usually  contains  considerable  amounts  of  those  compounds,  wliile  sewage 
as  collected  in  the  sewers  has  little  or  none. 

Ammonia. — The  Nessler  reagent  (a  double  iodide  of  potassium  and 
mercury)  is  a  veiy  sensitive  reagent  for  ammonia,  and  is  the  reagent  usu- 
ally used  in  determining  the  ammonia  in  a  water.  Inasmuch,  however,  as 
the  preseace  of  various  compounds  in  the  water  (magnesium  salts,  suliDhides, 
etc. )  interferes  with  the  indications,  the  usual  method  is  by  distillation  of 
a  measarred  quantity  of  the  water,  in  most  cases  after  adding  some  alkaline 
solution  (as  carbonate  of  sodium).  This  method  also  has  the  additional 
advantage  of  concentrating  the  ammonia  in  the  first  portions  of  the  distil- 
late, as  it  is  carried  off  by  the  steam.  The  result  of  such  test  is  generally 
reported  as  "Fi-ee  Ammonia,"  though  having  reference  to  the  fact  that 
a  solution  of  impiu-e  urea  when  ti'eated  in  this  way  jields  ammonia,  some 
chemists  prefer  to  call  it  "ureal  ammonia."  In  fact,  the  amoimt  of  am- 
monia so  obtained  represents  the  ammonia  as  such,  plus  that  derived  from 
the  decomposition  of  lu-ea  or  kindred  bodies  present. 

Albuminoid  Ammonia.— 'By  the  addition  of  alkaline  solution  of  potassium 
permanganate  and  distilling,  still  another  portion  of  the  niti'ogen  of  the 
organic  matter  is  obtained  as  ammonia  and  may  be  estimated.  Since  some 
of  the  nitrogen  of  decomposing  albumen  can  be  obtained  in  this  way,  and 
decomposing  albuminous  bodies  are  believed  to  be  the  favorable  soils  for 
the  development  of  the  germs  of  disease,  this  form  is  called  the  "Albuminoid 
Ammonia." 

Value  of  Albuminoid  Ammonia  Test. — This  method  of  testing  water  was 
proposed  by  Messrs.  Wanklyn,  Chapman,  and  Smith, '  and  on  account  of  its 
dehcacy,  ease  of  execution,  and  usually  (presumably)  reliable  indications, 
has  been  much  used  by  chemists.  It  has  naturally  been  severely  criticised,' 
and  by  some  it  is  rejected  as  valueless.  Others,  however,  rely  upon  it  im- 
pHcitly,  while  others,  probably  the  majority  of  those  who  have  made  a  study 
of  the  value  of  the  different  methods  of  water  analysis,  consider  it  of  value 
as  giving  information  regarding  a  water,  but  rely  upon  it  only  to  a  limited 
extent,  i.e.,  they  consider  the  probabilities  as  against  a  water  condemned 
by  this  process,  but  they  do  not  believe  that  a  svater  is  necessarily  good 
when  it  appears  to  be  so,  so  far  as  this  process  gives  any  indications.^ 

Nitrogen  Important. — The  determination  of  the  amounts  of  nitrogen  in 
these  forms,  whatever  may  be  the  imperfections  of  the  methods  employed 
or  of  the  conclusions  which  may  be  drawn,  is  of  the  highest  importance  in 
deciding  on  the  sanitaiy  value  of  a  water. 

Nitrates  and  Nitrites. — Nitrogen  in  the  form  of  nitrites  is  comparatively 
infrequent  in  water.  It  represents  the  transition  state  between  ammonia 
and  albuminoid  compounds  and  the  nitrates.  Its  presence,  even  in  small 
quantities,  is  usually  regarded  as  a  bad  indication.  Nitrogen  as  nitrates  is 
a  common  constituent  of  waters. 

Value  of  Test  for  Nitrates,  etc. — Some  consider  the  determination  of  this 
form  of  nitrogen  as  useless,  for  the  following  reasons  : 

1.  It  is  in  itself  harmless. 

Water  of  uucj^uestionable  purity  may  contain  nitrates,  e.g.,  rain,  especially 
when  its  fall  is  accompanied  by  electrical  phenomena,  as  well  as  water 
from  certain  formations  (notably  the  chalk  formation  in  England)  contains 
considerable  quantities  of  nitrates. 

'Journal  London  Chemical  Society,  xx.,  445. 

'^  Frankland,  Joiirnal  London  Ch.emical  Society,  ssi. ,  79,  xxix.,  847  ;  Tidy,  itid., 
XXXV.,  61,  96,  etc. 

^  Ekin,  Potable  Water,  p.  9.  London,  1880.  Vide  the  writer's  results  on  a  well 
water  of  IN'ew  York  City,  p.  432. 


428  AMERICAN   APPENDIX   TO    PAEKEs'    HYGIENE. 

2.  The  development  of  water  plants,  etc.,  in  the  water,  abstracts  or  de- 
stroys nitrates. ' 

3.  Sewage  ordinarily  contains  little  or  no  nitrogen  as  nitrates. 

As  before  stated,  nitrates  and  nitrites  are  to  all  appearances  produced 
by  the  action  of  certain  ferments  in  the  soil,  and  hence,  unless  a  water 
charged  with  nitrogenous  organic  substances  has  percolated  through  the 
soil,  or  has  otherwise  been  brought  in  contact  with  it,  those  substances 
may  not  be  present.  On  the  other  hand,  comparatively  large  amounts  of 
nitrates  in  soui'ces  of  supply  where  much  or  all  of  the  water  must  have 
reached  the  spot  by  percolation,  is  undoubted  evidence  of  what  is  termed 
"previous  sewage  contamination." '■'  Some  allowance  may  have  to  be 
made  in  certain  cases  for  the  passage  of  a  water  through  a  stratum  known 
to  contain  nitrates,  but  most  formations  do  not  contain  them.  The  average 
amount  of  nitrogen  as  nitrates  and  nitrites  in  the  sixty-six  samples  of  deep 
weU  water  from  the  chalk  formation,  which  affords  the  most,  analyzed  by 
the  Eivers  Pollution  Commission,"  was  O.Gl  part  per  100,000.  It  has  been 
remarked  that  the  nitrates  and  nitrites  are  principally  furnished  by  the 
decomposition  of  organic  animal  matters,  vegetable  matters  yielding  none 
or  mere  traces.* 

As  we  cannot  be  sure  that  the  process  of  decomposition  has  proceeded 
so  far  that  no  danger  is  to  be  apprehended,  the  presence  of  considerable 
amounts  of  nitrogen  as  nitrates  and  nitrites  is  to  be  regarded  as  a  suspi- 
cious sign. 

Professor  Mallet's  report  on  the  chemical  methods  for  the  determina- 
tion of  organic  matter  in  potable  water  (already  referred  to),  shows  (in 
connection  with  the  determination  of  nitrates  and  nitrites)  "a  very  obvious 
connection  between  the  results  of  chemical  examination  and  the  known 
sanitary  character  of  the  several  waters,  the  salts  of  nitrous  and  nitric  acid 
being  either  absent,  or  present  in  but  trifling  amount  in  the  water  of 
Class  I.,  believed  to  be  wholesome  ;  almost  universally  present,  and  in  many 
cases  in  large  quantities,  in  the  pernicious  waters  of  Class  IE.,  and  very 
variable  as  to  presence  and  quality  in  the  waters  grouped  together  under 
the  doubtful  head  of  Class  m.  No  aspect  in  which  I  have  compared  to- 
gether the  good  and  bad  natural  waters  has  afforded  so  definite  a  result  as 
this."  Accordingly,  under  "general  conclusions"  we  also  find,  "6.  With 
the  facts  of  this  investigation  before  me,  I  am  inchned  to  attach  special 
and  very  great  importance  to  a  careful  determination  of  the  nitrites  and 
nitrates  in  water  to  be  used  for  drinking." 

Reporting  Nitrates,  etc. — The  mode  of  reporting  results  obtained  in  this 
determination  is  varied  by  different  chemists,  and  the  same  results  may  be 
reached  and  different  figures  given.  The  report  may  be  :  1,  nitrogen  (N) 
in  nitrates  and  nitrites,  separately  or  together;  2,  nitric  acid  (HNOj), 
nitrous  acid  HNO.,.  Some  also  report  "nitrates"  meaning  HNO3,  and 
"  nitrites "  meaning  HNO„.  3,  nitric  anhydride  (N^OJ,  sometimes  incor- 
rectly called  "nitric  acid"  or  "nitrates,"  and  nitrous  anhydride  (N^Oj),  in 
the  same  way  incorrectly  termed  "nitrous  acid"  or  nitrites. 

Since  14  parts  of  nitrogen  N  are  equivalent  to  63  parts  of  nitric  acid 
(HNO3)  and  47  parts  nitrous  acid  (HNOJ,  or  54  parts  nitric  anhydride 
(N„0^)  and  38  parts  nitrous  anhydride  (N^O,),  very  diffea-ent  figiu'es  from 
different  analysts  may  mean  essentially  the  same  thing. 

'  Vide  Wanklyn,  Water  Anal.,  Fifth  edition,  p.  83. 

^  Frankland,  Water  Analysis,  p.  28  ;  Sixth  Report,  p.  12. 

»  Sixth  Report,  pp.  100,  101. 

*  Ibid.,  p.  13;  Ekin,  Potable  Water,  p.  10. 


WATER.  429 

Chlorine  in  Chlorides. — Sewage  always  contaius  considerable  amounts 
of  chlorides.  A  determination  of  the  amount  of  cliloiine  in  a  w^ater  is 
therefore  of  value. 

Since  water  naturally  contains  chlorides,  sometimes  much,  as  in  cases 
of  certain  strata,  proximity  to  the  sea,  etc.,  only  the  presence  of  more 
chlorine  than  normally  exists  in  a  water  is  sufficient  ground  for  a  suspicion 
of  sewage  contamination.  An  increase  of  1  part  per  100,000  may  be  re- 
garded as  indicating  sewage  pollution. '  As  an  analyst  may  often  be  ig- 
norant of  the  normal  amount  for  any  given  water,  he  may  be  misled  by 
this  test.  It  is,  however,  of  value  as  confirmatory  evidence,  or  as  an  indi- 
cation of  the  desirabiUty  of  a  more  extended  examination."  A  water  may 
be  contaminated  Avith  vegetable  matter,  without  any  appreciable  increase 
in  the  amounts  of  chlorides.  ^ 

Hardness. — By  "  hardness  "  is  meant  really  the  soap-destroying  power 
of  a  water.  Lime  salts,  which  form  insoluble  compormds  with  the  fatty 
acids  of  soap,  are  the  chief  cause  of  this  phenomenon,  though  compounds 
of  magnesia,  ii'on,  etc.,  may  contribute  to  the  hardness  of  a  water.  Two 
kinds  of  hardness  are  recognized:  1.  "Temporary,"  which  is  caused  by 
the  presence  in  the  water  of  earthy  oxides  or  carbonates  held  in  solution 
by  carbonic  acid.  On  boiling  the  water,  the  carbonic  acid  may  be  ex- 
pelled, and  these  compounds  separate  in  solid  form,  being  removable  by 
subsidence  or  filtration.  2.  "Permanent,"  caused  by  the  same  earths  in 
such  combinations  that  they  are  not  removed  by  boiling — sulphates,  chlo- 
rides, etc.,  chiefly  the  fii'st  named.  The  temporary  and  permanent  hard- 
ness together  constitute  "  total  hardness  ;  "  where  distinctions  are  not  made 
in  a  report,  total  hardness  is  meant.  To  express  the  hardness  in  some  tan- 
gible form  the  custom  in  this  country  and  England  is  to  give  the  results 
in  the  coiTesponding  amounts  of  carbonate  of  lime,  i.e.,  to  report  in  effect 
that  a  certain  quantity  in  the  water  destroys  as  much  soap  as  would  be  de- 
stroyed by  so  and  so  much  carbonate  of  lime. 

Degrees  of  "Hardness." — The  English  "degrees"  of  hardness  mean  the 
equivalent  of  so  and  so  many  grains  of  calcium  carbonates  per  gallon 
(parts  in  70,000).  In  a  few  instances  chemists  report  "degrees"  of  hard- 
ness in  a  similar  way,  meaning  the  equivalent  of  gi'ains  of  calcium  car- 
bonate in  the  U.  S.  gallon  (parts  in  58,318  or  58,372).  It  is  also  fre- 
quently reported  as  parts  in  100,000,  or  parts  in  one  million.  The  French 
"degrees"  signify  the  equivalent  of  parts  of  carbonate  per  100,000,  while 
the  G-erman  degrees  signify  the  equivalent  of  parts  of  lime  per  100,000. 

Sewage  is  quite  hard,  being  especially  high  in  permanent  hardness.  The 
test  for  hardness,  though  having  a  great  economic  importance  (in  washing, 
manufacturing,  etc.),  also  has  a  similar  bearing  with  the  chlorine  test,  i.e., 
abnormal  hardness  in  a  water  justifies  a  suspicion  of  sewage  contamination 
in  the  absence  of  other  possible  causes  for  it,  and  a  further  investigation 
is  desirable. 

Phosphates. — Sewage  contains  considerable  amounts  of  phosphates,  but 
in  presence  of  lime  and  earth  oxides  (if  the  water  contains  alkahne  or 
earthy  carbonates,  as  is  usually  the  case)  only  very  small  amounts  can  be 
detected  in  a  water.  ■■  The  presence  of  phosphates  is  asserted  by  some 
chemists  to  be  always  a  bad  indication.'^  In  some  cases,  however,  they 
might  be  derived  from  the  rocks  through  which  the  water  has  passed.  The 
amount  is  necessarily  so  small  that  usually  only  a  qualitative  test  is  made. 

'  Nichols,  p   33. 

'  Fischer,  Chem.  Techn.  des  Wassers,  p.  105;  Wanklyn,  Water  Analysis,  5th  ed., 

pp.  15  and  16.  s  Wanklyn,  loc.  cit.,  also  p.  41. 

■*  Wanklyn,  Water  Analysis,  p.  99.             ,  ^Phipson,  Chem.  News,  xl.,  1. 


430  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

Temperature. — The  temperature  of  a  water,  to  be  of  any  service  in  judg- 
ing of  its  quality,  must  of  course  be  taken  at  the  source  of  supply.  If  the 
temperatiu-e  of  a  source  is  high  (70°  Fahi'.  or  more),  the  water  is  flat  and 
unpalatable,  possiblj'  vmwholesome  on  that  account.  Such  temperatures 
also  favor  the  development  of  organisms  which  may  be  prejudicial  to  the 
quality  of  the  water. 

Appearance,  Color,  etc. — The  appearance,  color,  etc.,  of  a  water  should 
be  such  as  to  commend  it  to  the  palate.  The  natural  color  of  a  pure  water 
is  light  bluish,  but  impurities  may  modify  that  tint  very  much.  Tidy  ' 
recommends  the  use  of  the  test  in  conjunction  with  others,  asserting  that 
the  peculiar  tint  is  an  indication  of  the  kind,  and  the  tint-depth  an  indica- 
tion of  the  quantity  of  organic  matter  present.  This  vdew  of  the  matter  is 
regarded  as  "sentimental  "  by  some  other  authorities."  So  far  as  the  expe- 
rience of  the  writer  goes,  no  correspondence  seems  to  exist  between  the 
color  and  the  quaUty  of  a  water.  The  tests  are  usually  made  with  what  is 
kno^\^l  as  the  "  two-foot  tube,"  a  colorless  glass  tube  two  feet  long  and 
about  two  inches  in  diameter,  wdth  plates  of  glass  cemented  on  either  end, 
which  is  filled  with  the  water  to  be  examined. 

Odor. — Good  water  should  have  no  perceptible  odor  or  taste,  either 
when  taken  from  its  source  or  after  standing  for  any  length  of  time.  The 
development  of  an  odor  or  taste  on  standing  is  of  itself  extremely  suspic- 
ious. Waters,  especially  public  supplies,  at  times  are  temporarily  affected 
by  the  development  in  them  of  an  unpleasant  odor  and  taste,  which,  how- 
ever, does  not  seem  to  render  them  dangerous  to  health.  Such  occur- 
rences have  been  usually  attributed  to  some  pecuHar  condition  of  the  algae 
in  the  water. 

Standards  of  Purity. — Several  investigators  of  this  subject  have  laid 
down  certain  standards  of  purity,  or  limits  beyond  which  a  water  must  be 
regarded  as  contaminated,  while  within  them  a  water  is  considered  as  -pure. 
On  the  part  of  others,  strong  objections  are  raised  to  the  adoption  of  any 
such  "hard  and  fast  "lines."  The  source  and  history  of  a  Avater,  its  sur- 
roundings and  the  general  character  of  p\u:e  waters  in  the  district  where 
they  occur,  should  be  taken  into  account. 

The  standards  fixed  by  different  authorities  may  be  roughly  summarized 
as  folltows  per  100,000  parts  : 

Total  solids 30  to  50  parts. 

Nitrogen  as  nitraies 0.1  to 0.7 pai-t. 

Nitrites  and  ammonia,  when  they  can  be  detected  without  concentra- 
tion of  the  water,  are  regarded  as  indicating  an  imj)ure  water. 

Hardness 15  to  22.5 

The  Hmits  for  chlorine,  as  may  be  imagined,  vary  veiy  much  with  the 
locality;  over  five  parts  is  regarded  as  suspicious  in  most  districts. 

"Wanklyn  (fifth  edition,  p.  08)  gives  the  following  classification  and  limits 
for  albuminoid  ammonia  in  water  : 

1.  Extraordinary  purity 0  to  0.005  part. 

2.  Satisfactory 0.005  to  0.010     " 

3.  Dirty over  0.010     " 

Tests  made  with  potassium  permanganate  jdeld  such  different  results 

'Jour.  Lond.  Chem.  Soc,  xxxv.,  84. 

"  Frankland,  Chem.  News,  xxxlx.,  p.  69;  R.  Angus  Smith,  Chem.  News,  June,  1869. 

*  Mallet,  loc.  cit.,  General  Conclusions,  No.  3;  Nichols,  p.  40. 


WATER* 


431 


when  the  conditions  are  so  varied  by  different  chemists— alkaline  or  acid 
solutions,  hot  or  ordinary  temperatures,  excess  of  permanganate  or  not — 
that  the  standards  given  by  different  authorities  would  be  of  httle  use 
here.  Some  German  chemists  multiply  the  amount  of  oxygen  absorbed 
from  the  permanganate  by  20,  and  call  the  figure  "organic  matter."' 
Over  0.2  part  absorbed  oxygen  is  the  usual  limit,  though  some  allow 
more.  The  limits  suggested  by  Frankland  and  Tidy  for  the  processes  which 
they  have  respectively  investigated  and  described  are  : 


I.  Great  org.  purity 
n.  Medium  purity 

m.  Doubtful 

IV.  Impure 


Frankland. 
Sum  of  organic  elements,  Car- 
bon and  Nitrogen. 


Upland  waters. 

0.    to  0.2 

0.2  "  0.4 

0.4  "  0.6 

over  0.6 


Other  waters. 

0.    to  0.1 

0.1  "  0.2 

0.2  "  0.4 

over  0.4 


Tidy. 
Oxygen  absorbed  from  Per- 
manganate. 


Upland  waters. 

0. 

to  0.1 

0.1 

"  0.3 

0.3 

"  0.4 

over  0.4 

Other  waters. 

0.      to  0.05 

0.05  "  0.15 

0.15  "  0.21 

over  0.21 


Several  cases  have  been  recorded  where  the  standard  limits  mentioned 
have  not  been  reached,  and  waters  have  been  polluted  to  a  sufficient  extent 
to  cause  disease. 

Local  standards  may  be  established  more  safely  than  such  general 
ones,  since  the  pure  waters  of  a  given  district  have  usually  the  same  gen- 
eral characters.  In  the  case  of  a  suspected  well  it  is  advisable  to  have  an 
analysis  of  a  neighboring  well  known  to  be  pure,  or  at  least  presumably  so, 
for  comparison. 

The  necessity  for  obtaining  all  the  information  possible  about  a  water, 
as  well  as  the  results  of  the  chemical  examination,  is  clearly  of  the  greatest 
importance  in  deciding  upon  the  safety  of  any  particular  supply.  As  a 
rule,  too  much  is  expected  of  chemists  to  whom  water  may  be  sent  for 
analysis,  and  too  little  is  done  by  those  interested  most  in  the  matter,  in 
the  way  of  careful  examination  of  the  surroundings  of  their  sources  of 
water  supply. 

Professor  Church  gives  an  account  of  a  well  in  a  small  English  town 
which  suddenly  dried  up  without  apparent  cause.  An  investigation 
showed  that  a  neighbor  had  had  a  water-closet  close  by,  but  had  taken  it 
out,  and  had  substituted  an  earth  closet,  thereby  cutting  off  the  supply 
from  the  well.^  The  case  seems  an  extreme  one,  but  numbers  of  cases  al- 
most as  bad  are  to  be  found  on  record. 

In  connection  with  these  remarks  it  may  be  of  interest  to  present  anal- 
yses of  some  waters,  etc.,  which  have  been  accused,  on  very  good  grounds, 
of  having  transmitted  or  caused  disease.  The  evidence  with  regard  to 
some  cannot  be  looked  upon  as  absolutely  conclusive,  and  indeed,  with  re- 
gard to  almost  all,  some  caution  is  used  with  those  describing  the  sources 
and  their  surroundings,  in  asserting  that  these  waters  were  positively  the 
sole  and  only  source  of  the  contagion,  though  the  evidence  points  very 
strongly  in  that  direction. 

It  is  noticeable  that  in  some  of  these  cases  the  chemical  analysis,  inter- 
preted according  to  some  of  the  standards  quoted,  failed  to  indicate  con- 
tamination. 


'  Fischer,  Chem.  Techn.  des  Wassers,  p.  189. 
"  Plain  Words  about  Water.     London,  1877. 


432 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


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WATEE.  433 


E:51FEKENCES    AND    NoTES    TO    PrEOEDING    TaBLE. 

Wos.  1  and  2,  Oermantoicn,  Pa. — Prom  the  same  well.  Taken  nine  days  apart,  dur- 
ing the  prevalence  of  the  epidemic.  The  "total  solids  "  recorded  under  No.  1,  was 
from  still  another  sample.  A  child  living  some  distance  from  the  place  drank  some  of 
the  water  and  sickened  in  consequence,  otherwise  the  cases  were  among  those  living  in 
the  neighborhood  and  using  the  water.  Well,  ten  feet  from  a  brick  sewer,  which  was 
somewhat  choked  at  that  point. — Chemical  News,  xliii.,  188. 

No.  3,  Fairhaven,  Mass. — First  case,  September  30th;  second  case,  October  3d; 
third  case,  October  6th  ;  fourth  and  fifth  cases,  October  7th  ;  sixth  case,  October  8th; 
seventh  case,  October  9th  ;  eighth,  mild  case,  middle  of  October. 

The  entire  family.  No  others  took  the  disease  except  the  nurse  and  her  mother  who 
nursed  her.  Neither  of  them  drank  any  cf  the  water.  Well,  one  hundred  feet  from 
privy  vault.  Connection  between  the  two  proved  by  throwing  salt  into  the  privy  vault 
and  finding  an  increase  iii  the  chlorides  in  the  well  a  few  days  later. — "Massachusetts 
State  Board  of  Health  Report  for  1879,"  Supp.,  p.  270. 

No.  4,  Sciiuate,  Mass. — Examination  made  about  a  month  after  the  disease  pre- 
vailed in  the  family  and  among  neighbors  who  drank  the  water.  None  of  the  cases  fatal. 
Only  three  other  cases  (a  mile  away)  in  the  town  previous  to  the  outbreak  at  this  spot. 
Well,  thirty  feet  from  privy.  Water  contained  bacteria  and  infusoria. — "  Massachusetts 
State  Board  of  Health  Report  for  1879,"  Supp.,  p.  273. 

iVb.  5,  Grouville,  Island  of  Jei'sey. — Female  Orphans' Home.  House  isolated.  Well, 
sixty  feet  from  an  old  cesspool  used  only  for  urine  and  soapsuds  at  the  time  of  the  out- 
break. Disease  apparently  generated  de  novo.  No  new  cases  occurred  after  the  pump 
was  removed. — Chemical  Neics,  xl.,  97, 

No.  6,  Eagley,  near  Bolton,  England.  — Brook  received  the  excreta  of  operatives  at 
a  factory,  among  which  one  man  had  typhoid  fever.  Water  said  to  have  been  used 
only  to  wash  the  milk  cans.  No  one  affected  except  those  who  drank  the  milk  from 
this  dairy. — "  Massachusetts  State  Board  of  Health  Report  for  1877,"  p.  123. 

No.  7,  NeiD  York,  Manhattan  Island — Asyh/.m, — Well  over  one  hundred  feet  deep. 
No  ostensible  cause  for  the  appearance  of  the  disease,  except  communication  through 
the  drinking-water.  Sewage  appeared  to  reach  the  well  in  about  two  hours  from  the 
time  of  deposition  in  the  sewer.  Connection  between  sewer  and  well  proved  by  appli- 
cation of  the  "  lithia  test." 

No.  8,  Broad  St.,  St.  James  Parish,  London,  England,  1854. — The  number  of  cases  is 
unknown  ;  609  deaths  are  believed  to  have  resulted  directly  or  indirectly  from  drinking 
the  water  of  this  well.  Of  two  factories  situated  side  by  side,  the  workmen  in  one 
drank  the  water  and  were  almost  all  attacked,  while  in  the  other,  other  water  was 
drunk  and  the  workmen  escaped.  An  old  lady,  living  entirely  outside  of  the  affected 
district,  drank  the  water,  as  did  also  her  niece  living  with  her,  and  both  died  of  the 
disease.  No  one  else  in  their  immediate  neighborhood  was  attacked.  The  well  was 
closed  up  at  the  time,  but  opened  a  year  after  the  outbreak  and  pumped  out,  after 
which  this  sample  was  taken. — •'  Sixth  Report  Rivers  Pollution  Commission,"  p.  497. 

No.  9,  New  Orleans,  La. — Odor  of  the  water,  like  swamp  water.  Cistern  (wooden), 
old  and  rotten. — "Report  on  the  Water  Supply  of  New  Orleans  and  Mobile.  Dr.  Chas. 
Smart.     National  Board  of  Health  Bulletin,"  vol.  1.,  317. 

No.  10,  Mobile,  Ala. — Case  similar  to  the  last.  With  regard  to  this,  Dr.  Smart  notes 
particularly  that  the  fever  "prevailed  in  the  absence  of  prominent  sources  of  malarial 
exhalation  to  account  for  the  presence  of  the  disease." — "  National  Board  of  Health 
Bulletin,"  i.,  317. 

No.  11,  Rye  Beach,  Mass. — Digestive  disturbance  caused,  "characterized  by  a  sen- 
sation of  giddiness  and  nausea,  vomiting,  diarrhoea,  severe  abdominal  pain,  all  of 
which  was  accompanied  by  fever,  loss  of  appetite,  continued  indigestion,  and  mental 
depression."  Ice  taken  from  a  shallow  pond  choked  with  marsh  mud  and  decomi^os- 
ing  sawdust,  and  used  in  the  hotel  where  all  the  cases  occurred. — "Massachusetts 
State  Board  of  Health  Report  for  1876,"  p.  467. 
Vol.  II 28 


434  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

Testing  Connection  of  Well  and  Cesspool,  etc. — Wells  in  the  neighborhood 
of  houses  are  especially  liable  to  contamination  from  the  cesspool,  drain  or 
privy  vault.  The  most  convenient  mode  of  testing  whether  any  connection 
exists  between  the  well  and  such  possible  sources  of  contamination,  is  by 
adding  to  the  cesspool  or  privy  vault  some  soluble  compound,  and  testing 
for  its  presence  in  the  well.  Sometimes  largtJ  quantities  of  salt  are  thro^\•n 
in,  and  the  weU  water  is  then  tested  for  an  increase  in  the  proportion  of 
chlorides. '  This  method  may  be  affected  by  temporary  or  local  conditions, 
and  is,  on  that  account,  inferior  to  the  more  expensive  method  of  throwing 
soluble  lithium  salts  into  the  cesspool,  sewer,  etc.,  and  testing  the  water 
afterward  for  the  presence  of  Uthia.  ExcejDt  in  the  water  of  mineral 
springs,  lithia  is  of  rare  occurrence  ;  moreover,  very  minute  traces  can  be 
detected  by  the  spectroscope,  and  though  much  of  the  hthia  is  probably 
absorbed  by  the  soil,  enough  wiU  usually  work  its  way  through  if  the  sus- 
pected connection  exists. 

Ice. 

A  few  words  on  the  impurities  in  the  ice  so  lavishly  used  in  this  country 
for  cooling  our  beverages  in  hot  weather.  Cases  of  illness  have  occurred 
which  have  been  traced  to  the  use  of  ice  in  this  way,  though  not  very  fre- 
quently. The  commonly  received  impression  that  water  in  freezing  not 
only  rejects  all  impurities,  but  that  any  germs  if  frozen  into  it  are  neces- 
sarily killed,  requires  some  correction.  Water  in  freezing  wiU  enclose  par- 
ticles of  organic  or  other  matter  which  may  be  suspended  in  it,  and  almost 
any  microscopist  can  testify  to  the  persistent  vitality  of  many  of  the  lower 
forms  of  organisms,  even  after  being  imprisoned  for  a  long  time  in  blocks 
of  ice,  perhaps  benumbed  and  dormant  until  released,  but  living.  The 
general  rule  that  "  a  pond  or  river  which  is  unfit  as  a  water  supply  should 
not  be  used  as  a  source  of  ice  supply  " '"  is  a  good  one,  but  often  disre- 
garded. 

As  regards  the  chemical  analysis  of  ice,  it  should  contain  no  perceptible 
suspended  matter  when  melted,  very  little  dissolved  matter,  or  chlorine, 
and  the  albuminoid  ammonia  should  not  exceed  0.005  part  per  100,000.' 

Conclusion. 

In  discussing  the  question  of  water  supply  reference  has  necessarily 
been  made  to  certain  theories  which  are  now  engaging  the  attention  of 
sanitarians,  and  which  (inasmuch  as  they  are  theories  or  hj'potheses)  have 
both  strong  supporters  and  A^gorous  opponents.  Such  are  :  The  germ 
theory  of  disease  ;  the  "  drinking-water  theory ; "  the  purification  of 
rivers  by  flow  ;  the  generation  of  diseases  de  novo  ;  and  finally  the  value 
of  certain  of  the  chemical  tests  applied  to  water. 

It  must  be  remembered  that  these  theories  have  been  advanced  after  a 
careful  study  of  numerous  facts,  and  whether  true  or  not  as  they  are  now 
stated,  they  cannot  be  regarded  lightly.  Future  study  of  sanitary  science 
may  modify  these  views  as  at  present  held  by  their  sujjporters,  but  it  will 
be  always  desirable  to  keep  on  the  safe  side  in  selecting  a  location  for  our 
dwellings  or  deciding  upon  a  water  supply  for  our  households,  and  we 
should  not  unnecessarily  risk  the  health  or  lives  of  our  families. 

'  Nichols,  Water  Supply,  p.  133.  *  Ibid.,  p.  52.  ^  itid.^  p.  54. 


THE  CHAEACTEES  AND  DISTEIBUTION  OF 
AMEEICAN    SOILS. 

By  N.  L.  BEITTON,  PH.D. 

The  soil  is  generally  understood  to  be  the  upper,  superficial  portions  of 
the  accumulations  of  loosely  consohdated  materials,  which  in  most  regions 
form  the  surface  of  the  earth.  In  this  chapter  it  will  be  so  considered.  It 
is  the  part  of  the  earth's  crust  which,  directly  or  indirectly,  sujDports  vege- 
table and  animal  life,  and  is  thus  of  immense  importance  to  mankind.  The 
thickness  of  this  superficial  material  varies  greatly  in  difierent  locaHties ; 
in  some  we  find  very  little,  or,  indeed,  none  at  all,  the  rocks  coming  di- 
rectly to  the  surface  ;  but  such  are  hmited  in  area  and  mostly  confined  to 
the  slopes  and  summits  of  mountains  ;  nearly  everywhere  there  is  an  ap- 
preciable quantity  of  soil,  and  the  accumulations  are  occasionally  over  one 
hundred  feet  deep. 

To  render  what  follows  intelligible  to  all,  it  has  been  deemed  advisable 
to  preface  this  dissertation  with  some  of  the  leading  facts  relating  to  the 
origin,  structure,  and  constituents  of  soils  in  general 

Steuctuee  and  Composition. 

The  soil  is  constituted  of  variously  sized  fragments  of  mineral  and  or- 
ganic matters,  and  its  character  depends  on  the  relative  abundance  of  the 
different  constituents,  the  dimensions  of  the  fragments,  and  their  greater 
or  lesser  consoUdation.  It  is  invariably  permeated  to  some  extent  by 
water  and  air,  and  the  quantity  of  these  fluids  depends  on  the  permeability 
and  the  absorbing  property  of  the  soil,  which  vary  greatly.  The  size  of  the 
component  fragments  is  very  variable,  and  ranges  from  microscopical  par- 
ticles, which  make  up  the  greater  part  of  the  mass,  to  botdders  of  huge 
proportions. 

Mineralogically  considered,  it  consists  primarily  of  sand  and  clay  ;  these 
constituents  occur  either  alone  or  intermingled  with  each  other  in  various 
proportions ;  they  are  often  accompanied  by  pebbles,  or  even  large  stones 
of  different  kinds  of  rock,  and  generally  by  small  amounts  of  other  inorganic 
or  organic  matters.  Most  of  the  latter  is  derived  from  plants  and  is  known 
as  j)eat,  humus,  etc.  Clay  and  sand  are,  however,  the  bases  of  all  soils, 
and  one  of  these  minerals  is  always  present. 

Oeigin  of  Soils. 

AU  soils  have  been  derived  from  previously  existing  rocks  by  processes 
of  decay  and  disintegration  acting  through  immensely  long  periods  of 
time,  and  are  still  forming  wherever  rock  masses  are  exposed  to  agents 
which  produce  and  forward  these  changes.     The  materials  resulting  from 


436  AMERICAlSr    APPENDIX   TO    PARKEs'    HYGIENE. 

tliese  processes  are  found  either  in  situ,  where  the  rocks  furnishing  them 
■were  formerly  situated,  or  at  a  distance  fi'om  the  parent  rocks,  and  this 
commonly  manj^  miles. 

Among  the  most  widely  acting  and  important  of  the  agents  which  pro- 
duce decay  in  rocks  are  the  following  : 

(a)  Percolation  by  Water,  and  the  consequent  solution  and  removal  of 
some  ingredients. 

(b)  Frost,  which  promotes  disintegration  by  the  formation  of  ice  from 
the  water  contained  in  rocks,  the  exjDansion  accompanying  this  phenome- 
non forcing  fragments  loose. 

(c)  Oxidation  of  certain  constituents,  particularly  the  comj)ounds  of 
iron  in  pyrites,  hornblendes,  etc. 

(d)  Kaolination,  by  which  the  feldspars  are  reduced  to  clays. 

(e)  Tlie  Action  of  Vegetation,  plants  having  the  habit  of  forcing  their 
rootlets  into  minute  crevices,  and  by  subsequent  growth  and  chemical  ac- 
tion disintegration  ensues. 

(f)  Erosion  by  Water  or  lee. — The  destructive  action  of  rain,  cuiTents  of 
water,  ocean  waves,  etc.,  on  rocks  is  continually  in  progress.  Ice  erosion, 
now  confined  to  the  polar  regions  and  to  a  few  elevated  mountain  chains 
where  glaciers  yet  occur,  was  a  most  important  agent  of  soil  production  at 
a  former  period  of  the  earth's  history. 

These  agents  of  rock-destruction  act  independently  or  in  conjunction  ; 
there  are  also  other  less  important  ones  contributing  to  produce  the  same 
results,  which  need  not  here  be  discussed. 

The  most  imj)ortant  of  the  agents  which  tend  to  remove  and  distribute 
the  disintegrated  materials  resulting  from  the  above-enumerated  forces, 
and  to  whose  action  many  of  our  soils  owe  their  origin,  are : 

(a)  Water. — The  transporting  j^ower  of  water  is  well  knowTi.  The  pro- 
ducts of  rock-decay  become  washed  into  streams,  and  the  more  commin- 
uted portions,  the  clays  and  finer  sands,  are  carried  by  them  into  the 
rivers,  and  in  part  deposited  along  the  valleys,  forming  the  rich  flood- 
plains  which  in  many  cases  extend  over  hundreds  of  square  miles  of  terri- 
tory on  each  side  of  the  river  proper.  Deltas  have  a  similar  origin.  The 
continued  beating  of  waves  against  the  coasts  gradually  promotes  dis- 
integration, and  much  of  the  sand  thus  produced  is  ultimately  driven  upon 
the  shore  to  form  beaches. 

(b)  Ice. — At  jDresent  the  work  of  ice  in  this  connection  is  insignificant. 
But  during  the  period  of  past  time  kno^vn  to  geologists  as  the  Glacial 
Epoch,  it  played  a  grand  part  in  soil  production.  During  this  period  a 
great  ice-sheet,  many  hundreds  of  feet  in  thickness,  advanced  over  North 
America  from  arctic  and  sub-arctic  regions,  extending  southwardly  to  the 
coast  of  New  England  and  Long  Island,  the  Narrows  of  New  York  Harbor, 
and  thence  across  the  continent,  its  southern  margin  following  aj^proxi- 
mately  the  fortieth  parallel  of  north  latitude  to  the  IMissouri  River ;  thence 
bending  northward  it  joined  ■ndtli  another  sea  of  ice,  which  descended  from 
the  Eocky  IMountains  as  far  south  as  the  thirty-sixth  parallel.  Local  gla- 
ciers were  also  develoj^ed  on  the  Sierra  Nevada  and  along  the  Pacific  coast. 

This  ice-mantle  covered  all  explored  parts  of  North  America  north  of 
the  lines  above  described,  and  it  has  left  undeniable  proofs  of  its  work  on 
the  rocks  which  it  smoothed  and  striated,  in  the  immense  erratic  boulders 
and  in  the  soils  which  occur  within  the  areas  traversed.  In  its  slow  south- 
ward movement  it  carried  an  immense  amount  of  debris,  torn  from  the 
rocky  strata  over  which  it  passed,  and  during  the  ensuing  melting  this 
burden  was  left  scattei'ed  over  the  areas  occupied  by  the  ice.     The  melt- 


CHAEACTEES  AND  DISTRIBUTION  OF  AMERICAN  SOILS.  437 

ing  of  these  enormous  ice-sheets  was  accompanied  by  a  great  flow  of  water, 
which  fui'ther  distributed  the  rocks,  clay  and  sand,  and  effected  a  partial 
sorting  of  the  materials,  concentrating  fragments  of  similar.'  sizes  and  same 
specific  gravity.  Thus  were  formed  the  deposits  of  fine  and  coarse  gravels, 
sands,  and  "boulder-clays"  found  within  the  glaciated  ai'eas,  and  a  lai-ge 
part  of  the  soils  of  these  portions  of  Xoi'th  America  were  deposited  in  this 
manner. 

"Within  the  area  of  this  "  Glacial  Drift  "  all  varieties  of  soil  ai'e  found, 
as  the  manner  of  their  production  would  lead  us  to  expect,  and  radically 
differing  kinds  are  found  within  a  few  feet  of  each  other.  The  drift,  or 
till,  as  it  is  sometimes,  designated,  varies  in  amount,  however,  in  different 
districts  ;  in  many  localities  it  is  only  a  sHght  covering,  and  here  the  de- 
composition of  underlying  rock  has  originated  much  of  the  soil. 

(c)  Air. — ^Ye  may  add  atmos]Dheric  cuiTents  to  these  tAvo  most  impor- 
tant distributing  agents.  Then-  action  is  appreciable  only  on  very  hght, 
readily  movable  soils,  and  is  limited  in  extent  and  imporiance. 


Soils  Consideeed  wtth  Eegaed  to  theie  jMixeealogical  Compositions. 

Any  attemjDt  at  classifying  our  soils  under  this  consideration  must  at 
best  be  but  imperfect,  as  it  is  difficult  to  draw  the  hnes  between  the  divi- 
sions which  have  to  be  adopted.  A  soil  which  is  placed  under  one  category 
in  ceriain  pai'ts  of  the  country,  is  considered  as  belonging  to  another  in  other 
sections  ;  this  difficulty  is  due  to  their  relative  abundance  in  the  various 
districts.  It  has  been  thought  desii-able,  however,  to  present  the  following 
classes,  as  in  some  respects  the  divisions  here  made  are  simpler  and  more 
apparent  than  in  describing  them  according  to  theu'  origin,  this  being 
often  somewhat  obscui-e,  although  fi'om  a  strictly  scientific  standpoint  the 
more  satisfactory. 

The  three  most  important  and  widely  spread  classes  of  soil  as  here 
limited  are  as  follows  : — Sandy  Soils,  Clayey  Soils,  and  Loams. 

(a)  Sandy  Soils. — These  are  here  regarded  as  consisting  of  seventy-five 
per  cent,  or  more  of  C[uartz  sand  (silica).  They  are  found  throughout  the 
countiy,  and  ai'e  generally  healthful  and  desirable  for  building  sites,  as 
they  have  a  fi-ee  and  ready  natural  drainage,  and  are  only  to  be  avoided 
when  low-lring  and  satui'ated  with  water  or  organic  matter,  or  when  im- 
mediately underlain  by  impervious  strata,  forming  basins  in  which  water 
is  retained.  Such  a  geological  stmctiu'e  causes  permanent  saturation  of 
parts  of  the  soil,  and  is  often  productive  of  malarial  troubles.  It  is  there- 
fore advisable  to  examine  the  underlying  strata. 

(b)  Clayey  Soils. — Under  this  division  we  here  include  all  soils  consist- 
ing of  seventy-five  per  cent,  of  clay  (alumina  silicates)  or  a  higher  percent- 
age. They  are  widely  spread  all  over  the  country,  and  are  wet,  cold, 
impervious  materials,  and  hence  undesirable,  unless  the  inclination  of  the 
strata  is  sufiicient  to  afford  good  surface  drainage.  Clays  are  generally  to 
be  regarded  with  suspicion. 

(c)  Loamy  Soils. — These  vaiw  greatly  ia  composition,  being  made  up 
of  variable  amounts  of  clay  and  sand,  either  of  these  constituents  reaching 
seventy-five  per  cent.,  as  the  class  is  here  limited.  Those  approaching 
the  extreme  limits  of  this  definition  are  known  as  Clayey  Loams  and  Sandy 
Loams,  Only  the  varieties  consisting  very  largely  of  clay  are  to  be  avoided, 
and,  generally  speaking,  all  that  has  been  said  about  sandy  soils  is  appHca- 


438  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

ble  to  loams  as  "welL     They  are  perhaps  our  most  abundant  soils,  and  are 
nearly  eveiywhere  common. 

To  these  three  principal  classes  of  soils  the  following,  less  abundant 
ones,  may  be  added. 

(d)  Stony  or  Gravelly  Soils. — These  are  local  in  distribution.  Theu' 
natuTJil  drainage  is  excellent,  and  they  often  aftbrd  veiy  desii-able  sites  for 
habitations. 

(e)  Calcareous  Soils,  are  loams  or  sands  somewhat  impregnated  with  car- 
bonate of  lime.  The  amount  of  this  substance  j^resent  varies  considerably, 
sometimes,  but  rarely  reaching  fifty  per  cent,  and  ranging  downward  to 
five  per  cent.,  under  which  percentage  the  soil  is  not  noticeably  calcareous. 
Thev  occur  only  in  limestone  or  marble  regions,  and  are  generally  found 
■whei-ever  these  rocks  approach  the  sui*face,  being  the  result  of  their  dis- 
integi-ation.  Calcareous  soils  are  distinguished  fi-om  others  by  cam-ing 
"hard  "  waters,  this  character  being  due  to  the  presence  of  carbonate  of 
hme  in  solution.  This  is  not  necessarily  an  injurious  featui-e,  and  these 
soils  may  be  perfectly  salubrious. 

(f)  ATagne.iian  Soils,  result  from  the  decay  of  sei-pentines,  talcose  or 
chlorite  schists  or  other  rocks  principally  composed  of  magnesian  minerals  ; 
thev  are  penneable,  and  not  to  be  regarded  as  objectionable.  Their  only 
bad  feature  Hes  in  the  large  quantities  of  magnesian  salts  earned  by  the 
waters  coming  from  them.     These  soils  are  only  occasionally  met  with. 

(g)  Highly  Ferruginous  Soils. — These  overlie  deposits  of  bog-iron  ore, 
and  are  veiy  local  Their  salubrity  has  been  questioned,  and  malarial 
troubles  ascribed  to  their  proximity  in  certain  foreign  localities.  "We  have 
heard  of  no  such  experience  in  this  country. 

(h)  Soils  of  3Iud  or  Peat. — These  are  confined  to  low  gi'ounds  and  are 
essentially  marsh  soils ;  they  will  be  more  fully  discussed  under  that  head- 
ing. They  consist  of  loams  or  cLays,  saturated  -^-ith  water  and  highly  im- 
pregnated with  decaying  vegetable  matter,  the  latter  substance  frequently 
making  up  one-half  of  the  soil,  or  even  more.  True  peat  api^ears  to  be 
non-malarial,  but  all  these  wet,  mucky  soils  are  probably  dangerous  in 
other  ways,  and  it  is  safer  to  avoid  them. 

(i)  Soils  of  Humus  and  Mold,  result  from  abundant  vegetable  growth  in 
comparatively  diy  situations,  and  are  the  natural  soils  of  forests,  where  the 
accumulations  are  derived  fi'om  the  leaves  and  twigs  ot  trees  and  shi'ubs ; 
and  of  jDraii-ies,  where  they  form  from  grasses  and  other  herbs.  These 
soils  are  strictly  superficial  seldom  extending  more  than  a  foot  in  depth, 
while  peat  may  be  fifty  feet  in  thickness. 

Soils  Considered  with  Regard  to  their  Origin. 

Considered  from  this  point  of  view,  we  may  diride  oui'  soils  into  two 
quite  weh-marked  classes,  viz.  : — Transported  Soils  and  Indigenous  SoilSf 

A. — Transported  Soils. 

We  have  already  briefly  alluded  to  this  class  in  discussing  the  methods 
by  which  soil-foiining  materials  have  been  produced  and  the  agencies 
whereby  they  have  been  distributed.  These  soils  have  been  brought  to 
their  present  positions  from  other  places,  and  generally  have  little  in  com- 
mon with  the  underlying  rocks.  We  will  successively  discuss  the  different 
varieties  which  fall  under  this  heading. 


CHABACTERS  JlND  DISTRIBUTIOTST  OF  AMERICAN  SOILS.  439 

(a)  Soils  of  Glacial  Drift. — These  consist  of  unassorted  deposits  of  clay, 
sand,  gravel  and  boulders  brought  from  the  north  by  the  ice-sheets  of  th 
Glacial  Epoch  ;  and  are  found  throughout  the  areas  traversed  by  them 
In  some  locaUties  the  deposits  show^  signs  of  stratification,  but  generally 
this  structure  is  absent.  The  surface  of  the  country  over  which  they  are 
found  is  generally  sufficiently  diversified  by  the  uneven  thickness  of  the 
accumulations,  and  by  in-egularities  of  the  strata  on  which  they  rest,  to  af- 
ford free  drainage  in  some  direction,  and  unless  excess  of  clay  renders 
them  impervious,  desirable  building  sites,  from  a  sanitary  standpoint,  can 
generally  be  selected.  Unfortunately,  however,  this  latter  condition  some- 
times occurs,  and  the.  clay  interferes  seriously  with  drainage.  This  is  es- 
pecially true  in  certain  localities  along  the  southern  margin  of  this  drift 
on  the  Atlantic  sea-board,  where  the  conformation  of  the  surface  of  the 
"terminal  moraine  "  is  such  that  swamps  and  stagnant  ponds  are  numer- 
ous, the  non-porous  soil  retaining  water  in  hollows  often  surrounded  by 
much  higher  ground,  although  many  feet  above  tide-level.  Here  relief  is 
only  obtained  by  extensive,  and  therefore  expensive  systems  of  artificial 
drainage,  and  must  sooner  or  later  be  adopted  in  all  thickly  populated  dis- 
tricts where  such  conditions  prevail. 

From  what  has  already  been  said  of  the  boundaries  of  the  Glacial  Drift, 
its  geographical  distribution  will  be  apparent. 

(b)  Soils  of  St7^atified  Drift,  differ  from  the  Glacial  Drift  soils  in  having 
a  well-marked  stratified  structure,  the  clay,  sand,  and  gravel  composing 
them  being  arranged  in  successive  layers,  which  are  usually  readily  dis- 
tinguishable from  one  another.  In  many  districts  they  occur  with  the 
other  class  of  drift  soils,  and  were  deposited  from  the  currents  of  water 
and  the  lakes  which  accompanied  the  melting  of  the  glaciers  ;  they  occur 
also  in  non-glaciated  regions.  When  mostly  composed  of  sand  or  gravel, 
these  soils  are  perhaps  the  most  salubrious  of  all,  combining  a  perfect  natu- 
ral drainage  by  percolation,  with  great  capacity  for  retaining  heat,  and  free- 
dom from  organic  matter.  When  principally  composed  of  clay  they  are  to 
be  avoided. 

Perhaps  the  most  notable  of  these  soUs  are  those  forming  the  so-caUed 
"YeUow  Drift,"  from  its  predominating  color.  This  is  found  in  isolated 
patches  along  the  southern  coast  of  New  England,  over  nearly  the  whole 
extent  of  Long  Island  except  its  extreme  western  parts,  and  thence  extend- 
ing southwardly,  composing  nearly  all  the  soils  of  Southern  New  Jersey,  and 
of  Delaware  and  Eastern  Virginia ;  it  is  traceable  even  to  Florida,  along 
the  Atlantic  sea-board.  The  salubrity  of  these  districts  has  rendered  them 
famous.  Much  of  the  territory  is  covered  by  pine  forests,  popularly 
known  as  the  "  pine  barrens,"  and  these  are  well  known  to  be  non-malarial 
ia  a  great  many  localities.  This  is  undoubtedly  largely  due  to  the  charac- 
ter of  the  "  Yellow  Drift "  soil,  composed  almost  exclusively  of  sand  and 
gravel.  These  deposits  have  a  greater  antiquity  than  those  of  the  Glacial 
Drift,  and  were  deposited  at  a  period  when  a  large  part  of  eastern  North 
America  was  submerged.  They  are  therefore  also  known  as  the  "  Pre- 
Glacial  Drift."  Most  of  our  celebrated  sea^side  "Health  Resorts"  are 
situated  on  these  soils,  and  this  is  probably  the  most  potent  cause  of 
the  salubrity  of  these  places,  which  are  found  from  Montauk  Point  south- 
ward. 

In  speaking  of  sandy  soils,  we  have  alluded  to  the  danger  in  those  un- 
derlain by  beds  of  clay.  This  is  particularly  applicable  to  these  soils  of 
stratified  sand  and  gravel,  and  should  be  taken  into  account  in  the  selec- 
tion of  building  sites. 


440  AMERICAN    APPENDIX   TO    PARKES'    HYGIENE. 

(c)  TJie  Flood-plains  of  Bivers,  Terraces,  etc. — Rivera  cany  large 
quantities  of  solid  matter,  held  in  suspension  by  the  water.  When  the 
rapidity  of  their  flow  becomes  lessened  by  the  expansion  of  the  valley,  or 
a  decrease  in  the  amount  of  slope,  mvich  of  this  fine  silt,  which  is  mostly 
clay,  falls  to  the  bottom  and  these  valley-deposits  are  foiTaed.  The  flood- 
plains  occupying  ten-itory  only  sUghtly  elevated  above  the  level  of  the 
stream,  form  particulai-ly  dangerous  soils  ;  the  impermeability  of  the  clayey 
material,  and  the  nearly  level  sm-face  of  the  deposit,  render  the  natural 
drainage  very  bad,  and  these  soils,  although  rich  and  attractive  to  the 
farmer,  are  almost  invariably  malarial.  River  terraces  are  produced  by  the 
stream  cutting  through  such  deposits  to  gain  a  lower  level,  and  we  often 
find  a  number  of  these  in  crossing  a  valley,  each  marking  a  former  level 
of  the  water.  Being  more  elevated  than  the  flood-plains  they  ai'e  more 
desii'able,  but  the  impervious  nature  of  the  deposit  is  still  a  bad 
feature. 

Lake  terraces  owe  theii'  origin  to  a  similar  cause,  and  are  fonned  of 
similar  materials.  They  are  particularly  noticeable  around  the  Great 
Lakes,  and  were  deposited  when  the  level  of  the  water  stood  higher  than 
at  present.  They  contain  more  sand  and  gravel  than  river  terraces,  and 
are  less  objectionable, 

(d)  3Iarsh  Soils  consist  of  clay  or  sand,  mixed  with  variable  amounts  of 
decaying  organic  matter,  the  result  of  vegetable  growth,  which  often  con- 
stitutes more  than  one-half  of  the  mass,  and  this  mixture  is  saturated  with 
water.  Hence  these  soils  are  partly  composed  of  transported,  and  partly 
of  indigenous  material.  Unless  thoroughly  drained,  marsh  lands  are  veiy 
dangerous,  being  almost  always  malarial,  although  there  are  some  excep- 
tions to  this  statement.  The  growth  of  our  large  cities  is,  however,  so 
raj)id,  that  extensive  tracts  of  this  character  become  unavoidably  bccupied 
by  habitations,  and  malarious  sections  of  them  can  often  be  traced  to  this 
cause.  Complete  drainage  at  the  outset  is  the  only  means  of  preventing 
this  trouble.  Unhappily,  this  precaution  is  too  seldom  observed.  To  be 
perfect  and  permanently  valuable,  the  drain  conduits  should  be  placed  low 
enough  to  rid  not  only  the  sm-face  of  water,  but  also  the  soil  itself. 

Marshes  are  found  to  some  extent  in  all  sections  of  the  country,  but 
their  greatest  development  is  along  the  coasts  of  the  Atlantic  Ocean  and 
the  Gulf.  The  largest  are  the  Dismal  Swamp  of  Virginia,  and  the  Ever- 
glades in  Florida,  Brackish  swamps  are  popularly  kno"wn  as  "  salt 
meadows." 

^Marsh  soils  which  are  composed  for  the  gi'eater  part  of  true  perti,  pro- 
duced by  the  abundant  gi'owth  and  partial,  slow  decay  of  moisture-loring 
plants,  particulaiiy  the  Sphagnum  mosses,  are  aj^parently  free  from  malarial 
ti'oubles.  These  "peat  bogs"  are  often  many  feet  in  thickness.  They  are 
indigenous  rather  than  transported  soils,  but  from  other  relations  are  best 
here  considered.  The  cause  of  this  freedom  from  malaria  is  hitherto  un- 
explained, though  it  may  be  produced  by  the  antiseiDtic  action  of  the  or- 
ganic acids  in  the  peat. 

Such  deposits  occur  in  limited  areas  in  many  parts  of  the  United  States, 
but  with  us  never  occupy  the  extent  of  tenitory  covered  by  them  in  certain 
parts  of  the  Old  World,  as  Ii-eland,  Central  Germany,  and  Scandinaria  in 
particular.  In  Great  Britain  they  are  kno^\Ti  as  "moors "or  "heaths," 
and  in  America  these  are  found  only  in  Newfoundland,  Labrador,  etc. 

The  marine  alluvium  forming  oiu*  salt  meadows,  composed  of  the  de- 
caying remains  of  certain  grasses  and  rushes,  mixed  with  a  small  percen- 
tage of  silt,  also  seems  non-malarial  when  undistiu-bed,  perhaps  fi'om  a 


CHABACTEES  AND  DISTRIBUTIOIS"  OF  AMERICAN  SOILS.  441 

similar  cause  to  that  above  suggested.    These  "  meadows  "  are  found  along 
the  coasts,  wherever  land  is  occasionally  flooded  by  salt  water. 

(e)  Alkaline  Soils. — So  much  of  the  Far  West  is  covered  by  alkaline  plains 
that  they  here  deserve  notice.  The  soil  is  generally  a  light  loam,  some- 
times clayey  or  sandy,  containing  but  a  limited  amount  of  organic  matter, 
but  saturated  with  sulphates,  carbonates,  or  chlorides  of  soda,  potash,  mag- 
nesia, and  lime.  These  salts  render  the  waters  which  they  carry  intensely 
purgative,  and  almost  useless  for  domestic  or  manufacturing  purposes. 
Little  is  known  regarding  the  salubrity  of  these  soils,  but  the  fact  that  good 
water  must  either  be  pumped  from  a  very  great  depth  or  transported  long 
distances,  renders  their  occupation  improbable  except  in  favored  localities. 
Another  unfavorable  feature  is  experienced  in  the  clouds  of  alkali  dust 
blown  about  by  the  winds. 

Geograj)hically,  alkahne  soils  are  mostly  restricted  in  the  United  States 
to  the  Great  Basin — the  valley  lying  between  the  Rocky  Mountains  and  the 
Sierra  Nevada.  They  extend  over  portions  of  Idaho,  "Utah,  Wyoming, 
Nevada,  Arizona,  and  New  Mexico,  and  occupy  regions  formerly  covered 
by  extensive  inland  seas,  which  have  now  been  mostly  drained  away  by 
the  cutting  down  of  the  river  channels.  The  Great  Salt  Lake  of  Utah  and 
other  smaller  bodies  of  alkaline  water  still  remain. 

(f)  The  Sea-shore  Sands. — These  form  important  soils,  as  they  are  uni- 
formly healthful ;  and  although  for  many  reasons  they  are  seldom  selected 
for  permanent  habitations,  their  salubrity  is  unquestionable. 

(g)  Artificial  Soils. — Under  this  heading  we  here  include  all  deposits 
produced  by  artificially  filling  in  low  grounds.  In  laying  out  towns  and 
villages,  and  the  subsequent  construction  of  streets  and  buildings,  it  gen- 
erally becomes  expedient  to  bring  the  surface  of  the  ground  to  a  certain 
degree  of  uniformity  by  removing  the  tops  of  hills  and  filling  up  the  de- 
pressions, which  are  often  marshy.  This  practice  becomes  particularly 
necessary  in  large  cities,  where  land  is  very  valuable.  The  objects  gen- 
erally sought  by  "  filling  in  "  are  twofold  :  First,  bringing  the  surface  to  a 
desirable  grade  ;  second,  depositing  material  on  a  swampy  place  to  "  dry  it 
up,"  and  thus  escape  the  expense  of  properly  draining  it.  The  latter  object 
is  usually  only  apparently  attained,  and  is  always  done  with  the  very  great 
risk  of  producing  subsequent  sickness.  The  great  mortality  in  certain 
sections  of  our  cities  is  often  directly  traceable  to  mistakes  made  in  prepar- 
ing the  soil  for  building,  by  this  obnoxious  practice,  which  cannot  be  too 
strongly  condemned. 

The  areas  of  former  swamps,  and  the  channels  of  former  streams, 
now  covered  up,  are  apparent  in  the  relative  health  of  people  residing  on 
ground  formerly  occupied  by  them,  and  that  of  the  inhabitants  of  districts 
originally  dry.  All  such  places  should  be  thoroughly  drained  before  grad- 
ing and  building  are  begun,  and  the  authorities  should  insist  that  these 
precautions  be  taken. 

If  it  were  not  for  the  decidedly  objectionable  character  of  the  filling 
generally  employed,  such  soil  might  be  less  dangerous  ;  but  all  kinds  of 
waste  matter  and  rubbish  get  mingled  with  the  dirt,  and  a  very  unhealthy 
soil  is  the  result.  Besides  this  consideration,  the  mere  filling  up  of  a  wet 
hollow  does  not  efifect  any  real  drying  or  drainage,  but  rather  lessens  the 
possibility  of  the  stagnant  waters  disappearing  by  evaporation  ;  for  the  dirt 
becomes  saturated  with  water,  and  this  mixing  with  the  organic  portions 
produces  a  wet,  nasty,  almost  invariably  malaiial  soil,  with  no  chance  of 
effective  drainage. 

We  do  not  protest  against  filling  a  naturally  dry  depression  with  a  nat- 


442  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

urally  healthy  soil,  and  see  no  valid  reason  why  it  should  be  unhealthy. 
And  even  a  soil  charged  ^\^.th  organic  matter  may  ultimately  become  salu- 
brious when  used  for  this  purpose,  if  deposited  on  a  dry  substratum,  by 
oxidation  and  consequent  removal  of  the  orgaiiic  matters  contained ;  but 
we  do  not  recommend  this  practice. 

B. — Indigenous  Soils. 

These  result  from  the  decomposition  and  disintegration  of  rocks  in  situ, 
and  their  amount  is  constantly  increasing,  for  reasons  and  by  agencies  al- 
ready alluded  to.  The  character  of  the  rock  from  which  they  are  derived 
determines  their  structure  and  composition,  although  their  constituents 
are  sometimes  so  much  changed  in  the  processes  of  decay,  that  chemically 
they  may  be  essentially  different  from  the  original  rock.  Indigenous  soils 
are  greatest  in  amount  in  the  non-glaciated  parts  of  the  country,  where 
they  form  most  of  the  superficial  accumulations,  but  occur  also  to  some 
extent,  throughout  all  northern  North  America,  wherever  the  Glacial  Drift 
is  thin  or  wanting.  The  presence  of  large  quantities  of  Glacial  Drift  pre- 
vents or  retards  their  formation. 

The  most  important  of  these  soils  may  thus  be  classified  : 

(a)  Soils  derived  from  Granite,  Gneiss,  Trap.,  PorpJiyry,  and  Feld spathic 
Bocks  generally. — These  are  either  stiff  or  loose  clays,  or  loams,  a  true 
sand}'  soil  rarely  being  formed  from  such  rocks,  and  they  are  not  to  be 
regarded  as  highly  salubrious,  although  the  inclination  of  the  strata  may 
often  give  sufficient  slope  to  the  surface  of  the  deposits  to  provide  good 
drainage. 

Soils  produced  from  such  rocks  are  found  in  patches  along  the  eastern 
side  of  the  Appalachian  ^Mountain  system  (particularly  from  Western  New 
Jersey,  southward),  in  certain  parts  of  the  Rocky  Mountain  system  and  the 
Sierra  Nevada,  and  elsewhere  in  the  Far  West.  These  feldspathic  rocks 
ai'e  always  associated  with  hilly  or  mountainous  districts. 

(b)  Soils  derived  from  Slates  or  Shales. — Clayey  soils  result  also  from 
the  disintegration  of  these  rocks,  as  they  are  mostly  composed  of  this  min- 
eral, and  are  dangerous,  unless  the  strata  are  sufficiently  tilted. 

Soils  resulting  fi-om  this  source  are  found  abundantly  along  the  southern 
and  middle  portions  of  the  Appalachian  Mountains,  and  in  many  pai'ts  of 
the  southern  and  central  States  and  the  Far  West. 

(c)  Soils  derived  from  Sandstones. — The  breaking  down  of  this  rock 
produces  sandj'  or  loamy  soils,  clay  never  resulting  from  this  source. 
These  are  very  generally  salubrious,  unless  rendered  dangerous  by  local 
conditions  of  sewerage  or  improper  disposal  of  refuse,  which,  it  may  be 
here  remarked,  will  render  the  most  desirable  soil  unhealthy.  Such  soils 
are  so  common  south  of  the  Glacial  Drift,  that  no  attempt  at  indicating 
their  distribution  need  be  made. 

(d)  Soils  derived  from  Limestones  or  Marbles. — Calcareous  soils  result 
from  the  decomposition  of  these  rocks,  and  almost  invariably  accompany 
them.  Even  when  the  rocks  are  overspread  by  other  deposits,  the  soils 
are  usually  somewhat  impregnated  with  lime. 

Excepting  the  prevalent  occurrence  of  hard  waters,  these  soils  are  gen- 
erally desirable,  their  drainage  being  good.  They  ai'e  widespread  in  dis- 
tribution. 


CLIMATOLOGY  AND  METEOROLOGY. 

BY  J.  G.  EICHAEDSON,  M.D., 

Professor  of  Hygiene  in  the  University  of  Pennsylvania. 

Climatology. 

The  problem  of  furnishiiig  a  proper  definition  of  Climate,  abandoned 
as  hopeless  by  Dr.  Parkes  in  the  body  of  this  work,  is  to  a  certain  extent 
solved  by  Prof.  Loomis,  in  his  excellent  treatise  on  Meteorology,  by  the 
following  description  of  what  it  is,  and  depends  upon.  "  By  the  climate 
of  a  coiintry  we  understand  its  condition  relative  to  all  those  atmospheric 
phenomena  which  influence  organized  beings.  Chmate  depends  upon 
the  mean  temperature  of  the  year  ;  upon  that  of  each  month  and  each  day  ; 
upon  the  maximum  and  minimum  temperatures  ;  upon  the  frequency  and 
suddenness  of  the  atmospheric  changes  ;  upon  the  transparency  of  the 
atmosphere  and  the  amount  of  solar  radiation  ;  upon  the  moistui-e  of  the 
air  and  earth  ;  upon  the  prevalence  of  fogs  and  dew  ;  the  amount  of  rain 
and  snow  ;  the  frequency  of  thunder-storms  and  hail ;  the  direction,  force, 
and  dryness  of  the  winds,  etc.  All  these  particulars  can  only  be  deter- 
mined by  long-continued  and  careful  observations." 

The  magnificent  basis  for  a  comprehensive  system  of  American  CHma- 
tology  which  is  being  rapidly  laid,  by  the  diligent  observations  in  all  parts 
of  the  country  of  our  Signal  Service  Bureau,  will  doubtless  afford  us  in  the 
near  future  most  important  practical  results  ;  but  as  yet  the  chief  triumphs 
of  this  valuable  department  have  been  gained  in  the  science  of  meteorology, 
under  which  head  they  wiU  be  considered  more  in  detail. 

The  study  of  chmate  has  been  especially  aided  in  America  by  the  ob- 
servations tabulated  in  the  admirable  Isothermic  maps  (pp.  463,  464)  for 
which  we  are  so  much  indebted  both  to  the  Smithsonian  Institution  and  to 
the  United  States  Signal  Ofiice.  The  subject  appears  therefore  to  require 
a  more  detailed  exposition  than  that  given  in  the  body  of  this  book. 

As  Baron  Humboldt  in  his  "  Cosmos  "  remarks,  "  If  the  surface  of  the 
earth  consisted  of  one  and  the  same  homogeneous  fluid  mass,  or  of  strata 
of  rock  having  the  same  color,  smoothness,  density,  and  jDower  of  absorbing 
heat  from  the  solar  rays,  and  of  radiating  it  in  a  similar  manner  thi'ough 
the  atmosphere,  the  isothermal,  isotheral,  and  isochimenal  lines  would  all 
be  parallel  to  the  equator.  In  this  hypothetical  condition  of  the  earth's 
surface  the  power  of  absorbing  and  emitting  heat  would  everywhere  be 
the  same  in  the  same  latitudes." 

But  as  such  is  by  no  means  the  case,  we  find  an  infinite  variety  of  tem- 
perature, humidity,  and  amount  of  rainfall  existing  at  places  upon  the 
earth's  surface  at  the  same  distance  from  the  equator.  Hence  places 
having  exactly  the  same  latitude  may  possess  widely  different  climates. 


444  AMERICAN    APPENDIX   TO    PARKES'    HYGIENE. 

As  observed  by  Surgeon  General  Hammond,  "  the  climate  of  the  United 
States  is  colder  than  that  of  European  regions  of  the  same  latitude,  but 
warmer  than  places  similarly  situated  in  Asia.  Thus  the  fortieth  parallel 
of  north  latitude  passes  through  Philadelphia,  and  the  forty-first  runs  a 
few  miles  north  of  Naples.  The  mean  annual  temperature  of  the  former 
place  is  54.57°,  as  determined  from  observations  extending  over  six  years 
(for  twenty-four  years  ending  1876  the  mean  was  54.51''),  while  of  the 
latter  it  was  62.06°,  as  deduced  from  observations  continued  through 
eighteen  years.  The  fortieth  parallel  also  passes  through  Pekin,  but  there 
the  mean  annual  temperature  is  but  about  52°." 

Dr.  Hammond  thinks  that  the  theories  which  seek  to  explain  these  re- 
markable variations  on  the  ground  that  different  proportions  of  the  soil 
are  under  cultivation  in  Europe  and  America,  are  insufficient,  and  that  the 
probable  causes  exist  in  the  facts  that  the  prevailing  winds  of  Europe 
come  from  the  Atlantic  ocean,  and  being  loaded  with  moisture,  give  out  their 
latent  heat  as  the  vapor  they  carry  with  them  is  condensed  into  rain,  and 
that  the  Gulf  Stream,  rushing  out  of  the  Gulf  of  Mexico  heated  to  over 
seventy  degrees,  sweeps  along  the  northern  coasts  of  Europe  and  mitigates 
their  frigidity.  Moreover,  Europe  extends  north  to  about  the  seventy-first 
degree  only,  and  is  then  bounded  by  an  open  ocean  ;  whereas  tlie  conti- 
nent of  America  extends  to  the  eightieth  degree  of  north  latitude,  and  is 
enclosed  by  a  sea  of  ice.  "  From  this  region  cold  winds  proceed,  untem- 
pered  by  passing  over  any  intervening  water,  and  reduce  the  temperature 
of  the  whole  of  North  America."  Thus,  for  instance,  the  Isotherm,  or  Iso- 
thermic  hne  of  51°,  upon  which  occurs  the  same  mean  annual  temperature 
of  51°,  enters  our  Pacific  coast  high  up  near  Vancouver  Island,  on  the 
border  of  British  America,  crosses  the  continent  in  an  irregular  diagonal 
toward  the  Mississippi  Eiver  near  St.  Louis,  passes  almost  through  New 
York,  curves  upward  again  toward  the  Arctic  cii'cle  in  the  Atlantic,  in  con- 
sequence of  the  Gulf  Stream,  descends  in  Great  Britain  so  as  to  pass 
nearly  through  London,  traverses  Russia  near  Odessa,  China  near  Pekin, 
and  Japan  near  Kanagawa. 

As  a  general  result  of  the  investigations  upon  which  isothermal  charts 
are  founded,  we  find  that  in  the  northern  hemisphere,  the  west  side  of  the 
continent  is  the  warmer,  and  the  eastern  colder,  although  to  this  general- 
ization a  few  exceptions  are  met  with.  Even  in  the  island  groups  of  the 
northern  half  of  our  globe,  this  rule  generally  holds  good,  the  tempera- 
ture of  those  upon  the  eastern  coast  being  cold,  whilst  those  upon  the 
western  coast  are  relatively  warmer. 

In  the  southern  hemisphere  the  case  is  reversed,  the  eastern  side  of 
the  continents  being  warmer  than  the  western,  so  that  the  Isotherms 
which  pass  over  South  America  and  Africa,  curve  downward  upon  the  map, 
that  is  away  from  the  equator,  in  crossing  these  continents,  in  consequence 
of  a  mean  annual  temperature  of  70°,  for  example,  being  found  nearer  the 
south  fi'igid  zone,  upon  the  eastern  than  upon  the  western  coast. 

The  appended  Isothermic  maps,  copied  by  the  kind  permission  of  the 
Office  from  "Professional  Papers  of  the  Signal  Service,  No.  2,"  show  at  a 
glance  the  mean  monthly  temperature  for  January  (winter),  and  for  July 
(summer),  during  the  ten  years  preceding  1881,  for  different  portions  of 
the  United  States. 

They  constitute  some  of  the  most  important  contributions  to  practical 
Hygiene  yet  furnished  from  the  Signal  Service  Bureau,  and  being  thor- 
oughly accurate  and  rehable,  will  no  doubt  frequently  aid  our  readers  in 
judiciously  directing  invalids,  especially  phthisical  patients,  for  whom  they 


CLIMATOLOGY    AND    METEOEOLOGY.  445 

are  anxious  to  secure  the  potent  remedial  effects  of  removal  to  a  more 
suitable  climate. 

In  the  United  States  the  hottest  portion  is  the  southern  end  of  Florida, 
and  next  to  this  rank  Southern  Texas,  and  Southwestern  Arizona.  The 
mean  annual  temperature  of  the  whole  country  is  not  far  from  53°  F.  The 
areas  of  territory  having  a  mean  annual  temperature  above  55°,  comprise 
the  entire  cotton  region,  those  above  70°  the  sugar  and  rice  regions,  and 
between  50°  and  60°  is  included  most  of  the  tobacco  region.  As  may  be 
seen  by  consulting  the  accompanying  Isothermic  maps  (pp.  463,  464),  the 
cotton-growing  sections  lie  between  the  Isotherms  for  July  (the  hottest 
month),  of  75°  and  85°,  the  winter  limit  of  the  cotton  region  being  that  of 
the  Isotherm  of  35°  for  January  nearly.  The  regions  ranging  between  75° 
and  85°,  average  July  temperature,  appear  to  include  all  those  portions 
which  are  liable  to  epidemics  of  yeUow  fever. 

The  coldest  regions  are  found  in  the  noi-thern  part  of  New  England, 
Northern  Michigan,  Wisconsin,  and  Minnesota,  and  the  high  mountain  re- 
gion of  the  Cordilleras. 

On  the  whole  Atlantic  coast  from  Penobscot  Bay  to  the  mouth  of  the 
Eio  Grande,  and  the  whole  coast  of  the  great  lakes,  besides  a  considerable 
portion  of  the  Pacific  coast,  the  highest  observed  temperatures  range  from 
95°  to  100°.  The  Atlantic  plain  stretching  from  the  eastern  base  of  the 
Appalachian  system  of  mountains  to  the  neighborhood  of  the  coast,  and 
nearly  all  of  the  Mississippi  VaUey,  range  in  their  highest  summer  tem- 
perature between  100°  and  105°.  This  difference  is,  of  course,  due  to  the 
absence  of  any  cooling  influence  from  the  Atlantic  sea  breezes. 

The  highest  maximum  temperature  is  reported  from  Southwestern  Ari- 
zona, and  from  Southwestern  California,  where  the  thermometer  is  said  to 
have  registered  135°  in  the  shade.  The  average  maximum  on  the  Pacific 
coast  is  lower  than  on  the  Atlantic  coast,  ranging  between  90°  and  100°, 
but  at  some  distance  inland  in  the  great  valley  of  California  the  elevated 
temperatures  mentioned  are  met  with. 

The  distribution  of  population  in  accordance  with  mean  annual  tem- 
perature, throughout  the  wide  domain  of  our  Union,  is  a  question  of  much 
interest,  and  valuable  light  has  been  thrown  upon  it  by  recent  bulletins 
from  the  Census  office. 

According  to  these  Government  statistics,  it  appears  that  ninety-eight 
per  cent,  of  the  total  population  of  the  United  States  reside  in  regions  the 
mean  annual  temperatures  of  which  range  between  40°  and  70°  F. ;  eighty- 
two  per  cent,  dwell  in  sections  which  have  a  mean  annual  temperature  of 
60°  or  under  ;  sixty-nine  per  cent,  in  regions  where  the  temperature  is  at 
or  below  an  average  of  55°  ;  and  thu-ty-eight  per  cent,  inhabit  portions  of 
the  country  the  highest  mean  annual  temperature  of  which  is  50°.  From 
the  same  source  we  also  learn  that  ninety-seven  per  cent,  of  our  fellow- 
countrymen  are  exposed  to  summer  heats  which  have  a  range  of  20°  only, 
lying  between  the  mean  temperatures  for  July  of  65°  and  85°  F.  This 
leaves  a  scattering  fringe  of  population  of  only  three  per  cent,  outside  of 
these  Hmits,  who  suffer  a  more  intense  average  heat  or  cold. 

The  brief  but  interesting  statements  of  Professor  Parkes  in  the  text  of 
this  work,  under  the  section  treating  of  the  effect  of  lessened  pressure  of 
the  air  as  a  climatic  factor,  and  especially  in  its  relations  to  Phthisis,  may 
be  appropriately  supplemented  here  by  some  account  of  our  own  health 
resorts,  which  have  been  especially  studied  by  American  physicians  in 
reference  to  that  most  fatal  disease  upon  most  of  death  registers  of  the 
Northern  States — pulmonary  consumption. 


446  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

Among  the  most  valuable  of  the  inland  resorts,  so  useful  as  refuges 
from  the  rigors  of  a  northern  winter  in  New  England  and  the  Middle 
States,  must  be  mentioned  Aiken,  S.  C. 

Aiken  is  built  on  the  water  shed  between  the  Savannah  and  Edisto 
Rivers,  and  possesses  the  great  recommendation  of  a  Ught  porous  soil  from 
which  the  numerous  rains  readily  drain  off.  It  is  situated  near  the  iso- 
therm of  48°  mean  winter  (January)  temperature,  and  therefore  enjoys 
great  advantages  over  New  York  and  Philadelphia,  which  he,  it  may  be 
remembered,  near  the  isotherm  of  30°  for  the  same  month.  The  town 
possesses  several  excellent  hotels  and  boarding-houses,  good  markets, 
agreeable  society,  and  visitors  can  enjoy  many  pleasant  walks  and  di'ives 
over  the  neighboring  country.  It  is  120  miles  from  Charleston  and  67 
miles  from  Augusta,  Ga.,  with  both  of  which  it  is  connected  by  rail. 
Phthisical  patients  who  seek  the  benefits  of  cHmate  at  Aiken  can,  therefore, 
best  reach  their  destination  by  taking  passage  by  steamer  from  noi-thern 
ports  to  Charleston,  unless  symptoms  of  active  pidmonary  congestion  or 
actual  haemoptysis  render  a  sea-voyage  unsafe. 

No  signal  service  reports  from  Aiken  are  available,  but  those  from  At- 
lanta, seventeen  miles  distant,  give  a  mean  (coiTccted)  barometric  pressure 
for  1880  of  30.063  inches,  with  variations  during  twelve  months,  from  a 
minimum  in  March,  1881,  of  29.425  to  a  maximum  in  November,  1880,  of 
30.603  inches.  The  average  temperature  for  1880  was  62.1°  F.,  the  ex- 
tremes being  94°  in  July  and  1°  in  December.  In  November,  1880,  the 
mean  temperature  was  47.7° ;  in  December,  42.4° ;  in  January,  1881,  40.1°  ; 
in  February,  46°;  in  March,  48.7°,  and  in  April,  59.1°. 

The  rainfall  at  Aiken  is  rather  high,  averaging  about  55  inches,  and 
that  for  Atlanta  being,  in  1880,  62.7  inches,  of  which  8.21  fell  in  November 
and  5.7  in  December,  and  in  January,  February,  and  March,  the  monthly 
precipitation  was  8.35,  10.41,  and  10.98  inches,  respectively.  The  relative 
humidity  of  Atlanta  in  1880  averaged  66.7.  The  prevaihng  winds  at  Aiken 
are  from  the  S.W.,  and  are  fairly  warm  and  dry,  although  they  alternate 
occasionally  with  N.E.  and  E.  winds,  which  are  very  trying  to  the  invalid. 

Phthisical  patients  are  said  to  improve  at  Aiken  for  a  month  or  six 
weeks  veiy  satisfactorily,  and  then  become  subject  to  disappointing  re- 
lapses. Hence  it  is  a  good  locahty  to  direct  a  patient  to  if  he  has  con- 
tracted suspicious  bronchitis,  or  has  developed  slight  symptoms  of  pul- 
monary deposit  during  February,  in  a  more  northern  latitude.  March  can 
be  agreeably  spent  at  Aiken  by  such  invalids,  but  they  are  apt  to  find  the 
heat  oj^pressive  by  the  middle  of  April,  and  it  then  becomes  preferable  to 
move  slowly  northward.  A  physician  of  large  personal  experience  has 
given  his  oiiinion,  that  sojourning  in  Aiken  through  December  and  part  of 
January,  and  then  going  back  to  it  in  March  on  the  way  homeward,  after  a 
toiu'  through  Florida  during  the  latter  half  of  January  and  the  whole  of 
February,  is  a  programme  which  suits  most  consumptives  better  than  a 
continuous  residence  for  the  winter  in  either  one  or  the  other  of  these 
places.  An  important  consideration  to  invalid  tourists  is  that  malarial  dis- 
eases are  nearly  or  quite  unknown  among  the  inhabitants  of  Aiken. 

In  regard  to  the  climate  of  Florida,  it  is  probable  the  northern  part  of 
the  State  has  little  advantage  over  Aiken  and  Savannah,  although  great 
numbers  of  consumptive  patients  visit  and  spend  some  time  in  Jackson- 
ville, being  attracted  by  its  superior  accommodations  and  ease  of  access. 
Indeed,  many  remain  at  this  point  who  would  perhaps  be  improved  by  a 
nearer  appi'oach  to  the  equator,  where,  as  for  example  at  Enterprise,  the 
balmy  aii-  and  bright  sunshine  (which  contribute  to  give  the  peninsula  its 


CLIMATOLOGY    AND    METEOEOLOGT.  447 

name  of  "  the  Land  of  Flowers  "  )  are  Tery  important  and  valuable  to  the 
invalid. 

The  mean  height  of  the  barometer,  for  1880,  at  Jacksonville  was  30.108 
inches.  The  mean  temperature  for  the  same  year  was  70. 1'',  with  exti'emes 
diu'ing  twelve  months  ranging  from  99^  in  June,  1881,  to  19^  in  December, 
1880.  The  mean  temperature  for  November,  1880,  was  61.2°  ;  for  Decem- 
ber, 52.2^  ;  for  January,  1881,  52.7°  ;  February,  57.9° ;  March,  59.5°  ;  the 
mean  relative  humidity  was  71.8,  and  the  rainfall  for  1880  amounted  to 
65.51  inches,  of  which  16.25  inches  fell  in  the  month  of  September. 

The  various  resorts  upon  the  St.  John's  River  in  Florida,  in  the  neigh- 
borhood of  and  southward  of  Entei^Drise,  possess  the  advantages  of  an  equable 
climate,  moist  warmth,"  abundant  opportunity  for  outdoor  life,  and  a  good 
sup2:)ly  of  small  game  and  fresh  fruits.  The  chief  drawbacks  are  the  de- 
ficiency of  milk  and  of  good  fresh  meat,  and  the  presence  of  insects,  rep- 
tiles, and  malaria.  To  obtain  the  greatest  benefit  from  the  chmate  one 
must  absolutely  live  in  the  open  ah',  from  an  hour  after  sunrise  to  half  an 
hour  before  sunset. 

The  climate  of  Key  West,  on  the  southern  extremity  of  Florida,  is  said 
to  be  the  warmest  and  most  equable  on  the  eastern  coast  of  the  United 
States.  Even  in  January  the  south  winds  are  frequently  oppressive  and 
debilitating.  From  five  to  ten  "  northers  "  occur  every  winter,  and  though 
they  are  disagi'eeable  on  account  of  the  riolent  wind,  they  do  not  often 
reduce  the  temperatui'e  below  40°.  Dr.  D.  G.  Brinton  ("  Florida  and  the 
South ")  says  in  regard  to  Key  West,  though  the  proximity  of  the  Gulf 
Stream  renders  the  air  very  moist,  mists  and  fogs  are  extremely  rare, 
owing  to  the  ecjuability  of  the  temperatiu-e  ;  and  though  the  hygrometer 
shows  that  the  air  is  constantly  loaded  with  moisture,  this  same  equability 
allows  the  moon  and  stars  to  sliine  with  a  rare  and  glorious  brilliancy,  such 
as  we  see  elsewhere  on  dry  and  elevated  plateaux.  Another  effect  of  the 
Gulf  Stream  may  also  be  noted.  Every  evening,  shortly  after  sunset,  a 
cloud  bank  rises  along  the  southern  horizon  in  massive  irregailar  fleeces, 
dark  below  and  silver  gilt  above  by  the  rays  of  the  departing  sun.  This  is 
the  bank  of  clouds  over  the  Gulf  Stream,  whose  vast  cuiTent  of  heated  water 
is  rushing  silently  along  some  twelve  miles  distant.  The  mean  height  of  the 
barometer  at  Key  West  for  1880  was  30.076,  the  mean  temperature  for  the 
same  year  was  78.7°,  with  extremes  dui'ing  twelve  months  ranging  from  97° 
in  July,  1880,  to  56°  in  March,  1881.  The  mean  temperature  for  Novem- 
ber, 1880,  was  78.5°  ;  for  December,  70.1°  ;  for  January,  1881,  72.2°  ;  for 
Februaiy,  70.9°  ;  March,  70.6°,  and  for  April,  75.0° ;  the  mean  relative 
humidity  for  1880  was  73.4,  and  the  rainfall  for  the  same  year  only  33.41 
inches,  of  which  but  0.71  inch  was  precipitated  in  December. 

Although  much  injiuy  to  the  health  is  often  experienced  by  the  invalid 
from  the  malarious  affections  contracted  in  the  interior  of  the  State,  the 
sea-coast  of  Florida  is  said  to  be  entirely  exempt  from  these  dangerous 
maladies,  at  least  dui-ing  the  late  autumn  and  winter  months.  The  humid 
atmosphere,  which  while  it  tends  to  ease  cough  in  some  instances,  does 
appear  in  others  to  promote  the  softening  of  tubercular  deposit,  and  the 
frequently  crowded  condition  of  the  hotels  and  boarding-houses,  which 
often  compels  patients  affected  with  incipient  phthisis,  to  hear  and  see  the 
sufi'erings  of  others  in  the  advanced  stages  of  their  own  disease,  are  the 
chief  di'awbacks  to  the  incontestable  benefits  which  this  charming  climate 
affords  in  many  instances. 

The  climate  of  the  West  Indies  is  mild  and  balmy,  and  cases  of  phthisis 
often  improve  for  a  few  weeks  after  their  arrival  in  Havana,  Barbadoes, 


448  AMERICAN    APPENDIX    TO    PAKKES'    HYGIENE. 

etc.,  as  well  ■  as  in  the  Bermudas  and  tlie  Bahama  Islands.  Under  these 
circumstances  patients  gain  rapidly  in  weight,  often,  it  is  said,  at  the  rate  of 
three  or  four  pounds  a  week.  But  after  a  month  or  two  this  temporary 
improvement  is  apt  to  be  followed  by  a  period  of  depression,  especially  if 
the  debilitating  heats  of  early  spring  happen  to  come  on,  and  if  the  home- 
sick sufferer  should  incur  a  bronchial  attack,  as  often  is  the  case  during  his 
voyage  back  to  Charleston  or  Savannah,  all,  and  it  may  be  more  than  all, 
the  advantages  previously  gained  are  soon  sacrificed. 

The  climate  of  Texas  has  of  late  years  been  growing  in  favor  as  a  rem- 
edy for  consumption,  although  in  the  State  itself  a  well-founded  popular, 
as  well  as  medical  opinion,  demands  that  the  phthisical  patient  should 
spend  the  whole  year  and  not  a  jDart  of  it  only,  in  that  region,  if  he  hopes 
for  arrest  of  his  disease.  The  atmosi^here  of  the  Texan  table-lands  has  the 
great  advantage  over  tliat  of  Florida,  of  being  dry  instead  of  moist,  at  the 
same  time  that  it  is  sufficiently  warm,  and  therefore  allows  likewise  abun- 
dant outdoor  exercise,  and  promotes  freedom  from  catarrhal  attacks. 
Great  dryness  of  the  air  appears  to  have  a  directly  curative  influence  over 
some  cases  of  pulmonic  phthisis,  and  really  to  arrest  or  prevent  the  soften- 
ing of  tuberciilar  deposit. 

Prof.  H.  C.  Wood,  in  a  recent  article  on  this  subject,  states  that  Santa 
Fe,  which  is  the  capital  of  the  Territory  of  New  Mexico,  has  probably  the 
most  attractive  climate  of  the  whole  arid  belt  which  stretches  over  hun- 
dreds of  miles  through  New  Mexico  and  Texas.  It  is  situated  on  an  ele- 
vated jilateau  about  seven  thousand  feet  above  the  sea-level,  and  this 
moderate  elevation,  which  is  not  in  most  instances  sufficient  to  affect  the 
consumptive  seriously,  is  enough  to  give  immunity  from  the  excessive  heat. 
This  elevated  temperature  in  the  whole  of  the  Texan  Rio  Grande  region  is 
terribly  severe,  and  rendered  the  United  States  Post  at  Presidio  so  intoler- 
able that  it  had  to  be  abandoned.  Dr.  Wood  informs  us  that  the  com- 
manding officer  reported  the  thermometer  as  standing  frequently  at  mid- 
night during  the  month  of  June,  at  110^^  Fahr.  in  the  coolest  of  the 
dwellings  in  Presidio.  From  such  intense  heat  tlie  climate  of  Santa  Fe 
affords  an  invalid  visitor  therefore  most  welcome  relief.  The  mean  height 
(corrected  to  sea)  of  the  barometer  at  Santa  Fc  for  1880  was  29.809  inches, 
the  mean  temperature  for  the  same  year  45.4°,  with  extremes  during 
twelve  months  ranging  from  11°  below  zero  in  November,  1880,  to  92°  in 
June,  1881  ;  the  mean  temperature  for  November,  1880,  was  29.6°  ;  for 
December,  29.4°;  for  January,  1881,  23.7° ;  for  February,  33.6°  ;  for  March, 
86.7'^,  and  for  April,  51.2°.  The  mean  relative  humidity  for  1880  was  45.9, 
and  the  total  rainfall  for  1880  only  9.89  inches,  of  which  but  0.94  inch 
was  precipitated  in  November  and  December  of  that  year. 

In  regard  to  the  climate  of  Minnesota,  which  although  less  in  vogue 
than  formerly,  perhaps,  is  still  visited  by  many  of  the  less  debilitated 
phthisical  patients,  we  find  by  the  Signal  office  reports  that  the  mean  height 
of  the  barometer  at  St.  Paul  for  1880  was  29.926  inches,  the  mean  tem- 
perature for  the  same  year  44.1°  with  a  range  during  twelve  months  from 
—  27°  in  December  to  98°  in  August  of  1880.  The  mean  temperature  for 
November,  1880,  was  22.2°  ;  for  December,  13.9°  ;  for  January,  1881,  7.7°  ; 
for  February,  17.1°  ;  for  March,  30.3°  ;  and  for  April,  43.1°.  the  mean  rela- 
tive humidity  for  1880  was  69,  and  the  amount  of  rainfall  in  the  same  year 
29.76  inches,  which  was  precipitated  as  rain  on  eighty-two  days,  and  as 
snow  on  fifty  days  during  the  year.  Dr.  Staples,  of  Minnesota,  claims  that 
owing  to  the  geographical  position  of  his  State,  the  altitude  and  general 
physical  condition  of  the  surface  of  the  country,  the  nature  of  the  soil,  the 


CLIMATOLOGY   AISTD    METEOROLOGY.  449 

temperature  and  comparative  dryness  of  the  atmosphere,  the  character  of 
the  sun's  Hght,  the  freedom  from  all  forms  of  paludal  poison,  and  to  other 
causes,  the  climate  of  Minnesota  is  stimulating  and  favorable  in  its  effect 
upon  diseases  of  the  lungs  and  air-passages,  which  are  dependent  upon 
and  characterized  by  debility,  imperfect  digestion  and  assimilation,  and 
the  tubercular  or  strumous  diathesis.  Also,  that  the  beneficial  effects  of 
the  climate  are  largely  due  to  influences  exerted  directly  or  indirectly  upon 
the  functions  of  nutrition.  And  lastly,  that  acute  lobar  pneumonia  is  not 
to  any  great  extent  prevalent  in  Minnesota,  although  chronic  forms  of 
pneumonic  inflammation  do  occur,  and  that  the  cases  of  phthisis  originat- 
ing in  the  State  have  been  generally  of  pneumonic  origin,  but  that  this 
does  not  conflict  with  the  fact  that  phthisis  contracted  elsewhere,  and 
under  different  climatic  conditions,  may  be  benefited  by  influences  exist- 
ing in  Minnesota.  Dr.  Staples  considers  this  final  conclusion  verified,  espe- 
cially by  observing  the  large  number  of  the  present  inhabitants  of  the 
State,  now  in  good  health,  who  came  from  other  localities  as  invalids, 
suffering  from  evident  phthisis  pulmonalis,  either  caseous  or  tuberculous  ; 
he  closes  with  the  usual  caution  against  expecting  that  merely  temporary 
residence  is  likely  to  result  in  permanent  benefit  to  the  consumptive. 

The  pure  dry  atmosphere  of  Colorado,  the  surpassing  beauty  of  its  nat- 
ural scenery,  and  its  great  comparative  accessibility,  by  way  of  the  Pacific 
railroads,  have  contributed  to  develop  this  part  of  the  eastern  slope  of  the 
Kocky  Mountains  into  a  grand  sanitarium  for  consumptives.  The  mean 
altitude  of  the  barometer  at  Denver,  Col.,  for  1880,  corrected  for  its 
5,294  feet  above  the  level  of  the  sea,  was  29.980  inches  ;  the  mean  annual 
temperature  was  47.4°,  with  a  range  during  twelve  months  from  95°  in 
July,  1880,  to  —20°,  in  February,  1881;  the  monthly  average  for  Novem- 
ber, 1880,  was  22°,  and  for  December,  29.9°  ;  the  mean  relative  humidity 
was  48.4°,  and  the  amount  of  rainfall  9.58  inches,  precipitated  as  rain  on 
thirty-eight  days,  and  as  snow  on  thirty-nine  days  during  the  year.  Dr. 
Dennison,  of  Colorado,  who  has  written  extensively  upon  this  subject,  con- 
tends that  since  lessened  barometric  pressure,  corresponding  to  24  or  25 
inches,  has  been  shown  to  form  an  important  factor  in  successful  climatic 
treatment  of  phthisis,  the  resort  to  a  well-chosen  elevated  climate  should 
constitute  part  of  a  physician's  advice  to  every  consumptive  who  can  follow 
it,  and  for  whom  the  elevation  is  not  specially  contra-indicated.  Dr.  Den- 
nison claims  that  the  "favorable  or  positive  influence  of  high  altitudes 
upon  the  progress  of  consumption  is  best  shown  in  the  commencement  of 
chronic  inflammatory  and  hemoirhagic  cases,  and  generally  in  fibrous 
phthisis  in  young  and  middle  aged  subjects,  with  little  constitutional  dis- 
turbance. The  unfavorable  or  negative  influence  of  high  altitudes  upon 
the  progress  of  consumption  is  mainly  seen  in  proportion  as  the  disease 
approaches  or  is  complicated  with  the  following  conditions,  which  are  in- 
tensified by  an  irritable,  nei-vous  state,  and  lack  of  desirable  will-power,  aided 
by  the  stimulus  and  hope  of  youth  ;  i.e.,  First,  cardiac  disease,  if  associated 
with  increased  labor  and  abnormal  activity  of  the  heart.  Second,  the  stage 
of  softening  in  acute  cases  and  with  extensive  deposit.  Third,  chronic 
third  stage  cases  with  from  one-third  to  one-half  the  lung  surface  involved 
in  diseased  changes,  if  the  thermometrical  and  other  usual  signs  of  consti- 
tutional disturbance  are  present  in  a  marked  degree." 

It  is  true  that  in  classifying,  according  to  the  two  rules  of  Dr.  Denni- 
son just  quoted,  any  particular  patient  in  one  or  the  other  group,  we  have 
decided  almost  as  much  respecting  the  prognosis  of  the  case,  as  in  regard 
to  the  propriety  of  sending  it  to  Denver,  but  as  indicating  with  certainty 
Vol.  IL— 39 


450  AMERICAN    APPENDIX   TO    PAEKEs'    HYGIENE. 

those  consumptives  wlio  should  no/ venture  into  an  elevated  region,  these  sug- 
gestions have,  we  think,  a  definite  value  to  the  medical  profession  at  large. 

The  most  injurious  efifect  of  a  rarefied  atmosphere  upon  a  phthisical 
patient  is  the  promotion  of  hemorrhage  (perhaps  a  fatal  haemoptysis),  and 
this  is  so  decided  at  the  elevation  of  Denver,  that  it  is  common  to  recog- 
nize a  new-comer,  or  "tendei-foot,"  by  the  spots  of  blood  upon  his  hand- 
kerchief. This  danger  is  so  indisputable,  that  Dr.  Dennison  further  ad- 
vises that  in  serious  cases,  approach  to  the  region  of  high  altitude  should 
be  gradual,  or  even  at  the  snail's  pace  of  an  emigi-ant  wagon,  for  example. 
The  ascent  should,  moreover,  be  guided  by  observations  carefully  made 
upon  the  degree  of  disturbance  which  circulation  and  respiration  undergo, 
in  any  particular  patient,  at  lesser  elevations.  Such  caution  should  be 
especiaUy  practised  by  those  in  whom  hemorrhage  or  acute  symptoms  ex- 
ist or  are  easily  excited. 

Another  disadvantage  of  the  climate  of  Colorado,  is  the  severity  of  its 
winters,  which  deprives  very  delicate  patients  of  much  of  that  continuous 
out-door  life,  constituting  so  large  a  factor  in  the  cure  of  curable  con- 
sumption. 

The  chmate  of  Cahfomia  has  attracted  much  attention  during  the  last 
twenty-five  years  as  a  resort  for  phthisical  patients,  one  of  its  great  rec- 
ommendations being  that  it  is  singularly  equable,  the  country  around  San 
Fi-ancisco,  and  especially  on  the  elevated  table-lands  high  up  on  its  sur- 
rounding hill-sides,  being  seldom  touched  by  frost.  On  these  bits  of  table- 
land whilst  the  au-  below  may  be  foggy  and  chilly,  as  is  very  common  at 
some  seasons,  the  invahd  may  enjoy  a  brilliant  sunshine,  and  a  crisp,  dry, 
invigorating  air  which  invites  to  plenty  of  active  out-door  exercise.  The 
days  in  these  uplands  are  praised  as  being  neither  too  hot  nor  too  cold, 
and  yet  the  night  always  brings  enough  coolness  to  render  sleeping  under 
blankets  agreeable. 

The  mean  altitude  of  the  barometer  in  San  Francisco  for  1880  was 
30.051  inches,  the  mean  temperatiu'e  for  the  same  3'ear,  Si. 2°,  with  a 
range,  during  twelve  months,  between  a  maximum  of  79"^  in  September, 

1880,  and  a  minimum  of  iO"  in  March,  1881.  The  mean  temperatvire  of 
the  month  of  November,  1880,  was  53.9°  ;  of  December  53°  ;  of  January, 

1881,  53.7°;  of  Febmary,  54.9°;  of  March,  53.8°;  and  of  April,  57.1°. 
The  mean  relative  humidity  for  1880  was  75.6,  and  the  amount  of  rainfall 
30.07  inches,  which  was  all  precipitated  as  rain  on  seventy  days  in  that  year. 

The  southern  portions  of  California  are  also  very  highly  praised  as 
health  resorts  for  consumptives,  on  account  of  their  suj^erb  climate.  Thus, 
for  example.  Dr.  Adams  of  Oakland,  Cal.,  who  went  to  the  coast  about  the 
year  18G3  an  invalid,  and  has  been  fully  restored  to  health,  declares  that 
while  Monterey,  Santa  Cruz,  Santa  Bai'bara,  San  Diego,  and  Los  Angeles 
are  the  most  desirable  of  the  many  Pacific  coast  resorts,  he  considers,  for  a 
locality  combining  all  requisites,  Monterey  stands  at  the  head  of  the  list. 
"It  is  delightfully  situated  at  the  southeasterly  extremity  of  Monterey 
Bay,  about  one  hundred  and  twenty-five  miles  south  of  San  Francisco,  and 
connected  with  it  by  the  Southern  Pacific  Eailroad,  which  passes  through 
some  of  the  most  fertile  and  beautiful  valleys  of  the  State.  Here  there  is 
security  from  both  cold  winds  and  excessive  mid-day  heat.  Contrary  to 
the  generally  received  opinion,  that  we  have  an  almost  continuous  rainfall 
in  the  winter,  this  season  is  more  hke  the  Eastern  [Atlantic  coast  ?]  spring 
weather  in  May  and  June  ;  and  diuing  the  rainy  season  or  winter  months, 
we  have  more  sunny  days  than  any  other  portion  of  the  United  States." 
Dr.  Adams  asserts  that  for  the  multitude  of  people  in  the  Eastern  and  Mid- 


CLIMATOLOaY  AND  METEOROLOGY.  451 

die  States,  who  are  suffering  from  bronchial  difficulties,  incipient  consump- 
tions, hereditary  or  acquired,  or  from  the  nervous  exhaustion  of  mental 
overwork  and  various  other  causes,  and  who  therefore  dread  a  long,  cold,  and 
changeable  winter,  the  climate  and  health  resorts  of  California  are  supe- 
rior to  most,  and  second  to  none  in  the  world.  He  urges  most  emphati- 
caily,  however,  the  eminently  wise  counsel  that  persons  with  organic  dis- 
ease of  the  lungs  in  an  advanced  stage,  should  alivays  remain  at  home 
where  they  can  have  the  loving  attention  of  family  and  friends.  The  south- 
ern California  Channel  islands  are  strongly  recommended  as  health  resorts 
by  Dr.  J.  P.  Widney,  who  asserts  that  their  peculiar  merit  is  that  while 
lying  within  the  line  of  a  semi-tropical  climate,  they  are  entirely  exempt 
from  the  scourges  of  yellow  fever,  bilious  remittent,  and  ague  ;  and  their 
comjjaratively  small  size,  and  distance  from  the  main  land  save  them  from 
strong  sea-breezes  and  coast-fogs,  and  secure  for  them  a  remarkably  equa- 
ble temperature. 

The  mean  altitude  of  the  barometer  at  Los  Angeles,  Cal.,  for  the  year 
1880  was  30.007  inches,  the  mean  temperature  for  the  same  year  58  4°, 
with  a  range  during  twelve  months  from  a  minimum  of  35°  in  November, 
1880,  to  a  maximum  of  94°  in  April,  1881.  The  average  temperature  of 
November,  1880,  was  55.5° ;  of  December,  55.3° ;  of  January,  1881, 
51.7°;  of  February,  57.9°  ;  of  March,  55.8°  ;  and  of  April,  61.4°.  The 
mean  relative  humidity  for  1880  was  69.7,  and  the  amount  of  rainfall  18.65 
inches,  all  of  which  was  precipitated  in  the  form  of  rain  on  a  total  of  fifty- 
one  days  during  the  j^ear. 

These  remarks  upon  climate  as  a  remedial  agent,  especially  in  pulmon- 
ary complaints,  would  be  incomplete  without  a  few  suggestions  in  regard 
to  practically  utihzing  such  items  of  information  in  the  management  of 
phthisis.  With  respect  to  temperature,  a  uniform  cold  chmate,  such  as 
that  of  Minnesota  or  Colorado,  is  the  best  for  some  cases  ;  and,  on  the  other 
hand,  for  others  a  change  to  a  warm  chmate  has  appeared  to  accomphsh  all 
that  could  be  desked.  In  deciding  this  branch  of  the  question  Professor  A. 
Flint  very  judiciously  advises  that  the  feelings  and  choice  of  the  patient 
should  have  considerable  weight.  If,  for  example,  we  find  on  inquiry  that 
the  invalid  when  in  health  habitually  experienced  more  vigor  and  enjoy- 
ment in  summer  than  in  winter,  removal  to  a  warm  climate  would  probably 
be  best  suited  to  his  case,  but  if  the  reverse  is  true,  a  cold  climate  is  to  be 
preferred.  Moreover  the  condition  as  regards  feebleness  has  an  important 
bearing  upon  the  problem.  If  the  patient  is  so  feeble  as  not  to  be  able  to 
live  out  of  doors  in  cold  weather,  or  if  the  reaction  from  the  impression  of 
cold  be  slow  and  imperfect,  a  warm  climate  is  more  suitable.  Dr.  Brinton 
wisely  suggests,  in  addition,  that  cold  climates  such  as  Minnesota,  Labrador, 
or  the  Canadian  highlands,  are  better  adapted  to  patients  who  are  not  or- 
dinarily subject  to  catarrhs,  irritation  of  the  pharynx,  coughs,  pneumonia, 
and  pleurisy  ;  are  not  plethoric  ;  are  free  from  rheumatic,  neuralgic,  and 
gouty  pains,  which  become  worse  as  winter  approaches  ;  whose  throats  are 
angemic  rather  than  congested  ;  whose  livers  are  torpid  ;  and  who  are  op- 
pressed and  enervated  by  heat.  The  danger  of  hemorrhage  in  cold  and 
especially  elevated  regions  has  already  been  referred  to.  In  some  doubtful 
cases  invaluable  aid  may  be  derived  from  an  examination  of  the  sputum 
microscopically,  after  liquefying  by  boiUng  with  caustic  soda  solution  ac- 
cording to  Dr.  Fenwick's  method. ' 

'  See  my  paper  on  Pulmonary  Elastic  Tissue  in  the  Early  Diagnosis  of  Phthisis : 
Transactions  New  York  State  Medical  Society,  1872. 


452  AMEEICAN    APPENDIX   TO    PARKEs'    HYGIENE. 


Ozone  and  Rainfall. 

Dr.  Parkes  has  declared  in  the  text  that,  in  spite  of  the  difficulties 
attending  them,  observations  on  ozone  should  be  continued.  Since  he 
wrote  this  his  advice  has  been  followed  both  here  and  abroad,  and  some 
of  the  American  contributions  toward  unravelling  the  mystery  which  sm- 
rounds  the  influence  of  the  curious  substance  ozone  upon  human  health 
are  here  epitomized  for  the  benefit  of  our  readers. 

A  recent  writer  in  the  Science  Weekly  reports  that  the  results  of  his  ob- 
servations confirm  those  of  Houzeau  ;  namely,  that  a  wave  of  ozonization 
foUoivs  the  storm-wave  (as  that  of  neuralgic  influence,  see  page  454,  ac- 
companies it  on  the  side),  but  lagging  from  twelve  to  forty-eight  hours  be- 
hind it,  and  appreciably  corresponding,  in  intensity  and  duration,  to  the 
force  and  continuance  of  the  air-Avave  which  precedes  that  of  ozone.  This 
gentleman  made  use  of  ozonized  test-papers,  prepared  from  starch  and 
iodide  of  calcium,  and  while  admitting  the  force  of  objections  to  the 
complete  accuracy  of  his  method  contends  that  the  comparative  coloration 
of  such  papers  is  a  valuable  guide  to  the  relative  condition  of  the  atmos- 
phere in  regard  to  ozone.  The  coloration  obtained  was  certainly  in  great 
measure  due  to  ozone,  and  its  increase  or  decrease  was  probably  caused 
in  the  same  proportion  by  this  agent.  It  is  acknowledged  that  the  con- 
temporaneous influence  of  nitrogen  oxides  may  have  deepened  the  tints, 
but  it  could  scarcely  have  nevitralized  them,  and  insomu.ch  as  the  j^apers 
were  kej)t  moist  any  error  from  the  var3ing  humidity  of  the  air  was  in 
great  measure  cancelled.  Duplicate  observations  were  made  at  ten  feet, 
and  at  forty  feet  from  the  surface  of  the  earth,  and  the  average  of  these, 
although  nearly  always  the  two  sets  of  results  proved  identical,  was  re- 
corded as  the  color  mark  of  the  hours  they  were  exposed.  In  regard  to 
the  practical  minutiae  bearing  upon  the  application  of  this  test,  it  was 
noticed  that  at  the  periods  of  strongest  ozonization  the  paj^ers  were  changed 
tluroughout,  while  at  other  times  they  were  marked  at  spots  and  near 
the  edges,  showing  an  unequal  sensitiveness  to  the  reagent.  In  supple- 
mentary trials  to  determine  the  eftect  of  the  wind  it  was  found  that  those 
papers  exjDOsed  to  a  strong  current  of  air  were  sometimes  one-third  deeper 
in  tint  than  the  jDrotected  ones,  and  reached  their  maximum  much  quicker. 
These  contrasts  were  of  course  much  lessened  with  a  diminished  velocity 
of  the  wmd. 

Dr.  A.  W.  Nicholson,  one  of  the  most  recent  investigators  of  the  re- 
lation of  ozone  to  health,  furnishes  an  imj)oi*tant  paper  uj)on  the  subject 
to  the  "Michigan  Health  Board  Report  for  1881."  Dr.  Nicholson  takes 
issue  with  Pettenkofer,  who  asserts  that  the  hj^gienic  value  of  ozone  does 
not  seem  to  be  very  great,  since  it  can  never  be  detected  in  our  dweUiugs, 
where  we  sjsend  the  greater  part  of  our  lives,  and  are  better  than  if  ex- 
posed in  the  open  aii*.  He  attributes  the  failure  of  Pettenkofer  and  others 
to  detect  ozone  in  the  air  of  inhabited  apartments  to  the  decolorizing  action 
of  carbonic  acid,  or  carbonic  oxide,  from  our  fires,  interfering  with  the 
action  of  Schonbein's  test.  After  admitting  the  difficulties  surrounding 
accurate  determination.  Dr.  Nicholson  suggests  that  when  using  Schon- 
bein's test,  in  order  to  obtain  the  best  results  of  an  observation,  where  it 
is  necessary  to  guard  against  excess  of  moisture,  the  exposure  of  a  wet  and 
a  dry  shp  of  the  prepared  paper  at  the  same  time  appears  to  be  the  proper 
method  to  adopt.  Also  it  is  well  to  suspend  these  slips  at  points  where 
the  condensation  of  moistm-e  would  be  least  apt  to  occur.     To  render  the 


CLi:\rATOLOCTY    AXD    METEOROLOGY.  453 

paper  more  sensitive  so  as  to  occupy  a  shorter  period  of  time  in  making 
an  observation  Avould  also  be  a  great  desideratum.  It  is  ■well  known  that 
increased  velocity  of  the  wind  may  bring  more  ozone  to  a  given  point  than  if 
that  rapidity  were  less.  To  detei-mine  the  quantity  of  ozone  hkely  to  af- 
fect the  health  of  an  individual  subjected  to  the  influence  of  rapid  currents 
of  air,  it  is  desii'able  to  expose  the  test-paper  to  the  same  atmospheric  cur- 
rent. And  yet  the  loss  of  liberated  iodine,  to  which  the  darkening  of  the 
paper  was  due,  by  evaporation,  as  an  eiJect  of  just  such  a  current,  suggests 
that  perhaps  the  deepest  coloration  of  the  slips  of  test-paper  may  be  ob- 
tained, not  when  the  amount  of  ozone  is  the  greatest,  but  when  the  test- 
paper  is  best  protected  from  too  great  velocity  of  wind,  especially  when 
there  is  an  excess  of  nioistui-e  in  the  atmosphere. 

Dr.  Nicholson  found  ozone  more  abundant  in  a  pine  forest  than  in  the 
open  country  during  the  summer,  but  less  abundant  in  the  winter  ;  less 
abundant  in  coal-pits  and  over  swamps  than  in  the  open  country  ;  and  less 
abundant  generally  in  the  night  than  by  day.  The  results  of  these  inves- 
tigations in  regard  to  the  air  of  pine  woods  are  in  accord  with  the  state- 
ments of  Schreiber,  of  Vienna,  who  informs  us  that  the  turpentine  exhaled 
from  pine  forests  possesses,  to  a  greater  degree  than  all  other  bodies,  the 
property  of  converting  the  oxygen  of  the  air  into  ozone,  and  by  this  fact 
it  has  been  sought  to  explain  why  a  continued  residence  among  the  bal- 
salmic  odors  of  the  pines  has  long  been  credited  with  a  favorable  influ- 
ence in  cases  of  phthisis.  Dr.  Day,  of  Geelong,  Austraha,  in  an  able  pa2:)er 
pubhshed  some  years  since,  also  sustained  similar  views  in  regard  to  the 
activity  and  value  of  turpentine  as  an  ozonizer.  The  cai'eful  and  svste- 
matic  observations  now  being  carried  on  under  the  auspices  of  Dr.  H.  B. 
Baker,  the  energetic  Secretary  of  the  Michigan  State  Board  of  Health,  give 
promise  of  some  very  important  additions  to  our  knowledge  of  the  relations 
between  ozone  and  health  during  the  next  few  years. 

Ozone  is  stated  by  Dr.  John  Mulvany,  in  a  paper  contributed  to  the 
"  Michigan  Health  Board  Report  for  1880,"  to  have  a  marked  influence  upon 
the  human  procreative  functions.  Dr.  Mulvany  declai-es  that  in  a  xery 
.extended  series  of  obseiwations,  carried  on  in  all  parts  of  the  habitable 
globe,  he  has  repeatedly  found  the  births  few  where  ozone  is  scanty,  and 
numerous  where  it  is  abrmdant.  The  most  positive  evidence  in  support 
of  this  theory  he  obtained  in  Trincomalee  in  Ceylon.  The  village  is  low, 
but  httle  above  the  sea-level,  open  to  the  sea  on  the  N.  E.,  and  with  the 
jungle  on  the  S.  W.  Fi'om  May  to  September  the  S.  W.  monsoon  blows 
over  the  island,  and  in  passing  thi'ough  the  jungle  is  robbed  of  its  ozone. 
From  October  to  Apiil  the  X.  E.  monsoon  blows  over  the  bay  of  Bengal, 
and  anives  at  the  village  laden  with  ozone.  During  April  the  winds  veer 
from  N.  E.  to  S.  W.,  and  the  ozone  is  in  fair  proportion.  Such  peculiar 
conditions  afforded  a  very  suitable  opportunity  for  observing  the  effect  of 
ozone  on  the  chances  of  fecundation  among  the  Ceylonese  villagers,  and 
on  overhauling  the  baptismal  register  kept  by  the  Eoman  Cathohc  jDriests, 
Dr.  Mulvany  found  that  during  the  S.  "W.  monsoon,  a  period  extending 
from  May  to  September,  with  a  relative  proportion  of  ozone  expressed  by 
two  and  one-haK  degrees  on  SchiJnbein's  scale,  the  conceptions  were  only 
fifty-seven  per  cent,  of  the  number  occurring  in  the  period  from  October 
to  April,  when  the  amount  of  ozone  was  represented  by  eight  degrees,  or 
more  than  three  times  as  much. 

The  average  annual  rainfall  upon  the  surface  of  the  United  States,  ex- 
clusive of  Alaska,  is  approximately  29  inches,  that  for  the  spring  and  sum- 
mer months  is  about  17  inches,  and  the  entu-e  range  for  these  months  is 


454  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

from  0  to  38  inches  nearly.  According  to  some  curious  investigations 
repoi'ted  in  Census  Bulletin  No.  174,  published  June  3,  1881,  the  average 
rainfall  with  relation  to  population — that  is,  giving  weight  to  each  area  of 
the  countiy  in  proportion  to  the  density  of  its  popu.lation — was  in  1870 
43.5  inches ;  in  1880  this  had  decreased  to  42.9  inches  owing  to  the  move- 
ment of  population  toward  the  arid  regions  of  the  far  West.  More  than 
seven-tenths  of  the  people  of  the  United  States  are  settled  in  regions 
where  the  average  annual  rainfall  is  between  35  and  50  inches  ;  nine- 
tenths  of  the  inhabitants  reside  in  areas  of  country  where  the  rainfall 
averages  between  30  and  60  inches ;  and  ninety-five  per  cent,  of  the  popu- 
lation is  found  in  sections  where  the  average  rainfall  dui'ing  the  spring 
and  summer  months  ranges  between  15  and  30  inches. 


Electricity. 

A  very  important  American  contribution  to  our  knowledge  respecting 
the  probable  relations  of  electricity  to  disease,  especially  to  neviralgic 
attacks,  has  been  made  by  T>i\  S.  Weir  Mitchell,  of  PhiladeliDhia,  who  in  an 
ai'ticle  in  the  American  Journal  of  the  Medical  Sciences  for  April,  1877,  de- 
scribed the  remarkable  case  of  Capt.  Catlin,  U.  S.  A.,  and  gave  the  results 
of  his  observations  upon  the  connection  between  states  of  the  weather  and 
his  pain.  Dr.  Mitchell  concludes  that  there  seems  to  be  every  reason  to 
believe  that  the  popular  view  which  relates  some  fits  of  pain  to  storms  has 
a  distinct  foundation,  having  stood  the  test  in  this  single  case  of  a  long 
and  patient  scientific  study.  He  could  not  determine  which  of  the  sepa- 
rate factors  of  storms  (lessened  pressure,  rising  temperature,  greater  hu- 
midity, or  winds)  caused  the  neuralgia,  or  whether  some  yet  unknown 
agency,  perhaps  electricity  or  magnetism,  was  productive  of  the  evil.  The 
study,  however,  led  at  that  time  to  the  still  more  novel  and  valuable  con- 
clusion, that  every  stoi-m  as  it  sweeps  across  the  continent  (see  Meteor- 
ology, page  461)  consists  of  a  vast  rain  area,  at  the  centx-e  of  which  is  a 
moving  space  of  greatest  barometric  depression,  known  as  the  storm- _ 
centre,  along  which  the  storm  moves  like  a  bead  on  a  thread.  "The  rain 
usually  precedes  this  by  550  to  600  miles,  but  before  and  around  the  rain 
lies  a  belt  which  may  be  called  the  neuralgic  margin  of  the  storm,  and 
which  precedes  the  rain  about  150  miles.  This  fact  is  very  deceptive, 
because  the  sufferer  may  be  upon  the  far  edge  of  the  storm-basin  of  baro- 
metric depression,  and  see  nothing  of  the  rain,  yet  have  the  pain  due  to 
the  storm.  It  is  somewhat  interesting  to  figure  to  one's  self  thus — a  mov- 
ing area  of  rain  gix'dled  by  a  neuralgic  belt  150  miles  wide,  within  which, 
as  it  sweeps  along  in  advance  of  the  storm,  prevail  in  the  hurt  and 
maimed  limbs  of  men,  and  in  tender  nerves  and  rheumatic  joints,  renewed 
torments  called  into  existence  by  the  stir  and  perturbation  of  the  ele- 
ments." In  a  further  report  upon  this  interesting  subject,  made  to  the 
Philadelphia  College  of  Phy.sicians  June  6,  1883,  Dr.  Mitchell  and  Capt. 
Catlin  state  that  it  is  firmly  believed  that  neixralgia  accompanies  periods 
of  intense  auroi'al  displays,  but  owing  to  their  rare  occvuTence  it  cannot  be 
said  that  proof  is  conclusive.  Yet  the  connection  of  the  two  seems  too 
frequent  for  mere  coincidence.  In  the  remarkable  case  which  has  formed 
the  chief  subject  of  Dr.  Mitchell's  investigations  there  occurred,  after  an 
intense  magnetic  storm  without  ordinary  weather  disturbances,  on  Novem- 
ber 17,  1882,  at  two  in  the  aftei'noon,  "intense  stabbing  neui-algic  pains, 
which  continued  with  great  force  until  5  a.m.  on  the  18th,  and  intermitting 


CLIMATOLOGY    AND    METEOROLOGY.  455 

and  less  strong  fits  of  torment  were  felt  imtil  the  evening  of  that  day. 
This  intense  neuralgia  of  the  17th  seems  connected  with  the  magnetic 
storm  of  the  17th,  for  there  was  no  storm  of  barometric  depression  charted 
by  the  Signal  Bureau  within  neuralgic  range  for  that  date," 

In  order  to  determine  the  average  distance  of  the  storm-centre  at  the 
beginning  of  attacks  of  pain  in  this  interesting  case,  special  observations 
were  made  on  sixty  well-defined  storms  occurring  in  ten  consecutive 
months,  and  these  showed  a  sphere  of  influence  of  from  200  to  1,200  miles, 
and  an  average  of  680  miles.  Storms  coming  from  the  Pacific  coast  were 
felt  the  farthest  off,  in  fact  soon  after  they  began  to  descend  the  eastern 
slope  of  the  Kocky  Mountains.  Those  which  moved  along  the  coast  from 
the  Gulf  of  Mexico  were  associated  with  a  neuralgia  not  quite  so  in- 
tense nor  so  quickly  perceived.  If  neuralgia  begin  with  a  low  or  rising- 
barometer,  the  ridge  of  depression  is  narrow  and  invariably  broken  down 
within  seventy-two  hours,  and  more  frequently  within  twenty-four  or 
thirty-six  hours  ;  and  during  this  rise  coincident  with  the  pain,  the  differ- 
ence between  the  wet-  and  dry-bulb  thermometers,  instead  of  increasing, 
as  is  usual  with  this  barometrical  condition,  sometimes  actually  dimin- 
ishes, or  increases  for  a  few  hours  only,  and  then  diminishes,  showing  in- 
creasing humidity.  When  pain  occurs  with  this  instrumental  condition  the 
coming  storm  depression  will  carry  on  its  eastern  side  clouds  and  increas- 
ing moisture  and  sometimes  rain  or  snow,  clear  over  the  summit  of  the 
advancing  high  area  pressure  (high  pressure  area  ?)  in  front  of  it,  holding 
an  unusually  high  degree  of  relative  humidity  in  the  air,  on  the  high  east- 
ern slope  of  the  high  barometer  area.  These  are  the  conditions  under 
which  attacks  of  pain  come  on  with  the  rising  barometer.  Its  usual  condi- 
tion is  with  a  falling,  but  it  may  be  a  high  barometer,  rising  temperature, 
and  increasing  relative  humidity. 

Should  the  pain  be  on  during  a  day  of  intermitting  rain,  the  pain  as- 
sumes an  additional  activity  just  before  the  increasing  shower,  and  con- 
tinues twenty  or  forty  minutes  ;  this  will  sometimes  happen  four  or  five 
times  in  twelve  hours.  Each  little  increment  of  pain  seems  to  bear  about 
the  same  relation  to  the  showers  as  the  main  attack  bears  to  the  storm. 

The  protection  of  human  life  and  health  from  the  injurious  action  of 
electricity  on  the  grand  scale  upon  which  nature  displays  it  in  thunder- 
storms is  obviously  a  part  of  Preventive  medicine,  and  it  seems  proper, 
therefore,  to  add  a  few  words  respecting  it  in  this  place.  Such  reference 
is  the  more  appropriate  here  since  French  sanitarians  devote  considerable 
attention  to  the  subject,  and  even  in  their  elementary  books  for  the 
secondary  schools  (into  all  of  which  the  study  of  hygiene  has  been  intro- 
duced by  law,  according  to  the  decree  of  May  6,  1872)  the  ancient  riiles  of 
our  venerated  Dr.  Franklin  are  still  reverently  mentioned.  And  indeed 
such  honors  appear  by  no  means  ill-deserved  when  we  consider  that  the 
kite-string  in  Franklin's  memorable  experiment  in  a  field  (as  it  was  then) 
near  Philadelphia  has  become  the  progenitor,  not  only  of  the  multitude 
of  lightning-rods  which  protect  dwellings  in  every  part  of  the  civilized 
world,  but  also  of  the  marvellous  network  of  telegraph  wires  and  of  ocean 
cables  which  during  the  last  half-century  have  so  vastly  modified  the 
social  and  mercantile  life  of  mankind. 

The  electricity  of  the  atmosphere  is  the  result  of  physical  causes,  such 
as  the  movement  and  pressure  of  the  air,  friction  against  the  earth,  dif- 
ferences of  temperature,  and  chemical  reactions.  It  is  asserted  by  some 
that  our  planet  is  charged  with  negative,  and  celestial  space  with  positive 
electricity,  but  at  any  rate  there  is  httle  doubt  that  lightning  is  only  an 


456  AMERICAN    APPENDIX    TO    PARKEs'    nYGIENE. 

enormous  electric  spark,  passing  from  one  cloud  to  another,  or  from  a 
cloud  to  the  earth,  and  temiDorarily  restoring  the  disturbed  equilibrium  of 
electrical  tension. 

The  effects  of  a  thunderbolt  are  very  variable.  Sometimes  when  a  per- 
son is  directly  in  the  course  of  the  discharged  electricity  death  takes  place 
instantly  and  without  anj^  apparent  wound.  In  other  cases,  where  indi- 
viduals happen  to  be  situated  at  what  might  be  called  the  side  of  the  bolt, 
they  may  nevertheless  experience  more  or  less  serious  injuries,  occasionally 
fatal  in  their  character.  Lightning  not  infrequently  produces  burns  which 
may  be  quite  extensive,  or  it  may  leave  its  victim  suffering  from  hemi- 
plegia, paraplegia,  paralysis  of  a  single  limb,  or  from  amaui'osis,  these  af- 
fections being  in  such  instances  generally  incurable,  It  sometimes  hap- 
pens that  a  thunderbolt  will  tear  and  bui-n  the  clothing  of  an  individual 
and  overturn  surrounding  objects  without  doing  him  any  personal  harm, 
or  ■with  this  disturbance  of  circumjacent  bodies,  he  may  be  struck  with 
sjTicope,  fatal  or  only  momentary.  The  remarkable  escapes  from  serious 
injury  which  people  who  are  struck  by  lightning  occasionally  enjoy  are 
probably  due  to  the  great  obstruction  offered  to  the  passage  of  the  elec- 
trical current  by  the  human  skin  in  a  dry  condition,  this  resistance  being 
calculated  by  Poore,  the  great  English  electrician,  to  be  four  times  gi'eater 
than  that  offered  by  the  entire  length  of  the  Atlantic  cable. 

Death,  when  it  occui-s  from  lightning  stroke,  may  be  owing  to  some  ill- 
understood  disturbance  of  the  brain,  to  syncope,  to  asphyxia,  or  to  the 
effect  of  the  burns  and  wounds.  Post-mortem  examination  discloses  no 
characteristic  lesions,  although  congestion  of  the  heart,  lungs,  and  brain 
are  usually  found,  and  the  blood  is  ajDt  to  be  uncoagulated. 

The  great  means  of  protecting  houses  and  their  inhabitants  from  the 
evil  effects  of  a  stroke  of  lightning  is  of  com'se  a  well-constructed  light- 
ning-rod. "When  properly  arranged  a  rod  generally  seciu'es  persons  or 
things  situated  within  a  circle  the  diameter  of  which  is  four  times  the 
height  of  the  point  of  the  rod,  above  the  plane  in  which  such  objects  are 
placed.  The  lightning-rod  should  be  at  least  three-quarters  of  an  inch 
thick,  insulated  by  broad  glass  supports,  Avell  pointed  at  its  upper  end  with 
platinum  or  gold,  and  ought  to  have  its  lower  extremity  embedded  in  moist 
earth  to  the  depth  of  six  or  eight  feet. 

It  is  found  that  large  groups  of  men  or  animals  seem  to  attract  the 
lightning,  and  this  is  explained  on  the  theory  that  the  elimination  of  warm 
moisture  from  the  lungs  and  skin  of  so  many  individuals  produces  an  as- 
cending column  of  vapor  which  is  liable  to  conduct  the  flash  of  electricity 
downward  to  the  earth.  Hay  and  grain  stacks,  manure  heaps,  etc.,  proba- 
bly have  the  same  effect,  and  proximity  to  them  should  similarly  be  avoided 
during  thunder-storms. 

Prof.  Becquerel,  from  whose  excellent  "  Traite  d'Hygiene  "  much  of  the 
above  has  been  condensed,  gives  Dr.  Franklin's  five  rules  for  avoiding  be- 
ing struck  by  hghtning,  as  follows  :  "  1.  Always  avoid  the  neighborhood 
of  chimneys,  because  the  soot  which  lines  them  is,  like  metals,  a  good  con- 
ductor of  electricity.  2.  It  is  well,  for  the  same  reason,  to  keep  at  a  dis- 
ttmce  from  metallic  objects  generally,  and  to  lay  aside  gold  or  silver  chains, 
ornaments,  coins,  etc.,  during  a  thunder-storm,  3.  Never  place  yoiu'self 
under  a  lamp,  a  bronze,  or  other  ornament  of  metal,  a  tree,  or  any  high  ob- 
ject whatsoever  (when  you  have  reason  to  fear  a  lightning  stroke).  4. 
It  is  well  to  put  between  one's  self  and  the  earth  a  non-conducting  substance, 
such  as  a  thick  plate  of  glass,  for  example.  5.  The  less  the  indi\idual 
touches  the  walls  and  the  floor  of  a  house  the  less  he  Ls  exposed  to  being 


CLIMATOLOGY    AND    METEOEOLOGY.  457 

struck  by  lightning.  Hence  the  safest  preservative  means  would  be  to  oc- 
cupy during  thunder-storms  a  hammock  suspended  by  silken  cords  in  the 
middle  of  a  large  apartment."  This  last  suggestion  would  of  course 
chiefly  benefit  timid  hysterical  females,  to  some  of  whom,  however,  it 
would  fully  repay  all  the  trouble  involved  in  putting  it  into  practice  by 
relieving  that  agonizing  fear  of  being  struck  by  lightning,  which  we  may 
assure  them  is  totally  needless  when  they  adopt  such  a  sure  precaution 
against  the  dangers  of  atmospheric  electricity. 


Meteorology. 

From  the  time  the  great  Dr.  Johnson  uttered  his  famous  sarcasm  upon 
observers  of  the  weather,  to  wit :  "  A  certain  set  of  men  pass  their  lives  in 
observing  the  chaoges  of  the  weather,  and  die  at  a  good  old  age  with  the 
conviction  that  the  weather  is  changeable,"  little  has  been  accomplished  in 
rendering  us  more  truly  weather-wise,  until  the  splendid  results  attained 
by  our  own  Signal  Service  Bureau  gave  a  new  impetus  to  the  study  of 
meteorology. 

In  fact,  the  raison  d'etre  for  an  attempt  to  supj)lement  the  infor- 
mation furnished  by  Prof.  Parkes'  exhaustive  work  in  the  department 
of  meteorology  must  chiefly  be  based  upon  the  wonderful  development 
that  science  has  attained  through  the  labors  of  our  Signal  Service.  And 
in  this  respect  few  can  dispute  that  not  only  the  hygienists  of  America, 
but  also  those  of  the  Old  World,  are  under  great  obligations  to  our 
National  Government,  which,  taking  timely  advantage  of  oi^portunities 
never  before  presented  in  the  history  of  mankind,  has.  utilized  them  with 
marvellous  success. 

These  opportunities  consist,  of  course,  in  the  circumstances,  first,  that 
in  our  American  Union  there  is  a  larger  portion  of  the  earth's  surface  in- 
habited by  civilized  man,  now  under  the  same  jurisdiction,  and  controlled 
by  one  central  authority,  than  in  any  antecedent  epoch  ;  and,  second,  that 
by  the  most  extended  system  of  telegraphic  communication  ever  organized, 
it  has  been  possible,  during  the  last  decade,  for  the  first  time  in  the  history 
of  the  world,  to  obtain  instantaneous  and  simultaneous  weather  reports 
from  an  area  of  the  earth's  sui'face  occupying  the  whole  breadth  of  our 
continent,  stretching  from  the  thirtieth  almost  to  the  fiftieth  parallel  of 
latitude,  and  comprising  more  than  three  milhons  of  square  miles. 

Over  this  vast  section  of  country  signal  stations  have  been  established, 
Trader  the  direction  of  the  Weather  Bureau,  at  least  wherever  j)racticable, 
and  to  such  an  extent  as  the  yearly  appropriation  would  permit.  At  these 
stations  three  observations  are  taken  daily,  at  the  same  moment,  the  hours 
selected  being  7  a.m.,  3  p.m.,  and  11  p.m.,  Washington  time.  By  this  plan 
the  changes  fi'om  hour  to  hour  and  day  to  day,  as  well  as  the  effects  which 
are  produced  by  these  alterations,  are  noted,  and  after  being  forwarded 
to  the  central  office  are  reproduced  in  a  permanent  form  upon  the  daily 
weather  map  which  is  transmitted  as  far  as  practicable  over  the  country. 

Hence  these  daily  maps  may  justly  be  entitled  "  the  geography  of  our 
atmosphere."  Without  examining  them  we  can  no  more  secure  an  accu- 
rate conception  of  the  general  state  of  the  weather  than  we  could  gain  a 
correct  idea  of  the  real  arrangement  of  seas,  continents,  and  islands,  as 
represented  ujDon  geographical  maps,  by  walking  a  few  miles  along  the  coast 
or  cKmbing  over  a  range  of  mountains. 

The  benefits  from  a  sanitary  point  of  view  to  physicians,  and  indeed  to 


458  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

the  community  at  large,  of  being  enabled  to  accurately  forecast  the  weather 
twenty-four  or  forty-eight  hours  in  advance,  are  so  gi-eat  and  so  constantly 
serviceable  that  the  suggestions  we  submit  below  are  woiihy  of  minute 
attention  and  extensive  trial. 

These  clues  will  probably  furnish  more  or  less  valuable  (but  of  course 
not  infaUible)  daily  giudes  as  to  what  sanitary  precautions  in  regard  to 
clothing  should  be  instituted  against  heat,  cold,  or  wet ;  what  days  or  what 
hours  convalescents  (especially  children)  may  venture  out  into  the  open 
air;  when  is  the  best  time  for  invalids  to  be  subjected  to  any  necessary  re- 
moval, and  at  what  peiiods  neui'algic  and  rheumatic  patients  must  exer- 
cise additional  care  in  reference  to  exjDosui'e  to  atmospherical  ^•icissitudes. 
Obviousl}'  such  items  of  information  have — to  the  medical  profession  in  an 
especial  manner — a  highly  practical  and  sometimes  an  almost  incalculable 
value. 

Any  one  by  consulting  the  daily  "Indications,"  or  "Probabilities,"  in 
the  pubhc  prints  can  provide  against  the  weather  correctly  on  about  three 
hundred  days  in  each  year,  but  by  combining  with  the  results  of  the  Sig- 
nal Service  investigations  local  observations  upon  barometers,  winds, 
clouds,  etc.,  it  is  possible  to  advance  still  further  toward  absolute  jDre- 
cision,  and  eliminate  nearly  all  the  remaining  errors  in  forecasting  the 
weather,  blunders  which,  if  not  thus  corrected  for  individual  localities,  ai*e 
as  mortifying  as  they  are  injurious  to  health. 

The  general  prognostications  will  doubtless  become  more  and  more 
reliable,  with  each  added  year  of  experience  and  skill,  in  drawing  correct 
deductions  fi-om  the  observed  facts  of  Xatui'e,  but  on  account  of  the  apj^ar- 
ent  impossibility,  or  at  least,  so  far  as  Ave  can  now  see,  the  iusui^erable  dif- 
ficulty, of  maintaining  signal  stations  far  out  in  the  ocean  off  the  Atlantic 
and  Pacific  coasts,  there  will  probably  long  remain  a  belt  of  seaboai'd 
counti-y  on  each  shore  of  our  continent  to  the  weather  prognosis  for  which 
the  word  "  probabihties  "  can  only  be  api^Hed. 

This  comparatively  novel  apj^hcation  of  the  work  of  the  Signal  Service 
Office  to  the  daily  needs  of  j)ractical  hygiene  is  assoredly  one  of  the  most, 
if  not  the  most,  substantial  and  valuable  aids  meteorology  has  ever  contrib- 
uted to  sanitaiy  science,  and  we  therefore  make  no  apology  to  our  readers 
for  the  foUowing  explanation  as  to  these  investigations  and  their  interest- 
ing results. 

From  the  majority  of  the  296  stations  at  which  observations  are  taken 
thi'ee  reports  are  transmitted  daily,  cousisting  of  the  corrected  barometer 
reading,  record  of  temperature,  dew-point,  dii-ection  of  the  wind  in  miles 
per  hour  since  last  telegraphic  observation,  upper  clouds,  lower  clouds, 
and  the  reading  of  the  maximum  thermometer,  the  whole  being  sent  in  in 
the  regular  cipher  words. 

The  instruments  fui-nished  by  the  Service  are  directed  to  be  read  in 
the  following  order  :  first,  bai'ometer  ;  second,  exposed  thermometer ;  third, 
wet-bulb  thermometer;  fourth,  anemometer;  fifth,  amenoscope ;  sixth, 
rain-gauge.  In  all  cases  the  maximum  and  minimum  thermometers  are 
to  be  read  after  the  exposed  thermometer.  After  the  instruments  have 
been  read  the  character  of  the  clouds  and  the  state  of  the  weather  are  to 
be  noted. 

Each  observer  is  ordered  to  note  daily,  at  the  exact  moment  of  sunset, 
and  for  a  time  not  to  exceed  thuiy  minutes  aftei-wai-d.  the  character  of 
the  westei'n  sky  and  of  the  sunset,  classif%ing  and  reporting  them  as  "  fair- 
weather  sunsets,"  "  doubtful  sunsets,"  and  "  foul-weather  sunsets."  These 
tenns  are  used  in  theu-  ordinary  signification,  but  the  obsei-vers  of  the 


CLIMATOLOGY    AND    METEOROLOGY.  459 

Signal  Office  are  fui'ther  instructed  :  "  It  will  be  frequently  noticed  at  the 
time  of  sunset  tliat  the  western  sky,  while  exhibiting  generally  the  char- 
acteristics of  a  faii'-weather  sunset,  is  tinged  more  or  less  and  in  different 
places  with  the  colors  yellow  or  gi-een.  It  is  important  that  these  colors 
should  be  carefully  noted.  In  some  instances  the  sunset  will  be  found  a 
decidedly  yellow  sunset,  that  being  the  predominant  color  of  the  western 
sky.  The  color  green  is  rarely  the  predominant  color,  but  portions  of  the 
western  sky  will  sometimes  markedly  exhibit  it.*'  Records  are  to  be  kept 
at  each  office  showing  the  non-verification  or  verification  of  these  sunset 
predictions  on  the  succeeding  day. 

The  instruments  supphed  to  each  first-class  station  of  the  Signal  Ser- 
vice are  :  two  mercurial  barometers,  two  exposed  thermometers,  two  wet- 
bulb  thermometers,  two  maximum  thermometers,  two  minimum  thermom- 
eters, two  anemometers  and  one  self-registering  attachment,  one  large  and 
one  small  wind-vane,  a  rain-gauge  and  a  clock. 

The  instructions  for  suspending  and  reading  the  barometer  are  similar 
to  those  given  in  the  body  of  this  work,  but  the  following  suggestions  are 
well  worthy  of  reproduction  here  :  "In  moving  a  barometer  even  across 
a  room  it  should  be  screwed  up  and  carried  with  the  cistern  uppermost. 
For  travelling  it  is  provided  with  a  wooden  case.  On  steamboats  or  rail- 
roads it  should  be  hung  up  in  a  stateroom  or  car,  and  the  lower  end 
firmly  strapped  to  the  side  of  the  room  or  car,  to  prevent  jarring.  In 
wheeled  vehicles  (other  than  railway  cars)  (?)  it  should  be  carried  by 
hand,  supported  by  a  strap  over  the  shoulder,  or  held  upright  between  the 
legs  ;  but  it  must  not  be  allowed  to  rest  on  the  floor  of  the  carriage,  as  a 
sudden  jolt  might  break  the  tube.  If  carried  on  horseback  it  should  be 
strapped  over  the  shoulders  of  the  rider,  where  it  is  not  likely  to  be  in- 
jured, unless  the  animal  (quadruped)  is  subject  to  a  sudden  change  of  gait. 
When  I'equired  for  use  it  must  be  taken  from  its  case,  gently  inverted, 
hung  up,  and  unscrewed.  While  it  has  the  cistern  uppermost  the  tube  is 
full — is  one  solid  mass  of  metal  and  glass— and  not  easily  injured  ;  but 
when  hung  up  (in  position)  a  sudden  jolt  might  send  a  bubble  of  air  into 
the  vacuum  at  the  upper  end  of  the  tube,  and  the  instrument  become  use- 
less until  repaired.  Obsei'\'ers  must  never  sidng  the  barometer  or  endeavor 
to  force  the  mercury  against  the  top  of  the  tube  without  first  screwing  up 
the  large  adjusting  screw  at  the  base  of  the  cistern.  If  the  cistern  should 
become  du'ty  it  can  be  cleaned  safely  and  without  changing  the  zero  of  the 
instrument,"  for  which  directions  are  given.  (See  "Instructions  to  Ob- 
servers of  the  Signal  Service,"  1881,  p.  18.) 

In  regard  to  the  exposed  thermometer,  it  is  ordered  that  it  shall  be 
hung  in  the  regular  instrument  shelter,  in  such  a  way  that  it  shall  always 
be  in  the  shade,  and  at  least  one  foot  from  the  wall  of  any  building.  "  The 
readings  must  be  made  at  all  times,  but  especially  in  winter,  through  the 
panes  of  glass  without  raising  the  sash,  when  the  shelter  is  built  out  from 
a  window.  When  the  shelter  is  built  upon  the  roof  great  care  must  be 
exercised  in  making  the  readings,  in  order  to  prevent  the  instrument  from 
being  affected  by  the  heat  of  the  body  or  of  the  lantern  at  night.  The  ob- 
servation must  be  made  as  rapidly  as  is  consistent  with  accuracy."  It  is 
required  that  the  correctness  of  the  zero-mark  on  the  scale  of  every  ther- 
mometer be  tested  by  immersion  in  melting  ice  for  half  an  hour,  four  times 
annually. 

Many  points  of  detail  in  the  manipulation  of  the  maxima  and  minima 
thermometers  given  in  the  "  Signal  Service  Instructions  "  are  of  interest  to 
private  observers,  but  want  of  space  forbids  their  quotation. 


460  AMERICAN    APPENDIX    TO    PAEKES     HYGIENE. 

The  folio wiug  in  regard  to  the  comparatively  new  branch  of  systematic 
observation  of  water  temperatures  is  worthy  of  mention.  The  apparatus 
for  this  purpose  consists  of  a  small  thermometer  inclosed  in  a  cylindrical 
metallic  case.  A  portion  of  the  case  is  hinged  so  as  to  be  swung  open  when 
it  is  desired  to  read  the  thermometer.  A  valve  at  the  bottom  of  the  case 
admits  the  water  as  it  sinks  to  the  bottom  of  the  river  or  lake,  and  falling 
into  place  when  the  case  is  drawn  up  prevents  the  water  from  escaping. 
"At  stations  provided  with  this  thermometer  one  obsei'vation  will  be  made, 
at  2  P.M.  (Washington  time)  daily,  of  the  exposed  thermometer  and  the  tem- 
peratui'e  of  the  water  at  the  surface  and  bottom  of  the  lake,  bay,  or  river 
upon  which  the  station  is  located.  The  observer  will  select  some  conve- 
nient point  on  the  shore  (a  wharf  or  pier  when  practicable)  where  a  suffi- 
cient depth  of  water  exists  to  give  a  positive  difference  between  the  surface 
and  bottom  temperatures,  and  will  provide  himself  with  enough  strong 
cord  to  reach  the  bottom  at  the  place  selected.  .  .  .  Li  making  the 
observations  the  observer  will  first  note  the  temperature  of  the  air  as 
shown  by  the  exposed-air  thermometer  in  the  shelter ;  then  that  of  the 
surface-water  by  immersing  the  thermometer  in  the  upper  stratum  of 
water,  allowing  it  to  remain  long  enough  therein  for  the  mercuiy  to  ac- 
quix'e  the  temperatui'e  of  the  water  ;  and  then  lowering  the  c^dinder  slowly 
to  the  bottom,  will  allow  it  to  rest  there  long  enough  to  fiU,  after  which  it 
will  be  drawn  quickly  to  the  surface  and  the  temperature  shown  by  the 
thermometer  carefidly  noted." 

Since  the  temperatui'e  of  large  bodies  of  water  has  an  important  effect 
upon  that  of  the  adjacent  country,  we  may  expect  valuable  contributions 
to  both  climatology  and  meteorology  from  this  well-devised  series  of  expe- 
riments. 

Observations  on  the  humidity  of  the  air  are  made  with  the  wet-  and  dry- 
bulb  thermometer,  for  computations  from  which  extended  and  elaborate 
tables  for  a  great  variety  of  latitudes,  elevations,  and  pressures  are  fur- 
nished in  the  "Instructions." 

The  velocity  of  the  wind  is  measured  by  the  aid  of  an  anemometer  spe- 
cially manufactui'ed  for  the  United  States  Signal  Office.  This  instrument 
indicates  tenths  of  a  mile,  and  registers  up  to  990  miles.  At  some  of  the 
moi'e  important  stations  an  elaborate  "  electric  self-recording  anemometer 
attachment "  is  furnished.  At  such  stations  it  is  ordered  that  the  hourly 
velocity  of  the  wind  be  deduced  "from  the  record  of  the  fifteen  minutes 
(multiplied  by  four)  immediately  preceding  the  time  of  observation.  Li 
case  the  cups  are  moving  at  the  moment  of  observation,  and  the  anemom- 
eter has  not  closed  the  circuit  during  the  said  fifteen  minutes  but  during 
the  preceding  horn-,  the  number  of  miles  will  be  taken  from  the  whole  hour 
preceding." 

The  method  of  measuring  the  rainfall  adopted  by  the  Signal  Service 
Bureau  differs  from  Dr.  Parkes'  plan,  and  as  it  enables  an  observer  to  se- 
cure greater  accuracy  we  transcribe  it  in  detail :  "  The  rain-gauge  must  be 
placed  wherever  practicable,  with  the  top  of  the  funnel-shaped  collector  twelve 
inches  above  the  surface  of  the  ground,  firmly  fixed  in  a  vertical  position 
and  protected  from  interference.  It  must  be  examined  at  the  time  of  mak- 
ing each  of  the  three  telegraphic  observations,  the  amount  of  water,  includ- 
ing fog  or  dew,  it  contains  carefully  measui-ed  by  means  of  the  graduated 
rod  sent  with  each  gauge,  and  then  emptied  and  returned  to  its  proper 
position.  When  a  situation  at  the  level  of  the  ground,  with  a  sufficiently 
clear  exposui-e,  cannot  be  found,  the  gauge  will  be  j^laced  on  the  top  of 
the  instrument  room,  or  roof  of  the  building  occupied  by  the  observer, 


CLIMATOLOGY    AISTD    METEOEOLOGT.  461 

who  will  measure  the  height  above  the  ground  and  report  it  to  the  Signal 
Office.  The  measuring' rod  is  graduated  in  inches  and  tenths  of  inches, 
and  the  proportion  between  the  cylinder  and  funnel  is  as  one  to  ten,  so 
that  ten  inches  upon  the  rod  correspond  -with  one  inch  of  actual  rainfall, 
one  inch  to  one-tenth  of  rain,  etc."  Snow  is  directed  to  be  melted  and 
reported  as  rain,  the  fact  of  its  being  melted  snow  being  carefully  noted. 
When  from  any  cause  the  snow  cannot  be  melted  its  depth  wiU  be  meas- 
ured, and  ten  inches  of  snow  reported  as  one  inch  of  rainfall,  the  fact  of  its 
being  so  approximated  being  also  noted. 

In  regard  to  the  appearance  of  the  sky,  observers  are  instructed  to  re- 
port the  weather  as  dear  when  the  sky  is  three-tenths,  or  less  than  three- 
tenths,  covered  with  clouds  ;  fair  when  the  sky  is  from  four-tenths  to 
seven-tenths  (inclusive)  covered ;  and  cloudy  when  the  sky  is  more  than 
seven-tenths  covered. 

The  ingenious  system  of  forwarding  detailed  reports  at  a  minimum 
expense  to  the  Government  by  using  cipher  words  (such  as  "hub,"  which 
means  "  a  thunder-storm  with  light  rain,  wind  blowing  from  the  north," 
or  "rage,"  which  indicates  "rainfall  since  last  report  has  been  nineteen 
one-hundredths  of  an  inch")  is  no  doubt  more  or  less  famihar  to  our 
readers. 

Besides  the  causes  ordinarily  enumerated  as  producing  the  atmospheric 
vicissitudes  upon  our  globe  and  referred  to  in  the  body  of  this  work,  such 
as  the  motion  of  the  earth  upon  its  axis  and  the  obliquity  of  that  axis  to 
the  plane  of  the  ecliptic,  we  have  another  fact,  the  importance  of  which 
has  only  been  recognized  within  the  last  fev/  years,  and  that  is  the  move- 
ment of  areas  of  low  barometer  across  the  surface  of  the  earth,  the  conse- 
quences of  depressions  or  furrows  in  the  surface  of  our  atmosphere.  These 
areas  of  low  barometer  have  a  general  tendency  to  move  over  us  from  west 
to  east.  As  a  rule,  therefore,  when  the  area  of  low  barometer  is  west  of 
us  we  may  expect  a  storm,  and  although  this  storm  may  pass  by  us,  either 
nearer  to  or  further  from  the  North  Pole  than  the  spot  we  occupy,  without 
causing  our  neighborhood  an}'  great  disturbance,  it  is  almost  certain  to 
cross  our  meridian  at  some  point.  After  that  transition  has  been  effected 
the  winds,  following  as  they  do  the  course  of  such  a  depression  in  our 
atmosphere,  will  blow  over  us  in  an  easterly  direction,  varying  to  the 
northeast  or  to  the  southeast,  perhaps,  according  as  the  storm-centre  hap- 
pens to  be  travelling  above  or  below  our  parallel  of  latitude.  The  clouds 
will  of  course  be  blown  along  from  the  west  by  the  winds  which  are  hurry- 
ing across  toward  the  area  of  low  barometer,  which  has  now  progressed  to 
the  eastward  of  our  station,  and  after  a  few  hours  or  a  day,  depending  upon 
the  magnitude  of  the  cloud  accumulation,  we  will  see  the  blue  sky  again, 
and  know  that  this  particular  storm  is  over. 

Although  we  usually  find  that  it  takes  three  or  four  days  for  another 
area  of  low  barometer  to  reach  our  indi-^idual  locality,  we  must  remember 
that  there  is  no  absolute  certainty  about  the  distance  between  these  centres 
of  storms.  Another  low-barometer  area  may  advance  upon  us  in  one  or 
two  days,  or,  on  the  other  hand,  the  one  next  following  may  progress  so 
slowly,  or  may  be  diverted  from  its  track  in  such  a  way  that  it  may  not 
come  to  us  for  five  or  six  days,  and  when  it  does  arrive,  attack  us  from 
another  and  totally  different  dii'ection. 

The  path  of  an  area  of  low  barometer  across  the  country  has  been 
rather  fancifully  yet  aptly  compared  to  the  track  of  an  immense  water- 
cart,  the  centre  of  which  is  of  course  the  line  of  most  violent  storm.  The 
average  rate  of  such  a  storm-centre  is,  according  to  Prof.  Loomis,  26  miles 


462  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

per  hour,  the  mean  velocity  in  summer  being  21  miles  and  in  winter  30 
miles,  but  the  rapidity  with  Avhich  it  moves  is  very  variable,  and  may  attain 
to  50  miles  an  hoiu-  or  1,200  miles  in  the  twenty-foui\ 

Winds,  as  a  general  nolo,  tend  toward  the  area  of  low  barometer  as  a 
centre,  but  ranges  of  mountains,  valleys,  extensive  forests,  and  so  forth, 
often  produce  local  variations  in  the  dii-ection  of  these  converging  cun-ents 
of  air.  In  violent  storms  the  winds  tend  to  circulate  about  the  storm- 
centre  also  in  a  direction  contrai-y  to  the  motion  of  the  hands  of  a  watch. 
From  this  it  will  be  at  once  perceived  that  when  an  area  of  low  barometer 
happens  to  be  crossing  om-  continent  at  its  uj)per  part,  the  winds  felt  in 
places  along  its  centre  will  be  in  a  general  way  from  the  south,  and  vice 
versa.  That  is  to  say,  if  at  any  time  an  area  of  low  barometer  is  passing 
through  New  York  and  New  England,  the  winds  in  Philadelj^hia  will  be 
toward  it,  and  for  twelve  hours,  perhaps,  from  the  southeast,  then  for  an- 
other twelve  hours  nearly  south,  afterwai'd  veering  round  still  further  until 
a  southwest  or  finally  a  westerly  wind  brings  us  clear  weather.  On  the 
other  hand,  if  a  similar  storm-centre  is  travelling  through  Virginia  and 
Maryland,  the  winds  in  Philadelphia  will  be  northerly,  and  generally 
cooler. 

The  apparent  exceptions  to  the  rule  of  north  winds  being  cooler  and 
south  winds  warmer  are  obviously  due  to  large  volumes  of  warm  air  or  of 
cold  air,  respectively,  having  previously  been  blown  to  the  north  or  south 
of  a  particular  position. 

Although  the  general  direction  of  movement  of  the  areas  of  low  barom- 
eter seems  to  be  aroiind  the  earth,  in  the  direction  of  our  planet's  motion  — 
that  is,  toward  the  apparently  rising  sun — their  course  may  sometimes  vary 
very  widely  from  this,  and,  as  shown  by  the  maps,  they  may  occasionally 
travel  almost  due  north  for  three  or  four  days,  during  which  time  they 
traverse  a  distance  perhaps  of  1,000  or  1,500  miles  before  they  resume 
their  normal  easterly  tendency. 

Since,  therefore,  the  storm-centre  is  in  the  neighborhood  of  the  area  of 
low  barometer,  there  is  seldom  or  never  a  true  northeast  storm,  much  as 
we  hear  people  talk  about  "northeasters."  A  northeast  wind  with  rain  in 
any  particular  locality  results  usually  from  an  area  of  low  barometer  trav- 
elling eastwardly  a  few  hundred  miles  south  of  that  position. 

By  making  use  of  the  daily  predictions,  or  still  better  of  the  daily 
weather  maps  where  they  are  accessible,  as  general  guides,  and  correcting 
these  for  individual  localities  by  a  study  of  the  local  w4nds,  clouds,  and 
sunsets,  and  especially  by  obsendng  a  mercurial  or  aneroid  barometer, 
noting  its  fall  as  an  indication  of  the  approach  of  an  oncoming  area  of  low 
barometer  toward  the  exact  spot  on  which  we  live,  and  also  especially  ob- 
serving when  and  how  rapidly  it  rises  as  a  token  that  the  low  area  (which 
is  the  storm-centre)  has  passed  by  us,  it  is,  I  believe,  possible  to  attain  an 
accuracy  in  predicting  the  weather  which  appears  to  unscientific  persons 
almost  miraculous,  and  secures  for  us  as  practical  Hygienists  immense  ad- 
Tantages,  both  to  our  own  health  and  to  that  of  our  patients. 


YEXTILATIOX   AXD   WARMING. 

By  D.  F.  LIXCOLX,  M.D. 

The  subjects  of  ventilation  and  heating  have  to  be  studied,  in  America,  from 
a  point  of  view  somewhat  differing  from  that  taken  in  England.  As  re- 
gards the  requii'ements  of  cubic  space  and  supply  of  fresh  ail',  there  is  and 
can  be  no  diiference.  But  in  certain  respects,  for  example  as  regards  the 
standard  of  temperature  to  be  'maintained,  "we  find  ourselves  unable  to 
adopt  Enghsh  rules,  and  the  English  would  be  equally  unwilling  to  accejDt 
ours.  The  severity  of  our  seasons,  too,  has  f  orcecl  us  to  make  use  of  steam 
and  stoves  to  a  much  greater  extent  than  is  usual  in  England,  while  the 
old-fashioned  method  of  warming  by  the  fireplace  has  fallen  too  much  into 
disuse  among  us. 

Hot-air  FniXACES. 

"When  the  inmates  of  a  private  house  seek  comfort,  their  first  thought 
of  improvement  is  in  the  direction  of  increased  warmth.  The  halls  are  to 
be  made  as  wami  as  the  rooms ;  the  sleeping-rooms  are  to  made  comfori- 
able  for  occupancy  by  day ;  and  to  effect  this  purpose,  a  furnace  in  the 
ceilar  is  the  most  feasible  means,  if  the  house  be  of  moderate  size.  A 
house  of  more  than  three  large  rooms  on  the  ground  floor,  however,  with 
one  or  two  stories  of  rooms  above,  cannot  be  properly  heated  by  one  fur- 
nace (Philbrick).  However  powerful  the  appai-atus,  it  is  unsafe  to  tiy  to 
conduct  heated  air  more  than  six  feet  ia  a  horizontal  dii-ection  fi'om  the  fur- 
nace. Neither  should  we  attempt  to  conduct  a  hot-air  flue  against  the 
direction  of  the  prevailing  wind,  in  exjjosed  situations.  If  a  windwai-d 
room  cannot  be  wanned,  because  the  fui'nace  air  refuses  to  enter  it,  the 
remedy  is  to  open  a  chimney  flue  in  the  room  ;  it  may  be  necessaiy  to 
light  a  fire  to  increase  the  draught  of  the  chimney.  Aii'  cannot  be  forced 
into  a  tightly  closed  room  :  a  failure  to  warm  such  a  room  is  remedied  by 
opening  a  discharge  for  the  air  from  it.  Flues  supplying  different  rooms 
sometimes  "draw  against  each  other,"  as  chimneys  will;  this  is  hkely  to 
occur  when  the  supply  from  below  is  not  sufiScient  for  all,  either  becaiise 
the  air-box,  or  inlet  of  fi-esh  air  to  the  furnace,  is  too  small,  or  because 
after  it  has  been  closed  in  a  high  wind  some  one  has  neglected  to  open  it. 
A  most  eccentric  effect  is  sometimes  produced  when  a  ciuTent  of  hot  air 
passes  out  of  the  orifice  for  supplpng  fresh  air  to  the  fui-nace,  while  the 
air  is  sucked  downward  fi'om  the  rooms. 

The  best  way  to  heat  a  house  at  moderate  expense  seems  to  be  by  a 
combination  of  hot-air  furnace  in  the  cellar,  and  oj^en  fii'eplaces  in  the 
rooms.  The  false  fireplaces,  with  dummy  mantels,  which  take  the  place  of 
the  true  in  cheap  houses,  violate  not  only  the  principles  of  taste,  but  the 
laws  of  ventilation.  An  open  fireplace  in  a  closed  room  is  very  useful,  not 
YoL.  II.— 30 


466  AMERICAN    AFPENPIX   TO    PARKEs'    HYGIENE. 

merely  as  a  means  of  warmth,  nor  even  as  combining  warmth  and  ventila- 
tion ;  it  helps  greatly  in  giving  equality  of  temperatm-e,  by  drawing  the 
furnace  air  down  to  its  owTi  level.  This  it  does,  even  when  there  is  no  fire 
actually  burning  in  it. 

Fresh  air,  in  coming  into  a  furnace,  must  not  be  brought  through 
underground  ducts,  as  a  rule,  unless  we  can  be  sure  of  the  purity  of  the 
soil.  It  is  necessary  to  choose  a  point  for  the  intake  somewhat  above  the 
level  of  the  ground.  In  city  houses,  one  may  sometimes  see  alternate  half- 
bricks  removed  checker- wise  from  the  walls  of  the  outer  vestibule,  outside 
of  the  door,  which  is  a  safe  place  for  taking  air.  A  grating,  to  protect 
from  vermin  ;  a  slide,  to  regulate  amount ;  and  sometimes  a  sifter  of  cloth, 
to  keep  out  dust,  are  necessary.  To  obviate  the  inconveniences  arising 
from  wind-pressure,  it  is  well  to  arrange  inlets  on  opposite  sides  of  the 
house.  For  large  buildings,  reservoirs  may  be  planned,  in  which  the 
pressure  may  be  kept  equal  by  valves  at  inlets.  These  remarks  apply  to 
inlets  for  other  apparatus  than  furnaces. 

It  is  well  to  use  a  larger  size  than  is  considered  absolutely  necessary. 
There  is  economy  in  running  at  moderate  rates.  A  reserve  of  power  for 
the  coldest  weather  should  be  on  hand.  The  general  fault  of  hot-air  fur- 
naces is  that  they  deliver  the  air  too  hot  ;  and  this  must  be  obviated  by 
making  them  much  larger,  so  that  they  shall  not  have  to  be  raised  to  a 
red  heat,  and  may  at  the  same  time  furnish  a  larger  volume  of  aii*. 

Much  is  said  of  the  desirability  of  substituting  \vi-ought  for  cast  iron. 
The  former  possesses  the  advantages  of  superior  tightness  at  joints,  but  is 
said  to  wear  out  sooner.  The  passage  of  gases  through  joints  is  certainly 
undesirable.  Furnaces  built  of  soapstone  are  said  to  be  very  tight ;  they 
occupy  a  great  deal  of  space,  but  are  praised  for  the  qviality  of  their  air. 

Automatic  dampers  or  regulators  of  the  lower  air-draught  are  appli- 
cable to  furnaces  for  heating  air,  water,  or  steam.  Dampers  in  the  smoke- 
flues  are  undesmable  ;  the  joints  should  be  so  good  that  opening  and  shut- 
ting of  the  lower  door  is  sufficient.  ' 

Contamination  of  air  by  the  escape  of  carbonic  oxide  has  been  said  to 
be  a  source  of  esj^ecial  danger  in  the  case  of  cast-iron  stoves  and  fiu-naces 
(Deville  et  Troost).  Eecent  experiments  by  Professor  Ira  Remsen  (1881) 
seem  to  show  that  these  views  should  be  modified.  "  The  hypothesis  is  per- 
haps justifiable  that  carbonic  oxide  is  present  in  the  air  of  rooms  heated  by 
cast-iron  stoves  and  hot-air  furnaces,  but  not  that  it  is  present  in  quantities 
as  great  as  0.04  per  cent.  ;  and  it  remains  to  be  shown  whether  such  minute 
quantities  of  the  gas,  if  present,  can  act  injuriously  on  the  health  of  those 
who  breathe  it."  In  short,  Eemsen  was  unable  to  detect  the  smallest 
quantity  appreciable  by  the  Vogel-Hempel  process  in  air  which  had  been 
passed  over  white-hot  cast-ii'on  stoves. 

HOT-WATEK   A>fD    OTHER   APPABATUS. 

Hot-water  apparatus  is  more  costly  than  a  simple  furnace,  and  takes 
room.  It  is  comparatively  little  used  here.  It  is  highly  praised  by  Dr. 
Billings,  as  applied  to  the  heating  of  the  Barnes  Hospital,  near  Washing- 
ton. The  defect  which  he  notices  at  that  hospital  is  an  inabihty  to  raise 
or  lower  the  temperature  quickly,  which  ought  to  be  remedied  by  some 
simple  plan  for  partially  deflecting  the  incoming  air  (Figs.  lOG,  107).  The 
same  arrangement  ought  to  be  applied  to  steam  heaters,  although  some 
have  been  successful  in  arranging  mtdtiple  coils,  which  can  be  shut  off  in 
sections  for  the  pvu-pose  of  lowering  temperature. 


VENTILATIO:X    AXD    WARMING-. 


467 


-i 


^ 


The  advantage  possessed  by  both  hot-water  and  steam  over  hot-aii-  fui- 
naces  consists  in  the  power  of  transferring  heat  to  any  desu-ed  point. 
Both  ought  to  be  combined  with  aiTangements  for  ventilation,  as,  for 
example,  in  the  sketch  of  a  window-radiator  (Fig.  104). 

The  extent  to  which  heating  by  steam  is  carried  is  illustrated  by  the 
State  Lunatic  Asylum  at  Indianapolis,  which  has  a  total  volume  of  rooms 
—  2,574,084  cubic  feet,  warmed  by  34,100  square  feet  of  radiating  surface 
(two-thii'ds  indirect).  Steam  is  successfully  supjDlied 
by  comjDanies  in  New  York  to  private  houses  through 
street  mains,  like  gas.  Technical  improvements  in 
the  art  of  steam-fitting  have  been  made  in  great  num- 
bers by  American  mechanics. 

Steam  heat,  like  furnace  heat,  is  apt  to  be  exces- 
sive in  mild  weather.  Shutting  off  steam  is  not  always 
adapted  to  the  circumstances.  If  a  large  building  is 
to  be  wai'med  by  the- aid  of  propulsion,  the  method 
may  be  suggested  which  is  believed  to  have  been  first 
proposed  by  Major-General  M.  C.  Meigs,  U,  S.  A.,  for 
the  United  States  Capitol  at  Washington,  in  1856.  He 
placed  a  large  auxiliary  warming  coil  at  the  entrance  of 
the  main  supply-flue  that  leads  fi-om  the  fire  into  the  building.  By  shutting 
o£f  parts  of  this  coil  and  by  the  use  of  by-passages  and  regulating  shutters 
or  dampers,  the  air  entering  the  main  supply-flue  to  the  building  can  at 
all  times  be  warmed  to  a  uniform  temjoerature  of,  say,  50^  F.  Air  at  this 
temperatiu'e  can  be  safely  conducted  to  special  coil-boxes  in  any  j)art  of  a 
building,  where  it  receives  any  desii'ed  addition  of  heat,  and  enters  the 
rooms  at  from  50^  to  120°  F.,  as  may  be  needed.  This  arrangement  is  eco- 
nomical of  steam-pipe. 


Fig.  104.— Inlet  for  Fresh 
Air  under  Window.  (Gonge. ) 


VE>'TnLATi>'G  Stoves  akd  Geates. 

The  princijole  of  supplying  fresh  warmed  air  by  fireplaces  and  stoves 
in  the  room  has  been  applied  in  several  ways  in  the  United  States.  The 
"Galton  "  stove  seems  not  to  be  manufactured  here  ;  its  place  is  taken  by 
^  the  Fh'eplace  Heater,  and  the  Fire  on  the  Hearth, 

the  Dimmick  Heater,  and  the  Jackson  Fireplace. 
A  series  of  experiments  by  J.  P.  Putnam  '  gave 
the  following  resvilts  as  regards  the  percentage  of 
heat  rendered  available  for  wanning  a  room.  By 
an  ordinary  fireplace,  six  per  cent,  of  total  heat 
generated  ;  Fireplace  Heater,  thirteen  per  cent, 
with  wood,  twenty  j)er  cent,  with  coal ;  Dimmick 
Heater,  eighteen  per  cent,  with  wood,  twenty-five 
per  cent,  with  coal ;  Jackson  Fireplace,  wood, 
twenty-seven  per  cent.  An  improved  aiTange- 
ment  of  flues  would  add  five  j)er  cent,  to  these 
figures.  The  Fire  on  the  Hearth  is  mentioned  by 
Youmans  as  supplying,  with  a  small-sized  stove, 
over  ten  thousand  cubic  feet  of  air  at  160"  F.  in 
an  hour,  the  outside  temperature  being  46°  ;  it 
is  a  movable  cast-iron  stove,  wliile  the  others  are  set  in  the  chimney. 

It  is  to  be  hoped  that  the  "  ventilating  fireplaces  "  will  be  lai'gely  intro- 
duced into  the  better  class  of  houses. 


Fig.  105.— Stove  Trith  Fresh- 
air  Supply. 


'  The  Open  Fireplace  in  all  Ages,  by  J.  P.  Putnam.     J.  R.  Osgood  &  Co.,  1881. 


468  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

The  principle  of  inti'oducing  fresh  air  can  be  applied  in  a  cheap  and 
effective  way  by  running  a  fine  from  under  the  stove  to  and  thi'ough  the 
house-Avall,  as  represented  in  Fig.  105,  where  the  stove  is  seen  surrounded 
by  a  cylinder  of  sheet-iron  set  on  the  floor.  The  amount  of  fresh  aii'  thus 
introduced  is  abundant  for  domestic  jDuriDOses,  and  not  insignificant  (though 
greatly  inadequate)  in  the  case  of  schools.  This  principle  is  adopted  in 
the  Belgian  school  stove  exhibited  at  Philadelphia,  1876.  It  wiU  not  suc- 
ceed if  the  room  is  tight,  without  an  outlet  ;  for  the  ordinary  stove  dis- 
charges by  its  flue  barely  as  much  ah'  as  is  required  for  combustion. 

Temperature  and  Moisture. 

The  American  "  fondness  for  over-heated  rooms "  has  often  been  re- 
marked. No  doubt  a  part  of  this  fondness  is  merely  a  bad  habit,  and  is 
both  the  cause  and  the  index  of  delicacy  of  physicjue.  But  something 
must  also,  in  aU  probability,  be  ascribed  to  the  climate,  which  is  of  a  troj)i- 
cal  nature  for  sevend  months  in  the  year.  Those  accustomed  to  a  daily 
heat  of  70°  to  100°  in  summer,  may  jDerhaps  become  less  capable  of  resist- 
ing cold  in  winter.  It  is  also  a  fact  that  most  parts  of  our  country  possess 
a  drier  atmosphei'e  than  that  of  England,  and  Western  Europe,  and  that 
moisture  acts  as  a  protective  against  the  loss  of  bodily  heat ;  hence,  an 
American  room  in  winter,  with  a  dry  hot  air  (70°  F.),  may  appear  to  its  oc- 
cupants no  warmer  than  an  English  room  with  a  moister  air  at  65°  F.,  or 
even  at  a  lower  point.  The  change  which  has  occui'red  in  the  habits  of 
Europeans  and  their  descendants  in  America,  has  been  made  the  subject 
of  much  remark.  It  is  within  the  knowledge  of  the  writer,  however,  that 
families  have  been  brought  up  in  perfect  health,  and  adult  famiUes  are 
now  living,  in  temperatui-es  much  lower  than  those  usually  thought  needful. 
A  friend  of  the  writer's  keeps  his  house  at  60°  F.,  has  his  children  taught 
in  a  little  private  school  at  his  own  house,  and  in  summer  carries  them 
away  to  a  cool  seaside  resort ;  but  few  can  carry  out  such  a  plan.  The 
aged  prefer  80°  F. 

The  mildness  of  the  Enghsh  climate  permits  the  use  of  open  grates, 
which  with  us  are  necessarily  rej)laced  by  the  more  powerful  apparatus, 
stoves  and  furnaces  and  steam-heaters.  Hence  we  lose  the  effect  of  lumi- 
nous heat,  which  is  probably  greater  in  its  sensible  action  than  a  (measured) 
equal  heat,  without  Hght,  as  furnished  by  stoves.  Fui-thermore,  the  Eng- 
lish ojoen  fire  is  a  ventilating  agent,  sufficient  for  household  purposes ; 
while  the  closed  stove  in  common  use  among  us,  economical  as  it  is  of  heat, 
gives  very  little  ventilation.  Doubtless  the  discomfort  felt  in  close  rooms 
thus  heated  is  partly  due  to  a  mere  want  of  ventilation.  Another  source 
of  discomfort  is  the  escape  of  gas  (sulphurous  fumes)  through  leaks  in  ap- 
paratus ;  and  another,  the  mere  over-heating  of  air,  by  contact  wdth  very 
hot  iron,  which  seems  to  affect  its  sensible  qualities  in  a  disagreeable  way. 
Heaters — whether  furnaces,  stoves,  or  coils  of  steam  or  hot  water — ought 
to  yield  air  of  a  moderate  temperature,  ranging  from  90°  to  120°  F.,  accord- 
ing to  the  weather.  They  are  commonly  made  too  small,  and  have  to  be 
"  run  "  too  fast ;  this  is  especially  true  of  stoves  and  furnaces.  Low-pressure 
steam  (it  is  said)  usually  gives  heated  air  at  from  90°  to  110°  F.  ;  hot-air 
furnaces,  above  140°  F.  ;  hot-water  coils,  any  temperature  desired.  Such 
are  the  common  statements  ;  but  an  ordinary  hot-air  furnace  in  the  writer's 
house  is  now  giving  air  at  124"  F.,  and  another  in  a  neighbor's  house  at 
94°  F.,  the  outer  air  being  at  34°  F. 

As  regards  the  supplying  of  mois^ture  by  artificial  evaporation,  much 


YEXTILATIOX    AXD    WAE:inXG.  4.69 

may  be  said  on  iDoth  sides.  Some  persons  seem  to  require  a  moist  air.  A 
fine  jet  of  ^vater  thi'ovm  into  heated  air  gives  a  pleasant  quality ;  it  cools 
it,  also.  On  the  other  hand,  much  of  the  complaint  of  •'•'  diied-up  "  air  can 
he  remedied  by  ventilation,  as  ah'eady  stated  ;  and  in.  hospitals,  ^vhere  a 
hberal  supply  is  afforded,  a  very  low  proportion  of  moistui'e  is  compatible 
vdih  a  very  pleasant  eftect  upon  the  senses,  and  good  hygienic  results. 
The  requirement  of  seventy  per  cent,  of  satui-ation  is  inapplicable  to  this 
chmate. 

In  illustration  of  the  difference  between  the  American  and  the  English 
standards  of  temperatui-e  and  humidity  may  be  cited  the  obseiwations  (1) 
of  Sui'geon  D.  L.  Huntington,  at  the  Barnes  Hospital,  Washington,  and 
(2)  those  of  Dr.  Cowles,  at  the  Boston  City  Hospital — places  presenting 
very  considerable  differences  in  chmate. 

1.  Fii'st  week  in  December,  1877. — Avei-age  external  temperature,  38-^°  ; 
average  temperature  of  wards,  half  way  to  ceiling,  fi'om  71^  to  76'  F. ;  aver- 
age relative  humidity  of  house,  fi'om  44  to  59  ;  of  outer  air,  74. 

2.  Week  ending  December  10,  1878. — Average  external  temperatui-e, 
32'  F. ;  humidity,  76  ;  average  temperatui-e  of  air  at  head  of  beds  in  new 
ward,  68f  ^  F.  ;  average  relative  humidity  of  ward,  29:^. 

These  data  represent  the  degi-ee  of  diyness  which  is  not  simply  tolerated 
in  our  hospitals,  but  is  habitual,  and  is  consistent  with  a  "  peculiar  feeling 
of  freshness  and  purity  perceived  by  those  who  enter  the  room."  The 
uncomfortable  sensations  felt  in  some  warm,  dry  rooms  are  ascribed  by 
the  late  Eobert  Briggs  to  absence  of  moistui-e  ;  but  Billings  and  Cowles 
agree  that  they  are  caused  by  an  insufficient  supply  of  fresh  air.  The 
diyness  is  unavoidable  unless  water  is  evaporated  in  large  amounts  ;  and 
is  much  more  marked  in  really  cold  weather,  for  instance,  when  the  ther- 
mometer ranges  from  —20^  to  -r20"  F. 

With  these  statements  compai'e  some  in  the  present  work.  For  exam- 
ple, the  agreement  for  ventilating  the  Laiiboisiere  Hospital  stated  the  tem- 
perature required  as  15'  C,  or  59"  F.  ;  and  the  memorandum  issued  by 
the  Medical  Department  of  the  Pri%y  Council  in  1872,  for  the  government  of 
hosijitals  in  towns,  suggests  "warming  in  "uinter  to  60"  F."  (p.  358).  As 
a  provisional  stand ai'd  of  humidity,  De  Chaumont's  73  per  cent,  is  recom- 
mended (p.  153). 

The  advanced  thought  of  this  countiy  upon  the  subject  of  ventilation 
will  coincide,  doubtless,  in  the  statement  that  '"'the  amount  of  supply  for 
audience  halls  occupied  for  sessions  not  exceeding  two  or  thi-ee  hours' 
duration  should  in  no  case  be  less  than  30  cubic  feet  of  aii'  per  minute 
through  the  regular  flues  of  supply,  and  in  legislative  buildings  the  apjDar- 
atus  should  be  such  that  at  least  45  cubic  feet  of  air  per  person  per  minute 
can  be  fuimished,  Avith  a  possibihty  of  increasing  it  to  60  feet  per  minute 
when  desired  "  ( Billings j, 

Special  BrrLDiyos,  etc. 

One  of  the  most  satisfactoiy  small  hospitals,  in  point  of  heating  and 
ventilation,  is  the  Barnes  Hospital  at  the  Old  Soldiers'  Home,  near  Wash- 
ington. This  con  tarns  four  wards,  in  two  stories  ;  each  ward  has  twelve 
beds,  and  an  allowance  of  1,500  cubic  feet  per  bed.  The  wards  are  heated 
by  coils  of  hot  water,  j)laced  in  air-chambers  in  the  basement  at  the  walls. 
The  flow  of  water  to  each  coil  can  be  regulated  by  a  cock  ;  but  it  rec[uires 
an  hour  for  a  coil  to  cool  down,  and  an  arrangement  for  more  speedy 
change  is  to  be  desired.    (See  Figs.  105  and  106. )    The  fresh-air  flues  are  of 


470 


AMERICAN    APPENDIX    TO    PAIIKES     HYGIENE. 


terra-cotta  pipe  built  into  the  walls.  The  foul-air  flues  are  Hned  with  tin, 
and  are  cleaueLl  daily  ;  there  are  two  for  each  ward,  one  above  the  ceiling 
and  one  below  the  floor,  at  the  middle  ;  each  has  five  inlets  ;  and  the 
patients  being  under  military  discipline  tlie  inlets  are  not  defiled  as  they 
would  be  likely  to  be  in  a  civil  hospital.     These  ducts  lead  to  an  aspirator 

chimney,  heated  b}'  the  boiler  flues  and  kitch- 
en flues,  or  by  a  special  tire  when  the  boiler 
is  not  in  operation  in  moderate  weather.  The 
mean  velocity  of  the  uj^ward  current  of  air  is 
180  feet  per  minute  ;  with  good  fires  in  the 
gi-ates  at  the  base  the  highest  recorded  veloci- 
ty was  700  feet.  A  fan  is  used  to  force  cool 
air  thi'ough  the  heating  flues  in  moderate 
weather,  when  it  is  unsafe  to  open  windows. 
In  an  experiment,  all  the  outlets  to  a  certain 
ward  having  been  closed  for  thirty-five  min- 
utes, the  air  was  found  to  contain  11.23  per 
10,000  of  CO,  which  was  reduced  to  3.75  by 
ten  minutes'  use  of  the  fan. 

Examj^les  of  a  t^^De  of  construction  which 
oiigiuated  in  the  exigencies  of  militaiy  service 
ai'e  found  in  the  new  detached  wards  of  the 
Boston  hospitals.  The  "  WaiTen  "  ward  (Mas- 
sachusetts General  Hospital)  consists  of  a 
single  rooin  41  feet  square,  16  feet  high  at 
the  walls,  and  22^  feet  in  the  middle.  A  stack 
of  brick  flues  occupies  the  centre  ;  each  face 
of  the  stack  has  an  oj)en  grate  with  fire. 
Further  ventilatiou  is  insured  by  twelve  openings  in  the  floor,  around  the 
stack,  at  a  distance  of  5  feet,  and  leading  to  it  by  sub-floor  ducts.  There  is 
also  a  large  roof- ventilator,  and  the  upper  segment  of  each  window  can  be 
tilted  inward  when  desired.  The  supply  of  fresh  air  enters  by  foui'  inlets 
in  the  floor,  half-way  between  the  stack  and  the  corners  of  the  room,  having 
a  combined  section  of  8  square  feet.  At  a  velocity  of  5  feet,  the  supply 
(for  twenty  beds)  would  equal  2  feet  per  second  and  patient — say,  7,200 
cubic  feet  per  hour  and  patient.  This  air  is  wai'med  by  steam  in  a  base- 
ment. 

The  "  Bigelow  "  pa\'ilion  (same  hosi^ital)  is  a  long  stinacture  of  brick, 
with  double  Avails  of  brick,  j^ainted  to  exclude  dampness.  A  hall,  8  feet 
wide  and  24  feet  high,  runs  lengthwise  through  the  middle.  There  are  six- 
teen rooms  for  patients,  with  one  bed  each,  besides  accessory  rooms.  Each 
room  has  its  fireplace,  with  additional  means  for  extracting  air  at  top  and 
bottom,  so  as  to  change  the  air  once  in  ten  minutes.  Fresh  air  enters 
near  the  ceiling,  having  been  warmed,  something  in  the  Galton  method, 
by  contact  with  the  flue  of  the  fireplace. 

These  wards  are  one  story  in  height,  are  not  in  contact  with  any  other 
wards,  and  can  be  isolated  when  desii-ed.  The  latest  development  of  this 
type  is  found  in  the  new  (unfinished)  Johns  Hopkins  Hospital,  in  Balti- 
more, where  each  ward  is  practically  a  separiite  small  hospital,  and  it  is 
impossible  to  pass  from  one  ward  to  another,  or  from  the  corridor  which 
connects  the  basements,  A^ithout  going  into  the  open  air.  Ventilation  is 
effected  by  asjDiration,  by  a  separate  chimney  for  each  ward.  There  is  a 
single  duct  down  the  middle  of  the  ward,  under  the  floor,  with  one  branch 
to  each  bed,  opening  under  the  foot  of  the  beds.     Another  duct  is  placed 


Fio.  106. — Apparatus  for  rapidly 
changing  Temperature  of  incoming  Air. 
(Johns  Hopkins  Hospital.)  A.  Inlet: 
valve  in  p  isition  to  arlmit  a  little  un- 
warraed  air.  /f.  Slide-valve.  2>,  Valve. 
E,  Register,  air  entering  ward. 


VENTILATIOlSr    AND    WAKMING. 


471 


Fig.  107.— Massachusetts  General 
Hospital.  A,  House-wall.  B,  Valve- 
openinEr  through  wall.  C,  Valve  for 
regulating  heat,  in  position  to  give  the 
greate.'-t  heat.  D,  Handles  for  work- 
ing B  and  C,  placed  close  to  register 
in  ward. 


above  the  ceiling,  communicating  with  the  ward  by  five  openings.  The 
former  will  be  used  for  winter  ventilation,  the  latter  in  summer.  The 
ducts  are  of  galvanized  iron,  or  lined  with  that  material  to  prevent  leak- 
age. Each  ward  will  have  a  small  propelling  fan,  designed  to  force  air 
through  the  heaters  and  flush  the  ward  two  or  three  times  a  day.  The 
heaters  are  placed  in  the  basement  of  each  ward,  along  the  outer  walls  ; 
they  consist  of  steam-coils.  The  diagram  (Tig. 
107)  shows  that  the  supply  of  fresh  air  is  taken 
from  out-doors  ;  but  the  air  of  the  basement 
(which  is  used  for  no  other  purj)ose)  can  in 
cold  weather  be  drawn  upon.  The  "  base- 
ment" is  not  a  "ceUar,"  being  wholly  above 
gTound. 

The  Boston  City  Hospital  (375  beds),  fin- 
ished in  1864,  on  the  pavilion  plan,  was  at  first 
supplied  with  air  forced  through  underground 
brick  ducts,  exposed  to  pollution.  The  system 
for  the  original  pavilions  has  since  been  entire- 
ly changed  ;  propulsion  is  abandoned,  and  local 
steam-coils  are  placed  in  air-chambers  under 
the  points  to  be  supj)lied.  The  beneficial  effect 
upon  the  health  of  surgical  cases  was  shown 
by  the  fact  that  the  rate  of  deaths  from  com- 
pound fractures  fell  from  forty-one  to  twenty 
per  cent.  ;  after  amputations,  from  forty-four 
to  thirteen  per  cent. 

Certain  observations  made  in  the  new  one-story  wards  have  already  been 
mentioned.  These  wards  are.  94  x  2,6^  feet  in  the  clear,  and  with  curved 
roofs  averaging  18  feet  5  inches  in  height.  Each  has  twenty-eight  beds, 
giving  88|-  square  feet  of  floor-space,  and  1,629  cubic  feet  of  air-space  to 
each  bed.  Air  is  introduced  as  in  the  Johns  Hopkins  wards,  and  is  re- 
moved through  ridgepole  ventilators  without  traction.  A  general  uniform 
upward  movement  is  observed,  with  little  tendency  to  areas  of  stagnation. 
Analysis  gave  the  following  results:  mean  carbonic  acid,  0.0505  per  cent.  ; 
that  of  outside  air,  0.0325  ;  air-supply  per  head  per  hour,  3,333  cubic  feet; 
respiratory  impurity,  0.018  per  cent. 

The  accompanying  diagram  (Fig.  108)  gives  the  curve  of  the  central  axis 
of  the  hot  air  currents  entering  the  room  from  opposite  sides.  It  passes 
through  points  of  greatest  velocity,  ascertained  by  measurements  by  ane- 
mometer, taken  at  intervals  of  a  foot  in  perpendiculars  erected  on  the 
points  A,  B,  C,  D,  D,  C,  B,  A,  the  latter  being  three  feet  apart.  The  draw- 
ing is  to  scale,  and  shows  that  the  horizontal  impulse  is  nearly  expended  at 
D,  about  seven  feet  from  the  floor  and  nine  feet  in  fi'om  the  walls.  Above 
the  height  of  twelve  feet  the  general  upward  movement  becomes  sluggish, 
to  be  much  quickened  near  the  point  of  exit  E.  It  is  thought  that  the  air 
might  leave  the  room  more  quickly,  with  less  risk  of  readmixture,  if  the 
ceiling  were  lowered  to  the  height  of  at  most  fourteen  feet. 

The  New  York  Hospital  has  four  stories.  There  is,  one  window  to 
each  bed.  The  foul  air  flues  are  contained  in  the  external  piers,  which  are 
lined  with  hollow  brick  to  prevent  the  escape  of  heat.  The  openings  for 
discharging  air  from  the  wards  are,  partly  near  the  ceiling,  j)artly  near-  the 
floor,  and  one  under  the  middle  of  each  bed.  Hot  air  is  conveyed  by  cast- 
iron  tubes  running  through  the  middle  of  these  flues,  fitted  so  as  to  be  air- 
tight ;  but  this  collocation  of  foul  and  fresh  air  tubes  seems  questionable. 


472 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


There  is  the  peculiarity  of  two  fans — one  for  propulsion  and  one  for  ex- 
haust. The  average  air-supply  is  stated  at  2,400  cub.  ft.  per  bed  and  hour. 
The  hall  of  the  House  of  Representatives,  at  Washington,  is  supplied 
with  air  taken  from  a  distant  high  tower,  and  passing  through  a  tunnel. 
Forced  in  by  fan-power,  it  enters  through  apertures  ha\dng  a  total  sectional 
area  of  300  square  feet  on  the  floor  and  125  in  the  galleries,  and  passes  out 
through  the  ceiling.  A  fan  was  fomierly  so  placed  as  to  accelerate  the  exit, 
but  the  result  was  to  create  a  partial  vacuum  in  the  hall,  with  a  strong  ten- 


FlG.  108.— City  Hospital,  Boston.     Floor  of  Ward,  26  feet  across. 
(Scale,  8  feet  to  the  inch.) 

dency  of  the  air  in  the  corridors  to  enter  through  the  doors,  bringing  dis- 
agreeable odors.  This  fan  is  now  employed  in  aspirating  from  the  cor- 
ridors, with  satisfactory  results.  An  analysis  made  after  three  and  a  half 
hours  of  session,  550  persons  being  present,  showed  a  proportion  of  7.G7 
parts  of  CO,  per  10,000. 

The  Madison  Square  Theatre,  in  New  York  City,  is  one  of  the  best  ven- 
tilated buildings  of  its  class.  The  air  is  taken  in  at  a  tower  above  the 
roof  ;  it  is  sifted  thi-ough  a  conical  bag  of  cheese-cloth,  forty  feet  long,  sus- 
pended in  the  tower  ;  it  is  heated  by  steam  in  winter,  and  cooled  in  sum- 
mer by  passing  over  ice,  four  tons  being  required  for  each  evening.  One 
fan,  at  the  foot  of  the  tower,  forces  the  air  in  ;  another,  on  the  roof,  ex- 
hausts it.  The  doors  and  windows  are  kept  closed.  Heating,  cooling,  and 
distributing  take  place  in  the  cellar.  The  air  is  introduced  by  pipes,  run- 
ning under  the  risers  ;  an  opening  in  the  riser,  at  each  seat,  discharges  a 
forward  current,  with  a  velocity  of  two  and  a  half  feet  per  second.  Other 
jets  enter  at  the  front  of  the  footlights,  and  below  the  balconies.  The 
exits  are  chiefly  under  the  balconies,  so  that  there  is  a  general  movement 
away  from  the  stage.  It  is  thought  that  the  acoustic  effect  is  improved  by 
this  circumstance.  The  footlights  are  ventilated  into  a  horizontal  duct,  in 
which  the  gas-pipe  is  laid,  thus  heating  the  gas  before  it  is  burned.  The 
great  dome  light,  and  the  other  gas-lights,  are  enclosed  in  glass,  and  ven- 


VENTILATION    AND    WAKMING.  473 

tilated  upward.  The  supply  is  a, 500  cubic  feet  per  hour  and  head  ;  the 
theatre  seats  650  persous. 

The  New  York  State  Reformatory  at  Elmira  contains  500  cells.  A 
block  of  cells  resembles  a  huge  one-story  shed,  through  the  middle  of 
which  runs  a  pile  of  boxes,  two  deep  and  three  high.  The  boxes  repre- 
sent cells.  The  free  space  near  the  outside  walls  is  sujDplied  with  warm 
air  from  below  ;  this  freely  enters  at  the  grated  doors  of  cells  ;  the  foul  air 
passes  out  by  two  orifices  in  the  rear  wall  of  each  cell,  one  of  which  is  so 
arranged  as  to  ventilate  the  niche  for  the  night-pail.  The  foul  air  ducts 
are  4x4  inches,  and  terminate  in  heated  chambers  and  asj)irating  chimneys 
in  the  roof.  The  inta,ke  of  fresh  air  is  in  a  tower,  and  a  fan  is  used  to 
force  the  current. 

One  of  the  best  ventilated  churches  in  the  United  States  is  said  to  be 
the  Presb}i;erian  Chui-ch  in  Fifth  Avenue,  New  York  (Dr.  Hall's),  which 
has  a  capacity  of  seating  2,000.  The  intake  is  by  a  tower  100  feet  high, 
and  the  supply  is  from  10,000  to  15,000  cubic  feet  per  minute,  depending 
on  the  speed  of  the  fan.  At  the  lower  rate  of  speed,  and  with  a  congrega- 
tion of  1,400,  the  result,  after  a  service  of  an  hour  and  a  half,  was  a  pro- 
portion of  12|-  parts  carbonic  acid  per  10,000,  The  fan,  however,  is  con- 
tinued in  operation  during  the  interval  of  morning  and  afternoon  service, 
thus  thoroughly  flushing  out  the  room.  The  entire  basement  story  forms 
an  air-chamber,  from  which  the  warmed  air  passes  through  openings  in 
the  risers  of  the  stationary  foot-benches  of  each  pew,  the  supply  to  each 
pew  being  under  the  control  of  its  occupants.  The  air-supply  is  warmed, 
first,  by  4,410  feet  of  steam-pipe  in  the  duct,  just  after  passing  the  fan  ; 
second,  by  9,000  feet  of  pipe  fixed  to  the  ceiling  of  the  basement.  The 
latter  pipe  aids  greatly  in  warming  the  floor. 

A  plan  of  combined  heating  and  ventilation  has  become  popular  in 
the  Lake  States  and  Canada,  under  the  name  of  the  Ruttan  system.  The 
proprietors  profess  to  produce  remarkable  heating  effects  by  means  of  large 
tubular  casi^iron  fumaq^s,  which  are  said  to  weigh,  in  general,  four  times 
as  much  as  "  ordinary''  stoves  "  (their  largest  weighing  5  tons).  Owing  to 
their  size,  they  are  able  to  warm  large  amounts  of  au-  to  a  point  not  above 
90°  F.  The  foul  air  is  extracted  by  openings  in  the  base-boards,  close  to 
the  floor,  and  thence  passes  under  the  floor  to  an  exhaust-shaft  heated  by 
an  iron  smoke-flue.  It  is  said  that  the  air  is  changed  once  in  half  an  hour 
or  less. 

The  principle  of  induction  of  au'-currents  is  apphed  in  Gouge's  ventila- 
tor. This  consists  of  a  small  metal  tube,  heated  by  a  gas-jet,  with  an  open 
end  near  the  floor  ;  at  a  sudden  enlargement,  near  the  ceiling,  a  second 
opening  is  made,  into  which  au-  is  drawn  by  the  inductive  force  of  a  current 
already  estabhshed.  If  the  tube  passes  through  another  stoiy,  other  open- 
ings and  enlargements  are  made.  The  principle  of  induction  is  the  same 
that  is  used  in  the  water-blasts,  for  ventilating  mines. 

Where  funds  are  scanty,  a  very  cheap  and  fit  plan  is  to  run  plain  straight 
tin  pipes  from  some  point  near  the  floor  to  a  point  above  the  roof,  capping 
them  to  prevent  rain  and  wind  from  entering.  .  There  must  be  no  bends, 
and  no  exposure  to  cold  until  the  roof  is  passed.  While  the  house  is 
warmed,  the  current  in  such  pipes  is  constant. 

"Aspiration  from  above"  is  used  in  many  schools  and  institutions. 
Pipes  are  run  upward  from  the  rooms  to  one  large  tin-lined  box  in  the 
garret,  which  is  heated  by  steam,  and  discharges  through  the  roof.  The 
plan  is  adapted  to  old  buildings  without  flues,  pro^ided  the  pipes  run 
straight.     For  dormitories,  it  may  serve  a  very  excellent  pvurpose. 


474 

The  small  space  allowed  in  raili-oad  cars  makes  it  extremely  hard  to  ven- 
tilate them.  An  ordinary  passenger  car  gives  about  33  cubic  feet  -per  man  ; 
a  smoking-cai'  50  feet.  Nichols'  results  of  analyses  of  ah'  were  correspond- 
ingly imfavorable,  viz.  :  For  smoking-cars,  from  12.7  to  36.9  of  CO^  per 
10,000  ;  average  22.8.  For  jDassenger  cars,  lowest  17.4,  highest  36.7, 
average  23.2. 

Some  cars  are  furnished  with  valve-boards  at  the  ends,  on  which  a  no- 
tice is  painted  to  show  their  use.  lu  othei*s,  the  windows  are  aiTanged  so 
that  they  can  be  raised  only  a  couj^le  of  inches — in  the  hope  of  protecting 
passengers  against  indiscriminate  ventilation.  In  others,  a  positive  venti- 
lation is  secured  by  valves  in  the  monitor  roof,  which  are  regulated  by  the 
conductor  with  a  stick. 

The  elevated  railroads  in  New  York  wann  their  cars  by  steam  pipes 
under  the  seats ;  each  car  is  connected  by  rubber  tubes  with  its  neighbors, 
and  the  whole  system  is  constantly  supplied  with  dry  steam  fi'om  the  en- 
gine, the  condensed  water  being  blown  through  to  the  rear  of  the  train 
and  there  discharged  by  a  vent.     This  does  not  secure  ventilation. 

A  supply  of  fresh  warmed  air  can  be  furnished  by  making  use  of  the 
motion  of  the  car  to  force  air  over  the  heater.  The  heater  is  inclosed  in  a 
fresh-air  box  at  one  end  of  the  cai',  from  which  the  heated  air  is  led  in 
wooden  pipes  to  any  part  where  the  supply  is  wanted.  The  supply  neces- 
sai'ily  ceases  when  the  car  stops  ;  but  usually  the  need  for  ventilation  also 
ceases  at  the  same  time. 

A  combination  of  hot- water  pipes  cu'culating  around  the  base,  and  no- 
pressure,  open  steam-pipes  at  a  high  level,  distributes  the  heat  effectively. 

The  pi'oblem  of  cooling  the  air  of  a  sick-room  in  connection  with  venti- 
lation was  illustrated  during  the  illness  of  the  late  President  Gai'lield.  An 
outside  temperatiu-e  of  from  80""  to  100^  F.  was  to  be  exj)ected.  It  was 
computed  that  from  thi-ee  to  foiu-  tons  of  ice  daily  (?)  would  be  required 
in  order,  by  its  melting,  to  cool  the  necessary-  amount  of  air  {twelve  thousand 
cubic  feet  per  hour).  Air  was  forced  by  an  engina  thi'ough  an  ice-box  of 
the  capacity  of  six  tons  ;  on  leaving  this  the  air  traversed  another  appa- 
ratus consisting  of  a  box  6^  feet  long  and  27  inches  square,  provided  with 
a  large  number  of  cotton  screens,  kept  constantly  wet  by  the  water  which 
dripped  from  the  ice  ;  thence  it  was  taken  to  the  President's  room  by  a 
tin  tube.  To  prevent  the  noise  of  the  engine  reaching  the  room,  a  tube  of 
canvas  was  aftei-ward  substituted,  when  the  sound  entirely  ceased.  A 
l-l-inch  blower  being  foimd  insufficient,  one  of  36  inches  was  substituted. 
The  temperature  of  the  enteiing  au*  was  found  to  be  55.1°,  while  that  of 
the  oj)en  air  was  84.6''.  The  process,  however  expensive,  was  satisfactory 
in  accomplishiug  the  object  desired. 

In  the  Fifth  Avenue  Presb}i:erian  Chvu'ch  of  New  York  City  the  au'  is 
cooled  in  the  inlet  shaft  by  spray  from  a  perforated  pipe.  ^Yhen  the  tem- 
perature of  the  water  was  69^,  the  air  passing  through  the  spray  was  cooled 
fi'om  77"  to  73'  ;  by  the  use  of  ice  the  temperature  has  been  lowered  as 
much  as  six  degrees. 

General  M.  C.  Meigs  has  experimented  with  window-sashes  containing 
double  thickness  of  glass,  for  the  pui-pose  of  checking  the  loss  of  heat  by 
radiation  and  otherArise.  A  thermometer  placed  between  the  panes  indi- 
cates a  temperatui'e  veiy  nearly  half-way  between  that  outside  and  that 
within  the  room. 


EEMOVAL    OF    HOUSE-WASTE. 

By  EDWAED   S.  PHTLBEICK,  M.A.  S.O.E.,  Boston,  Mass. 
The   Need   of   Pkoiipt   Removal. 

The  opinion  of  all  intelligent  persons  is  unanimous  upon  this  question. 
Nevertheless  the  practice  of  most  communities  is  very  far  behind  the 
theory.  It  needs  no  argument  to  convince  us  that  it  is  not  proper  or  con- 
ducive to  health  to  allow  fecal  matter  or  organic  waste  in  any  form  to  ac- 
cumulate, either  in  the  interior  of  our  dwelHngs,  or  in  their  immediate 
vicinity.  Nature  has  given  us  a  sense  which  is  disgusted  by  siTch  practices, 
and  it  requires  no  high  degree  of  refinement  to  condemn  them  from  the 
tribunal  of  good  taste  alone,  without  recoui'se  to  hygienic  laws  or  local 
statistics. 

It  seems  strange  that,  with  such  unanimity  of  opinion,  no  better  devices 
should  be  used  by  the  majority  of  our  people  than  the  old-fashioned  privy 
with  its  vault,  or  the  more  modern  water-closet  with  its  cesspool.  The 
former  is  often  located  within  the  house-walls,  or  under  a  roof  connected 
with  the  house,  while  the  latter  is  rarely  far  from  the  dwelling,  even  when 
the  house-lot  is  large  enough  to  allow  it  to  be  so. 

This  firmly  rooted  custom  probably  originated  in  the  popular  belief  in 
certain  supposed  powers  of  the  soil  for  purification  and  disinfection.  But 
this  belief  is  founded  on  a  fallacy  which  we  think  it  quite  time  to  expose. 

Soil  is  capable  of  such  action  only  to  a  verj^  hmited  extent,  depending 
mostly  for  its  efficiency  upon  the  oxygen  in  the  air  which  it  holds  in  its 
pores,  or  upon  the  plant  roots  which  may  find  their  way  into  it. 

When  once  the  soil  has  become  saturated  with  filth  around  a  vault  or 
cessjDOol,  its  purifying  power  ceases  and  can  never  be  resumed,  unless  air 
or  the  roots  of  plants  can  penetrate  the  mass.  It  is  evident  that  these 
agents  have  a  very  hmited  access  to  the  soil  around  a  large  majority  of  the 
cesspools  and  vaults  now  in  use.  In  cities  or  towns,  very  little  if  any 
such  absorption  by  roots,  or  thorough  decomposition  by  air  in  the  pores  of 
the  soil,  can  be  possible 

The  inevitable  result,  then,  is  an  accumulation  of  a  dangerous,  putre- 
scent mass,  which  would  not  be  tolerated  if  it  happened  to  be  within  the 
reach  of  our  senses.  It  is  certainly  not  the  part  of  intelligence  or  wisdom 
to  ignore  these  facts  simply  because  they  do  not  constantly  offend  the  eye 
or  the  olfactory  nerves. 

The  evil  influences  arising  from  such  accumulations  are  manifold. 
Wherever  the  water  supply  is  drawn  from  wells  or  springs  near  the  house, 
the  drinking-water  is  liable  to  become  infected  with  the  germs  of  conta- 
gion. This  may  happen  though  the  well  is  on  higher  ground  than  the 
cesspool  or  vault.  For  the  suj)ply  of  water  is  drawn  fi-om  the  bottom  of 
the  well,  which  is  generally  twenty  feet  or  more  in  depth,  and  often  below 


476  AMERICAN    APPENDIX    TO 

the  bottom  of  the  cesspool  itself.  No  matter  how  clear  and  cool  the 
water  may  appear,  it  may  coutaiu  more  seeds  of  contagion  than  the  puddle 
in  the  street,  which  is  open  to  the  sun  and  au-. 

In  the  "  Report  of  the  State  Board  of  Health,  Lunacy,  and  Charity  of 
the  State  of  Massachusetts  for  1880,"  an  instance  of  well-poisoning  is  re- 
lated as  follows : 

"  If  the  risk  is  not  in  aU  cases  gi-eat  fi'om  the  contamination  of  wells  by 
vavdts,  etc.,  3-et  it  is  often  unsuspected,  so  far  as  any  taste,  smell,  or  appear- 
ance of  the  water  is  concerned,  and  maybe  attended  with  the  most  serious 
results,  a  striking  illustration  of  which  is  fm-nished  by  Dr.  George  Atwood, 
of  Fairhaven,  as  ha^ing  occiu'red  in  his  experience. 

"In  the  latter  part  of  August,  jMi-. was  ill  with  what  seemed  to  be 

dysentery,  but  not  so  as  to  prevent  his  keeping  about.  On  September  7th, 
he  felt  quite  ill  and  sent  for  Dr.  Atwood,  who  pronounced  the  disease  typhoid 
fever.  In  the  meantime  his  dejections  had  been  passed  fi-eely  in"  the  privy 
vault,  which  was  one  hundred  feet  distant  from  the  well  (nearly  twenty  feet 
deep)  and  separated  from  it  by  a  dry  gravel  and  loam.  After  this  date 
there  were  two  heavy  rains,  presumably  washing  the  fluid  and  soluble  por- 
tion of  the  excrement  from  the  vault,  through  the  soil  into  the  well,  by  a 
channel  ah-eady  formed  or  by  soakage  into  the  gi-ound  water.  The  water 
in  the  well  was  very  low  at  the  time,  and  could  be  aU  pumped  out  in  a 
few  minutes. 

"  September  30th,  the  wife  became  ill  with  tA-^^hoid  fever. 

"  October  3d,  a  daughter  became  ill  with  typhoid  fever. 

"October  6th,  another  daughter  became  ill  with  t^-j^hoid  fever. 

"  October  7th,  two  sons  became  ill  with  typhoid  fever. 

"  October  8th,  another  daughter  became  ill  AAith  tA-;[Dhoid  fever. 

"  October  12th,  another  daughter  became  ill  with  typhoid  fever. 

"  The  youngest  boy  had  the  disease  in  a  mild  form,  beginning  about 
the  middle  of  October. 

"An  examination  of  the  well-water  by  Prof.  Nichols,  October  17th, 
showed  that  it  contained  in  parts  per  100.000. 

Ammonia 0.001 

Albuminoid  ammonia 0.013 

Total  solids 20.030 

Chlorine 3.300 

"In  order  to  ascertain  whether  there  was  a  du-ect  communication  be- 
tween the  vault  and  well,  a  bushel  of  coarse  salt  v\-as  jDut  in  the  vault 
October  24th,  and  a  bushel  of  fine  salt  October  31st,  and  the  subsequent 
chemical  examination  gave  the  following  result : 

"Amount  of  chlorine  in  parts  per  100.000. 

Dates.  Dates. 

October  26th 3.9 

October  29th 3.9 

November  2d 4.0 

November  oth 4.4 

November  8th 3.5 

November  13th 3.4 


November  17th 3.4 

November  20th,  rain 3.3 

November  23d' 3.1 

November  26th 3.1 

November  30th 3.0 

December  3d  = 2.9 


while  before  putting  in  the  salt,  the  chlorine  was,  as  stated  above,  only  3.3. 
"It  seems  clear  that  the  effect  of  the  salt  was  directly  felt  in  the  well, 

'  Water  low  in  well.  ^  Water  low. 


EEMOVAL    OF    HOUSE-WASTE.  477 

and  that  there  was  abundant  opportunity  for  the  dejections  of  a  man  ill 
with  typhoid  fever  to  pass  into  the  water  which  his  family  were  in  "the 
habit  of  di'inking.  No  other  cases  of  typhoid  fever  were  known  to  ha;ic^ 
occurred  in  the  vicinity  during  the  summer." 

Other  cases  of  a  similar  nature  and  with  similar  results  are  cited  in  the 
same  report. 

It  may  be  argued,  however,  that  wells  are  fast  being  abandoned  in  our 
towns  and  villages,  and  that  wherever  circumstances  admit,  water  is  intro- 
duced by  street  mains  for  public  use. 

No  one  will  question  the  advantages  of  a  public  water-supply,  when  a 
proper  and  rehable  source  is  found ;  but  it  must  not  be  supposed  that 
Such  an  improvement  renders  the  privy  vault  and  cesspool  harmless  or 
even  tolerable.  The  people  may  get  pure  water  to  drink,  but  other  and 
new  sources  of  trouble  arise  as  follows  : 

As  soon  as  water  flows  freely  from  faucets,  and  the  labor  of  pumping 
is  avoided,  the  consumption  of  water  for  domestic  purposes  is  found  to  in- 
crease at  least  fivefold.  Indeed,  the  leakage  from  imperfect  and  cheap 
fixtures  is  often  enough  to  raise  the  amount  to  ten  or  even  twenty  times 
the  quantity  formerly  raised  by  hand  pumping. 

The  quantity  of  filth  discharged  from  the  house  may  not  be  increased, 
but  the  volume  of  sewage  which  is  thus  sent  into  the  cesspool  is  soon 
visibly  in  excess  of  its  powers  of  absorption.  Sometimes  the  cesspool  over- 
flows upon  the  surface,  making  a  nasty  place  in  the  grass  overgrown  with 
rank  herbage. 

Sometimes  it  soaks  through  the  ground  along  the  outside  of  the  house- 
drain  which  brings  it  and  makes  an  entrance  through  the  joints  of  the 
ceUar-walL  The  writer  recently  saw  a  case  where  sewage  had  thus  soaked 
in  under  a  pile  of  coal,  out  of  which  the  foul  stuff  slowly  worked  its  way 
about  the  cellar  floor. 

It  often  rises  in  the  cesspool  above  the  mouth  of  the  inlet-pipe,  stop- 
ping the  usual  circulation  of  air  through  the  drain.  This  is  almost  always 
followed  by  the  forcing  of  foul  gas  through  the  traps  in  the  basement 
story.  The  undue  pressure  finds  new  leaks  in  the  drain,  and  works  untold 
mischief  where  least  seen  and  least  thought  of. 

Even  when  the  workmanship  is  perfect,  a  result  but  rarely  found,  the 
result  is  far  from  desirable.  The  owner  constructs  new  cesspools  one 
below  the  other,  till  every  available  place  is  exhausted,  and  the  pollution 
reaches  his  neighbor's  lot  without  aflbrding  relief.  The  absorbent  powers 
of  the  soil  soon  become  overtaxed  and  the  accumulation  continues,  crowd- 
ing into  every  crack  till  all  the  soil  in  the  vicinity  of  the  house  is  a  mass 
of  corruption.  The  more  water  the  family  use,  the  worse  is  the  nuisance. 
The  apparatus  for  cleaning  vaults  and  cesspools  is  repeatedly  called  upon, 
and  the  neighbors  all  become  disgusted  with  the  operation,  while  the  cost 
of  these  frequent  emptyings  becomes  onerous.  The  soil  about  the  house 
thus  becomes  pestiferous.  Emanations  are  constantly  going  on  during 
the  summer  which  are  certainly  depressing  to  the  vigor,  if  not  actually 
poisonous. 

Now  what  is  the  remedy  for  this  ?  A  candid  investigation  of  the  case 
can  lead  to  but  one  reply,  viz.  :  That  the  development  of  a  system  of  pub- 
lic sewerage  must  progress  pari  passu  with  that  of  a  public  water-supply. 

The  administration  of  any  town  or  city  that  ignores  this  maxim  is  surely 
planting  the  seeds  of  future  pestilence,  while  seeming  to  promote  the  wel- 
fare of  its  people.  The  demand  for  a  supply  of  water  is  naturally  more 
easily  appreciated  by  the  masses  than  the  need  of  sewers.     But  it  is  quite 


47S  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE, 

time  for  those  men  who  have  at  heart  the  jDermauent  welfare  of  the  com- 
mmiity  in  which  they  Hve,  to  look  beyond  the  clamor  of  the  people  and 
carefully  to  weigh  all  the  probable  consequences  before  taking  a  step  which 
may  lead  in  the  wrong  direction. 

It  may  perhajDS  be  urged  that  the  system  of  removal  of  filth  by  icater  car- 
riage is  not  a  necessai*y  result  of  the  introduction  of  a  public  water-supply. 
There  are  many  towns  where  a  system  of  dry  removal  of  house  offal  has 
been  attended  with  a  degree  of  success.  This  system  has  many  advocates  in 
England,  where  it  has  had  the  widest  development,  and  is  doubtless  worthy 
of  some  attention.  Its  friends  urge  in  its  favor  the  forcible  argument  that 
agriculture  demands  all  the  w^aste  products  of  our  towns,  and  that  these 
substances  should  be  carried  to  the  farms,  where  they  are  needed,  without 
first  diluting  them  with  a  bulk  of  water  which  renders  their  transport  and 
utilization  too  costly.  The  Chmese  are  sometimes  quoted  as  an  example 
of  a  frugal  people,  who  do  not  aUow  such  things  to  be  wasted  ;  they  pick 
up  in  the  streets  the  droppings  of  all  animals  before  allowing  them  time 
to  become  an  offence.  The  cheapness  of  labor  in  China  undoubtedly  ena- 
bles them  to  do  many  things  there  with  better  economical  results  than  the 
same  methods  would  produce  with  us,  but  the  facts  do  not  prove  that  the 
real  sanitary  results  in  Chinese  cities  are  better  than  in  our  own.  Tiie  same 
system  is  pursued — or  at  least  has  been  till  very  recently — in  many  of  the 
old  towns  of  Southei'n  Europe.  No  one  can  walk  about  the  narrow  streets 
in  Naples,  Palermo,  or  even  some  parts  of  Rome,  without  great  risk  of  defil- 
ing the  boots  with  human  ordure.  In  Madrid,  we  are  told  that  not  even  a 
privy  existed  in  1760,'  "It was  customary  to  throw  the  ordure  out  of  the 
windows  at  night,  and  it  was  removed  by  scavengers  the  next  day.  An 
ordinance  having  been  issued  by  the  King  that  every  householder  should 
build  a  privy,  the  people  violently  oj)posed  it  as  an  arbitraiy  proceeding, 
and  the  physicians  remonstrated  against  it,  alleging  that  the  filth  absorbed 
the  unwholesome  particles  of  the  air,  which  otherwise  would  be  taken  into 
the  human  body  His  Majesty,  however,  persisted,  but  many  of  the  citi- 
zens, in  order  to  keep  their  food  wholesome,  erected  privies  close  to  their 
kitchen  fireplaces." 

All  this  may  justly  be  called  lack  of  system,  when  compared  with  the 
methods  piu'sued  in  the  modern  towns  of  Manchester  and  Rochdale,  in 
England,  where  the  system  of  "  dry  removal "  has  had  as  great  a  degree 
of  success,  perhaps,  as  anywhere.  But  even  there  the  results  are  far  from 
satisfactory.  Such  a  system  can  only  be  made  tolerable  by  the  enforce- 
ment of  a  rigid  discipline  in  its  administration,  and  is,  therefore,  better 
adapted  to  prisons,  barracks,  hospitals,  etc.,  than  to  communities  gov- 
erned by  civil  law.  It  may  possibly  be  satisfactory  in  a  small  community 
or  a  somewhat  scattered  population,  but  its  success  depends  upon  great 
thoroughness  in  the  daily  attendance — a  thing  which  it  is  difficult  if  not 
impossible  to  attain  in  large  towns,  especially  when  governed,  as  with  us 
in  America,  by  officers  annually  elected  by  the  people.  In  short,  its  ad- 
ministration, if  properly  conducted,  partakes  largely  of  the  character  of 
what  is  known  as  paternal  government,  and  is  in  no  degree  automatic. 
The  apparatus,  moreover,  is  cumbrous  and  often  offensive,  as  well  as  the 
processes  involved — such  as  the  carting  through  the  streets,  etc.  No  sys- 
tem of  dry  removal  provides  for  the  waste  waters  of  the  laundry,  scullery, 
etc.,  which,  in  large  towns,  are  quite  as  important  items  and  quite  as  likely 

'  Dr.  Edward  Barcome  in  his  History  of  Epidemics,  as  quoted  by  Baldwin  Latliam 
in  Sanitary  Engineering,  p.  31. 


REMOVAL    OF    HOUSE-WASTE.  479 

to  make  trouble  as  the  alvine  discliarges.  In  view  of  these  considerations 
it  is  not  surprising  that  the  system  of  removal  of  filth  by  water  carriage 
should  be  ah'eady  largely  accejoted  by  our  people.  Its  popularity  is  in- 
deed so  great,  that  scarce  any  other  method  is  known  or  considered  in  the 
hundreds  of  new  towns  which  are  constantly  springing  up  all  over  the 
West.  In  fact,  the  use  of  the  water-closet  is  not  confined  at  all  to  towns  or 
houses  provided  with  a  public  water-supply.  It  has  become  a  matter  of 
course  in  the  country  house  as  well  as  in  the  village  or  city. 

It  is,  therefore,  to  be  taken  for  granted  now  that  every  good  house 
must  be  provided  with  this  convenience.  It  has  become  rather  a  necessity 
than  a  luxury  among  all  who  can  afford  its  moderate  cost.  Accordingly, 
the  cesspool,  among  all  suburban  districts  as  well  as  in  many  villages  and 
towns,  has  taken  the  place  of  the  old  privy  vaiilt. 

So  far  as  the  closet  goes,  if  properly  devised  and  ventilated,  properly 
located  and  constructed,  it  is  a  long  step  in  advance  of  the  privy.  But  the 
gain  is  not  a  great  one  if  the  ordinary  leeching  cesspool  is  the  receptacle 
of  the  discharges. 

The  only  proper  disposal  of  the  flow  from  water-closets,  among  all 
communities  that  can  afford  it,  is  a  well-devised  system  of  sewerage  de- 
livering the  flow  either  on  the  land  or  into  the  sea,  but  not  into  any  small 
rivers  or  watercourses  whatever. 

This,  of  course,  is  applicable  to  large  towns  and  cities,  not  to  a  scattered 
population,  the  needs  of  which  it  is  proposed  to  consider  later. 

The  development  of  a  proper  system  of  sewers  is  entirely  a  local  ques- 
tion, and  should  be  studied  and  perfected  by  experts  in  every  locality  where 
it  arises.  Yet  some  general  rules  have  been  established  by  the  experience 
of  the  first  twenty  years  which  it  would  be  best  to  conform  to  m  all  cases. 


Ultimate  Disposal  of  the  Sewage. 

First,  as  to  the  ultimate  disposal  of  the  sewage.  This  subject  has  been  so 
thoroughly  probed  and  discussed  that  we  can  avail  ourselves  of  the  inves- 
tigations of  some  of  the  most  intelligent  men  of  our  day.  "  In  Berlin  a 
scientific  commission  was  appointed  in  1862,  and  made  exhaustive  experi- 
ments, continued  through  many  years.  They  proved  by  scientific  analysis 
and  by  induction,  what  had  long  before  been  learned  in  England  by  prac- 
tical experience.' 

"  I.  That  with  cesspools  and  privies,  the  soil  and  well-water  become 
dangerously  polluted. 

"11.  That  sewers  need  not  pollute  the  soil. 

"in.  That  streams  become  so  foul  when  used  as  receptacles  for  sewage, 
that  measures  must  be  taken  for  their  purification. 

"  IV.  That  the  only  practicable  means  of  purifying  sewage  is  by  irriga- 
tion." 

"They  have,  therefore,  adopted  a  sewerage  system  which  is  to  be  com- 
pleted in  1883,  and  which  provides  for  the  purification  of  the  sewage  by 
ii'rigation." 

In  1876  a  committee  was  appointed  by  the  Local  Government  Board  of 
England  to  inquire  into  the  several  methods  of  treating  sewage.  This 
Committee  arrived  at  the  following  conclusions,  which  are  quoted  from 
their  report : 

'  Seventh  Annual  Report  of  State  Board  of  Healtli  for  Massachusetts,  1876,  p.  310. 


480  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

"1.  That  the  scavenging,  sewering,  and  cleansing  of  toi^'ns  are  necessarj-  for  comfort 
and  health,  and  that  in  all  cases  these  observations  involve  questions  of  how  to  remove 
the  refuse  of  towns  in  the  safest  manner,  and  at  the  least  expense  to  the  rate-payer. 

'*  2.  That  the  retention,  for  any  lengthened  period,  of  refuse  and  excreta  in  privy 
cess-pits,  or  in  cesspools,  or  in  stables,  cow  sheds,  slaughter  houses,  or  other  places  in 
the  midst  of  towns,  must  be  utterly  condemned  ;  and  that  none  of  the  so-called  dry 
earth  or  pail  systems,  or  improved  privies,  can  be  approved,  other  than  as  palliations 
for  cess-pit  middens,  because  the  excreta  is  liable  to  be  a  nuisance  during  the  period 
of  its  retention  and  a  cause  of  nuisance  in  its  removal ;  and  moreover,  when  removed, 
leaves  the  crude  sewage,  unless  otherwise  dealt  with  by  filtration  through  land,  to  pol- 
lute any  watercourse  or  river  into  which  such  sewage  ma}'  flow.  We  have  no  desire 
to  condemn  the  dry  earth  or  pail  system  for  detached  houses,  or  for  public  institu- 
tions in  the  country,  or  for  villages,  provided  the  system  adopted  is  carefully  carried 
out. 

"3.  That  the  sewering  of  towns  and  the  draining  of  houses  must  be  considered  a 
prime  necessity,  under  all  conditions  and  circumstances,  so  that  the  subsoil  water  may 
be  lowered  in  wet  districts,  and  may  be  preserved  from  pollution,  and  that  waste  water 
may  be  removed  from  houses  without  delay,  and  that  the  surfaces  and  channels  of 
streets,  yards,  and  courts  may  be  preserved  clean. 

"  4.  That  most  rivers  and  streams  are  polluted  by  a  discharge  into  them  of  crude 
sewage,  which  practice  is  highly  objectionable. 

"  5.  That  so  far  as  we  have  been  able  to  ascertain,  none  of  the  existing  modes  of 
treating  town  sewage,  by  deposition  and  by  chemicals  in  tanks,  appear  to  effect  much 
change  beyond  the  separation  of  the  solids  and  the  clarification  of  the  liquids.  That 
the  treatment  of  the  sewage  in  this  manner,  however,  effects  a  considerable  improve- 
ment, and  when  carried  to  its  greatest  perfection,  may  in  some  places  be  accepted. 

"  6.  That  so  far  as  our  examinations  extend,  none  of  the  manufactured  manures 
made  by  manipulating  towns'  refuse,  with  or  without  chemicals,  pay  the  contingent 
costs  of  such  modes  of  treatment ;  neither  has  an^'  mode  of  dealing  separately  with 
excreta,  so  as  to  defray  the  cost  of  collection  and  preparation  by  a  sale  of  the  manure, 
been  brought  under  our  notice. 

"  7.  That  town  sewage  can  best  and  most  cheaply  be  disposed  of  and  purified  b}' 
the  process  of  land  irrigation  for  agricultural  purposes,  where  local  conditions  are 
favorable  to  its  application.  But  that  the  chemical  value  of  sewage  is  greatly  reduced 
to  the  farmer  by  the  fact  that  it  must  be  disposed  of  day  by  day  throughout  the  entire 
year,  and  that  its  volume  is  generally  greatest  when  it  is  of  the  least  value  to  the  land. 

"  8.  That  land  irrigation  is  not  practicable  in  all  cases,  and  therefore,  other  modes 
of  dealing  with  sewage  must  be  allowed. 

''  9.  That  towns  situated  on  the  sea-coast,  or  on  tidal  estuaries,  may  be  allowed  to 
turn  sewage  into  the  sea  or  estuary,  below  the  line  of  low  water,  provided  no  nuisance 
is  caused  ;  and  that  such  mode  of  getting  rid  of  sewage  may  be  allowed  and  justified 
on  the  score  of  economy." 

Signed  by  Robert  Rawlinsox, 

Clare  Lowell  Read. 

The  Combination  of  Sewage  j^u)  Scrface  Water. 

After  providing  for  the  ultimate  disposal  of  the  sewage,  among  the  many 
questions  to  be  decided  in  planning  a  system  of  sewei-age  for  any  given  place 
is  this.  How  large  a  poi'tion,  if  any,  of  the  surface-water  drainage  is  to  be 
admitted  into  the  sewers  ?  It  has  been  customary  in  most  cases  to  provide 
sewers  for  the  removal  of  all  the  sui-plus  rain-water  which  would  collect  in 
the  streets,  together  with  the  house  drainage.  Of  late,  however,  several 
small  towns,  both  in  England  and  this  country',  have  provided  sewers  for 
the  house  drainage  alone,  or  admit  a  very  small  quantity  of  the  surface- 
water,  the  larger  part  of  which  is  either  left  to  flow  off  on  the  surface  or 
by  special  conduits  leading  to  natui'al  watercotu'ses. 

This  last  has  often  been  called  the  sejMrate  system  of  sewerage.  It  has 
the  follo^'ing  advantages,  which  operate  with  most  force,  however,  in  small 
toicns,  viz.,  economy  in  consti'uction,  and  freedom  from  deposit  when  in 
use.  The  sa-^dng  in  cost  will  be  apparent  when  we  consider  that  in  the 
combined  system  the  size  of  sewers  must  be  adapted  to  caxrj  the  heaviest 


REMOVAL    OF   HOUSE-WASTE.  4S1 

rainfall,  which  in  our  climate  often  brings  into  the  sewers  connected  there- 
with a  volume  of  water  some  twenty  to  thirty  times  as  great  as  that  of  the 
sewage  alone.  It  is  sometimes  found,  as  at  the  city  of  Memphis,  Tennessee, 
where  the  separate  system  is  used,  that  a  six-inch  pipe  is  sufficient  to  col- 
lect the  sewage  for  a  continuous  length  of  over  haK  a  mile  of  street,  lined 
with  houses ;  while  if  the  rain-T^ater  were  to  be  provided  for,  a  conduit 
of  many  times  that  capacity,  with  a  con-esponding  cost,  would  be  required. 

The  second  advantage  refeiTcd  to,  that  of  freedom  from  deposit,  arises 
from  the  frequency  of  the  maximum  flow  in  small  pipes,  which  causes 
such  sewers  to  be  seJf-cleandng  to  a  greater  degree  than  in  larger  ones. 
The  small  sewers  are4ikely  to  be  half  filled  by  the  daily  flow,  during  at 
least  a  part  of  the  day,  while  the  large  ones,  proportioned  for  carrying 
rain-water,  may  be  so  filled  only  at  rare  intervals,  during  heavy  rains, 
and  for  a  great  part  of  the  time  they  carry  only  a  driblet,  say  five  or  six 
per  cent,  of  their  whole  capacity.  The  small  pipe  can  be  flrished  daily  by 
a  moderate  expenditure  of  water,  and  should  be  so  flushed,  while  the  large 
sewer  would  require  a  larger  quantity  of  water  to  properly  flush  it  than 
most  towns  could  conveniently  supply.  It  therefore  would  seldom  get 
flushed  except  by  heavy  rains,  which  occur  at  long  intervals,  between 
which  serious  deposits  may  sometimes  occur. 

Another  and  a  very  important  reason  for  keeping  the  sewage  separate 
from  rain-water  exists  in  aU  those  localities  where  the  sewage  must  be 
artificially  treated  in  any  way,  either  by  chemicals  or  otherwise  ;  also  where 
it  must  be  pumped  to  bring  it  to  the  desired  place  for  ultimate  disposal, 
or  where  it  is  used  for  irrigation  of  crops.  It  is  evident  that  it  would  be 
a  great  drawback  upon  any  system  for  handling  the  sewage,  if  the  plant 
for  this  purpose  must  be  adapted  to  a  maximum  flow  that  occurred  only 
at  long  intervals  and  for  short  periods,  after  heavy  rains,  leaving  a  large 
portion  of  this  plant  idle  for  three-fourths  or  nine-tenths  of  the  time. 

If  sewage  is  disposed  of  by  irrigation,  which,  as  we  have  seen  above, 
is  recommended  as  the  most  satisfactory  method  of  purifying  it,  the  only 
way  to  recover  any  part  of  the  cost  of  the  process  is  to  apply  it  to  growing 
crops.  If  a  considerable  part  of  the  rain-water  is  mixed  with  the  sewage, 
this  great  difficulty  arises,  viz.:  The  whole  flow  must  be  disposed  of  daily, 
and  no  crops  can  thrive  if  subjected  to  flooding  in  periods  of  rain,  while 
but  scantily  watered  in  times  of  drouth.  In  short,  the  farmer  could  not 
raise  a  crop  with  profit  who  was  obliged  to  take  ten  times  as  much  water 
as  his  crops  need  after  a  rain,  even  if  supplied  tolerably  well  in  the 
drouth. 

The  objections  to  the  separate  system  are  as  follows.  It  will  be  seen 
that  they  apply  with  considerable  force  in  large  towns,  or  those  of  dense 
population,  and  as  many  towns  now  small  and  scattered  may  hope  to  be- 
come large  and  dense,  as  experience  has  shown  they  often  do  in  our 
country,  it  behooves  such  towns  to  be  cautious  about  committing  them- 
selves to  a  system  which  may  bring  much  trouble  eventually,  and  prove  in 
the  end  to  be  more  costly  rather  than  less. 

It  is  found  that  wherever  the  streets  are  paved  and  the  traffic  is  large, 
the  flow  of  water  from  their  surfaces  after  a  rain,  and  more  especially  after 
the  melting  of  winter  snows,  is  as  foul  as  the  flow  in  the  house  drains,  and 
therefore  as  unfit  to  be  conducted  into  running  streams  or  ponds  as  any 
form  of  sewage.  In  fact,  the  street  wash  of  Boston  or  New  York,  when  the 
snow  is  melting  in  April,  is  so  foul  that  no  proper  disposition  can  be  made, 
of  it  separately  from  the  sewage,  and  therefore  no  plan  for  so  separating  if 
could  be  reasonable,  expedient,  or  productive  of  good  results. 
Vol.  II. -31 


482 


AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 


If  two  sets  of  conduits  are  required,  one  for  the  flow  of  sewage  and 
another  for  siu-face  water,  no  certain  saving  in  first  cost  would  result.  In 
fact,  a  combined  system  would  often  cost  less  than  the  two.  Moreover,  two 
sets  of  conduits  under  our  streets  would  lead  to  much  trouble  in  arranging 
the  details,  such  as  the  proper  levels,  and  which  pipe  should  pass  over  the 
other  where  intersecting  at  street  corners.  Trouble  has  also  arisen  whei-e 
such  a  double  system  existed,  in  the  service  pipes  of  one  s^'stem  being 
interfered  with  by  the  main  of  the  other  system  in  trying  to  construct 
such  sei'vices  on  proj^er  slopes  between  the  houses  and  the  mains.  Mis- 
takes are  hkel}^  to  occur,  also,  in  making  the  private  connections  to  the 
mains,  by  entering  the  wTong  main,  which  class  of  mistakes  are  difficult  to 
avoid  in  such  a  complication,  where  the  administrative  officers  and  fore- 
men in  charge  of  the  work  are  subject  to  change  in  their  personnel. 

Large  sewers  are  now  constructed  so  as  to  be  more  self-cleansing  than 
formerly,  by  contracting  their  section  at  the  bottom,  so  that  the  stream 
flows  over  an  invert  in  the  large  sewer  of  a  similar  shape  to  the  lower  half 
of  a  small  pipe. 

Fig.  109,  which  is  copied  from  Baldwin  Latham's  work,  shows  the  im- 
provements made  in  this  respect. 


Fig.  109. 


Old  Form  of  Oval  Sewer. 


New  Form  of  Oval  Sewer. 


Since  it  is  not  proper  to  discharge  crude  sewage  into  small  streams,  aU 
towns  that  are  remote  from  the  sea  or  very  large  livers  should  provide  for 
the  purification  of  their  sewage,  to  prevent  it  from  becoming  a  nuisance. 

The  system  of  disposal  of  sewage  by  inigation  of  the  sdil  has  been 
referred  to  above,  as  the  most  efficient,  most  economical,  and  least 
harmful  of  the  processes  hitherto  tried  for  its  pmification,  at  all  places 
where  a  suitable  ojiportuuity  can  be  found,  within  a  reasonable  distance, 
for  its  development.  Its  application  has  hitherto  been  limited  in  this 
country  to  a  verj'  few  cases,  and  even  in  these  the  experiment  has  been 
on  a  small  scale,  e.  g.,  the  hospitals  for  the  insane  at  Worcester  and  at 
Dan  vers,  Mass.,  and  at  Augusta,  Me.  This  method  can  never  be  pursued 
with  any  prospect  of  economic  results  as  to  the  crops  produced  on  the 
sewage  farms,  unless  the  collection  of  the  sewage  should  be  made  without 
much  or  any  rain-water.  The  exclusion  of  the  surface  water  becomes  more 
imperative  in  America  than  in  England  for  the  reason  that  American  towns 
which  have  a  pubhc  water-supply  consume  a  much  larger  quantity  of 
■water  per  capita  than  European  ones,  by  means  of  which  the  sewage  is 
more  largely  diluted,  and  therefore  of  less  value  as  a  manure  per  ton. 
The  distribution  of  water  in  most  of  our  towns  is  not  only  liberal  but  lav- 
ish, being  aggravated  by  a  reckless  waste  which  the  municipal  authorities 


EEMOVAL    OF    HOUSE-WASTE. 


4S; 


have  hitherto  taken  no  efficient  steps  to  check  in  most  cases.  The  enor- 
mous expenditure  for  fixed  plant  in  water-works  which  has  taken  place  in 
cities  like  New  York,  Philadelphia,  and  Boston,  with  the  actual  quantities 
of  water  now  distributed,  would,  if  properly  husbanded,  supply  hberaUy 
fully  twice  the  present  j^opulation  in  these  cities.  No  large  city  of  this 
class  can  ever  dispose  of  their  sewage  upon  the  land  with  a  hope  to  pro- 
duce crops  by  irrigation,  tiU  some  way  shall  be  provided  for  checking  this 
prodigal  waste  of  water  and  thus  rendering  the  sewage  less  dilute  in  its 
character.  The  sewage  farm  at  Barking,  on  the  Thames,  has  a  small  por- 
tion of  the  sewage  of  London  to  dispose  of,  and  its  profits  have  been 
reduced  to  a  microscopic  amount,  if  not  a  negative  quantity,  by  this  super- 
abundance of  watei'.  Yet  the  quantity  of  water  distributed  per  capita  of 
population  in  London  is  far  less  than  that  enjoyed  and  M-asted  by  the  large 
American  cities.  The  following  table  is  made  up  from  "  Croes'  Statistical 
Tables,"  giving  figaires  for  1880,  for  eleven  prominent  American  towns, 
while  those  for  London  are  taken  from  official  reports  quoted  at  London 
for  the  same  year,  in  Engineering  (vol.  xxx.,  p.  195). 

Consumption  of  Water  in  1880,  in  various  American  Cities,  compared  with 

London. 


Citj. 

Population. 

Gallons  daily. 

Daily  consump- 
tion per  capita. 

New  York 

1,206,299 
847,170 
566,663 
503,185 
362,839 
350,518 
313,190 
255,139 
233,959 
156,389 
159,871 

4,388,000 

95,000,000 
67,647,782 
34,616,831 
66,163,942 
38,214,700 
27,500,000 
25,000,000 
19,524,847 
13,824,000 
16,021,624 
26,525,991 
150,398,107 

78 

Philadelphia,  Pa 

80 

Brooklyn,  N.  Y 

61 

Chicago,  HI 

131 

Boston,  Mass 

105 

St.  Louis,  Mo 

78 

Baltimore,  Md 

79 

Cincinnati,  0 

76 

San  Francisco,  Cal 

59 

Pittsburgh,  Pa 

102 

Washington,  D.  C 

166 

London,  England' 

34 

But  it  is  the  opinion  of  all  sanitarians,  that  for  all  inland  towns  having 
no  opportunity  to  discharge  their  sewage  into  the  sea  or  some  large  river 
in  a  way  which  would  create  no  nuisance,  the  purification  of  their  sewage 
becomes  imperative.  For  this  purpose  irrigation  is  the  only  rational 
method  of  treatment,  and  should  be  adopted,  even  if  the  crops  produced 
are  not  a  source  of  profit.  If  the  notion  of  profit  is  abandoned  as  unattain- 
able, the  process  may  be  much  simphfied  by  allotting  more  sewage  to  the 

'  The  consumption  in  London  is  doubtless  reported  here  in  imperial  gallons  of  288 
cubic  inches,  while  the  American  cities  reckon  by  wine  gallons  of  238  inches  only.  - 
This  would  require  an  addition  of  25  per  cent,  to  the  figures  given  for  London  to 
make  the  comparison  fair  ;  but  on  the  other  hand  the  consumption  in  London  is  re- 
ported for  the  month  of  July  only,  which  is  doubtless  larger  than  the  average  for  the 
year,  perhaps  by  an  equivalent  ratio.  Moreover,  the  report  of  the  London  official 
gives  only  the  population  actually  served  with  water  in  their  houses,  which  we  sup- 
pose to  be  a  smaller  ratio  of  the  whole  population  than  is  the  fact  in  American  cities. 


484  AMERICAN    APPENDIX    TO    PARKES'    HYGIENE. 

area  treated  than  the  crops  could  be  expected  to  profitably  use,  and  re- 
moving the  water  by  uuder-drains  after  it  has  filtered  through  the  soil. 
Such  a  process  cannot  be  kept  up  continuously  with  success.  There  must 
be  intermission  by  means  of  two  or  more  fields  for  alternate  treatment, 
giving  each  field  such  period  of  rest  as  will  enable  the  water  with  which  it 
is  gorged  to  soak  down  and  admit  the  air  to  the  pores  of  the  soil.  It  is 
this  ver}-  air  in  the  pores  that  does  the  work  of  chemical  purification  by 
means  of  its  oxygen,  which  process  is  moi'e  important  and  more  ejSicient 
for  the  purification  of  the  effluent  water  than  the  straining  or  mechanical 
filtration. 

This  process  is  iDerfectly  applicable  to  villages  and  small  towns,  and  re- 
quires less  expenditure  for  its  maintenance  than  is  generally  supj)osed.  It. 
is  not  entirely  automatic,  however,  and  needs  frequent  attention  in  divert- 
ing the  flow  from  one  plot  to  another,  as  often  as  the  soil  becomes  sat- 
urated. Such  attention,  however,  would  not  be  an  onerous  tax  upon  a 
village  of  a  thousand  inhabitants  or  more. 


Irrigation  below  the  Surface. 

For  all  small  villages  or  collections  of  houses,  as  well  as  for  single 
houses  in  the  country  where  the  land  is  not  entirely  flat,  a  distribution  of 
the  sewage  can  be  made,  about  a  foot  below  the  surface,  by  porous  tiles, 
which  has  been  tried  both  in  England  and  this  country  with  success  ;  and 
the  process  is  nearly  automatic  when  the  apparatus  is  properly  prej)ared, 
requiring  attention  only  at  loug  intervals.  The  requisites  for  this  system 
are  as  follows  : 

First. — Land  adapted  to  grass,  nearly  level  or  gently  sloping,  at  the 
rate  of  one-fourth  of  an  acre  for  a  single  family,  or  an  acre  for  a  combin- 
ation of  eight  to  ten  families,  if  provided  with  a  constant  water-supply 
under  jDressure.  If  the  water-supply  is  limited  to  what  may  be  pumped  by 
hand,  one-half  of  the  above  area  will  be  ample. 

Second. — -The  highest  part  of  the  land  devoted  to  the  piirpose  should 
be  at  least  five  feet  below  tlie  level  of  the  toj)  of  the  drain  where  it  leaves 
the  house. 

Third. — The  soil  should  be  thoroughly  under- drained,  if  not  resting  on 
a  di-y  and  porous  subsoil  by  nature.  Under-drains  are  often  needed  in 
clayey  or  retentive  soils,  and  should  be  laid  at  least  four  or  five  feet  below 
the  surface,  at  intervals  of  about  twelve  feet,  with  a  free  outfaU. 

Fourth. — The  land  should  be  graded,  unless  toleral^ly  smooth  before, 
hand,  so  as  to  avoid  sudden  inequalities.  A  surface  that  is  adapted  to 
smooth  mowing  by  hand  is  good  enough  for  the  purpose. 

Fifth. — The  soil  must  be  entirely  free  from  roots  of  ti'ees  and  shrubs. 
These  would  choke  the  pipes  in  a  few  weeks. 

The  cost  of  the  work  will  vary  with  the  local  conditions.  It  can  be  laid 
out  by  any  intelligent  mechanic,  with  an  ordinary  spirit  level  and  straight- 
edge twenty  feet  long,  though  if  on  a  large  scale,  requiring  an  acre  of  land 
or  more  to  be  treated,  an  engineer's  level  would  be  a  convenience. 

If  house  drainage  is  conducted  du-ectly  into  porous  tiles  laid  under  the 
surface,  the  fluid  jDarts  will  escape  at  eveiy  joint,  while  the  sohd  matter 
is  apt  to  cling  to  the  interior  and  gradually  fill  them,  till  they  become 
practically  useless,  unless  taken  up  and  cleaned. 

In  order  to  avoid  this  result  it  is  advisable  to  provide  a  tank  or  tight 
cesspool  whei-e  all  the  sewage  is  arrested  for  a  while,  duiing  which  time 


EEMOVAL    OF    HOUSE-WASTE. 


485 


COwygg  or  C^ncygfaa  . 


StpHON  Tank. 

Verticai-  Seictiom* 


°  Ain  Hoj-g 


OUTV^- 


|-(oLE  AT  A    Capped    amp   Covej^ep  \»/\th  5A.Ne 


Plan  , 


,AIH  HOLE  AND  VENT  PlPC 
TO  Bt    EXTENDED  .TO    A, 

PnoptH  Place 


SeictiohBC, 


BOTTOM 
OF  OUTLET 


^,J-^<^Jlower  end 

pr  SIPHON 


Bottom  of  basin 

UNDEFl  SFHON 


Fig.  110. 


486  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 

the  solid  matters  become  macerated  and  finely  divided  by  fermentation, 
before  entering  the  distributing  pipes.  Moreover,  if  such  a  tank  be 
allowed  to  overflow  constantly  into  tlie  porous  pipes  by  a  dribbling  dis- 
charge, they  would  become  choked  after  a  while  even  then.  In  order  to 
keep  them  free,  the  flow  must  be  intermittent  and  take  j)lace  with  such  a 
rush  as  to  till  the  whole  system  of  distributing  pipes  at  once,  and 
brush  away  shght  obstructions  which  may  have  been  left  by  former  dis- 
charges. 

There  are  two  methods  of  obtaining  this  result :  First,  by  providing  a 
stop-gate  in  the  outlet-pipe  where  it  leaves  the  tank,  to  be  opened  by  hand 
when  the  tank  is  full  and.  closed  again  when  empty.  Second,  by  pi'oviding 
a  siphon  or  float  to  discharge  the  tank  automatically  whenever  filled. 

Of  course  the  latter  method  is  far  more  satisfactory,  if  made  rehable, 
but  it  is  somewhat  more  costly,  and  the  siphon,  as  heretofore  constructed, 
is  not  always  reliable,  i.e.,  the  apparatus  for  setting  the  siphon  in  action 
does  not  always  work  as  expected. 

Field's  siphon  has  generally  been  used  for  this  pui'pose,  and  works 
well  with  pure  water ;  but  if  used  with  sewage  on  a  small  scale,  it  is  Hable 
to  miss,  unless  the  cup  into  which  it  discharges  is  occasionally  brushed 
out.  When  used  on  a  large  scale,  as  for  a  combination  of  several  houses, 
this  difficulty  disappears. 

Several  other  devices  have  been  used  for  starting  a  siphon.  Li  one  a 
tumbler  tank  is  placed  in  the  upper  part  of  the  flush  tank,  which  upsets 
when  filled,  tui'ning  on  brass  trunnions,  and  righting  itself  at  once  when 
empty.  A  tumbler  tank  of  two  gallons  capacity  will  start  a  sij)hon  of  two 
inches  diameter,  if  the  lower  or  discharging  end  dips  in  water  as  soon  as 
the  flow  through  it  begins.  It  is '  important  that  it  should  not  so  dip 
when  no  ivater  is  flowing  through  it,  for  in  that  case  the  flush  tank  would 
never  be  filled  again  after  once  discharging  ;  but  it  can  be  so  arranged  that 
a  very  shght  flow  would  seal  the  discharging  end. 

The  device  patented  by  IVIr.  Field  was  to  accomplish  this  result. 

The  tumbler  tank  accomplishes  the  result  well  enough  when  filled  with 
pure  water,  but  if  used  for  sewage,  the  solid  matters  are  apt  to  adhere 
more  or  less  to  its  sides  and  thereby  destroy  its  poise,  on  which  its  cer- 
tainty of  action  depends. 

Other  devices  have  sought  to  accomplish  the  same  end  by  a  float  ac- 
tuating a  valve  in  the  bottom  of  the  flush  tank,  or  by  a  bucket  in  a  side 
chamber  which  can  be  filled  by  the  overflow  of  the  tank,  and  thereby  be- 
comes heavy  enough  to  open  the  valve,  while  a  small  leak  in  the  bottom 
allows  the  valve  to  raise  it  again  after  the  tank  is  empty. 

All  of  these  contrivances  are  subject  to  failure  from  wear  of  moving 
parts  except  Field's  siphon,  which  it  is  hoped  may  be  perfected  still 
further.  Fig.  110  shows  the  two  tanks  and  the  Field  siphon  as  modified 
by  the  writer,  the  changes  being  at  least  a  partial  remedy  for  the  imper- 
fections complained  of. 

If  the  siphon  were  to  be  applied  as  the  outlet  of  the  same  tank  which 
receives  the  sewage  for  maceration,  etc.,  it  would  often  become  choked  by 
solid  matter.  It  is  therefore  best  to  provide  a  second  tank  between  this 
and  the  siphon.  The  first  is  called  the  "  settling  basin  "  and  the  latter  the 
"flush  tank"  on  Fig.  110,  for  the  last  is  alternately  filled  and  emptied, 
while  the  first  remains  always  full. 

Siphons  are  often  constructed  inside  of  the  flush  tank,  but  it  is  better 
to  make  them  accessible  at  all  times  by  placing  them  outside,  as  here 
shown. 


EEMOVAL    OF    HOUSE- WASTE. 


487 


A 


Fig.  111. — A,   Section  across  Branch. 
Section  lengthwise  of  Branch. 


A  t"wo-incli  siphon  is  as  large  as  can  be  surely  set  in  action  by  tlie 
drainage  of  a  single  house. 

The  surest  method  of  starting  such  a  siphon  would  undoubtedly  be  to 
provide  a  copper  float  in  the  tank  with  an  ordinary  brass  cock,  such  as  is 

used  on  water-supjDly  pipes 
for  the  automatic  filling  of 
house  tanks ;  but  the  float 
must  be  adjusted  so  that 
the  cock  should  be  opened 
instead  of  closed,  when  the 
sewage  rises  to  the  over- 
flow hne  of  the  siphon. 
Supply  this  cock  with  jDure 
water  under  pressure  from 
some  outside  soiu'ce  by  a 
small  jDipe,  and  let  the  dis- 
charge be  dehvered  by  a 
tight  connection  through 
the  arch  of  the  siphon,  in 
such  a  way  that  it  would 
fall  free  of  the  sides  of  the 
tube  into  the  cup  or  basin 
where  the  siphon  is  made 
to  discharge.  A  very  small 
stream  of  water,  thus  ap- 
pHed,  would  start  the  siphon  with  certainty,  and  with  scarce 
a  moment's  delay,  if  its  discharging  end  is  so  placed  as  to 
be  sealed  with  water  by  a  shght  flow. 

The  outlet  pipe  for  this  aj)j)aratus  should  be  four  or  five 
inch  stoneware  pipe  for  a  two-inch  siphon.  If  over  one 
hundred  feet  in  lengih,  and  on  an  inclination  less  than  two 
in  one  hundred,  the  larger  size  may  be  prefei^able. 

The  distributing  pipes  should  be  cylindi-ical  and  two 
inches  bore.  The  quantity  needed  "v\t.U  vary  with  the  porosity 
of  the  soil  and  the  size  of  the  flush  tank.  The  tank  here  shown 
contains  STy'L  cubic  feet  when  filled.  The  j)ipe  should  be  of 
sufficient  length  to  contain  about  one-half  this  amount,  say 
19  cubic  feet.  Since  the  sectional  area  of  a  two-inch  pipe 
is  3.14  square  inches,  it  will  requii'e  about  46  linear  feet  of 
the  pipe  to  contain  one  cubic  foot.  They  should  then  be 
about  46  times  19,  or  874  feet  in  length.  If  the  soil  is  ex- 
tremely porous,  a  smaller  quantity  would  doubtless  answer 
the  purpose,  since  a  larger  proportion  of  the  water  would 
soak  away  while  the  siphon  is  discharging  the  tank. 

These  distributing  pipes  should  be  laid  with  a  perfectly 
uniform  slope  of  not  over  six  or  eight  inches  in  one  hundi'ed 
feet.  Even  less  than  this  will  often  answer.  If  the  slojDe 
exceeds  this  amount,  the  water  may  bui'st  up  at  the  lower 
end  and  make  a  nuisance.  They  should  not  be  covered  over  ■«-ith  Trough; 
eight  or  ten  inches  below  the  surface  of  the  ground.  In  order 
to  combine  these  two  conditions,  the  ground  must  be  somewhat  smoothly 
graded,  and  the  lines  for  the  pipes  must  be  laid  out  to  conform  to  the  con- 
tour of  the  surface,  i.e.,  the  trenching  must  follow  hnes  which  have  a  sui'- 
face  slope  limited  as  above  stated.     The  trenches  may  be  at  intervals  of 


Fig.  112.— Per- 
spective VieTV  of  Un- 
glazed  2-inch  Tiles 
and 
Covers. 


488 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


five  or  six  feet,  dividing  tlie  field  in  a  gridiron  fasliion.  The  tiles  must  be 
laid  one-fourth  of  an  inch  open  at  joints. 

The  branches  where  the  two-inch  pipes  leave  the  main  should  be  so 
made  as  to  allow  no  fluid  to  be  retained  in  the  main,  but  lead  fi'om  its 
bottom,  as  shown  in  Fig.  111. 

The  branches  can  be  made  rights  and  lefts  to  suit  the  places  where  used, 
and  can  be  either  of  the  Y  or  J  form.  Ordinary  piiDe-branches  are  in- 
tended for  combining  two  streams  into  one,  but  these  are  for  dividing  one 
stream  into  two.  They  should,  therefore,  be  formed  as  shown  in  the  draw- 
ings, having  no  socket  on  the  small  hole,  which  is  to  abut  against  the  first 
piece  of  two-inch  tiles.  These  porous  tiles  have  sometimes  been  laid  upon 
boards  bedded  in  the  trench,  to  seciu-e  a  more  uniform  gradient  and  pre- 
vent dislocation  of  joints;  but  the  decay  of  the  boards  soon  allows  the 
pipe  to  become  displaced  by  settlement,  and  it  is  better  to  place  ten-a 
cotta  troughs  under  the  pipe,  breaking  joints  therewith.  Similar  pieces, 
about  four  inches  long,  are  placed  over  the  joints  as  covers  (see  Fig.  112). 

It  is  often  objected  to  this  system  that  the  pipes  would  become  filled 
with  ice  in  Northern  winters  unless  buried  deeper  than  eight  inches.  But 
experience  has  shown  that  such  is  not  the  fact  near  Boston.      If  buried 


deeper,  the  roots  of  gi-ass  and  the  air  do  not  get  so  good  access  to  the  sew- 
age, which  is  therefore  likely  to  accumulate — a  result  which  we  wish  by  aU 
means  to  avoid.  When  laid  near  the  surface  no  such  accumulation  occurs, 
and  the  fi'equent  flow  of  warm  water  from  the  house  prevents  the  gi'ound 
from  freezing  under  and   around  the  pipes,  if  covered  with  sod. 

In  places  where  a  sufficient  slope  exists,  the  sewage  of  single  houses 
may  be  distributed  on  the  surface  with  advantage.  The  above  cut  shows 
such  a  method,  which  has  been  in  use  for  several  summers  at  a  house 
used  only  as  a  summer  resort,  and  has  been  attended  with  comi^lete 
success.  There  is  an  overflow  pipe  fi-om  the  cesspool,  which  is  perfectly 
tight,  indicating  when  it  is  full.  The  gate  in  the  outlet-pipe  is  then 
opened  and  the  whole  contents  distributed  on  the  kitchen  garden  in  ten 
minutes*.  If  an  opportunity  is  selected  when  the  wind  is  blowing  from 
the  house  to  the  garden,  no  offensive  odors  are  perceived,  and  the  growing 
crops  soon  absorb  the  fluid,  much  to  their  advantage  (see  Fig.  113). 


Disconnecting  House  Dratks  from  Sewers. 

The  complete  separation  of  the  air-space  in  our  house  drains  from 
that  in  the  public  sewers  is  now  insisted  on  by  most  European  municipal 
authorities  where  regulations  are  enforced  on  such  subjects.  This  separa- 
tion is  even  more  important  in  cases  where  a  cesspool  is  used  in  place 
of  a  sewer,  for  the  gases  of  the  cesspool  are  much  the  more  foul,  and  no 


EEMOVAL    OF    HOUSE-WASTE. 


489 


amount  of  ventilation  will  prevent  their  becoming  so.  The  cesspool  is 
but  a  retort  where  such  gases  are  constantly  evolved  from  the  decompo- 
sition of  the  fluids  and  sohds  retained  in  them. 

The  devices  for  attaining  this  separation  which  are  apphed  in  England 
are  not  so  well  adapted  to  the  climate  of  New  England,  Here  the  severity 
of  the  winters  requires  the  separating  trap  to  be  placed  several  feet  under 
the  ground,  and  as  it  should  be  kept  accessible,  a  man-hole  or  well  is  gen- 


V//////////Z 

Fig.  114. — Main  Trap  and  Air-hole  for  House  Drain. 


eraUy  constructed  over  it  in  brick-work,  with  a  perforated  iron  cover  at 
the  top,  as  ^own  in  the  annexed  cut  (Fig.  114).  If  this  is  used  in  a  snowy 
climate,  a  bent  pipe  should  be  extended  fi-om  the  interior  of  the  chamber 
to  a  point  a  few  feet  above  the  surface,  where  it  may  be  protected  by  a 
wire-basket.     Little  or  no  offence  is  hkely  to  arise  from  such  an  opening. 


The  Ventilation  of  House  Drains. 

This  subject  has  attracted  much  attention  of  late,  and  deserves  careful 
consideration.  The  hability  of  the  interior  surfaces  of  house  drains  to  be- 
come foul  by  the  accumulation  of  solid  matter,  or  from  the  formation  of  a 
slimy  coating  of  organic  matter  on  their  interior  walls,  is  well  known,  and 
the  high  temperature  of  the  di'ains  as  compared  with  that  existing  in  the 
sewers  conduces  to  a  more  rapid  decomposition  of  such  matter  than  in  the 
sewers  themselves.  A  constant  change  or  current  of  air  thi'ough  every 
part  of  the  di-ain,  is  therefore  essential  to  avoid  the  concentration  of  such 
gases.  If  such  concentration  occui',  the  risk  of  harm  is  multipHed,  by  the 
weU-known  law  of  diffusion  of  gases,  by  which  they  penetrate  very  smaU 
cracks,  and  through  imperfection  of  workmanship  or  inefficiency  of  the 
water  seal  in  the  traps,  might  enter  and  mix  with  the  air  of  the  house. 
"When  houses  are  artificially  heated  this  tendency  is  increased  by  the 
diminished  density  of  the  air  within  the  house,  causing  a  shght  inwai-d 
pressure  through  all  such  fissui-es. 

Our  best  municipal  codes  now  require  the  house  di-ains  to  extend  up 
through  the  roof  over  every  separate  "  stack  "  or  vertical  hne  of  soil  pipe, 
of  a  size  not  less  than  four  inches.  This  size  is  found  necessaiy  in  order 
to  avoid  accumulation  of  frost  by  condensation  at  the  top,  and  other  rea- 
sons. 

In  order  to  provide  a  draft  through  these  pipes,  the  fresh  air  should  be 
freely  admitted  to  the  drain  at  its  lower  end,  next  to  the  trap  by  which  it  is 
separated  from  the  outside  drain  and  sewer. 

Such  an  oj)ening  as  referred  to  in  connection  with  Fig.  11-4,  can  be  made 


490  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

to  terminate  an}T\'laere  above  ground,  and  within  a  few  feet  of  the  siu-face, 
without  risk  of  offence,  for  the  draft  is  ahnost  always  inward.  It  is  custo- 
mary to  terminate  them  by  a  pipe  extending  some  three  feet  above  ground 
against  the  j-ard  fence,  with  some  protection  at  the  orifice,  to  prevent 
stones,  etc.,  from  being  thrown  in  by  childi'en. 

The  need  of  a  draft  thi'ough  every  part  of  the  house  drain  is  not  the 
only  reason  for  their  being  open  to  the  aii'  at  the  top.     It  is  impossible  to 
retain  the  water  seal  in  the  best  forms  of  traps — the  most  simple  ones— un- 
less the  atmospheric  pressure  is  freely 
admitted  just   below   the  water  seal. 
The   jiartial    vacuum    that   follows   a 
charge  of  water  as  it  descends  a  verti- 
cal hue  of  pipe  is  such  that,  without  a 
free  admission  of  air  below  every  trap, 
the  pressure  on  the  house  side  of  the 
Fig.  115.— Veuted  s-Traps.  trap  would  force   the  water  through 

them  and  leave  them  unsealed.  It 
therefore  becomes  necessary  to  apply  branch  vents  to  each  separate  tube 
(see  Fig.  115).  This  is  particularly  needed  in  connection  with  waste  pipes 
smaller  than  four  inches  in  diameter*. 

In  order  to  ascertain  the  amount  of  risk  incurred  by  lack  of  air  in  the 
outlets  of  traps,  the  writer  was  employed  by  the  National  Board  of  Health, 
in  the  summer  of  1882,  in  connection  with  E.  W.  Bowditch,  Esq.,  to  make  a 
series  of  experiments  with  apparatus  constructed  for  the  purpose.  The 
folio ^^-ing•  is  an  abstract  of  the  rejjort  upon  these  experiments,  pubhshed  in 
August,  1882,  in  columns  of  the  New  York  Sanitary  Engineer : 

"  A  typical  stack  of  four-inch,  and  another  of  two-inch  waste  pijjes  were 
erected  in  a  vertical  position,  extending  fifty-seven  and  a  half  feet  above 
the  basement  floor,  ■s\ith  branches  in  the  basement  and  on  the  floors 
above,  and  having  the  upper  ends  open  to  the  aii*  eight  and  one-fourth  feet 
above  the  upper  floor. 

"  The  vertical  pipes  extended  down  to  a  point  two  feet  above  the  base- 
ment floor,  from  which  they  turned  to  a  slope,  falUng  this  two  feet  in  a 
horizontal  distance  of  thirty-two  feet. 

"  The  two-inch  waste  joined  the  four-inch  pipe  at  a  branch  on  this  slope 
five  and  a  half  feet  from  the  lower  end  of  the  vertical  portion.  A  foui'- 
inch  running  trap  was  attached  to  the  lower  end  of  the  slope,  having  a 
foui'-inch  air-hole  close  above  it,  to  represent  the  foot  ventilation.  At 
a  point  on  the  slope  six  feet  below  the  lower  end  of  the  vertical  reach,  a 
branch  was  inserted  with  a  four-inch  traj)  in  it,  marked  (n)  on  the  plate,  to 
represent  an  inlet  for  a  basement  water-closet,  or  for  any  other  desired  fix- 
ture at  that  level.  The  relative  position  of  these  branches  and  flows  is 
shown  on  the  accompanying  plate  (Fig.  116). 

"Traps  may  lose  thefr  water  seal  hj  siphon  action,  i.e.,\yj  lack  of  afr- 
pressure,  either  when  water  is  poured  through  them,  or  when  poiu'ed 
through  the  main  waste  pipe  into  which  they  discharge  from  fixtures  at  a 
higher  level.  These  two  processes  are,  therefore,  examined  separately, 
as  desci'ibed  below. 

"  Since  it  is  now  generally  admitted  that  the  upper  ends  of  all  soil  or 
waste  pipes  should  be  wide-open  to  the  aii',  all  experiments  were  tried 
under  this  condition,  except  where  otherwise  noted  for  sjDecial  purposes 
thei'e  explained. 

"  "We  will  first  consider  the  loss  of  the  water  seal  in  traps  caused  by 
water  flowiut?  thi-oui^h  them  from  the  fixtiires  attached  thereto. 


WAVES  Tank- 

i~i    n 


Fig.  116. 


Xdbu^Tj^a^f, 


^  (jiArK  Jrtya, 


WWV^'tkW_-'a[&a»8Wk^W;ji!WTia^  ^ 


mMn~.\\\^ii^A/iM^y''S'A)i.M/,7^!^^       jK^-^'.i^-/r,,/A& 


Quantities  poured  in  expressed  in 

depths  of  ' 

water  in  the  pail. 

3 

inches. 

2 

(( 

If  inch. 

u 

H 

1 

a. 

4 

i 

1 

4 

1 

4 

492  AMERICAN    APPENDIX    TO    PARKEs'    HYGIENE. 


"A.  Experiments  with  a  Two-inch  Waste-pipe,  open  at  the  Top. 

(1)  "A  conical  hopper  was  placed  at  the  upper  floor,  over  the  two-inch 
S-trap  at  (e),  having  Ig  inch  depth  of  seal,  and  having  a  branch  of  two 
inches  calibre  twenty-one  inches  long,  with  a  descent  of  one  foot,  before 
joining  the  Y-branch  on  the  main  at  D. 

"  This  trap  was  found  to  lose  its  seal  completely  every  time  a  two-gallon 
pail  was  emptied  into  the  hopper,  unless  pains  were  taken  to  pour  the  last 
part  of  the  water  slowly,  by  which  the  seal  might  with  cai-e  be  restored. 

(2)  "  Smaller  quantities  of  water  were  then  poured  in  quickly,  as  is 
often  done  in  practice,  with  the  following  results  : 

Loss  of  water  in  trap. 

1|-  inch ,  seal  lost. 

If     "     " 

2^  inches " 

21          a  (t 

5  

2        "       •-' 

1|  inch 

If     "     " 

n  ''  " 

1      "    seal  kept. 

1^    "     seal  barely  kept. 

(3)  "  In  order  to  test  the  effect  of  a  strainer  in  retaining  the  water  by 
checking  the  flow,  two  cross-bars  were  then  inserted,  just  above  the  trap 
water,  to  represent  a  bar-strainer.  Water,  to  the  amount  of  one  and  a 
fourth  inch  in  depth  in  the  bottom  of  the  pail,  was  then  poured  into  the 
hopper,  but  the  trap  still  lost  its  seal,  the  water  in  it  being  lowered  one 
and  three-fourths  inch. 

(4)  "  To  test  the  effect  of  a  vent  pipe  on  this  combination,  a  hole  was 
cut  at  the  crown  of  the  trap,  and  one  end  of  a  lead  pipe  of  one-inch  calibre 
and  twenty-eight  and  a  lialf  feet  in  length  was  coupled  to  it.  The  pij)e 
lay  in  a  coil  on  the  floor  with  the  other  end  wide  open.  Nine  full  pails  of 
water  were  then  emptied  into  the  hopper,  the  loss  of  water  in  the  trap,  on 
measurement,  being  found  to  be  as  follows,  after  each  pailful,  \iz.  :  1^ 
inch,  ^  inch,  ^  inch,  ^  inch,  f  inch.  If  inch.  If  inch,  ^  inch,  nothing.  The 
seal  was  lost  twice. 

"The  manner  in  which  the  water  was  poured  influenced  the  result 
materially.  Less  water  was  lost  if  it  hit  on  one  side  of  the  hopjDcr  and 
whirled  about  during  its  downward  flow,  than  if  it  was  jjoured  in  directly 
toward  the  centre,  without  such  spiral  motion. 

(5)  "  The  vent  hole  was  then  enlarged,  and  a  coil  of  pipe  of  1^  inch 
calibre  was  coupled  on  to  it,  having  a  length  of  fifty  feet.  Ten  pailfuls 
were  then  quickly  poured  into  the  hopper  in  succession,  finding  the  loss 
of  water  in  the  trap  after  each  as  follows,  the  strainer  remaining  at  the 
bottom  of  the  hopper  :  1  inch  five  times,  |-  inch  twice,  ^  inch  once,  ^  inch 
twice.  So  that  there  was  always  at  least  f  inch  of  water  seal  remaining. 
A  shorter  vent  pipe  of  same  size,  or  a  larger  one  of  same  length,  would  of 
course  produce  better  results  by  lessening  the  friction  encountered. 

(G)  "Closing  the  vent  hole,  an  ordinary  wash-bowl  was  then  placed 
over  the  same  trajp,  having  an  outlet  of  1^  inch  diameter,  with  a  bar- 


REMOVAL    OF    HOUSE- WASTE.  493 

strainer.  It  -was  filled  several  times  and  discharged  -without  losing  any 
water  that  could  be  detected  from  the  trap.  Such  traps  often  do  lose 
their  water,  however,  in  practice,  when  discharging  into  smaller  wastes, 
under  circumstances  otherwise  similar,  except  as  to  the  cleanness  of  the  in- 
terior of  the  pipes. 

"  B.  Experiments  with  a  Four-inch  Waste  or  Soil-pipe,  open  at  the  Top. 

(1)  "  A  conical  hopper  was  placed  on  the  third  floor,  on  the  four-inch 
S-trap,  at  (b),  having  a  water-seal  of  1^  inch,  with  a  branch  twenty-two 
inches  long  between  the  trap  and  the  Y-branch  on  the  main, 

"Five  pailfuls  in  succession  were  poured  into  the  hopper,  with  loss  of 
water  as  stated  below,  viz.  :  f  inch,  3^  inches,  2  J  inches,  f  inch,  2f  inches. 
The  seal  was  thus  lost  three  times  out  of  the  five.  Smaller  quantities  of 
water  were  then  poured  in,  with  the  following  results,  viz.  : 

Quantities  of  water  in  bottom  of  a  t„^„  „f  ^ +;,  :„*„„„*„ 

two-gallon  paU.  ^°®'  °^  "^'^P*^  ^'^  ^'^'^P  ^^^«*- 

HaK  full.  2    inches seal  lost. 

3|-  inches  deep.  If  inch. 

3|      "  "  2    inches seal  lost. 

5        "         "  .     3f       "     

Q  (I  it  OJL  "  " 

(2)  "  A  vent  pipe,  1^  inch  diameter,  and  one  foot  long,  was  then  in- 
serted in  the  upper  side  of  the  pipe,  six  inches  below  the  crown  of  the 
trap,  and  ten  pails  discharged  in  succession,  with  the  result  of  losing  the 
seal  completely  three  times,  and  having  but  -^  inch  seal  two  other  times, 
while  the  remaining  five  trials  lowered  the  water  respectively  f  inch,  1-^ 
inch,  I"  inch.  If  inch,  and  1:^  inch. 

(3)  "The  size  of  the  vent  was  then  increased  to  two  inches.  Six  suc- 
cessive pailfuls  were  emptied,  lowering  the  trap  water  as  follows,  viz.: 
1  inch,  1:^  inch,  J  inch,  If  inch,  If  inch,  2^  inches,  the  last  losing  the 
seal. 

(4)  "The  vent  pipe  was  then  increased  to  three  inches  in  diameter, 
stiU  one  foot  long.  Ten  successive  pailfuls  were  emptied,  with  losses  of 
trap  water  as  follows,  viz.  :  If  inch,  1^  inch,  1^  inch,  1  inch,  ^  inch,  f 
inch,  ^  inch,  1^  inch,  1^  inch,  1^  inch.     The  seal  being  lost  once, 

(5)  "  This  vent  hole  was  then  sealed  up,  restoring  the  original  form 
of  the  pipe  as  far  as  possible,  and  another  vent  pipe  of  1^  inch  diameter 
and  one  foot  length  was  inserted  on  the  highest  part,  or  crown  of  the 
trap.  Nine  successive  pails  were  emptied,  with  loss  of  water  in  the  trap 
as  follows,  viz. :  1^  inch,  2f  inches,  2  inches,  1  inch,  2^  inches,  f  inch,  ^ 
inch,  1^  inch,  1^  inch.     The  seal  was  thus  lost  three  times  out  of  nine. 

(6)  "  The  vent  pipe,  still  one  foot  long,  was  enlarged  to  two  inches, 
with  an  elbow  two  inches  long,  at  its  upper  end.  Ten  pailfuls  in  succes- 
sion were  emptied  with  the  following  losses  in  the  trap,  viz. :  l^^g  inch,  1^- 
inch,  1^  inch,  2^  inches,  1^  inch,  1|  inch,  ^  inch,  1^  inch,  :^  inch,  2|- inches. 
The  seal  was  here  twice  lost,  and  came  very  near  it  twice  more, 

(7)  "  The  vent  pipe,  one  foot  long,  was  then  increased  to  three  inches 
diameter.  Ten  pails  were  emptied,  with  loss  of  water  as  follows,  viz, :  ^ 
inch,  f  inch,  ^  inch,  f  inch,  1^  inch,  1  inch,  f  inch,  ^  inch,  f  inch,  1^ 
inch.     The  seal  was  not  lost  now,  though  coming  within  f  inch  of  it. 

"In  all  these  three  last  experiments,  where  the  vent  was  in  the  crown 


494 

of  the  trap,  the  water  was  seen  to  dash  wp  into  the  vent  pipe,  and  spill 
over  the  top  of  it,  even  when  a  foot  long  and  three  inches  diameter. 
When  it  receded,  a  portion  of  this  water  dropped  back  into  the  trap,  and 
just  sufficed  to  keep  its  seal  when  the  vent  was  thi'ee  inches  in  diameter, 
but  not  when  smaller.  The  loss  of  water  was  plainly  attributable  to  the 
momentum  of  the  stream  when  passing  through  the  traj),  quite  as  much  as 
to  the  air  draft.  This  was  proved  by  varying  the  direction  in  which  the 
water  was  poured  into  the  hopper.  The  above  records  are  all  the  results 
of  pouring  it  in  at  the  side  of  the  hopper  opposite  the  trap,  so  that  the 
velocity  of  the  water  acquired  in  its  fall  from  the  pail  through  the  hopper 
was  not  impaired  by  such  an  abrupt  change  of  direction,  when  striking  the 
bottom  of  the  trap,  as  it  would  be  if  the  pail  were  applied  either  directly 
over  the  trap,  or  half-way  between  this  and  the  former  position.  Moreover, 
there  was  no  strainer  at  the  base  of  the  hoj^per,  to  break  the  momentum, 
the  hopper  being  of  the  form  formerly  much  iised  for  Avater-closets. 

(8)  "In  order  to  eliminate,  in  some  degree,  the  effect  of  this  momentum, 
the  same  experiments  were  tried  with  another  form  of  hoj^per,  suitable 
for  a  water-closet,  and  having  its  trap  above  the  floor,  such  as  is  marked 
'  Water-closet  No.  1 '  on  the  plate.  The  distance  through  which  the 
water  had  to  fall  from  the  edge  of  the  hopper  to  the  bottom  of  the  trap 
was  thus  reduced  by  ten  inches.  The  trap  had  a  seal  of  two  inches,  and 
was  first  tried  with  no  vent  in  it.  It  discharged  directly  into  a  patent  Y- 
branch  with  expansion  at  toj),  devised  for  the  purpose  of  preventing  siph- 
oning. Nine  pailfuls  were  emptied  with  a  lowering  of  the  trap  water  as 
follows,  viz.  :  1  inch,  -k  inch,  If  inch,  2  inches,  ^  inch,  nothing,  2^  inches, 
1^  inch,  2:^  inches,  losing  the  seal  three  times  in  the  nine.  Another  trial, 
under  similar  conditions,  showed  a  loss  of  the  seal  three  times  in  five. 

(9)  "A  vent  pipe,  one  foot  long,  and  one  and  a  half  inch  diameter, 
was  then  applied  at  the  crown  of  the  trap.  Ten  pailfuls  were  emptied 
to  favor  a  loss  of  water  by  momentum,  but  no  appreciable  loss  of  water 
occurred. 

"  In  order  to  eliminate  from  the  last  two  experiments  the  possible 
effect  of  the  offset  in  the  main  pipe  directly  under  the  connection  of  this 
branch,  the  same  experiment  was  tried  on  the  floor  below,  at  '  Water- 
closet  No.  2,'  with  essentially  similar  results,  indicating  that  the  offset 
did  not  modify  the  case  percejDtibly. 

(10)  "  The  effect  of  excessive  lengths  of  vent  pipe  was  experimented 
on  with  the  result  that,  under  conditions  which  indicated  perfect  security, 
with  a  pipe  one  foot  long  and  one  and  a  half  inch  diameter,  on  a  four- 
inch  trap,  a  coil  of  pipe  fifty  feet  long  coTipled  to  the  vent  rendered  it 
inefficient  once  in  eight  trials,  the  trap  having  two  inches  seal  being 
siphoned  in  this  case,  and  lost  one  inch  of  water  three  other  times  out  of 
the  eight. 

"In  another  case  where  a  short  vent  of  one  inch  diameter  seemed  to 
be  quite  efficient,  a  coil  of  one-inch  25ipe  with  a  length  of  twenty-eight  and 
a  half  feet  being  coupled  to  it,  rendered  the  vent  of  apparently  little  use, 
for  the  trap  lost  its  seal  at  every  trial. 

(11)  "In  order  to  test  the  effect  of  a  partial  closing  of  the  top  of  the 
soil  pipe,  a  piece  of  pasteboard  was  laid  over  it,  having  a  hole  of  only  two 
inches  diameter.  Such  a  stricture  is  often  produced  above  the  roofs  of 
buildings  in  cold  climates  by  the  formation  of  ice  through  condensation 
of  the  vapor  of  water  which  rises  with  the  air  through  the  soil  pipes.  It 
was  found  that  it  was  much  more  difficult  to  retain  the  water  in  the  traps 
in  all  cases  under  this  condition,  except  where  special  vents  were  applied 


EEMOVAL    OF    HOUSE- WASTE.  495 

to  the  traps  themselves.     In  sucli  cases  the  strictui-e  aloove  described,  at 
the  top  of  the  soil  pipe,  seemed  to  produce  no  appreciable  effect. 

"We  -will  next  consider  the  loss  of  water  in  traps  by  the  flow  past  them 
fi'om  above  through  the  main  into  which  they  discharge. 


"  C.     Experiments  ivith  a  Two-inch  Waste-pi];>e,  open  at  the  Top. 

(1)  "A  trap  of  one  and  a  half  inch  calibre  of  S-form,  having  four  and 
one-fourth  inches  depth  of  seal,  and  having  strips  of  glass  inserted  in  its 
sides  where  the  lead  w^is  removed,  was  apphed  at  the  branch  marked  Gr  on 
the  plate.  The  plug  connecting  with  the  two-inch  waste  was  then  drawn 
from  the  bath-tub  on  the  floor  above  and  the  water  allowed  to  run  a  few 
seconds.  The  water  in  the  trap  was  found  to  have  fallen  4^  inches. 
The  next  trial  destroyed  the  water  seal  with  a  flow  of  ten  seconds.  A 
third  trial  produced  the  same  result  in  four  seconds. 

"Five  pailfuls  of  water  were  then  poui'ed  in  succession  into  the  hopper 
at  (e)  on  the  third  floor,  with  this  result  :  The  seal  was  twice  entirely  lost, 
and  for  three  times  the  water  was  lowered  4^  inches,  leaving  only  i  inch 
seal. 

(2)  "  This  deep  trap  was  then  removed  and  an  S-trap  of  same  calibre 
applied  in  its  place,  vdih  glass  strips  in  its  sides  and  a  vent-hole  one  inch 
in  diameter  on  its  crown.  Five  pailfuls  in  succession  were  poured  into 
the  hopper  above  with  no  percejotible  loss  of  water  in  this  trap.  Its  water 
was  agitated  less  than  -J  inch. 

(3)  "  The  vent-hole  was  then  half  covered,  and  the  experiment  repeated 
^\ith  scarce  a  perceptible  loss  of  water. 

(4)  "The  vent-hole  being  Avide  oiDen,  the  bath  plug  was  withdrawn 
for  twenty  seconds.  The  water  in  the  trap  oscillated  about  ^  inch,  but 
was  not  lowered  perceptibly. 

(o)  "This  trap  was  removed  and  a  Cudell  trap  substituted,  such  as  is 
shown  at  S  on  the  plate,  with  no  air- vent  in  it.  The  bath  plug  above  was 
raised  for  ten  seconds,  and  the  trap  was  found  to  have  lost  all  its  water. 
The  plug  was  raised  again  twice  for  six  seconds  each  time,  and  the  trap 
twice  again  comjDletely  lost  its  water  seal.  Three  pailfuls  of  water  were 
emptied  at  the  hopper  in  succession,  and  the  trap  lost  its  water  seal  each 
time. 

(6)  "This  trap  was  removed  and  a  Bower's  trap  substituted  without 
special  air  vent,  such  as  is  shown  at  T  on  the  plate.  The  plug  was  drawn 
from  the  bath  above  for  fifteen  seconds,  and  the  trajD  was  found  to  have 
lost  1-^  inch  of  water,  leaving  about  yV  inch  water  seal.  A  second  and  a 
third  trial  of  the  same  flow  without  refilling  the  trap,  left  less  than  Jg-  inch 
of  seal.  Air  was  now  readily  sucked  up  through  the  trap  by  the  mouth, 
in  spite  of  its  ball,  which  was  new  and  clean.  On  filling  the  trap  again 
and  pouring  a  jDailful  into  the  hopper  above,  f  inch  seal  was  left.  Two 
pails  more,  without  first  filling  the  trap,  left  about  :^  inch  seal.  The  hop- 
per was  then  filled  by  a  pailful  of  water  and  discharged  by  lifting  a  plun- 
ger, and  -^  inch  seal  was  left. 

(7)  "  This  trap  was  replaced  by  an  Adee  trap,  such  as  is  shown  at  Q  on 
the  plate,  having  1^  inch  seal.  The  flow  from  the  bath  above  destroyed 
the  seal  in  ten  seconds  for  three  trials  in  succession.  Three  successive 
pailfuls  of  water  emptied  at  the  hopper  above  left  from  -^-^  to  -^  inch  seal 
after  each. 


496  AMEKICAN    APPENDIX    TO    PARKES'    HYGIENE. 


"  D.  Experiments  icith  a  Four-inch  Waste  or  Soil-pipe,  open  at  the  Top. 

(1)  "  The  foiir-inch  trap  at  (g)  on  tlie  plate,  having  two  inches  depth  of 
seal,  was  observed.  The  vent-hole  in  the  trap  was  at  first  closed.  The 
discharge  of  a  pailful  of  water  at  the  hopper  above  lowered  the  trap 
water  y^  inch.  The  simultaneous  discharge  of  the  hopper  and  water- 
closet  above  lowered  the  trap  water  2y\  inches,  destroying  the  seal.  The 
discharge  of  the  hopper  while  the  bath  waste  was  flowing,  lowered  the  trap 
water  2Jg-  inches  and  broke  the  seal.  The  discharge  of  the  water  closet 
above,  six  times  in  succession,  lowered  the  trap  water  respectively  |-J  inch, 
1^  inch,  \  mch,  1\  inch,  |  inch.  It]-  inch.  The  discharge  of  the  water- 
closet,  and  hopper,  and  bath  together,  six  times  in  succession,  lowered  the 
trap  water  from  2 f^^  inches  to  2^  inches,  destroying  the  seal  every  time. 

(2)  "The  vent-hole,  1.^  inch  diameter,  in  this  trap  Avas  then  opened, 
the  water-closet,  hoppei",  and  bath  were  then  discharged  simultaneously 
ten  times  in  succession,  with  the  loss  of  only  ^  inch  of  water  from  the  trap 
in  any  ins';ance. 

(3)  "  This  same  experiment  was  twice  repeated  with  the  top  of  the 
soil-pipe  closed,  showing  a  loss  of  only  f  inch  of  water  from  the  trap  in 
any  case. 

(4)  "  The  water  in  the  large  trap  at  (J)  on  the  plate,  was  obser\-ed  with 
discharges  of  water  from  above,  similar  to  those  noted  in  the  last  three  ex- 
periments, and  ^^ith  results  so  essentially  similar  that  they  are  hardly  worth 
reciting  in  detail. 

(5)  "An  8-trap  of  1^  inch  cahbre  and  1|- inch  depth  of  seal  was  at- 
tached to  the  branch  marked  J  on  the  plate,  on  the  second  floor,  with  no 
vent  in  the  trap.  Water  was  discharged  ten  times  in  succession  from  the 
bath  and  water-closet  above,  for  periods  of  from  five  to  eight  seconds  each. 
The  trap  was  unsealed  four  times  and  lost  from  f  inch  to  1^  inch  of  water 
at  the  other  six  trials. 

(6)  "The  same  experiment  was  repeated  with  an  opening  in  the  crown 
of  the  trap  1^^  inch  diameter,  with  loss  of  water  in  the  traj)  as  follows  : 
\  inch,  few  di'ops,  ^  inch,  ^  inch  twice,  few  drops  twice,  ^-g  twice,  few 
drops. 

(7)  "  A  Bower's  trap  was  attached  at  the  same  place,  with  no  au'-vent  in 
it.  The  water-closet  above  was  discharged  while  the  bath  waste  was 
running  ten  limes  successively.  The  trap  lost  its  water  seal  four  times 
and  lost  at  the  other  six  trials  from  \  inch  to  1:^^  inch  of  water, 

(8)  "A  Cudell  trap  was  then  substituted  at  the  same  branch  marked  J. 
The  water-closet  was  discharged  above  while  the  bath  waste  was  flowing 
ten  times  in  succession.  Nine  times  the  water  was  all  taken  out  of  the 
trap  and  once  there  was  about  ^  inch  left. 

(9)  "  A  round  trap,  having  24-  inches  seal,  as  shoAMi  at  E,  was  then  sub- 
stituted at  this  branch  J.  The  discharge  of  Water-closet  No.  1  lowered  its 
water  ^  inch.  The  discharge  of  the  same  closet  and  the  hoj^per  together 
lowered  it  f  inch.  Further  trials  of  this  trap  showed  that  the  discharge 
of  the  largest  volumes  of  water  jDossible  at  once  from  the  three  fixtures 
above  could  not  unseal  it,  for  though  quantities  of  air  were  drawn  through 
it,  as  seen  through  the  glass  in  its  sides,  there  was  so  much  space  for  the 
air  to  pass  by  the  water  that  the  seal  always  remained  efficient.  It  would 
be  instructive  to  try  such  a  trap  after  it  had  been  encumbered  with  grease 
and  other  rubbish,  as  is  often  the  case,  and  where  this  space  for  aii"  to 
pass  by  the  water  might  pei'haps  not  be  found. 


EEMOTAL    OF    HOUSE-WASTE.  497 

"  Before  deducing  any  rules  for  practice  from  these  experiments,  it  must 
he  remembered  that  they  were  made  with  new,  clean,  enamelled  pipes, 
whUe  those  in  ordinaiy  use  are  always  more  or  less  encumbered  with  scales 
and  tubercles  of  rust,  and  with  the  gTease  and  shmy  coating  deposited  by 
the  sewage.  Even  in  vertical  j)ipes  such  collections  often  reduce  the  diani- 
eter  ^  of  an  inch,  thereby  reducing  the  sectional  area  of  a  four-inch  pipe 
about  124  per  cent,  and  of  a  two-inch  j^ipe  about  23  per  cent.  ;  while  in 
sloping  waste  pipes,  like  those  under  wash-trays  and  bath-tubs,  the  accu- 
muliition  of  sohd  matter  from  the  sewage  often  amounts  to  a  permanent 
occupation  of  one-half  or  thi-ee-foiuths  of  the  whole  section. 

'■It  needs  but  a  ca'sual  reference  to  the  above  experiments  to  prove  what 
is  generally  known  and  admitted  ah-eady,  that  the  difficulty  of  retainin"- 
water  in  traps  increases  as  the  size  of  the  waste  pipe  decreases,  so  that  we 
must  expect,  -nith  pipes  that  have  been  used  for  any  considerable  period, 
much  more  tendency  in  the  traps  to  lose  theii'  seal  by  unecjual  air 
pressure  than  in  the  cases  recorded  above  under  conditions  which  are 
otherwise  similar.  Two  causes  combine  to  produce  this  result,  viz.  :  The 
smaller  pipe  is  filled  by  a  less  volume  of  water,  which  acts  like  a  piston  as 
it  i^asses  downward,  while  the  ah-  that  follows  from  the  vents  above  finds  in 
the  smaller  pipes  less  room  to  flow  in  and  a  consecjuent  increase  of  friction, 
which,  by  impairing  its  velocity,  leaves  the  unequal  pressui-e  which  we 
complain  of. 

'•Moreover,  there  are  various  conditions  afi"ecting  the  stability  of  water 
in  traps  which  may  not  have  been  foreseen  and  covered  in  these  experi- 
ments. The  various  results  actually  arising  when  repeating  the  same 
experiment  under  conditions  apparently  identical  show  how  unsafe  it  is 
to  make  general  deductions  from  a  small  number  of  trials. 

"  These  variations  may  be  accounted  for  in  pari  by  the  various  jDaths 
taken  by  the  water  when  jDoui-ed  at  different  times  fi'om  one  vessel  to 
another,  and  when  running  down  a  vertical  pipe.  There  is  always  a 
tendency  to  follow  a  spii'al  course.  "When  such  a  twist  is  given  to  the 
water  at  the  start,  in  the  hopper,  it  generally  checks  the  velocity  so  as  to 
prevent  the  unsealing  of  the  trap  attached  to  it.  "When  occuiTing  in  the 
vertical  pipe,  as  it  passes  by  the  connections  of  other  branches,  it  makes  a 
great  dilierence  whether  the  path  of  the  spkal  happens  to  hit  exactly 
across  the  opening  of  such  a  branch,  or  happens  to  pass  on  the  other  side 
of  the  main. 

"It  would  rec|uire  much  more  time  and  labor  than  we  have  spent  upon 
the  subject  to  exhaust  any  considerable  part  of  such  possible  variations 
which  are  hkely  to  occur  in  daily  practice.  The  relative  size  and  position 
of  the  difterent  branches,  the  cjuantities  of  water  passing  through  them, 
and  the  endless  number  of  combinations  of  flow  from  different  fixtures 
which  occui'  daily  in  any  large  house  or  hotel ;  all  tend  to  vary  the  result 
to  a  degree  which  should  induce  a  piiident  man  to  allow  a  large  margin  on 
the  side  of  safety.  The  risks  are  known  to  be  considerable  in  case  of  ex- 
IDOsui'e  of  untrapped  di-ains  in  dwellings.  It  should  also  be  remembered  in 
this  connection  that  we  live  in  a  climate  where  artificial  heating  of  houses, 
varm  chimneys,  and  the  careful  closing  of  wall  and  window  cracks,  combine 
to  produce  a  decided  pressure  of  au'  from  without  the  house  inward,  act- 
ing thi'ough  all  our  house-di-ains,  through  several  successive  months  every 
yeai',  and  that  we  know  of  no  method  as  yet  so  satisfactory  for  resisting  this 
pressui-e  as  the  use  of  the  water-sealed  trap.  We  are  aware  that  a  large 
number  of  ingenious  devices  ha's-e  been  introduced  to  supplement  the 
water-seal  by  mechanical  valves  with  moving  cups,  balls,  and  flaps,  but  we 
Vol   II,— 33 


498  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

have  never  seen  one  of  these  devices  which  could  be  rehed  upon  to  shut 
out  air  after  the  apparatus  had  been  used  and  defiled  for  a  few  months 
by  a  flow  of  ordinary  house-drainage,  whether  from  laundry,  kitchen,  or 
lavatoiy. 

Conclusions  and  Recommendations. 

"  When  hoppers  are  used  for  the  emptying  of  slops,  having  a  trap  below 
the  flow,  it  is  difficult  to  preserve  the  seal  in  the  ordinary  form  of  S-trap 
even  by  a  vent-pipe  attached  thereto.  The  momentum  of  the  falling  water 
helps  to  do  the  mischief.  An  abrupt  change  of  direction  may  impair  this 
momentum.  But  since  it  is  manifestly  useless  to  try  to  control  the  direc- 
tion in  which  the  water  is  emptied  into  the  hopper,  we  should  endeavor  to 
check  it  by  the  form  of  the  apparatus.     .     .     . 

"  When  a  short  hopper  is  used  for  emptying  slops,  with  a  trap  above  the 
floor,  though  the  momentum  of  the  falling  water  is  considerably  reduced 
by  the  diminished  distance  through  which  the  water  falls  from  the  pail  to 
the  trap,  there  is  still  no  security  for  keeping  the  water  in  the  trap,  unless 
supplied  by  a  special  air-vent.  This  should  be  at  least  one  and  a  half 
inch  in  diameter,  if  more  than  a  few  feet  in  length,  and  even  larger  if 
passing  to  other  floors  above. 

"  Other  forms  of  tx-aps  which,  like  the  one  referred  to  in  the  Experiment 
D  (9),  might  save  and  retain  their  water  by  means  of  a  lateral  expansion  of 
their  basins,  are  objectionable,  owing  to  the  amount  of  filth  which  they  re- 
tain, subject  to  decomposition.  The  ordinary  S  trap  alone,  with  ample 
au'-vent,  is  therefore  recommended  for  use  under  water-closets,  and  also 
for  all  other  fixtures  where  its  proper  ventilation  can  be  secured  within 
reasonable  limits  of  expense. 

"  The  above  precautions  are  of  more  importance  and  should  be  observed 
with  greater  care  when  waste-pipes  are  used  of  smaller  size  than  four  inches 
to  carry  the  flow  for  more  than  one  or  two  feet  in  distance. 

"  The  difficulties  arising'  in  such  conditions  are  illustrated  by  the  Ex- 
periments A  and  C  above  noted. 

"  Whenever  branch  inlets  are  connected  to  a  line  of  waste  or  soil  pipe 
that  is  vertical  or  approaching  that  direction,  above  which  branches  other 
fixtures  are  used  for  discharging  water  into  the  same  main,  there  is  great 
risk  of  losing  the  water  from  the  traps  of  such  branches  whenever  the  up- 
per fixtures  are  used, 

"  No  form  of  trap  without  special  air-vent  has  come  to  our  notice  which 
is  not  likely  to  lose  its  water-seal  under  such  circumstances,  even  when  the 
top  of  the  soil  or  waste  pipe  is  open,  except  those  which,  like  the  round 
trap,  are  objectionable  for  retaining  filth.  This  form  of  trap  shown  at  R 
on  the  plate  is  largely  used  about  Boston.  They  Avould  be  safe  if  always 
tight,  but  have  a  joint  for  cleaning  purposes  which  is  often  leaky.  Experts 
differ  according  to  their  individual  experiences  as  to  their  liability  to  be- 
come choked  with  filth  in  their  upper  part. ' 

"  The  best  and  most  simple  remedy  for  the  siphoning  of  traps  in  most 
cases  is  undoubtedly  to  be  found  in  the  introduction  of  air  at  the  normal 
pressvire  at  the  crown  of  the  trap.  The  reason  for  jDreferring  the  crown  to 
any  other  j)lace  can  be  found  in  the  above  record,  see  Experiment  B  (2) 
(3)  (4)  (5)  (6)  (7). 

'  The  writer  has  used  a  modification  of  this  form  of  trap  with  a  round  bottom,  as 
shown  on  the  cut  Fig.  117,  which  is  less  likely  to  retain  filth  than  those  with  a  fiat  base. 


EEMOVAL    OF   HOUSE-WASTE. 


499 


Fig.  117. 


"  No  definite  rules  can  be  given  for  the  size  and  length  of  vent-pipes. 
Yet  it  may  be  said  that  it  is  not  safe  to  trust  to  a  vent-pipe  of  less  size  than 
that  of  the  trap  it  is  to  serve  until  we  get  above  two  inches  in  diameter,  ex- 
cept they  be  of  only  a  few  feet  in  length  be- 
fore they  join  those  of  a  larger  size.  The 
greater  efficacy  of  a  vent  applied  directly 
at  the  trap,  as  compared  with  the  air-sup- 
ply through  the  top  of  the  main  soil-pipe, 
is  shown  by  Experiments  B  (11)  and  D 
(2)  and  (3). 

"  There  is  still  another  risk  arising 
from  change  of  air  pressure  in  drains, 
besides  that  of  siphoning  traps.  The  lat- 
ter is  the  result  of  lack  of  pressure,  while 
an  excess  of  pressure  is  also  to  be  avoid- 
ed. The  following  experiment  illustrates 
this  point :  It  is  applicable  to  all  house- drains  having  an  exterior  main 
trap,  or  discharging  into  a  cesspool  at  a  point  below  the  water-line  by 
a  dijDiDing  inlet  pipe,  as  is  often  done  for  the  sake  of  checking  the  back 
flow  of  gas  from  the  cesspool.  The  trap  at  the  lower  end  of  the  system, 
at  the  point  marked  V  on  the  plate,  was  filled  with  water,  and  the  air 
inlet  just  above  it  was  capped.  The  trap  at  (n)  on  the  basement  floor 
was  then  filled  with  water,  and  a  pailful  emptied  at  the  hopper  on  the  third 
floor,  connecting  to  the  four-inch  main.  The  air  was  so  compressed  ahead 
of  the  falling  water  that  it  was  forcibly  blown  out  at  the  trap  (n),  carrying 
with  it  a  good  deal  of  water,  showing  how  foul  air  from  a  drain  can  thus 
be  ejected  into  the  apartments  of  a  house  in  considerable  volumes.  The 
fixture  connected  to  such  a  trap  may  generally  be  able  to  collect  and  re- 
store to  the  trap  enough  of  the  water  expelled  to  save  its  seal,  and  thus  no 
apparent  defect  would  be  found,  unless  the  blowing  out  of  the  foul  air 
through  the  trap  happened  to  attract  attention. 

"  On  removing  the  cap  from  the  air-hole  near  V,  and  repeating  the  ex- 
periment, no  apparent  disturbance  followed  in  the  trap  (n). 

"  Another  experiment  was  tried  to  illustrate  the  retarding  effect  of  fric- 
tion and  the  consequent  change  of  pressure  in  small  waste-pipes,  viz. :  An 
ordinary  S  trap  of  1^  inch  seal,  and  1^  inch  calibre  was  attached  in  the  base- 
ment to  the  branch  marked  U  of  the  two  inch  waste  pipe.  This  represents 
a  combination  frequently  occurring  in  the  waste-pipes  of  pantry  sinks. 
This  trap  was  filled  with  water,  and  a  pailful  emptied  into  the  two-inch 
waste  on  the  third  floor  above.  The  air  was  forcibly  blowTi  out  of  the  trap 
at  U  by  the  compression  of  air  ahead  of  the  descending  charge,  even  when 
the  four-inch  air-hole  near  V  was  open  in  the  main  below.  This  result  was 
plainly  due  to  the  friction  caused  by  the  air  rushing  through  the  abrupt 
bend  at  the  connection  marked  Z.  It  shows  the  risk  incurred  by  branch- 
ing small  waste  pipes  into  one  another  when  used  on  several  floors,  and  the 
impropriety  of  using  a  quarter  bend  and  T  branch  at  Z,  instead  of  a  Y 
branch. 

"  Though  condemned  by  English  authorities,  it  is  doubtless  a  safer  way 
to  connect  the  waste-pipes  of  baths,  bowls,  etc.,  used  on  upper  floors,  directly 
to  the  large  soil-pipe  by  Y-branches,  as  near  as  practicable  to  the  fixtures 
drained,  than  to  erect  long  lines  of  smaller-sized  wastes  separately  for  such 
purposes.  Certainly  the  larger  the  pipe,  the  less  is  the  risk  of  any 
abnormal  air-pressure  occurring  by  its  use  so  long  as  the  wastes  are  not 
likely  to  become  encumbered  seriously  by  accretion  of  solid  matter. 


500 


AMERICAN    APPENDIX   TO    PARKES     HYGIENE. 


"  The  l)ro^ision  of  separate  wastes  for  baths,  etc.,  all  the  way  to  the  base- 
ment is  eousidered  important  in  England,  probably  because  of  a  dislike  to 
make  inlets  in  the  soil-pipe  used  for  water-closets.  But  the  risks  arising 
from  the  use  of  a  small-sized  waste  through  such  distances  are  thus  proved 
to  be  considerable,  and  should  not  be  ignored  ;  while  those  ai-ising  from  the 
common  use  of  a  four  or  five  inch  pipe  for  water-closet  and  general  refuse 
water  on  sevei-al  floors  may  have  been  overrated  in  England." 

Grease  Interceptors. 

Wherever  kitchen  and  pantiy  sink  drains  which  are  used  for  the  dis- 
charge of  water  from  the  washing  of  table  dishes  cannot  be  provided  with 
a  xery  rapid  fall,  the  congealing  of  the  gi'ease  is  hkely  to  form  a  deposit 
on  the  inside  of  the  di'aiu  which  often  obstructs  it  entirely. 

The  use  of  a  larger  pipe  does  not  remedy  the  difficulty,  for  the  quantity 

is  often  sufficient  to  till  a 
drain  eighteen  inches  in 
diameter  in  a  few  months. 
The  only  efficient  remedy 
is  to  apply  an  intercepting 
tank,  as  near  the  sink  as 
possible,  so  as  to  avoid  the 
filling  of  the  drain  with 
grease  between  these  re- 
ceptacles and  the  sink. 
The  best  material  of  which 
to  coustmct  the  tank  is 
Portland  cement,  mixed 
with  clean  sharp  sand,  and 
moulded  in  forms  as  for 
large  sewer  pipes.  They 
are  now  constnicted  for 
the  pm'pose  in  Boston, 
with  a  bowl-shaped  bot- 
tom inside  and  flat  bottom 
outside,  moulded  in  one  or  two  pieces,  to  accommodate  the  desired  depth 
below  the  surface,  and  fitted  with  an  iron  flange  and  cover.  The  outlet 
jDipe  is  made  of  a  four-inch  soil-pipe  T  bi^anch,  which  admits  of  being 
cleaned  out  from  above. 

The  gTease  then  congeals  and  floats  on  the  surface,  and  can  be  removed 
when  convenient.  This  aiTangement  is  shown  in  Fig.  118.  The  outlet  for 
water  being  immersed  several  inches  below  the  surface,  the  water  is  allowed 
to  flow  ofl",  while  the  grease  accumulates  on  the  toji  of  the  standing  water. 


Fig.  118.— a.  House-wall.    B,  Ventilation  Pipe.    C,  Inlet.    D,  Outlet. 


IiiPORT.^NCE  OF  Simplicity. 

One  of  the  most  frequent  faults  to  be  found  in  the  planning  of  the 
plumbing  and  drainage  of  American  houses  is  in  the  multiplication  of  fix- 
tures for  the  convenience  of  the  inmates,  scattered  without  consideration 
and  without  sufficient  reason  all  about  the  house.  It  is  difficult  to  render 
such  aiTangements  safe  without  a  large  outlay  in  safeguards,  and  even  then 
an  unnecessary  risk  is  incuiTed  by  lack  of  simplicity.     It  is  impoi-tant  to 


REMOVAL    OF    HOUSE-WASTE. 


501 


limit  these  conveniences  to  the  immediate  vicinity  of  the  soil-jDipe,  and  to 
avoid  all  drain  or  waste  pipes  passing  in  a  nearly  horizontal  du-ection.  A 
common  error  is  illustrated  by  the  annexed  cut  (Fig.  119),  where  a  wash- 
bowl waste  is  connected  with  a  water-closet  trap,  several  feet  distant,  by  a 


Fig.  119. 


pipe  under  the  floor,  difficult  of  access,  and  so  nearly  horizontal  as  to  in- 
sure its  being  soon  fiUed  by  a  deposit  of  slimy  filth,  thi'ough  which  the 
water  finds  its  way  slowly  and  with  difficulty.  Such  an  arrangement  can 
never  be  satisfactory.  The  bowl  should 
be  placed  close  to  the  closet,  and  should 
drain  into  the  soil-pij)e  by  a  separate 
branch  below  the  water-closet  trap,  hav- 
ing a  special  trap  under  the  bowl  itself. 

One  of  the  most  comphcated  and 
objectionable  pieces  of  apparatus  is  the 
old-fashioned  and  largely  used  "pan" 
water-closet,  w^hich  is  now,  however, 
being  generally  superseded  by  various 
better  patterns.  Nearly  all  the  new  de- 
vices are  better  that  the  pan  closet,  which 
is  by  all  means  to  be  avoided. 

Among  the  best  forms  for  general 
use  are  the  simple  hoppers  with  traps 
above  the  floor.  This  position  for  the 
trap  brings  the  water  it  contains  in 
plain  sight,  and  reduces  to  a  minimum 
the  surface  hkely  to  be  soiled  above  the 
trap-water.  Moreover,  it  diminishes  the 
chance  of  loss  of  the  trap-water  by  mo- 
mentum, an  important  item.  Where  to 
be  used  by  servants,  children,  or  arti- 
sans, the  water-supply  should  be  made 
automatic,  and  metered  by  a  waste-sav- 
ing apj)aratus,  as  illustrated  on  the  an- 
nexed cut  (see  Fig.  120).  The  weight  of 
the  person  on  the  seat  is  thus  made  to 
hft  the  valve  in  the  bottom  of  the  tani, 

which    should    be    placed     directly    over  Fig.  120. -Tank  with  Automatic  supply. 

the  closet,  and  thereby  fill  the  service-box  beneath.     T^Tien  the  weight  is 
removed  from  the  seat  this  valve  closes  and  the  lower  one  opens, 


dis- 


502  AMERICAN    APPENDIX    TO    PARKES     HYGIENE. 

cliarging  an  ample  and  definite  quantity  of  water  with  a  sudden  dasli,  which 
expels  all  the  contents  of  the  trap  below.  The  ordinary  method  of  flushing 
hopper  closets  by  a  faucet  is  a  miserable  makeshift.  Even  if  the  faucet 
is  left  open  for  half  the  time,  with  the  consequent  waste  of  several  hundreds 
of  gallons  of  water  per  hour,  the  object  sought  is  not  gained,  for  such  a 
driblet  does  not  properly  flush  the  trap  or  the  drain  below.  It  is  a  per- 
fectly useless  waste,  and  leaves  undisturbed  the  filth  which  may  have  col- 
lected in  the  trap  or  in  the  drain  below  it. 


FOOD  ADULTEEATION. 

,      By  E.  G.  love,  Ph.D. 

Legislation. 

The  first  movement  toward  securing  comprehensive  legislation  against  the 
adulteration  of  foods  and  drugs  in  this  country  was  made  in  1879.  A  com- 
petition for  the  best  essay  on  the  subject  of  food  and  drug  adulteration, 
with  drafts  of  suitable  bills  for  its  prevention,  was  instituted  by  the  Sanitary 
Engineer,  under  the  direction  of  the  National  Board  of  Trade.  Prizes 
amounting  to  $1,000  were  offered  for  the  best  essays,  which  sum  was 
placed  at  the  disposal  of  the  Board  by  Mr.  F.  B.  Thurber,  one  of  its  mem- 
bers. The  committee  of  award  being  also  required  by  the  terms  of  the 
competition  to  frame  laws  suitable  for  State  and  National  enactment,  was 
selected  as  representing  the  different  interests  involved.  The  Committee 
was  composed  as  follows :  Dr.  John  S.  Billings,  Surgeon  United  States 
Army  ;  Professor  C.  F.  Chandler,  President  Board  of  Health,  New  York  ; 
Ex-Chancellor  B.  Williamson,  Elizabeth,  N.  J.  ;  A.  H.  Hardy,  Esq.,  Bos- 
ton ;  John  A.  Gano,  Esq.,  Cincinnati. 

In  October,  1880,  several  essays,  with  drafts  of  laws  were  sent  in,  and 
on  the  29th  of  that  month  the  committee  made  its  repoi't  to  the  Board  of 
Trade.  In  none  of  the  essays  submitted  was  there  any  evidence  to  show 
that  dangerous  adulterations  existed  to  any  extent  in  this  country.  This 
fact  was  corroborated  by  several  extensive  examinations  of  food  products 
made  about  that  time,  and  proved  most  conclusively  to  the  minds  of  the 
Committee  that  there  was  no  foundation  whatever  for  the  statements  so 
frequently  made  by  ignorant  persons  that  our  food  supply  was  dangerously 
adulterated.  This  same  conclusion  had  been  already  reached  by  many 
persons  who  had  made  special  study  of  the  subject.  The  publication  of 
wild  and  fanciful  stories  as  to  poisonous  substances  found  in  articles  of 
food,  while  it  may  give  a  certain  notoriety  to  the  writer  of  such  fiction,  can 
result  only  in  needlessly  alarming  the  public  and  in  detriment  to  many 
commercial  interests,  and  it  should  be  most  emphatically  condemned. 

If  the  substances  generally  used  as  adulterants  are  not  positively  dan- 
gerous to  health,  then  the  question  of  food  adulteration  should  be  con- 
sidered, as  stated  in  the  Committee's  report,  more  from  the  commercial  than 
from  the  sanitary  standpoint.  The  Committee  also  expressed  the  opinion 
that  there  was  more  danger  to  life  and  health  in  this  country  from  adul- 
terated drugs  than  there  Avas  from  adulterated  food,  and  that  any  legislation 
which  aimed  to  correct  the  one  must  also  deal  with  the  other.  This  sugges- 
tion was  very  pertinent  at  that  time,  inasmuch  as  a  bill  had  been  previously 
introduced  in  Congress,  which  was  entirely  unsuitable  and  inadequate  for 
the  purpose,  and  which,  moreover,  referred  only  to  articles  of  food. 

If  the  adulteration  of  food  is  considered  simply  as  a  commercial  matter, 
the  execution  of  laws  enacted  for  its  prevention  would  naturally  devolve 


5  04  AMERICAK    APPENDIX   TO    PAEKEs'    HYGIENE. 

upon  a  commercial  rather  than  vij)on  a  sanitary  organization.  Such  is  the 
case  in  Canada,  where  the  enforcement  of  the  Adulteration  Act  is  placed 
upon  the  Department  of  Inland  Eeveuue.  Inasmuch,  however,  as  the  in- 
dividual States  in  this  country  have  no  similar  department,  and  as  the 
projDosed  legislation  should  include  drugs  as  well  as  food,  it  was  thought 
expedient  by  the  committee  to  entrust  the  execution  of  the  laws  for  this 
object  to  the  State  Boards  of  Health  ;  and  where  such  boards  do  not  exist 
it  was  suggested  that  they  be  created  by  independent  legislation. 

"  The  questions  involved  are  in  a  high  degree  technical  and  require 
special  training  in  those  charged  with  admin istenng  the  law  ; "  but  it  was 
the  ojiinion  of  the  committee  that  the  existence  of  such  health  authorities 
might  be  taken  for  granted. 

While  the  competition  did  not  result  in  furnishing  the  draft  of  an  act 
which  met  the  views  of  the  committee,  many  suggestions  were  obtained, 
and  the  committee  subsequently  presented  to  the  Board  of  Trade  di'afts  of 
National  and  State  acts.  These  drafts,  together  with  the  committee's  re- 
port, were  approved  by  the  Board  of  Trade  on  December  15,  ISSO,  and 
resolutions  were  adopted  directing  the  President  and  Secretary  of  the 
Board  to  transmit  to  the  United  States  Senate  and  House  of  Representatives 
copies  of  the  report  of  the  coinmittee  and  of  the  draft  of  a  national  act, 
requesting  in  behalf  of  the  Board  the  passage  of  the  same. 

Copies  of  the  report  and  drafts  of  acts  were  also  sent  to  the  State 
Boards  of  Trade  with  the  request  that  they  use  their  influence  to  secure 
the  desired  legislation.  The  bill  introduced  in  Congi'ess  was  subsequently 
modified  by  excluding  all  reference  to  inter-State  traffic,  and  by  the  sub- 
stitution of  the  "  Secretary  of  the  Treasury' "  for  the  "  National  Board  of 
Health."  In  this  form  it  was  reported  by  the  Committee  on  Commerce  of 
the  House  of  Eepreseutatives,  but  up  to  the  j)resent  time  it  has  not  be- 
come a  law. 

In  1881,  three  States— New  Jersey,  New  York,  and  IMichigan — passed 
laws  to  prevent  the  adulteration  of  food  and  drugs. 

New  Jersey. — In  New  Jersey  the  law  was  approved  March  25th,  and 
went  into  effect  thirty  days  later.  The  bill,  as  passed,  w-as  the  same  as 
that  recommended  by  the  National  Board  of  Trade  for  State  enactment ; 
and  its  pi'oy^sions  correspond  in  general  with  those  contained  in  the  bill 
introduced  in  Congress.  The  enforcement  of  the  law  was  placed  in  the 
hands  of  the  State  Board  of  Health,  and  soon  after  its  passage  the  board 
•appointed  eight  persons  as  a  "  Council  of  Analysts  and  Chemists."  Circu- 
lars were  sent  to  the  local  boards  of  health,  and  to  physicians  and  others, 
asking  for  any  information  in  their  possession  of  cases  of  poisoning  or  in- 
jury to  health  hy  the  use  of  improperly  prepared  or  adulterated  foods  anc? 
dnigs.  A  series  of  examinations  was  commenced  by  the  anal^'sts,  the  re- 
sults of  which  were  subsequently  published.'  The  Legislatiu-e  whicK 
passed  the  law  rendered  its  enforcement  practically  inoperative  by  the 
appropriation  of  only  $500  for  carrying  out  its  provisions.  Early  in  1883 
the  law  was  amended  in  several  important  particulars.  One  section  of  the 
amended  act,  referring  to  the  disposal  of  penalties,  reads  :  "In  case  of  any 
suit  not  otherwise  provided  for,  the  penalty  shall  be  paid  to  the  person 
bringing  the  suit."  This  is  an  un^dse  pi-ovision,  as  it  encourages  prosecu- 
tions for  violations  of  the  law,  with  no  other  object  than  the  j)ocketing  of 
the  penalty  by  private  indi^-iduals.  The  report  of  the  Board  of  Trade 
committee,  ah'eady  referred  to,  distinctly   says   that  "  under  no  cu'cum- 


'  Fifth  Annual  Report  of  tlie  Board  of  Health  of  New  Jers'^y,  1881. 


FOOD    ADULTERATIOiSr.  505 

stances  should  fees  or  moieties  to  informers  be  allowed."  Another  section 
gives  power  to  any  officer  of  any  local  board  of  health  to  inspect  any  article 
of  food  or  diiigs,  whether  offered  for  sale,  "  or  whether  in  transit  or  other- 
wise." xls  local  boards  of  health  are  liable  to  have  officers  who  are  in  no 
way  Cjuahfied  for  snch  inspections,  and  who  might  make  them  for  the  sole 
jDui'pose  of  obtaining  the  tine  imposed,  in  case  of  conviction,  it  is  \erx  clear 
that  this  section  gives  too  much  power  to  individuals  ;  and  it  is  altogether 
likely  that  sooner  or  later  cases  will  arise  under  this  section  which  will 
bring  disrepute  upon  the  law  and  great  annoyance  to  commercial  interests. 
The  amendment  is  to  be  commended  in  one  particular,  in  that  it  allows 
the  Boai'd  of  Health  to  expend  §1,000  annually  in  carrying  out  the  pro- 
visions of  the  act. 

It  has  been  stated  by  one  of  its  officers  that  it  is  not  the  intention  of 
the  Board  of  Health  "to  chase  every  commercial  fraud,"  but  "to  look 
after  adulterations  harmful  to  health."  If  this  be  true,  the  commercial 
interests,  which  were  largely  considered  by  those  who  drafted  the  original 
law,  will  receive  little  protection  in  New  Jersey  ;  and  the  consumers  and 
honest  tradesmen,  in  whose  interest  the  law  was  presumably  enacted,  must 
look  elsewhere  for  that  protection  fi'om  commercial  frauds  which  they 
had  every  reason  to  expect  would  be  furnished  by  the  State  Board  of 
Health. 

The  first  case  brought  to  trial  under  the  New  Jersey  law  was  in  May 
last,  in  which  a  person  was  convicted  of  selling  skimmed  milk.  So  far  as 
we  know,  this  is  the  only  case  u]d  to  the  present  time. 

New  York. — The  legislation  against  food  and  drug  adulteration  in  New 
York  commenced  by  the  introduction  of  a  bill  in  the  Legislatiu'e  during 
the  winter  of  1880-81.  The  bill  was  passed  and  became  law  on  June  2, 
1881 ;  but  it  did  not  go  into  effect  until  ninet}'  days  later.  The  bill '  was 
that  recommended  by  the  Board  of  Trade,  and  jDlaced  the  enforcement  of 
the  act  upon  the  State  Board  of  Health.  The  sum  of  §10,000  was  ap23ro- 
priated  for  caiTying  out  its  provisions. 

It  is  a  fact  worthy  of  note  here  that  the  passage  of  this  law  was  largely 
due  to  the  support  and  co-op)eration  of  the  leading  food  and  di'ug  manu- 
factui'ers  and  dealers. 

The  first  step  taken  by  the  Board  was  the  aj^pointment  of  eight  exj^erts, 
including  chemists  and  pharmacists,  who  were  asked  to  make  examinations 
of  the  foods  and  drugs  sold  in  the  State,  for  the  pui-pose  of  ascertaining  to 
what  extent  adulteration  existed,  and  also  to  determine  the  natui-e  of  the 
adulterants  employed.  The  supeiwision  of  this  work  was  placed  in  the 
hands  of  the  Sanitary  Committee  of  the  Board.  To  each  analyst  was 
assigned  a  group  of  foods  or  drugs  for  examination,  it  being  the  opinion 
of  the  committee  that  more  could  be  accomplished  in  such  j)reliminary 
work  in  this  way  than  by  giving  to  each  one  all  the  samples  from  a  certain 
locality.     The  samples  were  collected  by  two  inspectors. 

The  reports  '  of  these  examinations  fully  corroborated  the  existing  evi- 
dence, that  most  of  the  adulterations  of  food  were  such  as  to  affect  the 
pocket  more  than  the  health.  Unwholesome  adulterants  were  foimd,  but 
none  which  were  really  poisonous. 

On  the  completion  of  this  preliminaiy  work,  the  Board  dirided  the  State 
into  three  districts,  and  appointed  four  public  analysts  and  one  inspector, 
to  each  of  whom  a  fixed  salary  was  paid  in  lieu  of  all  fees. 

^  A  copy  of  this  act  will  be  found  at  the  end  of  this  article. 

^  See  Second  Annual  Eeport  State  Board  of  Health  of  Xew  York,  1882.     Abstracts 
of  the  same,  The  San.  Eng.,  vol.  v.,  March,  1882. 


506 

The  actual  work  of  the  Board  in  the  enforcement  of  the  adulteration 
law  commenced  in  the  summer  of  1882.  The  report  of  the  Sanitary  Com- 
mittee for  1882  shows  that  up  to  the  close  of  the  year  286  samples  of  foods 
and  dinigs  had  been  submitted  to  the  public  analyists  for  exanjination,  of 
which  19-1  had  been  reported  upon.  Of  119  samples  of  food,  50  were  found 
adulterated  ;  while  of  75  samples  of  drugs,  32  were  adulterated.  During 
December,  1882,  prosecutions  were  commenced  in  twenty-four  cases  for 
violations  of  the  law.  These  included  seventeen  cases  for  selling  cream  of 
tartar  adulterated  with  terra  alba,  starch,  etc.,  to  the  extent  of  from  thirty- 
seven  per  cent,  to  ninety-five  per  cent.  ;  two  cases  of  coffee  adulterated 
with  chicory  and  burnt  peas  ;  four  cases  of  mustard  adulterated  with  from 
forty  per  cent,  to  seventy-one  per  cent,  of  floui* ;  and  one  of  precipitated 
sulphur,  containing  thu'ty  per  cent,  of  sulphate  of  lime.  One  of  the  cream 
of  tartar  and  one  of  the  mustai-d  cases  were  made  test  cases  and  convic- 
tions secured  in  l^oth  instances.  The  defendants  in  the  other  mustard 
cases  and  in  the  coffee  cases  pleaded  guilty  and  paid  the  penalty. 

The  cream  of  tartar  case  was  appealed,  and  the  decision  reserved,  prin- 
cipally on  the  ground  that  criminal  intent  had  not  been  proved.  The 
Board  of  Health  did  not  carry  this  case  to  a  higher  court,  and  the  other 
cream  of  tartar  cases  were  never  brought  to  trial.  The  action  of  the 
Board,  however,  resulted  in  calling  public  attention  to  the  fact  that 
adulteration  existed,  and  also  in  very  materially  improving  the  quahty  of 
certain  articles  of  food,  as  was  shown  by  subsequent  examinations.  As 
another  result,  the  Board  of  Health  held  a  conference  with  the  manufac- 
turers, for  the  jDurpose  of  ascertaining  their  views  relative  to  the  sale  of 
mixtures,  such  as  mustard  and  flour,  coffee  and  chicoiy,  etc.  It  was  the 
opinion  of  the  manufacturers  present  at  this  conference  that  the  com- 
ponents of  a  mixture,  as  well  as  the  percentage  of  the  princii)al  or  charac- 
teristic constituent,  should  be  printed  upon  the  label  ;  but  not  the  per- 
centage of  each  constituent  present.  The  Board  subsequently  passed 
resolutions  permitting  the  sale  of  mixtures  of  mustard  and  coffee,  which 
resolutions  received  the  Governor's  aj^proval  in  March,  1883,  and  so  be- 
came law.' 

The  action  of  the  Board  of  Health  in  instituting  proceedings  against 
the  retail  grocer  instead  of  the  wholesale  dealer  or  manufacturer  was 
somewhat  criticised,  as  being  of  the  nature  of  persecution,  and  on  the 
further  ground  that  the  grocer,  having  purchased  his  merchandise  in  good 
faith,  sujjposed  it  was  unadulterated.  This,  of  course,  is  a  very  important 
matter  in  the  enforcement  of  any  food  adulteration  law.  Legal  proceed- 
ings should  be  brought  against  the  manufacturer,  if  possible,  but  failing 
in  this,  against  the  wholesale  merchant,  or  lastly  against  the  retail  dealer, 
who  may  or  may  not  know  the  exact  nature  of  the  goods  he  sells.  The 
manufactiu^er  is  the  most  responsible,  and  should  first  be  brought  to  ac- 
count ;  but  this  does  not  free  the  retailer  from  responsibility  or  exempt 
him  from  prosecution  in  case  he  violates  the  law.  It  is  often  impossible 
to  reach  the  manufacturer  except  through  the  retail  dealer,  and  while  the 
Board  of  Health  would  gladly  prosecute  the  former,  such  a  course  is,  as  a 
rule,  impossible,  from  the  fact  that  the  retailer  is  unwilling  to  testify 
against  the  manufactui'er.  To  purchase  an  article  in  very  small  quantities 
from  the  manufactiirer  or  wholesale  merchant,  if  possible  at  all,  would 
arouse  suspicion,  and  doubtless  result  in  the  purchaser  getting  the  genu- 
ine and  not  the  adulterated  article.     The  Board  can  hardly  be  expected 

'  A  copy  of  these  resolutions  will  be  found  at  the  end  of  this  article. 


FOOD    ADrLTERATIOlSr.  507 

to  buy  a  barrel  of  flour  or  a  firkin  of  butter  in  order  to  get  a  few  ounces 
for  analysis. 

The  prosecution  of  the  retailer,  therefore,  is  in  the  majority  of  cases, 
the  only  practicable  plan  for  those  charged  with  the  enforcement  of  the 
law,  unless  the  retailer  himself  will  become  a  witness  for  the  prosecution. 

The  public  have  a  right  to  assume  that  the  merchant  who  offers  goods 
for  sale  knows  the  nature  of  the  goods  he  sells.  It  is  a  part  of  his  busi- 
ness. Some  allowance  must,  of  course,  be  made  in  the  case  of  articles 
which  require  chemical  examination  to  reveal  their  nature  ;  but  most 
grocers  would  be  very  indignant  if  told  that  they  could  not  tell  whether 
mustard  was  one-half-  flour,  or  pepper  two-thirds  sawdust.  Many  will 
assert  that  they  can  distinguish  genuine  butter  from  oleomargarine  by  the 
taste,  and  yet,  if  prosecuted  for  selling  the  latter  for  the  former,  would 
say,  or  allow  it  to  be  said  for  them,  that  they  did  not  know  it  was  oleo- 
margarine. 

The  retail  grocer  can  always  protect  himself  by  purchasing  his  stock  of 
reputable  dealers,  or  secure  himself  against  pecuniary  loss  by  demanding 
a  written  guarantee  as  to  the  quality  of  the  goods  he  buys,  and  thus  avoid 
all  probability  of  prosecution. 

As  to  proving  criminal  intent  it  is  absolutely  impossible  to  do  so  in  very 
many  cases  which  might  arise  in  the  enforcement  of  an  adulteration  law, 
notwithstanding  that  the  prosecution  might  be  morally  certain  that  the 
dealer  knew  just  what  he  was  selling.  Judges  Cockburn  and  Blackburn 
have  both  decided,  in  adulteration  cases  brought  before  the  Court  of  Queen's 
Bench,  that  it  was  not  necessary  to  prove  criminal  intent  in  such  prosecur 
tions,  and  that  the  gTocer  is  supposed  to  know  what  he  sells. 

These  remarks  relative  to  the  enforcement  of  the  Food  Adulteration  Act 
in  the  State  of  New  York  will  apply,  to  a  greater  or  less  extent,  in  States 
where  existing  or  future  legislation  may  render  similar  prosecutions  essen- 
tial. 

The  operation  of  the  law  in  New  York  State  has  demonstrated  that  its 
enforcement  should  be  placed  in  the  hands  of  one  person,  to  whom  the 
Board  of  Health  should  give  sufficient  power  to  enable  him  to  act  promptly 
in  an  emergency.  Moreover,  this  work  involves  a  certain  knowledge  of 
technical  and  analytical  chemistry  for  its  intelligent  and  energetic  per- 
formance. The  director  of  the  work  should  be  qualified  to  say  what  kind 
of  an  analysis  is  necessary,  and  be  able  to  judge  of  the  value  of  an  analy- 
sis with  a  view  to  prosecution  ;  and  he  should  also  be  so  thoroughly  imbued 
with  the  importance  of  the  work,  that  he  will  perform  the  duties  imposed 
with  promptness  and  energy.  Anything  short  of  this  will  result  in  the  ac- 
complishment of  little  practical  good  in  the  suppression  of  adulteration. 
It  is  also  important  that  counsel  specially  qualified  for  the  work  be  employed 
to  conduct  prosecutions. 

The  funds  appi'opriated  by  the  last  Legislature  for  enforcing  the  Adul- 
teration Act  were  withheld  in  consequence  of  the  Governor's  veto.  This 
partly  accounts  for  the  apparent  inactivity  of  the  Board  of  Health  in  carry- 
ing out  the  provisions  of  the  law  at  the  present  time. 

The  enforcement  of  the  food  law  may  be  said  to  have  passed  the  experi- 
mental stage  in  New  York  State,  and  with  energy,  discretion,  and  the 
needed  funds  it  can  be,  and  should  be  felt  in  the  suppression  of  adulteration. 

Michigan. — In  June,  1881,  Michigan  passed  a  law  to  prevent  the  adul- 
teration of  food,  drink,  and  medicine.  The  act  differs  entii'ely  from  that 
passed  in  New  York  State,  and  recommended  by  the  Board  of  Trade.  The 
first  defect  noticeable  in  the  law  is  that  no  one  in  particular  is  entrusted 


508  AMERICAN    APPENDIX    TO    PAKKEs'    HYGIENE. 

with  its  enforcement.  It  is  made  the  cTuty  of  the  prosecuting  attorneys  of 
the  State  to  appear  for  the  people,  but  no  one  is  likely  to  commence  pro- 
ceedings for  violations  of  the  law,  unless  it  be  some  injured  or  aggi^ieved 
individual.  Moreover  the  law  does  not  contain  any  detinition  of  adiiltera- 
tion,  and  provides  for  no  standards  of  puiity.  It  is  evidently  aimed  more 
especially  at  glucose  and  oleomargarine,  as  these  are  the  only  substances 
mentioned  in  the  act.  The  law  should  be  so  comprehensive  as  to  avoid  all 
necessity  for  the  mention  of  any  particular  articles  of  food. 

The  statutes  of  veiw  many  States  contain  laws  which  were  directed 
against  some  one  article  of  consumption,  but  which,  for  want  of  some  pro- 
vision for  their  enforcement,  have  long  been  so  much  dead  matter.  We 
have  heard  of  no  cases  being  brought  under  this  act,  and  doubt  whether 
Michigan  will  ever  be  any  better  off  for  its  passage. 

JIassachui<etts. — In  May,  1882,  the  State  of  Massachusetts,  through  the 
efforts  of  its  Board  of  Health,  Lunacy,  and  Charity,  passed  a  law  for  the 
prevention  of  food  and  di-ug  adulteration.  This  law  is  substantially  the  same 
as  that  jDassed  in  New  York  State.  Its  enforcement  is  placed  in  the  hands 
of  the  State  Board  of  Health,  and  the  law  empowers  the  Board  to  expend 
annually  an  amoimt  not  exceeding  83,000  for  the  i^urpose  of  carrA-ing  out 
its  provisions. 

Soon  after  the  passage  of  the  act  the  Board  appointed  two  analysts,  one 
for  the  examinations  of  foods,  and  the  other  for  that  of  drugs.  Regulations 
were  also  adojDted  for  the  guidance  of  the  analysts  in  procuring  and  examin- 
ing samples. 

At  the  meeting  of  the  Legislature  next  following  the  passage  of  the  act, 
the  law  was  amended  by  increasing  the  annual  appropriation  from  83,000 
to  85,000,  and  providing  that  two-fifths  of  this  amount  should  be  annually 
expended  in  the  enforcement  of  the  law  against  the  adulteration  of  milk. 
Under  this  provision  the  Board  have  appointed  two  additional  analysts, 
whose  duties  will  be  confined  especially  to  the  examination  of  milk. 

Prosecutions  have  been  already  commenced  for  violation  of  the  law% 
and  there  seems  to  be  every  probability  that  the  enforcement  of  the  law- 
will  be  a  success. 

Louisiana. — The  State  of  Louisiana  passed  a  law  in  July,  1882,  pro- 
hibiting the  sale  of  adulterated  foods  and  drugs.  The  act  bears  some 
shght  resemblance  to  that  recommended  by  the  Board  of  Trade,  and 
adopted  in  seveial  States  ;  but  the  changes  that  have  been  made  are  such 
as  will  seriously  affect  its  efficiency  if  its  enforcement  is  ever  attempted. 
The  definitions  of  "food "and  "dmg"  are  omitted,  and  the  definition  of 
adulteration  is  incomplete.  No  provision  is  made  for  drugs  not  men- 
tioned in  the  "  United  States  Pharmacopoeia."  A  part  of  one  section  reads 
as  follows:  "No  person  shall  manufacture,  sell,  or  offer  for  sale  within 
this  State  any  drugs,  gToceries,  such  as  sugar,  coffee,  tea,  butter,  cheese, 
or  any  other  article  to  be  consumed  as  food  or  drink,  unless  the  package 
when  sold  at  wholesale,  or  the  package  from  which  it  is  taken  when  sold 
at  retail,  be  stamped  in  plain  large  letters  showing  the  true  cjuahty  and  kind 
of  the  articles  sold.  .  .  ."  There  is  a  fine  of  twenty-five  dollars  for 
riolating  this  provision.  As  this  section  reads,  the  clause  "  or  the  package 
fi'om  which  it  is  taken  when  sold  at  i*etail  "  refers  to  the  wholesale  package, 
and  consequently  no  prorision  is  made  for  stamping  the  nature  of  the  ai'- 
ticle  upon  the  package  which  the  consumer  who  buys  at  retail  receives. 
If  it  was  intended  that  the  packages  sold  at  retail  should  be  stamped 
under  all  circumstances,  as  indicated  in  the  law,  we  should  still  object  to 
it  on  the  ground  that  the  law  should  take  it  for  gi-anted  that  the  consumer 


FOOD    ADULTEEATION.  509 

was  getting  tlie  genuine  article,  unless  informed  to  the  contrary.  If  the 
retailer  gives  oleomargarine  when  asked  for  butter,  or  chicory  when  asked 
for  coffee,  he  should  be  required  to  furnish  such  information,  in  some 
foi-m,  to  the  purchaser ;  but  to  require  the  honest  grocer  to  stamp  every 
article  he  sells  as  pure,  appears  like  a  needless  tax  upon  trade. 

Another  section  provides  that  the  State  Board  of  Health  shall  analyze 
any  di'ugs  or  foods  it  may  think  necessary,  and  in  case  any  such  aii;icle  is 
deleterious  to  the  public  health,  it  shall  publish  the  results  of  the  analysis 
and  "warn  the  pubhc  against  its  consumption." 

This  law  evidently  does  not  contemplate  any  general  supervision  and 
examination  of  foods  and  di'ugs. 

The  foregoing  gives  some  genei'al  idea  of  what  has  been  accomplished 
so  far  in  suppressing  the  adulteration  of  foods  and  drugs  in  this  country. 
Many  States,  having  as  yet  no  general  adulteration  law,  have  passed  cer- 
tain acts  aimed  at  the  suppression  of  adulteration  in  particular  articles. 
Without  attempting  to  mention  these  in  detail,  it  may  be  said  that  as  the 
majority  of  them  make  no  provision  for  enforcing  the  law  nothing  fui'ther 
is  heard  of  them. 

Adtjlteratiojt. 

The  limits  of  this  paper  will  permit  only  a  few  remarks  on  the  adulter- 
ation of  some  of  the  more  important  articles  of  food  in  this  country. 

Milk. — Of  the  more  important  articles  of  human  food,  none  is  more 
generally  adulterated  than  milk  ;  and  at  the  same  time  greater  efforts  have 
been  made  to  prevent  the  adulteration  of  milk  than  of  any  other  food. 
The  reason  for  such  efforts  is  apparent  in  the  fact  that  all  recognize  milk 
as  a  very  important  article  of  food,  both  for  young  and  old  ;  and  where  it 
forms  so  prominent  an  element  in  the  food  of  infants  it  is  especially  impor- 
tant that  it  be  obtained  pure  and  unadulterated. 

Many  States  which  have  no  general  adulteration  law  have  jDassed  spe- 
cial laws  to  prevent  the  adulteration  of  milk  ;  and  where  no  State  legisla- 
tion existed  Boards  of  Health  have  taken  up  the  question,  and  have  done 
much  to  stop  the  fraud.  For  certain  reasons  local  Boards  of  Health  are  in  a 
better  position  to  act  than  State  Boards  ;  and  in  most  of  our  larger  cities  there 
are  one  or  more  milk  insjDectors,  usually  under  the  control  of  the  Health 
Board,  where  such  an  organization  exists.  The  perishable  nature  of  milk 
makes  it  necessary  that  its  examination  be  attended  to  immediately.  This 
can  be  done  hj  local  authorities,  whei^eas,  if  the  milk  be  sent  to  a  distance 
for  examination  by  an  officer  of  the  State  authority,  it  would  in  most  cases 
be  sour  before  it  reached  its  destination,  and  the  results  obtained  would 
consequently  be  less  satisfactory  than  when  reached  with  a  fresh  sample. 
Moreover,  if  milk  adulteration  is  to  be  prevented,  daily  inspection  of  the 
supj)ly  is  essential.  For  this  reason  the  State  Boards  of  Health  have  done 
less  than  local  authority  toward  the  suppression  of  this  exW,  except  in 
some  cities  where  there  was  an  analyst  of  the  State  Board. 

The  most  common  forms  of  milk  adulteration  are  the  removal  of  the 
cream  or  skimming,  and  the  addition  of  water.  Occasionally  a  milk  is 
found  which  contains  a  little  carbonate  of  soda,  added  to  counteract  some 
actual  or  possible  souring  of  the  milk  ;  and  less  frequently  a  little  caramel 
or  burnt  sugar  to  disguise  the  bluish  color  consequent  upon  excessive 
skimming.  As  to  the  long  list  of  unsavory  compounds  which  are  given  as 
adulterants  of  milk,  they  are  very  seldom,  if  ever,  met  with  in  this  country. 

The  efforts  that  have  been  made  in  some  of  our  larger  cities,  notably  in 


510  americajST  appendix  to  parkes'  hygiene. 

New  York,  to  suppress  the  sale  of  skimmed  milk  have  met  -with  ^dgorous 
opposition  from  interested  parties.  It  is  claimed  that  skimmed  milk  is  per- 
fectly wholesome  and  contains  much  nutritious  substance,  that  it  can  be 
sold  in  cans  properly  labelled,  and  that  consequently  there  is  no  good 
reason  for  prohibiting  its  sale.  No  one  will  dispute  the  claim  that  skimmed 
milk  is  wholesome  ;  but  there  are  other  grounds  upon  which  its  sale  is 
prohibited.  In  the  first  place  there  is  practically  no  demand  for  skimmed 
milk,  and  when  sold  at  all  it  is  under  the  supposition,  on  the  part  of  the 
purchaser,  that  it  is  the  genuine  article.  Secondly,  experience  has  sho-\m 
that  even  though  the  cans  containing  skimmed  milk  are  so  labelled  the 
milk  will  not  be  sold  as  such.  These  cans  are  usually  placed  behind  a 
counter  or  in  a  refrigerator  where  the  label  is  not  visible  to  the  purchaser  ; 
and  the  milk  might  be  placed  in  another  can  after  reaching  the  dealer's 
premises.  The  labels  on  the  cans  are  often  no  better  than  no  labels.  In 
one  case  where  the  law  prescribed  a  letter  of  a  certain  length  the  dealer 
complied  in  this  particular,  but  made  the  letters  so  naiTow  as  to  be  en- 
tirely illegible.  Thirdly,  in  cities  large  numbers  of  infants  and  children 
are  dependent  upon  cow's  milk  as  food,  and  when  the  milk  is  deprived  of 
its  cream  it  loses  a  most  important  element  of  its  nutrition.  Fourthly, 
skimmed  milk  is  about  twenty-four  hours  later  in  reaching  the  market 
than  the  pure  article,  and  it  is  consequently  so  much  nearer  its  souring 
point.  Such  milk,  taken  into  the  child's  stomach,  would  most  probably 
sour  before  it  could  be  digested.  Granting  that  skimmed  milk  could  be 
sold  under  its  true  name,  and  that  it  contained  all  the  nutrition  needed  by 
the  child,  the  fact  that  it  cannot  be  obtained  in  a  fresh  condition  would  be 
sufficient  reason  for  our  health  authorities  pi'ohibiting  its  sale  in  large 
cities. 

Another  form  of  adulteration,  even  more  serious  than  the  last,  is  the  sale 
of  milk  of  diseased  cows.  There  are  numerous  cases  on  record  which 
prove  that  the  milk  obtained  from  such  animals  is  unfit  for  food,  as  it  is 
very  liable  to  produce  sickness  and  disease  in  those  consuming  it.  Milk 
may  also  serve  as  a  carrier  of  disease  when  such  exists  on  the  premises 
where  the  milk  is  produced. 

A  word  may  be  said  here  on  the  use  of  the  lactometer  for  detecting 
milk  adulterations.  This  instrument  is  merely  a  hydrometer  graduated 
for  milk,  and  detects  certain  adulterations  which  affect  the  specific  gravity 
of  the  liquid. 

Diuocourt,  the  originator  of  the  lactometer,  fixed  upon  1.029  as  the 
minimum  density  of  genuine  milk  ;  and  the  New  York  City  Board  of 
Health,  as  well  as  the  health  authorities  in  other  cities,  have  adopted  the 
same  standard.  In  graduating  the  lactometer  the  100  mark  corresponds 
to  a  specific  gravity  of  1.029,  and  the  0  mark  to  1.000.  The  inteiwening 
space  is  divided  into  100  parts.  In  testing  milk  it  is  cooled  to  60°  F.,  and 
the  lactometer  is  placed  in  it.  If  the  instrument  sinks  to  the  100  mark 
the  milk  would  pass  as  genuine,  but  if  it  sinks  to  60  we  know  that  the 
sample  consists  of  at  least  forty  parts  of  water  and  sixty  parts  of  milk. 
The  minimum  density  of  1.029"^  is  below  that  of  the  average  pure  milk  ; 
and  it  is  possible,  therefore,  for  the  milkman  to  add,  say,  ten  per  cent, 
of  water  without  its  being  detected  by  the  lactometer.  The  skimming 
of  the  milk  increases  its  gi'avity  and  consequently  it  stands  higher 
by  the  lactometer.  Water  might  even  be  added  to  the  skimmed  milk 
without  the  gravity  falling  below  1.029.  Such  doctoring  as  this  would 
give  a  product  of  an  unnaturally  blue  color,  and  the  absence  of  cream 
would  also  be  shown  by  the  appearance  of  the  sides  of  the  vessel  contain- 


FOOD    ADULTERATION.  511 

ing  the  milk.  The  addition  of  cream,  as  well  as  the  addition  of  water,  pro^ 
duces  a  lowering  of  the  gravity,  but  we  know  of  no  instance  where  a  per- 
son has  been  detected  of  adulterating  milk  with  cream. 

The  lactometer,  therefore,  detects  only  the  grosser  frauds  practised  by 
milkmen.  In  some  cases  a  chemical  analysis  of  the  milk  is  necessary  ;  but 
the  time  involved  in  making  an  analysis  is  such  as  to  render  this  means  of 
detecting  adulteration  impracticable  for  every-day  inspection. 

Coffee,  Tea. — The  adulterations  of  coffee  are  for  the  most  part  confined 
to  chicory  and  dandelion  roots,  peas,  hominy,  rye,  and  other  cereals. 
These  are  roasted  and  gTound,  and  mixed  -with  the  coffee  in  varying  jDro- 
portions.  Sometimes  the  coffee-bean  is  slightly  coated  and  polished,  and 
in  New  York  and  Brooklyn  there  are  establishments  which  make  quite  a 
business  of  this.  This  is  clearly  an  adulteration,  for  although  little  or  no 
foreign  matter  may  be  added,  the  polishing  is  done  to  conceal  damage  or 
make  the  bean  "aj)pear  better  than  it  really  is,  or  of  greater  value." 

Of  the  adulterants  of  coffee,  chicory  is  the  most  common  ;  and  it  is 
claimed  that  many  persons  prefer  this  mixture  to  the  pure  coffee.  The 
addition  of  chicory,  as  well  as  the  other  substances  mentioned,  is  noticed 
only  in  the  ground  coffee,  as  its  presence  in  the  unground  coffee  would  be 
very  easily  detected.  The  best  plan,  therefoi-e,  is  to  buy  the  coffee-bean, 
either  roasted  or  unroasted,  and  to  grind  it  as  needed.  After  a  little 
practice,  it  becomes  an  easy  matter  to  pick  out  in  the  ground  coffee  par- 
ticles of  chicory,  pea,  etc.  The  former  are  usually  soft,  and  lack  the 
smooth  appearance  of  bits  of  coffee-bean  ;  while,  if  peas  are  present,  the 
outer  coating  becomes  detached,  and  is  easily  recognized.  When  the 
coffee  is  ground  very  fine,  a  microscopical  or  chemical  examination  is  often 
necessary  to  detect  adulteration. 

There  is  nothing  unwholesome  in  chicory,  peas,  rye,  etc.,  but  when 
they  are  sold  for  genuine  coffee,  wholly  or  in  part,  it  is  a  fraud  upon  the 
purchaser,  and  the  infusion  possesses  Httle  or  none  of  the  pleasant  aroma 
and  taste  of  the  unadulterated  article. 

The  various  preparations  sold  under  the  names  of  coffee  extracts,  coffee 
essences,  etc.,  consist  for  the  most  part  of  mixtures  of  caramel,  licorice, 
etc.,  with  usxially  no  trace  of  coffee  in  them. 

As  many  persons  prefer  or  are  obliged  to  use  some  substance  cheaper 
than  pure  coffee,  it  would  be  a  needless  restriction  upon  trade  to  prohibit 
entirely  the  sale  of  "mixtures."  The  dealer,  however,  should  be  re- 
quired to  label  distinctly  all  such  mixtures,  and  sell  them  for  what  they 
really  are.  In  New  York  State  the  sale  of  coffee  mixtures  is  permitted, 
provided  the  mixture  contains  at  least  fifty  per  cent,  of  coffee  (see 
Addenda). 

The  adulterations  of  tea  consist  in  the  use  of  exhausted  and  foreign 
leaves,  in  the  addition  of  "lie  "  or  imitation  tea  and  mineral  substances, 
and  lastly,  in  the  artificial  coloring  and  coating  of  the  tea-leaves. 

"  Lie "  tea  consists  of  tea-dust,  the  sweepings  of  the  tea  warehouses, 
etc.,  made  up  into  small  masses  of  different  sizes,  with  gum  or  rice-water, 
and  usually  colored  to  imitate  genuine  tea.  It  is  found  in  the  lower 
grades  of  China  tea,  although  not  restricted  to  them,  and  can  generally  be 
picked  out  without  difficulty.  From  the  very  nature  of  the  "  lie"  tea,  it  is 
clearly  not  a  wholesome  article  of  food. 

The  "facing  "or  coloring  of  tea  is  practised  to  a  very  great  extent 
with  the  China-grown  teas,  and  also  with  those  from  Japan.  The  practice 
has  been  carried  on  for  so  many  years  that  it  is  doubtful  whether  the 
average  consumer  has  any  idea  of  the  color  of  the  genuine  leaf.     The 


512  AMEKICAN    APPENDIX   TO    PARKE  s'    HYGIENE. 

substances  used  are  Prussian  blue,  indigo,  turmeric,  soapstone,  and  gyp- 
sum. It  is  said  to  be  practised  because  there  is  a  demand  for  these 
highly  colored  teas,  but  it  is  none  the  less  an  adulteration.  It  serves  no 
good  purpose  in  the  tea,  and  the  better  class  of  tea  merchants  and  others 
admit  that  the  tea  would  be  better  without  it.  '^^^lile  no  one  has  ever 
been  known  to  have  been  seriously  injiu'ed  by  drinking  faced  tea,  the 
facing  is  not  wholesome. 

The  passage  by  Congi-ess,  in  March,  1883,  of  a  law  prohibiting  the 
importation  of  adulterated  tea,  has  already  done  much  to  improve  the 
quality  of  teas  sold  here. 

Flour,  Bread. — So  far  as  examinations  of  flour  and  bread  have  been 
made  in  this  country  they  have  failed  to  show  any  serious  adulteration. 
Occasionally  cases  are  reported  of  sickness  caused  by  eating  bread,  but 
when  the  matter  has  been  carefully  inquired  into  there  usually  is  sufficient 
ground  for  the  belief  that  the  sickness  was  due  to  certain  mould  fungi, 
rather  than  to  any  adulteration  in  the  bread  itself.  From  the  nature  of 
the  case  it  is  impossible  to  estimate  the  sickness  due  to  this  cavise  ;  but 
while  such  cases  are  rai^e,  it  is  clear  that  all  danger  can  be  avoided  by  a 
sufficient  amount  of  care.  Damaged  flour  is  doubtless  occasionally  em- 
ployed where  it  should  be  rejected. 

At  one  time  there  was  great  objection  raised  agamst  the  use  of  alum  in 
bread  preparations,  but  of  late  years  not  so  much  is  heard  of  it.  Alum  is 
employed  in  two  ways  and  for  two  entirely  diflerent  purposes.  Sometimes 
it  is  added  to  damaged  or  even  to  good  flour  in  order  to  improve  the  ap- 
pearance of  the  bread.  This  use  is  certainly  objectionable,  not  so  much 
because  the  small  amount  of  alum  used  \d\\  do  any  harm,  but  because  it 
is  used  to  conceal  the  defects  of  a  damaged  article,  and  one  which  in 
many  cases  is  not  fit  for  food.  The  second  use  to  which  alum  is  put  is  in 
baking  powders  in  combination  with  bicarbonate  of  soda.  Here  it  serves 
merely  to  liberate  the  carbonic  acid,  and  in  so  doing  ceases  to  exist  as 
alum,  and  is  converted  into  the  hydrate  of  alumina.  The  objections 
urged  against  the  use  of  alum  are  based  entirely  upon  theoretical  grounds, 
considering  it  as  alum  rather  than  as  the  hydrate  of  alumina. 

Butter,  Cheese,  Lard. — The  adulteration  of  butter  is  earned  on  to  a 
very  considerable  extent  in  this  country.  Taking  New  York  City  as  an 
example,  it  is  probable  that  if  a  person  should  buy  butter  at  eveiy  grocery 
store  in  the  city,  fully  one-half  of  the  samples  would  be  found  to  be  adul- 
terated. In  some  cases  there  is  little  or  no  butter  present,  the  sample 
consisting  principally  of  foreign  fat.  Most  grocers  keep  more  than  one 
grade  of  butter,  the  better  and  higher  priced  grades  often  being  the  genu- 
ine article.  It  is  a  common  thing  to  see  cousj^icuous  signs  reading, 
"Fine  Creamery  Butter,"  "Nice  Dairy  Butter,"  etc.,  offered  at  the  price 
of  genuine  butter,  which  on  analysis  prove  to  be  anything  but  the  real 
article. 

As  might  be  supposed  the  most  common  adulterant  and  substitute  is 
oleomargarine.  Some  samples  consist  of  this  entirely  ;  others  contain  more 
or  less  lard  ;  and  still  others  are  mixtures  of  butter  and  oleomargarine. 
Statements  have  appeared  to  the  efl'ect  that  cotton-seed  oil  is  sometimes 
used  as  an  adulterant.  While  this  may  be  so,  no  cases  of  this  kind  have 
come  under  our  observation,  nor  do  we  know  of  any  well-authenticated 
cases. 

Adulteration  with  an  excess  of  water  or  salt,  or  by  the  addition  of 
other  substances  is  seldom  met  with. 

We  are  in  the  habit  of  eating  aU  manner  of  fats  in  oui'  food,  in  one 


FOOD    ADULTER ATTOIs\  513 

form  or  anotlier,  and  no  one  ever  thinks  of  tlieir  being  more  un-n-liolesome 
than  butter.  An  artificial  butter,  made  of  clean  fat  and  in  a  manner  to 
exclude  foreign  contamination,  has  never  been  sho-^-n  to  be  an  un-ohole- 
some  article  of  food.  Persons  engaged  in  the  dairy  business  usually  admit 
this  ;  but  ther  claim,  and  veiy  properly  too,  that  ai'tificial  butter"^  should 
be  sold  for  what  it  really  is.  It  is  therefore  a  commercial  question,  Hke 
many  others  met  vrith  in  food  adulteration.  At  the  same  time,  as  it  con- 
stitutes a  violation  of  law  to  sell  the  artificial  for  the  natural  product  it  is 
clearly  the  duty  of  those  charged  with  the  enforcement  of  the  law  to  see 
that  the  fraud  is  suppressed. 

Of  late  years  some  manufactru-ers  of  oleomai'garine  have  been  in  the 
habit  of  adding  a  certain  percentage  of  lard,  the  reason  for  so  doing  be- 
ing generally  given  that  the  product  does  not  melt  so  readily  in  wa]-m 
weather.  The  melting-point  of  lard  is  several  degrees  above  that  of  oleo- 
margarine, and  might  naturally  serve  the  pui^pose  claimed  ;  and  yet  one 
can  hardly  lose  sight  of  the  possible  vdsh  to  cheapen  the  cost  of  manu- 
facture. 

The  most  important  adulteration  of  cheese  in  this  country  consists  in 
the  substitution  of  lard  for  butter  fat  in  the  process  of  maniifacture. 
Skimmed  milk  is  employed,  and  the  fat  lost  in  the  cream  is  replaced  by 
using  lard.  There  is  no  ground  for  prohibiting  the  sale  of  lard  cheese, 
jDro-sided  it  is  sold  for  what  it  really  is.  This  is  seldom  done,  however,  and 
the  manufacture  and  sale  of  whole-milk  cheese  is  greatly  injiu-ed  in  conse- 
quence. 

Lard  is  sometimes  adulterated  with  water  and  salt ;  and  numerous 
statements  have  appeared  to  the  effect  that  foreign  fats  are  sometimes 
substituted  in  part  for  that  of  the  hog.  It  would  be  a  matter  of  some 
surprise  if  there  was  no  foundation  for  such  reports  ;  but  the  difficulty  of 
estabhshing  the  fact  of  such  adulteration  has  led  to  quite  contrary  asser- 
tions. The  attention  which  this  subject  has  of  late  attracted  will  doubtless 
lead  to  more  positive  infonnation.  From  the  examination  of  many  sam- 
ples of  lard,  it  is  e-^ident  that  the  careless  and  uncleanly  method  of  render- 
ing sometimes  practised  results  in  the  production  of  an  article  unfit  for 
human  consumjDtion. 

Canned  Foods. — The  very  general  use  of  canned  fruits  and  vegetables 
renders  the  contamination  of  such  foods  with  tin,  lead,  zinc,  etc.,  a  very 
imiDortant  matter.  That  such  contamination  exists  in  many  cases  is  be- 
yond doubt ;  but  there  ai-e  great  differences  in  the  quantities  of  these 
metals  found.  Other  things  being  equal,  that  can  would  contain  most 
dissolved  metals  which  had  been  put  up  the  longest.  If  the  date  of  prep- 
aration were  stamped  upon  each  can  it  would  give  the  purchaser  some 
idea  of  where  he  might  find  most  contamination.  Aside  from  this  there 
ai'e  certain  requirements  which  should  always  be  obseiwed  by  the  manu- 
factui'ers  of  such  articles.  The  tin  plate  employed  should  be  of  the  best 
kind,  and  free  from  lead.  If  the  soldering  is  done  with  ordinary  solder  it 
should  never  be  allowed  to  come  in  contact  with  the  contents  of  the  can. 
The  contamination  of  canned  foods  with  lead  is  usually  owing  to  the  care- 
less soldering  of  the  cover,  by  which  the  liquids  in  the  can  act  upon  the 
solder  containing  lead.  This  is  supposing  that  good  tin  jDlate,  and  not 
"  terne  "  plate  is  used  in  making  the  can.  The  Dii-ector-General  of  Cus- 
toms of  France  has  forbidden  the  use,  in  the  pi'eservation  of  food,  of  cans 
which  are  soldered  on  the  inside,  unless  fine  tin  is  employed  exclusively 
for  the  purpose. 

The  quantity  of  tin  found  in  canned  foods  varies  from  .1  of  a  gi-ain  to 
Vol.  II.— 33 


514 

3  or  4  gi'ains  per  quart  can.  It  is  impossible  to  say  just  what  the  effect 
would  be  in  the  continued  taking  into  the  system  of  small  quantities  of 
tin.  It  does  not  appear  to  act  as  a  cumulative  poison,  but  large  doses 
would  doubtless  be  attended  with  serious  results.  The  small  amount  of 
this  metal  which  would  be  taken  by  the  use  of  canned  foods  projDerly  pre- 
pai'ed  would  px'obably  not  produce  any  apj^reciably  injurious  eftect.  Lead, 
however,  acts  as  a  cumulative  poison  and  the  use  of  food  containing  it 
should  be  avoided,  whether  it  be  the  canned  article  or  that  prepai'ed  in 
enamelled  vessels  containing  lead. 

A  case  was  recently  reported  where  serious  sickness  attended  the  use 
of  cherries  presei-ved  in  a  glass  jar  having  a  plain  zinc  cover.  It  was 
found  that  the  contents  contained  a  small  quantity  of  zinc,  whereas  the 
same  fruit  preserved  at  the  same  time  in  jars  having  glass-lined  covers  did 
not  contain  this  metal.  The  conclusion  reached  in  this  case  was  that  it 
was  one  of  zinc-poisoning. 

It  is  often  a  fact  that  in  cases  of  sudden  sickness,  attributable  to  some 
article  of  food,  an  examination  shows  the  presence  of  a  foreign  substance 
more  or  less  objectionable,  and  the  conclusion  is  immediately  reached  that 
this  substance  was  the  cause.  Sometimes  the  conclusion  is  reached  ■with- 
out any  examination  ;  and  very  often  it  happens  that,  if  the  case  is 
carefully  investigated,  the  alleged  cause  proves  not  to  be  the  true 
one. 

Where  there  is  dovibt  as  to  the  actual  cause,  such  doubt  should  be  ex- 
pressed, and  so  avoid  arousing  public  distrust  of  an  article  of  food  which 
may  be  in  no  way  responsible  for  the  sickness.  Unfortunately,  there  ap- 
pear to  be  certain  poisons,  noticed  more  especially  in  animal  foods,  of 
which  nothing  is  known,  and  which  are  often  the  cause  of  sickness  un- 
justly attributed  to  some  harmless  contamination  present. 

Pepper,  Mustard,  Sjnces. — These  are  notoriously  adulterated,  and  the 
adulterants  employed  are  often  composed  of  almost  anything  which  can  be 
made  to  resemble  the  genuine  article.  The  plea  which  is  always  urged 
when  the  question  of  pure  sj^ices  is  discussed  is  that  the  consumer  does 
not  want  the  pure  article,  that  in  most  cases  it  is  too  strong.  The  obvious 
answer  to  such  an  objection  is  that  the  consumer  can  use  less  of  it.  We 
doubt,  howevei',  whether  the  average  consumer  has  ever  seen  certain  con- 
diments in  a  state  even  approaching  purity.  At  the  same  time,  if  the  con- 
sumer wants  flour  in  his  mustard,  and  charcoal  in  his  pepper,  let  him  have 
them,  they  -oill  never  do  him  any  harm  ;  but  for  the  sake  of  those  who 
prefer  the  pure  articles,  require  the  dealer  to  label  his  wares  just  what 
they  are.  It  is  safe  to  say  that  if  this  were  insisted  on  by  a  vigorous  en- 
forcement of  the  law,  most  people  wovdcl  soon  decide  to  do  the  "adulter- 
ating "  in  their  own  kitchens. 

LiTERAxrKE. — The  following  are  a  few  of  the  more  important  works  on 
food  adulteration  :  Food,  its  Adulterations,  and  the  Methods  for  their  De- 
tection, A.  H.  Hassall  (1876) ;  Foods,  their  Composition  and  Analvsis,  A.  "W. 
Blyth  (1882)  ;  The  Analysis  and  Adulteration  of  Foods,  James  Bell  (1881 
and  1883)  ;  Lexikon  der  Yerfalschungen  der  Nahrungsmittel  und  Ge- 
tranke,  H.  Klencke  (1879)  ;  Sanitary  Examinations  of  Water,  Air,  and  Food, 
C.  B.  Fox  (1878)  ;  On  Food,  H.  Letheby  (1872)  ;  Die  menschlichen  Nahr- 
ungs-  und  Genussmittel,  etc.,  J.  Konig  (1880)  ;  Die  Praxis  des  Nalu'ungs- 
mittel-Chemikers,  F.  Eisner  (1880)  ;  Die  wichtigsten  Nahrungsmittel  xmd 
Getriinke,  etc.,  O.  Dietzsch  (1879)  ;  Nahrungs-  und  Genussmittel,  etc.,  A 
Yogi  (1872)  ;  Butter,  its  Analysis  and  Adulterations,  O.  Hehner  and  A. 


FOOD    ADULTERATION.  515 

Angell  (1877) ;  Dictionnaire  des  alterations  et  falsifications  des  Substances 
alimentaires,  etc.,  A.  Chevallier  et  E.  Baudrimont  (1877) ;  The  Analyst, 
Vols.  I.-VnJ    1877  to  date. 


ADDENDA. 

The  following  are  copies  of  the  food  adulteration  law  of  the  State  of 
New  York,  and  the  resolutions  regarding  "  naixtures,"  passed  by  the  State 
Board  of  Health : 

AN  ACT  to  prevent  the  adulteration  of  food  or  drugs. 

[Chapter  407,  Laws  of  1881. J 

The  People  of  the  State  of  New  York,  represented  in  Senate  and  Assembly, 
do  enact  as  follows  : 

Section  1.  No  person  shall,  within  this  State,  manufacture,  have,  offer 
for  sale,  or  sell  any  article  of  food  or  drugs  which  is  adulterated  within  the 
meaning  of  this  act,  and  any  person  violating  this  provision  shall  be  deemed 
guilty  of  a  misdemeanor,  and  upon  conviction  thereof  shall  be  punished 
by  fine  not  exceeding  fifty  dollars  for  the  first  offence,  and  not  exceeding 
one  hundred  dollars  for  each  subsequent  offence. 

Sec.  2.  The  term  "  food,"  as  used  in  this  act,  shall  include  every  article 
used  for  food  or  drink  by  man.  The  term  "  drug,"  as  used  in  this  act, 
shall  include  all  medicines  for  internal  and  external  use. 

Sec.  3.  An  article  shall  be  deemed  to  be  adulterated  within  the  mean- 
ing of  this  act — 

a. — In  the  case  of  drugs. 

1.  If,  when  sold  under  or  by  a  name  recognized  in  the  United  States 
Pharmacopoeia,  it  differs  fi'om  the  standard  of  strength,  quality,  or  purity 
laid  down  therein. 

2.  If,  when  sold  under  or  by  a  name  not  recognized  in  the  United  States 
Pharmacopoeia,  but  which  is  found  in  some  other  pharmacopoeia  or  other 
standard  work  on  Materia  Medica,  it  differs  materially  from  the  standard 
of  strength,  quality,  or  purity  laid  down  in  such  work. 

3.  If  its  strength  or  purity  fall  below  the  professed  standard  under 
which  it  is  sold. 

h. — In  the  case  of  food  or  drink. 

1.  If  any  substance  or  substances  has  or  have  been  mixed  with  it  so  as 
to  reduce  or  lower  or  injuriously  affect  its  quality  or  strength. 

2.  If  any  inferior  or  cheaper  substance  or  substances  have  been  substi- 
tuted wholly  or  in  part  for  the  article. 

3.  If  any  valuable  constituent  of  the  article  has  been  wholly  or  in  part 
abstracted. 

4.  If  it  be  an  imitation  of,  or  be  sold  under  the  name  of,  another  ar- 
ticle. 

5.  If  it  consists  wholly  or  in  part  of  a  deceased  or  decomposed,  or  putrid 
or  rotten,  animal  or  vegetable  substance,  whether  manufactured  or  not,  or, 
in  the  case  of  milk,  if  it  is  the  produce  of  a  diseased  animal. 

6.  If  it  be  colored,  or  coated,  or  polished,  or  powdered,  whereby  dam- 
age is  concealed,  or  it  is  made  to  appear  better  than  it  reaUy  is,  or  of 
greater  value. 

7.  If  it  contain   any  added  poisonous   ingredient,  or  any  ingredient 


51G  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

which  may  render  such  article  injurious  to  the  health  of  a  j^erson  consum- 
ing it :  Pro^'ided  that  the  State  Board  of  Health  may,  with  the  approval  of 
the  Governor,  from  time  to  time  declare  certain  articles  or  preparations  to 
be  exempt  from  the  provisions  of  this  act :  And  i^rovided  further,  that  the 
provisions  of  this  act  shall  not  apj^ly  to  mixtures  or  compounds  recognized 
as  ordinary  articles  of  food,  proAided  that  the  same  are  not  injui'ious  to 
health  and  that  the  articles  ai'e  distinctly  labelled  as  a  mixture,  stating  the 
components  of  the  mixttu'e. 

Sec.  4.  It  shall  be  the  duty  of  the  State  Board  of  Health  to  prepare  and 
publish  from  time  to  time  lists  of  the  articles,  mixtures,  or  compounds  de- 
clared to  be  exempt  from  the  provisions  of  this  act  in  accordance  with  th6 
preceding  section.  The  State  Board  of  Health  shall  also  fi'om  time  to  time 
fix  the  limits  of  variability  jDermissible  in  any  article  of  food  or  drug,  or 
compound,  the  standard  of  which  is  not  estabhshed  by  any  national  phar- 
macopoeia. 

Sec.  5.  The  State  Board  of  Health  shall  take  cognizance  of  the  interests 
of  the  public  health  as  it  relates  to  the  sale  of  food  and  drugs  and  the 
adulteration  of  the  same,  and  make  all  necessary  investigations  and  in- 
quiries relating  thereto.  It  shall  also  have  the  supervision  of  the  appoint- 
ment of  pubhc  analysts  and  chemists,  and  upon  its  recommendation  when- 
ever it  shaU  deem  any  such  officers  incompetent,  the  appointment  of  any 
and  every  such  officer  shaU  be  revoked  and  be  held  to  be  void  and  of  no 
effect.  Within  thirty  days  after  the  passage  of  this  act,  the  State  Board  of 
Health  shall  meet  and  adopt  such  measiu'es  as  may  seem  necessary  to 
facilitate  the  enforcement  of  this  act,  and  prepare  rules  and  regulations 
mth  regard  to  the  j^roper  methods  of  collecting  and  exammmg  articles  of 
food  or  drugs,  and  for  the  appointment  of  the  necessary  inspectors  and 
analysts  ;  and  the  State  Board  of  Health  shall  be  authorized  to  expend,  in 
addition  to  all  sums  ah-eady  appropriated  for  said  Board,  an  amount  not 
exceeding  ten  thousand  dollars,  for  the  piu'pose  of  carrying  out  the  pro- 
visions of  this  act.  And  the  sum  of  ten  thousand  dollars  is  hereby  appro- 
priated out  of  an}'  moneys  in  the  treasury,  not  otherwise  appro2:)riated, 
for  the  purposes  in  this  section  provided. 

Sec.  6.  Every  person  selling  or  offering  or  exposing  any  article  of  food 
or  drugs  for  sale,  or  delivering  any  article  to  purchasers,  shall  be  bound 
t;0  serve  or  supply  any  public  analyst  or  other  agent  of  the  State  or  Local 
Board  of  Health  appointed  under  this  act,  who  shall  apjjly  to  him  for  that 
purpose,  and  on  his  tendeiuug  the  value  of  the  same,  with  a  sample  suffi- 
cient for  the  purjDOse  of  analysis  of  any  article  which  is  inchided  in  this 
act,  and  which  is  in  the  possession  of  the  j^erson  seUing,  under  a  penalty 
not  exceeding  fifty  dollars  for  a  first  offence,  and  one  hundred  dollars  for 
a  second  and  subsequent  offences. 

Sec.  7.  An}'  violation  of  the  provisions  of  this  act  shall  be  treated  and 
punished  as  a  misdemeanor  ;  and  whoever  shall  impede,  obstruct,  hinder, 
or  otherwise  prevent  any  analyst,  insjoector,  or  prosecuting  officer  in  the 
performance  of  his  duty  shall  be  guilty  of  a  misdemeanor,  and  shaU  be 
liable  to  indictment  and  punishment  therefor. 

Sec  8.  Any  acts  or  parts  of  acts  inconsistent  with  the  provisions  of  this 
act  are  hereby  repealed. 

Sec.  9.  All  the  regulations  and  declarations  of  the  State  Board  of 
Health  made  under  this  act,  from  time  to  time  and  promulgated,  shall  be 
printed  in  the  statutes  at  lai'ge. 

Sec.  10.  This  act  shall  take  effect  at  the  expiration  of  ninety  days  after 
it  shall  become  a  law. 


FOOD    ikDULTEEATIOE".  517 


RESOXmONS    ReGAEDCvG    ]SIlXTrBES. 

"Resolved,  That  under  and.  p-orsuant  to  Section  -4  of  Chapter  407  of 
the  Laws  of  1881,  the  follo"vvliig  mi:s:tai-es,  when  distinctly  labelled  in  the 
manner  provided  in  subdivision  7  of  Section  3  of  said  act,  are  ■within  the 
conditions  hereinafter  prescribed  declai'ed  to  be  exempt  and  permitted  to 
be  sold  under  the  provisions  of  the  said  act. 

"  1st.  Coffee  mixtures  containing  no  other  substances  except  chicory, 
peas,  or  cereals,  and  in  which  mixtures  the  pui-e  coffee  shall  not  be  less 
than  fifty  per  cent,  of  the  whole  mixture  or  compound,  provided  that  the 
exact  percentage  of  coffee  be  printed  upon  the  label  of  each  package. 

"2d.  Mustard  mixtures  with  wheat  or  rice  flour,  to  which  no  other 
substance,  or  article,  or  any  coloring  matter,  except  turmeric  is  added,  and 
in  which  mixture  the  pure  fariua  of  mustard  shall  not  be  less  than  foriy  per 
cent,  of  the  whole  mixtui-e  or  compound,  exclusive  of  the  mustard  hulls. 

"  The  labels  on  the  above  mixtures  shall  contain  the  names  of  each  and 
every  ingredient  of  the  mixture. 

"The  labels  shall  also  exhibit  the  percentage  of  the  characteristic  con- 
stituents ;  for  example,  the  percentage  of  coffee  in  the  coffee  mixtm-e  and 
the  percentage  of  mustard  in  the  mustard  mixtm-e. 

'•  The  above-mentioned  information  shall  be  printed  on  the  labels  in 
black  ink,  in  legible  antique  type,  of  a  size  easily  to  be  read,  on  one  side 
of  the  package." 

Approved  JIarch  24,  1883. 


DISINFECTION  AND   DEODORIZATION. 

Bx  EOGEE  S.  TRACY,  M.D., 

Sanitary  Inspector  of  the  Board  of  Health,  New  York. 

The  Nature  of  the  Contagia. — -The  tbeoiy  that  the  z^'motic  diseases  are 
dependent  on  and  are  propagated  by  micro-organisms  has  been  gaining 
ground  i-ecently  in  America  as  elsewhere.  Dr.  Cabell,  however,  has  called 
attention  to  the  prevalence  of  typhoid  fever  in  Virginia,  at  various  times,  in 
places  where  periodic  (malarial)  fevers  had  been  common,  the  latter  dis- 
eases subsiding  on  the  appearance  of  the  former.'  A  similar  succession  of 
these  diseases  has  been  noticed  of  late  years  in  New  England,  and  malarial 
disorders  have  made  their  appearance  in  districts  hitherto  entirely  free 
fi'om  them,  but  where  typhoid  fever  has  been  almost  endemic.  Here  also 
the  enteric  fever  has  diminished  as  the  periodic  fever  has  increased.  These 
facts  suggest  some  subtle  relation  of  these  diseases  to  each  other,  and  raise 
a  doubt  as  to  the  dependence  of  either  disease  upon  a  specific  organism. 

In  1875,  Drs.  Edward  Cm-tis  and  Thomas  E.  Satterthwaite  made  a 
series  of  investigations  into  the  pathogeny  of  diphtheria,  but  found 
that  verj"  much  the  same  symptoms  were  produced  in  rabbits  by  the  in- 
oculation of  diphtheritic  membrane,  scrapings  from  the  human  tongue,  or 
Cohn's  fluid  in  a  putrescent  condition.'  They  found  that,  after  filtering 
out  the  particulate  matters,  the  fluid  was  harmless. 

A  strong  presentment  of  the  micro-organism  theory  was  made  by  Dr. 
William  T.  Belfield,  of  Chicago,  in  the  Cartwright  Lectures,  delivered  before 
the  Alumni  of  the  College  of  Physicians  and  Surgeons  of  New  York,  in 
Februai-y,  1883.' 

Purification  of  the  Air  by  Chemical  Methods. 

It  is  not  believed  that  aerial  disinfectants  are  of  any  use,  except  in  such 
quantity  as  to  be  destructive  of  human  hfe.  ExiDeriments  on  the  micro- 
organisms show  that  they  resist  the  action  of  jDoisons  and  destructive  gases 
in  proportions  that  are  fatal  to  higher  organisms.  Gases  and  vapors 
liberated  in  a  tenanted  room  must  therefore  be  looked  upon  only  as  deo- 
dorants. The  best  of  these  is  probably  ozone,  which  may  be  added  to  the 
air  of  a  room  by  the  methods  suggested  in  the  text.  The  various  patented 
ozone  generators  possess  no  advantage,  except  that  of    neatness,  over  a 

'The  Etiology  of  Enteric  Fever,  by  J.  L.  Cabell,  M.D.,  Trans.  Am.  Med.  Associa- 
tion, 1877,  p.  411. 

"Report  of  the  Board  of  Health,  New  York,  1874-75,  p.  657. 

^  On  the  Relations  of  Micro-Organisms  to  Disease,  N.  Y.  Medical  Record,  February 
and  March,  1883. 


DISE^FECTION    AND    DEODOEIZATION".  519 

simple  stick  of  phosphorus  in  a  saucer  of  water,  and  the  mechanical  de- 
vices for  discharging-  the  vapor  of  carbolic  acid  and  other  ill-smelling  sub- 
stances into  the  atmosphere  are  of  no  practical  value  except  as  deodorizers. 
As  regai'ds  the  effect  of  poisonous  solutions  on  the  low  forms  of  organic 
life,  the  experiments  of  Dr.  George  M.  Sternberg,  United  States  Army, 
show  that  mercuiic  chloride  (corrosive  sublimate)  is  the  most  powerful 
disinfectant  we  possess.'  The  results  given  below  were  obtained  by  ex- 
periments with  the  micrococcus  of  gonorrhoeal  pus,  which  appeared  to 
resist  the  germicide  agents  longer  than  the  other  organisms  which  were 
tried.  After  exposure  to  the  poisons  the  vitahty  of  the  genns  was  tested 
by  introducing  them  into  sterihzed  bouillon. 

Percent.     Efficient  in  the  pro- 
portion  or  1  part  m 

Mercuric   chloride 0.005  20,000 

Potassium  permanganate 0.12  833 

Iodine , 0.2  500 

Creasote 0.5  200 

Sulphuric  acid 0.5  200 

Carbohc  acid 1.00  100 

Zinc  chloride 2.00  50 

Tinct.  ferri  chloridi 4.00  25 

Sahcyhc  acid,  dissolved  by  sodium  borate . .  4.00  25 

A  much  weaker  solution  (from  one-half  to  one  fourth  the  strength  above 
given)  was  found  to  prevent  further  development  of  the  micrococci,  and  fer- 
ric sulphate,  which  failed  in  a  saturated  solution  to  destroy  the  vitahty  of 
the  germs,  arrested  theii"  development  in  a  one-half  per  cent,  solution. 
Zinc  sulphate  was  found  to  have  no  germicide  value  in  a  solution  of  twenty 
per  cent.  The  action  of  zinc  chloride  and  sulphate,  and  of  ferric  sulphate 
in  arresting  the  development  of  germs  seemed  to  be  due  to  the  precipita- 
tion of  organic  matter  in  the  nutritive  medium  rather  than  to  any  direct 
action  on  the  living  organisms. 


PUEDFICATION    OF    KoOMS    ATTER   INFECTIOUS    DISEASES. 

By  some  persons  chlorine  is  preferred  to  sulj)hurous  oxide  for  fumigation. 
For  100  cubic  feet  of  space  it  would  be  necessary  to  use  about  one-half  or 
three-foui'ths  of  a  pound  of  black  oxide  of  manganese,  and  from  thi-ee- 
fourths  to  one  pound  of  strong  commercial  muriatic  acid  ;  or  the  same 
amount  of  manganese  oxide  may  be  used  with  an  equal  weight  of  salt  and 
from  one  to  one  and  one-half  pound  of  oil  of  vitriol ;  or  between  one  and 
two  pounds  of  chloride  of  lime  with  nearly  an  equal  weight  of  acid  diluted 
with  about  twice  its  bulk  of  water.  Sulphurous  oxide  and  chlorine  cannot 
be  used  together,  as  they  neutrahze  each  other.  Any  of  the  above  mix- 
tures should  be  made  in  an  earthen  dish  lai'ge  enough  to  allow  for  "frothing 
up."  The  evolution  of  the  gas  is  so  rapid  that  it  is  difficult  for  a  person  to 
make  the  mixture  complete  before  he  is  driven  away  by  the  fumes." 

'  Experiments  to  Determine  the  Germicide  Value  of  Certain  Therapeutic  Agents, 
Am  Jonr.  of  Med.  Sciences,  April,  1883,  p.  321.  These  experiments  confirm  the  con- 
clusions of  Dr.  Koch,  of  Berlin.  See  also  an  article  in  the  same  number  of  this  joui-nal 
by  Dr.  J.  C.  Wilson,  p.  345. 

■^  Waller :  Art.  Disinfectants  in  Biick's  Hygiene,  vol.  ii. ,  p.  555. 


520  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 


Disinfection  rs  Various  Dise.\ses. 

For  disinfection  of  bed-linen,  towels,  and  body  clothing  of  patients  ill 
with  contagions  diseases,  it  has  been  recommended  to  use  a  solution  of  four 
ounces  of  zinc  sulphate  and  two  ounces  sodium  chloride  to  the  gaUon  of 
water  (practically  a  solution  of  zinc  chloride). '  Discharges  to  be  received 
in  vessels  contaiuing  a  solution  of  ferrous  sulphate  (one  and  one-half  pound 
to  the  gallon).  "When  such  articles  can  be  burned,  that  is  the  best  way  to  dis- 
pose of  them.  Straw-beds  should  always  be  destroyed  by  fire,  and  hair  mat- 
tresses and  stuffed  furniture  should  be  ripped  open  and  the  contents  spread 
out  so  as  to  be  thoroughly  exposed  to  the  sulphurous  fumigation.  When 
rags  are  used  about  the  mouth  and  nose  of  the  patient,  as  in  diphtheria, 
scarlatina,  or  phthisis,  they  should  be  immediately  bui-ned.  Recovered 
patients  should  never  be  allowed  to  mingle  with  well  persons  again,  until 
the  body  and  especially  the  hair  has  been  thoroughly  washed  with  soap  or 
borax,  and  cleaned  of  all  scurf. 

Isolation  of  such  patients  is  essential.  The  sick-room  should  be  visited 
only  by  those  in  immediate  attendance  on  the  patient.  Ventilation 
should  be  brought  al)out  by  means  of  an  ojoen  fire  and  windows  o^Dening  to 
the  external  air.  It  has  been  suggested  by  Dr.  Malcolm  McLean,  of  Xew 
York,  that  the  cracks,  keyholes,  and  other  openings  about  doors  or  win- 
dows communicating  with  other  parts  of  the  house  should  be  hermetically 
closed  by  jjasting  strips  of  paper  over  them,  excejjtmg  of  coui-se  the  door 
of  eutiT,  which  should  have  a  large  sheet  constantly  Avet  with  a  solution  of 
carbolic  acid  hung  over  it  on  the  inside. 

In  view  of  recent  experiments,  it  would  seem  that  mercuric  chloride 
would  be  a  better  disinfectant  for  use  in  such  cases  than  the  commonly 
used  zinc  chloride.  Dr.  J.  C.  "Wdson '  suggests  that  the  physician  should 
himself  carry  this  substance  with  him,  and  in  such  cases  should  j^ut  two 
drachms  into  a  gallon  of  water,  to  be  used  in  disinfecting  the  discharges. 
This  would  make  a  solution  of  the  strength  of  about  1  to  500.  One  di-achm 
(1  to  1,000),  or  even  thu'ty  grains  (1  to  2,000),  would  probably  answer  the 
jjui-pose,  and  as  the  drug  costs  only  fifteen  cents  an  ounce,  it  is  probably  the 
cheapest  and  best  disinfectant  in  the  market,  having  neither  color  nor  odor. 


Local  Use  of  Disin'fectaxts. 

Apartments. — Ozone,  produced  by  phosphorus  two-thirds  coAered  "nath 
water,  or  by  mixing  potassium  permanganate  and  suljjhuric  acid.  Fumi- 
gation. 

Bed-linen,  Towels,  etc. — Zinc  chloride  (two  ounces  to  the  gallon  of  water) 
or  mercuric  chloride  (one  drachm  to  the  gallon  of  water). 

Cellars,  Outhouses,  Stables,  etc. — Quickhme  sprinkled  about.  White- 
wash.    Carbolic  acid,  strong  solution  (1  to  100). 

Cesspools,  Privy-vaults,  Water-closets,  etc. — Ferrous  or  ferric  sulphate, 
saturated  solutions.  Zinc  sulphate  (two  pounds  to  the  gallon)  and  chloride 
(one-half  poinid  to  the  gallon).    These  latter  are  better  for  water-closets,  be- 

'  See  Instructions  for  Disinfection,  prepared  for  the  National  Board  of  Health  by 
Profs.  C.  F.  Chandler,  Henry  Draper,  G.  F.  Barker,  S.  O.  Vander  Poel,  E.  G.  Janeway, 
and  Ira  Remsen.  Printed  in  New  York  State  Board  of  Health  Report  for  1881-82, 
p.  118. 

■'  In  article  previously  cited  in  foot-note,  p.  519. 


DISINFECTIOIS"    AND    DEODORIZATION". 


521 


cause  they  cause  no  discoloration.  The  Metropolitan  Disinfectant,  much 
used  in  New  York  for  disinfection  of  privies,  contains  half  a  gallon  of  dead 
oi],  one  gallon  of  copperas  solution  (saturated),  diluted  with  water  to 
make  three  gallons. 

A  patented  apparatus,  called  the  Germicide,  is  in  frequent  use  in  New 
York  for  disinfecting  water-closets.  Every  time  the  closet  is  used  a 
small  amount  of  zinc  chloride  is  discharged  into  the  pan  or  bowl,  and  the 
vapor  of  thymol  is  mingled  with  the  atmosphere  of  the  room. 

Ccn-pses,  when  infectious,  should  be  wrapped  in  cloth  saturated  with  a 
strong  solution  of  zinc  chloride  or  carbolic  acid,  and  a  pad  of  sawdust  or 
fine  sha\ings  saturated  with  the  same  solution  placed  under  the  hips,  to 
disinfect  discharges. 

The  bodies  of  those  who  have  died  of  small-pox  should  be  buried  in 
air-tight  coffins  (metallic)  and  no  funeral  should  be  allowed. 

Street  Gutters,  etc. — Ferric  or  ferrous  sulphate.  Chloride  of  lime.  The 
New  York  Board  of  Health  uses  a  zinc  and  iron  solution  obtained  as  a  by- 
product in  de-tinning  scrap-tin  plate.  It  contains  about  4^  per  cent,  of 
ferrous  sulphate,  14  x^er  cent,  of  feiTous  chloride,  and  9  per  cent,  of  zinc 
chloride. 

Utensils. — Zinc  cliloride  (two  ounces  to  the  gallon).  Mercuric  chloride 
(one  drachm  to  the  gallon).  Potassium  permanganate  (one  ounce  to  the 
gallon).     The  latter  salt  stains  clothing  bro^vn. 

The  Girondin  Disinfectant  and  Piatt's  Chlorides  are  in  very  common 
use.  An  analysis  of  the  former,  made  by  Waller,  shows  the  following  con- 
stituents : 

Pel-  cent.  Oz.  in  gallon. 

Zinc    sulphate 19.692  32.64 

Cupric    sulphate 1.202  1.99 

Calcium  sulphate 0.480  0.79 

Water,  traces  of  calcium  chloride,  etc. .   78.626  130.34 


100.000 


165.76 


Piatt's  Chlorides   contain  satiirated  solutions  in  the  following  pro- 
portions : 

Zinc  chloride 40  per  cent. 

Lead  chloride 20 

Calcium  chloride 15 

Aluminum  chloride 15 

Magnesium  chloride 5 

Potassiiun  chloride , 5 


VITAL    STATISTICS. 

By  EOGEE  S.  TEACY,  M.D., 
Sanitary  Inspector  of  the  Board  of  Health,  Xew  York. 

It  is  important  to  know  not  only  the  exact  number,  if  possible,  of 
births,  marriages,  and  deaths  in  a  population,  as  well  as  the  number  of  the 
li^•ing,  but  the  value  of  such  statistics  is  immensely  increased,  if  it  can  be 
learned  with  accuracy  what  ai'e  the  occupations,  residences,  birth-places, 
ages,  race,  etc.,  of  the  persons  enumerated,  as  well  as  the  meteorological 
conditions  under  which  they  have  lived  from  day  to  day.  An  attempt  was 
made  in  the  Ujiited  States  in  1870  to  furnish  a  complete  census  of  the 
poijulation  upon  such  a  comprehensive  plan,  but  as  the  time  allowed  for  its 
comjoletion  was  only  three  months,  the  work  was  full  of  inaccui-acies.  The 
census  of  1880  was  conducted  on  a  larger  scale,  and  is  expected  to  furnish 
a  greater  body  of  important  facts,  with  more  complete  and  useful  classifica- 
tions, than  any  such  work  hitherto  undertaken  in  the  world.  The  magni- 
tude of  the  task  may  be  inferred  from  the  fact  that,  at  the  present  time 
(October,  1883),  more  than  three  years  after  its  incei^tion,  the  fii'st  volume 
of  reports  is  barely  ready  for  distribution. 

The  first  attempt  at  registration  in  tliis  country  seems  to  have  been  m 
the  colony  of  ^Massachusetts  Bay,  where  in  September,  1639,  it  was  ordered 
that  births  and  deaths  should  be  reported  to  the  town  clerk  by  parents  and 
householders  "nithiu  one  mouth.  Newly  married  men  were  also  to  give 
the  clerks  certificates  of  their  marriage.  Similar  orders  were  issued  by 
the  Plymouth  colony  in  IGK).'  Many  States  at  present  have  laws  regard- 
ing the  registration  of  vital  statistics,  but  it  is  so  difficult  to  carry  out  a 
law  of  this  character,  that  the  records  throughout  the  country  are  veiy 
imperfect.  In  1876,  Dr.  Bowditch  expi-essed  the  opinion  that  no  State  in 
the  Union,  nor  the  United  States  as  a  nation,  had  any  j)roi)er  system  for 
the  registration  of  vital  statistics.^ 

The  registration  of  bii'ths  and  marriages  is  nowhere  comj^lete.  That 
of  deaths  is  believed  to  be  complete,  or  nearly  so,  in  Boston,  Providence, 
New  York,  Philadelphia,  and  Washington.  New  York,  being  surrounded 
by  water,  is  particularly  favored  in  this  respect,  as  the  avenues  of  exit  from 
the  city  are  few  and  easily  guarded.  The  only  way  of  procuring  reports  of 
births  and  marriages,  with  any  pretension  to  completeness,  seems  to  be 

'  See  paper  by  Dr.  J.  S.  Billings  on  Registration  of  Vital  Statistics  in  Am.  Journal  of 
tlie  Med.  Sciences,  January,  1888.  The  early  history  of  registration  in  the  United  States 
is  given  by  Dr.  Sutton  as  an  appendix  to  the  Second  Annual  Report  of  Births,  Marriages, 
and  Deaths  in  Kentucky  for  1853.  He  gives  nearly  all  the  State  laws  on  this  subject  in 
an  appendix. 

"■'  See  Dr.  H.  I.  Bowditch's  Essay  on  Public  Health  in  America.  Boston,  1877. 
Quoted  by  Dr.  T.  B.  Curtis,  in  Buck's  Hygiene,  vol.  ii.,  p.  307. 


VITAL    STATISTICS.  523 

the  rigid  and  impartial  enforcement  of  penalties  in  cases  of  non-compliance 
with  the  law. 

In  the  case  of  reports  of  death  and  sickness,  absolute  accuracy  is  im- 
possible of  attainment.  The  cause  of  death  is  always  a  matter  of  opinion, 
and  although  opinions  may  agree  in  the  vast  majority  of  cases,  there  will 
always  be  a  sufficient  number  of  deaths  in  which  the  cause  is  extremely 
doubtful,  to  vitiate  any  conclusions  that  can  be  drawn  from  the  mortahty 
returns,  except  relative  ones. 

In  a  comparison,  therefore,  of  the  deaths  and  diseases  of  one  period 
with  another,  of  one  locality  with  another,  of  one  occupation  or  age,  or 
condition  in  life  with  another,  of  one  season  with  another,  will  be  found 
the  only  practically  useful  conclusions  which  the  hygienist  can  draw  from 
such  data.  Under  the  law  of  averages,  the  limits  of  error  and  the  causes 
of  error  will  vary  with  considerable  regularity — there  will  always  be  about 
so  many  faulty  diagnoses,  so  many  intentionally  false  returns,  so  many 
omissions  to  report — so  that,  even  with  admitted  gross  inaccuracies  which 
can  never  be  entirely  eliminated,  our  present  statistics  properly  handled 
may  teach  practical  sanitarians  many  useful  lessons,  especially  with  regard 
to  the  causes  affecting  the  health  of  small  districts. ' 

'  For  comparatively  full  discussions  of  these  subjects  see  Vital  Statistics,  by  Dr.  T. 
B.  Curtis  in  Buck's  Hygiene  ;  Reporc  of  9tli  United  States  Census  (Vital  Statistics) ; 
Essay  on  Registration,  by  Dr.  C.  F.  Folsom,  in  8th  Report  of  State  Board  of  Health  of 
Mass.  ;  Report  on  Registration  of  Prevalent  Diseases,  by  Dr.  F.  W.  Draper,  in  7th  Re- 
port of  Mass.  Board  of  Health  ;  Essay  on  Vital  Statistics,  by  E.  B.  Eliott,  Proceedings 
of  Am,  Association  for  the  Advancement  of  Science,  1856.  See  also  papers  on  Vital 
Statistics,  by  Dr.  J,  S.  Billings,  in  The  Sanitary  Engineer,  October  4,  I8bl3,  et  seq. 


SOME   HINTS   TO   SANITAKY   INSPECTOES. 

By  FEEDERICK  N.    OWEX. 

The  following  suggestions  for  the  sanitaiy  examination  of  buildings  or 
localities  are  designed  for  the  vise  of  local  health  officers  and  those  who,  in  the 
capacity  of  family  physician,  may  be  called  upon  to  examine  into  the  cause 
of  outbreaks  of  contagious  or  infectious  diseases  ;  and  although  by  no 
means  exhausting,  the  subject  may,  by  directing  the  attention  of  the  in- 
spector to  some  of  their  more  prominent  causes,  enable  him  to  elaborate 
other  lines  of  investigation  which  will  lead  him  to  a  solution  of  the  problem. 

Before  beginning  an  examination  of  a  building  or  locahty  which  is 
thought  to  be,  or  is  complained  of  as  being  in  an  unsanitaiy  condition,  the 
inspector  should,  first  of  all,  by  careful  cjuestioning  of  inmates,  neighbors, 
and  others,  not  excepting  children,  strive  to  obtain  e\*idence  of  offensive 
odors,  disagreeable  taste  of  drinking-water,  and  the  hke,  that  will  give  him 
something  tangible  to  work  upon.  He  will  often  find  that  this  testimony 
will  be  uniform  in  a  certain  direction,  and  will  save  him  much  time 
and  labor  in  the  investigation  he  is  about  to  make,  by  dii'ecting  his  atten- 
tion to  some  oi^e  point  as  the  probable  cause  of  the  trouble.  For  exam- 
ple, if  offensive  odors  are  noticed  only  when  the  wind  is  from  the  east  the 
inspector  would  do  "U'ell  to  begin  his  search  for  the  nuisance  in  that  direc- 
tion. 

After  ha^-ing  satisfied  himself  of  the  nature  of  the  complaint  the  inspec- 
tor should  note  the  character  of  the  inmates  of  the  house  or  houses  ;  their 
cleanliness,  modes  of  life,  dress,  occupation,  and  the  like.  These  poiuts 
"will  all  give  him  a  general  idea  of  the  predisposition  of  the  family  to  dis- 
ease, and  will  sometimes  account  for  the  immunity  from  disease  of  certain 
members  of  a  family  or  a  whole  household  during  an  ej)idemic. 

Should  any  one  in  the  house  be  ill,  a  diagnosis  of  the  case  should  be 
made  ;  and  if  the  disease  is  found  to  be  jDreventable,  the  family  physician 
should  be  consulted,  and  all  points  bearing  on  the  case,  such  as  hereditary 
or  constitutional  trouble  should  be  carefully  noted.  If  the  beginning  of  the 
period  of  incubation  of  the  disease  corresjoonds  with  the  residence  of  the 
jDatient  at  some  other  place  than  that  where  the  disease  appeared,  it  is  safe 
to  assume  that  the  poison  was  taken  into  the  system  at  that  place.  Illness 
often  is  developed  in  a  family  during  the  early  autumn  which  has  been  con- 
tracted during  the  summer  in  some  unhealthy  locality.  When  the  cause 
of  disease  has  been  traced  in  this  way  to  some  remote  place,  the  detailed 
examination  of  the  premises  where  the  person  is  ill,  is  of  course  unneces- 
sary. In  cases  of  oubreaks  of  contagious  diseases  the  first  j^oint  to  be 
learned  is  the  date  of  the  first  appearance  of  the  disease  in  the  community, 
after  which  every  condition  of  food,  drink,  exposure,  intercourse,  sewage, 
and  the  like,  should  be  thoroughly  investigated.  In  case  of  illness  among 
children  who  have  attended  the  same  school  the  school-buildjng  should  be 
thoroughly  examined. 


J 


SOME    HINTS    TO    SANITARY    INSPECTORS.  525 

After  having  made  in  this  way  what  may  be  called  the  personal  part  of 
the  examination,  and  obtained  all  the  information  possible,  the  attention 
of  the  examiner  should  next  be  directed  toward  the  location  and  surround- 
ings of  the  houses  in  which  the  disease  shows  itself.  In  the  case  of  isolated 
country-houses  the  character  of  the  soil  on  which  it  stands,  viz.,  sand  and 
gravel,  rock,  or  clay,  is  an  important  factor  in  its  salubrity.  Eain  falling 
on  the  surface  of  a  sandy  soil  sinks  rapidly  into  the  ground  and  renders 
the  site  of  the  house  comparatively  dry.  Clay  and  rock,  on  the  other 
hand,  being  impei'vious  to  moisture,  water,  in  sinking  through  the  toj)  soil 
and  coming  in  contact  with  them,  flows  along  their  surface  to  some  lower 
point.  In  this  way  inequahties  in  substrata,  or  fissures  in  the  rocks  acting 
like  great  bowls,  retain  large  bodies  of  water,  and  should  a  house  be  sit- 
uated directly  over  one  of  them  render  it  damp  and  unhealthy.  Situations 
at  the  base  of  hills  are  particularly  unhealthy,  as  the  ground  water  coming 
from  the  higher  lands  is  checked  in  its  flow  by  the  sudden  change  in  the 
grade,  and  forced  to  the  surface,  making  the  soil  more  moist  than  at  any 
other  point. 

Trees,  too,  near  a  house  are  unhealthy  for  several  reasons  :  1,  they  cast 
a  shade  on  it  and  render  it  damp  ;  2,  they  prevent  the  free  cii'culation  of 
air  about  it ;  3,  in  the  autumn  the  dead  leaves  lying  on  the  ground  and 
rotting  give  off  an  odor  which  is  considered  quite  unhealthy. 

Neighboring  streams,  ponds,  and  marshes  sometimes  exert  a  very  bad 
influence  on  the  health  of  a  household  or  community.  The  presence  of 
stagnant  water  is  always  to  be  looked  upon  with  suspicion,  and  measures 
aimed  at  its  removal  should  be  recommended.  Especially  is  this  the  case 
where,  from  any  cause,  the  level  of  the  water  is  liable  to  fluctuate,  at  times 
covering  the  banks,  and  again  leaving  large  areas  exposed.  Malaria  is 
generally  a  companion  to  these  conditions,  and  wiU  be  found  to  decrease 
when  proper  drainage  is  instituted,  and  the  water-level  is  made  unvarjdng. 
In  some  instances  small  streams  which  have  received  sewage,  have  been 
known  to  carry  typhoid  contagion  to  persons  in  districts  through  which 
they  flow  by  the  drinking  of  the  water  thus  contaminated.  Although 
streams  so  polluted  become  again  fit  for  drinking  by  the  oxidation  of  their 
impurities,  it  is  still  a  mooted  question  at  just  what  distance  below  the 
point  of  contamination  in  the  course  of  a  stream  its  water  again  becomes 
wholesome.  It  is,  therefore,  best  to  examine  streams  as  far  up  as  possible 
when  there  is  any  likeliliood  of  their  being,  or  having  been  used  for  drink- 
ing at  the  place  under  examination.  Too  much  attention  cannot  be  be- 
stowed on  the  wells  of  the  district,  and  a  thorough  study  of  all  possible 
sources  of  contamination  should  be  made,  in  addition  to  the  analysis  of  the 
water  by  a  competent  chemist.  A  quantitative  analysis  in  all  cases  is  to  be 
preferred,  as  the  examiner  is  able  by  it  to  determine  with  greater  accuracy 
the  probable  cause  and  recentness  of  the  contamination. 

The  inspector  should  provide  himself  with  a  note-book  in  which  he 
should  record  all  facts  learned  by  questions  and  observations,  together  with 
sketches  of  the  location,  and  arrangement  of  the  buildings,  their  water- 
supply,  plumbing,  drainage,  etc.  Never  tmst  to  memory.  _  Enter  every 
little  item,  no  matter  how  seemingly  unimportant.  The  writer  has  been 
saved  many  an  awkward  predicament  by  having  every  detail  jotted  do-^Ti. 
Besides  this,  the  inspector  can  much  more  readily  grasp  the  case,  and  be 
able  to  make  an  intelligent  report  by  this  attention  to  small  matters. 
When  on  the  ground,  time  should  not  be  considered  an  element  in  the 
problem.  What  is  required  is  an  absolute  mastery  of  the  facts,  no  matter 
how  long  it  takes  ;  and  in  some  cases  it  may  take  days  and  even  weeks. 


526 

Although  it  has  already  been  suggested  that  every  person  who  is  at  all 
likely  to  throw  light  on  the  subject  should  be  questioned  before  beginning 
the  examination,  the  inspector  never  should  accept  as  a  fact  any  statements 
that  may  be  made  by  them  ;  but  should  always  and  only  depend  on  the 
evidence  of  his  own  senses. 

After  having  thoroughly  studied  the  surroundings,  attention  should 
next  be  dii-ected  to  the  dwelling.  And  here  at  the  outset  household  dirt 
should  be  recognized  as  an  important  factor  in  its  healthfulness.  The  dust 
that  accumulates  on  walls  and  f  urnitm-e,  and  is  swept  from  the  floors,  would, 
if  sprinkled  over  the  patients  in  the  surgical  ward  of  a  hospital,  induce  such 
a  condition  of  the  wounds  as  would  endanger  life.  Soiled  clothing,  slop- 
pails,  garbage  barrels,  the  use  of  the  water-closet  as  a  slop-sink,  etc.,  are  all 
sources  of  foul  odors.  The  inspector  must  expect  discouragement  from 
the  inmates  when  investigating  the  habits  of  the  family.  They  will  gen- 
erally try  to  shield  themselves,  and  AviU  often  be  quite  incensed  at  the  mere 
suggestion  of  their  being  the  cause  of  tho  trouble,  and  will  censure  their 
landlord  or  neighbors. 

The  various  points  to  notice  indoors,  are  : 

I.  The  Dryness  of  the  Air. — This  may  be  judged  by  the  sensation  ongoing 
suddenly  into  the  cellar.  If  it  is  noticeably  damp  it  may  come  from  one  of 
several  causes :  first,  the  cellar  may  be  acting  like  a  drain,  catching  the 
gi'ound  water  that  flows  into  it  from  all  sides  ;  second,  the  rain-water  leader 
may  be  broken,  discharging  the  water  into  the  ground  and  allowing  it  to 
percolate  into  the  cellar  ;  third,  the  water-pipes  may  have  burst ;  fourth, 
the  drain  may  be  broken.  During  the  greater  part  of  the  year  there  is  a 
constant  upward  current  of  air  in  buildings,  which  creates  a  partial  vacuum 
in  the  cellar,  sucks  in  air  from  the  surrounding  ground  and  distributes  it 
through  the  house.  As  the  cellar  air  is  dry  or  damp,  so  will  be  that  of 
the  house  ;  and  great  care  should  be  taken  to  discover  the  cause  of  any 
moisture  there  may  be  noticed  about  the  walls  or  floor.  A  wet  and  dry 
bulb  hygrometer,  such  as  is  used  by  the  Coast  Survej^  is  an  admirable  in- 
strument for  rapid  determination  of  the  humidity  of  aii',  and  of  course 
much  more  accui-ate  than  mere  bodily  sensation.  A  humidity  of  60,  satur- 
ation being  100,  should  be  considered  the  limit  for  healthy  dwellings  in 
this  country. 

II.  Tiie  Mode  of  Heating  the  Building. — Where  hot-air  furnaces  are  used, 
the  position  of  the  air  inlet  and  the  condition  of  the  ducts  should  be  care- 
fully examined.  Cracks  or  openings  in  the  fresh-air  duct,  or  the  position 
of  the  air  inlet  near  a  drain  opening,  or  other  source  of  contamination  will 
allow  foul  air  to  pass  into  the  heating  chamber  of  the  furnace  and  be  dis- 
tributed through  the  house. 

ni.  The  Means  for  Ventilation. — As  a  rule  American  houses  have  no 
other  way  of  changing  the  air  than  by  opening  the  windows.  Water- 
closets  oftentimes  are  found  with  no  connection  with  the  outer  air,  located 
in  the  middle  of  the  house,  and  what  ventilation  there  is,  is  into  the  rooms 
of  the  house. 

IV.  The  Plumbing  and  Drainage. — Unfortunately  in  most  buildings,  the 
pipes  are  so  hidden  behind  wood-work  and  under  floors,  that  it  is  impossible 
to  examine  them  without  calling  in  carpenters  and  subjecting  the  family  to 
great  inconvenience.  A  thorough  examination  cannot,  however,  be  made 
without  exposing  the  plumbing  to  view,  and  no  positive  statement  of  its 
condition  ought  to  be  made  on  merely  a  cursory  inspection.  The  plumbing 
system  in  any  building  is  very  much  like  a  broom,  standing  on  end,  with 
the  handle  in  the  cellar.   The  inspector  will  therefore,  find  his  work  greatly 


SOME    HINTS    TO    SANITARY   INSPECTORS.  527 

simplMed,  by  beginning  with  the  trunk  Knes  of  pipe  and  following  out  the 
branches,  making  an  oft-hand  sketch  as  he  goes  from  floor  to  floor,  showing 
the  positions  of  the  various  fixtures,  the  arrangement  of  the  pipes  and  their 
points  of  junction  with  each  other.  Too  much  care  cannot  be  taken  in  ex- 
amining the  pipes  for  imperfect  caulking  of  joints,  open  connections,  putty 
joints,  holes  plugged  with  corks,  rag  patches,  spots  of  corrosion,  and  the 
like. 

The  fixtures  should  be  examined  and  their  traps  tested  in  order  to  learn 
theii-  efficiency  as  barriers  against  the  entrance  of  sewer  air.  To  make 
these  tests,  as  great  a  pressure  should  be  brought  to  bear  on  the  traps  as 
there  is  a  possibility  of  their  being  subjected  to  when  the  plumbing  is  in 
constant  use.  To  do  this,  all  the  basins,  baths,  and  other  fixtures  above 
the  traps  to  be  tested  and  on  the  same  line  of  piping,  should  be  filled  with 
water  and  then  discharged  simultaneously,  care  being  taken  that  all  the 
pipes  are  free  from  obstruction.  The  fixtures  below  the  trap  should  then 
be  filled  and  discharged  in  the  same  way.  If  the  trap  retains  its  seal  under 
these  tests,  it  is  safe  to  assume  that  it  is  an  effectual  barrier  to  the  en- 
trance of  sewer-air  into  the  building.  Every  trap  should  be  tested  in  this 
way,  and  a  note  made  of  the  result. 

Pin-holes  or  air-holes  which  it  is  impossible  to  see  with  the  naked  eye, 
often  occur  in  pipes,  and  it  is  therefore  best  to  supplement  the  examination 
by  a  test  by  which  these  defects  may  be  detected.  For  this  purpose 
some  volatile  substance,  hke  the  oil  of  peppermint,  is  used,  which  being 
introduced  into  the  piping  of  a  building,  finds  its  way  through  any  defect 
and  is  immediately  detected  by  its  penetrating  odor.  To  make  the  test : 
pour  into  the  top  of  the  j)ipe,  or,  if  the  pipe  does  not  extend  through  the 
roof,  into  the  highest  fixture,  a  pailful  of  boiling  water,  then  half  an  ounce 
of  the  oil,  followed  by  another  pail  of  hot  water.  The  hot  water  sent  down 
before  the  oil  warms  the  pipes  and  prevents  the  oil  from  clinging  to  them. 
That  sent  after  it  tends  to  volatilize  the  oil  and  carry  it  into  every  part  of 
the  system.  Great  care  should  be  taken  in  handling  the  oil,  as  a  drop  will 
scent  the  whole  building  and  destroy  the  test.  It  is  therefore  better  for  two 
persons  to  make  it ;  one  to  handle  the  oil,  and  the  other  to  search  for  traces 
of  it  throughout  the  house.  The  former  should  in  no  case  come  down  in- 
to the  house  until  the  whole  system  of  piping  has  been  examined  by  the 
latter  as  a  very  little  of  the  oil  on  his  fingers  will  impregnate  the  dwell- 
ing. It  sometimes  becomes  necessary  to  resort  to  other  methods  of  test- 
ing than  that  by  the  oil  of  peppermint,  as  for  instance,  when  it  is  impossi- 
ble to  introduce  the  oil  into  the  j)ipes  without  danger  of  the  odor  getting 
out  into  the  house.  In  such  cases  the  smoke  test  is  sometimes  used. 
While  the  peppermint  is  apphed  at  the  top,  the  smoke  test  is  applied  at 
the  bottom,  and  is  made  by  forcing  smoke  up  the  drains  and  pipes  by 
means  of  a  small  fan  blast.  If  any  imperfections  occur  in  the  pipes,  the 
smoke  is  forced  out  and  is  readily  detected.  The  fan  shoidd  be  con- 
nected with  the  pipes  at  the  lowest  possible  point  and  before  applying  the 
test,  aU  oj)enings  known  to  exist  and  through  which  the  smoke  might  be 
discharged,  should  be  carefully  closed. 

A  list  of  defects  in  the  plumbing  and  drainage  of  houses  that  have  been 
encountered  by  a  firm  of  English  engineers  has  been  slightly  altered  to 
meet  American  practice,  and  is  given  below  as  being  a  concise  statement 
of  the  experience  of  the  writer  :  1.  Common  brick  sewers  with  flat  bot- 
toms, under  or  near  houses.  2.  Earthen-pipe  drains,  either  broken  or  with 
leaky  joints,  laid  under  the  cellar  floor,  saturating  earth  with  sewage.  3. 
Pipe  drains,  either  earthen  or  iron,  laid  under  houses  without  sufficient 


528  AMERICAN    APPENDIX   TO    PARKEs'    HYGIENE. 

fall,  01'  with  the  fall  the  wrong  way.  4  Drains,  both  earthen  and  iron, 
without  running  traps,  admitting  air  from  sewers  or  cesspools  to  the  pij^es 
in  the  house.  5.  Drains  without  a  free  current  of  aii'  moving  constantly 
thi'ough  them.  6.  Rat-burrows  from  built  drains  or  sewers  undermining 
flags  and  floors,  and  admitting  foul  aii'  to  the  house.  7.  Eat-buiTows 
worked  alongside  perfect  pipe-drain  from  street  sewers  and  into  houses. 
8.  Defective  connections, between  soil-  or  waste-pipes  and  sewers,  admitting 
foul  air  to  houses.  9.  Soil-  or  waste-pipes  without  any  or  sufiicient  ventila- 
tion. 10.  Defective  water-closet  appai'atus.  11.  Water-closet  cisterns  with 
overflows  joined  to  soil-pij^e  or  drain.  12.  Safes  under  closets  or  basins 
connected  to  soil-pij^e  or  drain.  13.  Two  or  more  fixtures  with  unven- 
tilated  traps  on  the  same  line  of  pipe,  siphoning  each  other  when  used. 
11.  Sink  overflow-pipes  joined  to  soil-pij^es  untrapped  or  with  trap  liable 
to  sij^hon.  15.  Overflows  from  basins  or  baths  connected  with  waste-pipe 
on  sewer  side  of  trap,  admitting  foul  gases  to  rooms.  16.  "Water  supphes 
to  sinks  taken  from  water-closets  or  other  contaminated  cisterns,  and  used 
by  cai-eless  servants  for  di-inking  pui-poses.  17.  House  cisterns  and  tanks 
with  overflows  direct  into  soil-pipes  or  drains.  18.  Traps  of  every  descrip- 
tion without  ample  ventilation  to  prevent  them  from  siphoning.  19.  Scul- 
lery sinks  connected  direct  to  drains  admitting  foul  aii*  to  houses,  not  only 
through  traps,  but  through  joints  of  brick- work  all  round,  as  shown  by  the 
smoke  test.  20.  Bell  traps  with  loose  covers  on  scullery  sink  connected  to 
drains.  21.  Gullies  or  traps  in  sculleries,  laundries,  larders,  refrigerators, 
etc.,  connected  to  drains  usually  dry  and  untrapped.  22.  Eain-leaders 
used  as  ventilators  to  drains,  delivering  foul  air  to  bed-room  windows,  or 
under  eaves  or  roofs.  23.  Ash-pits  near  larders  and  pantries  ;  ash-pits 
liable  to  soak  foul  moisture  through  house- walls.  24,  Defects  of  drainage 
and  rat-burrows  fi'om  neighbors'  houses.  25.  Water-cisterns  in  areas  near 
ash-pits  or  sculleries,  and  with  overflows  direct  to  di-ains.  2G.  Wash-basins 
in  dressing-rooms  connected  directly  in  any  way  to  drains  or  soil-pipes. 

27.  Cisterns  of  all  kinds  in  houses  with  overflow  connected  dii-ect  to  drains. 

28.  Cessj)ools  near  houses,  and  cesspools  or  defective  drains  near  wells, 

29.  Neighbors'  drains  crossing  under  houses,  or  joining  drains;, 

If  an  outbreak  of  contagious  or  infectious  disease  is  being  studied, 
and  up  to  this  point  the  inspector  has  not  reached  any  conclusion  as  to  its 
cause,  it  would  be  well  for  him  to  examine  the  food  used  in  common  by 
the  families  in  which  the  disease  occurs.  MUk  has  so  often  been  the  cai*- 
rier  of  contagion,  that  everything  which  in  any  way  could  affect  it  should 
be  carefully  examined  :  the  dairy  from  which  it  comes,  the  cows,  the 
milk  cans,  the  water  they  are  washed  in,  should  all  receive  attention.  Then 
again,  the  ice  may  be  the  cause  of  the  trouble.  Impure  water  in  freezing 
does  not  make  pure  ice,  and  hence  the  pond  or  other  sources  fi-om  which 
it  is  taken  should  be  examined  for  any  possible  cause  of  contamination. 

Many  more  lines  of  investigation  might  be  suggested  ;  but  sj)ace  will 
not  admit  of  their  being  mentioned.  Hundreds  of  points  can  only  ba 
learned  by  exi^erience,  and  all  that  can  be  claimed  for  this  article  is  what 
its  title  imports — Some  Hints  to  Sanitary  Inspectors, 


INDEX. 


Ablution  rooms,  ii.  207 

in  tropical  barracks,  ii.  215 
AbscissEe,  ii.  189 
Abyssinian  Expedition,  water  supplied  on 

board  ship,  i.  6 
Acarus  domesticus,  i.  289 

farinse,  i.  341.  249 
Access  pipes  to  sewers,  ii.  23 
Accessory  foods,  i.  208 
Acclimatization,  is  it  possible  ?  ii.  80,  92 
Accoutrements,  weights  of,  ii.  243-246 
Acetic  acid  in  beer,  i.  296 
Acid,  hydrochloric,  effects  of,  i.  141 
Acids,  factors  for,  i.  296  ;  ii.  382,  383 

in  beer  and  wine,  i.  294-304 
Acland,  Dr.,  on  cholera  in  St.  Clement,  1. 

57 
Act,  Rivers  Pollutions,  ii.  19 
Admissions  into  hospital,  number   of,   ii. 

286 
Adams  on  lead-poisoning,  i.  18 
Adults,  supply  of  water  for,  i.  4 
Aeroscope  of  Pouchet,  i.  196 
African  stations,  ii.  321 
Agave  americana,  i.  276 
Ague  at  Tilbury  Fort,  i.  49 

brassfounders',  i.  135 
Agues,  decline  of,  in  England,  i.  48 
Air,  i.  112 

albuminoid  ammonia  from  organic 
matter — Angus  Smith,  Moss,  de 
Chaumont,  i.  124 

amount  required  for  lights,  i.  162 

amount  required  for  ventilation,  i.  157 

carbonic  acid  in,  i.  113 

chemical  examination  of,  i.  197 

composition  of,  i.  113  ;  ii.  93 

currents  of,  effects,  ii.  89 

diseases  from  living  substances  in,  i. 
136,  137 

diseases  produced  by  impurities  in,  i. 
133 

distr'.bution  of,  in  ventilation,  i.  168 

divided  currents  of,  for  purifying 
water,  i.  30 

estimation  of  free  and  albuminoid  am- 
monia in,  i.  199 

Vol.  n.— 34 


Air,  examination  of,  i.  195 

examination  of,  by  the  senses,  i.  195 

fresh,  good  effects  of,  in  disease,  ii.  7 

foul,  effects  of,  i.  112 

gaseous  substances  in,  i.  121 

how  is  purity  of,  to  be  secured  ?  ii.  7 

impure,   from  combustion,  effects  of, 

i.  145 
impurities  in,  i.  114 
increased  pressure  of,  ii.  91 
in  holds  of  ships,  i.  132 
in  soils,  calculation  of  quantity,  i.  347 
in  the  Arctic  regions,  i.  114 
lessened  pressure  of,  ii.  89 
limit  of  permissible  impurity  in,  i.  159 
mean  movement  of,  i.  169 
means  by  which  it  is  set  in  motion,  i. 

168 
meter,  Casella's,  i.  193 
microscopical  examination  of,  i.  196 
mode  of  supplying,  i.  205 
movement  of,  ii.  89 
naovement  of,  in  room,  i.  93 
movement  of,  perceptible  rates,  i.  165 
movements     produced      by     unequal 

weights  of,  i.  171 
nitric  and  nitrous  acids  in,  i.  200 
of  cesspools,  i.  121 
of  churchyards  and  vaults,  i.  129 
of  enclosed  spaces,  i.  119 
of  marshes,  i.  131 
of  mines,  132 
of  railway  cars,  i.  127 
of  sewers,  i.  127 
of  ships,  CO3  in,  i.  123 
of  sick  rooms,  i.  120 
of  stables,  CO2  in,  i.  123,  124 
of  towns,  i.  126,  130 
of  workshops,  i.  121 
organic  matter  in,  i.  134, 125, 199,  200 
oxidizable  matter  in,  i.  300 
purification  of,  ii.  169 
purifiers,  action  of,  ii.  170 
purifiers,  gaseous,  ii.  170 
purifiers,  liquid,  ii.  170 
purifiers,  solid,  ii.  170 
quantity  of,  required,  i.  157 


530 


INDEX. 


Air,  rate  of  movement  of,  i.  193 

scheme  for  examination  of,  i.  261 

sewer,    producing    enteric    fever,    i. 
148-152 

solid  particles  in,  i.  114 

supplied,  source  of,  i.  167 

suspended  matters  in,  i.  115 

temperature  of,  ii.  52 

unknown  conditions  of,  i.  156 

vapor  in,  from  respiration,  i.  124 

vitiated  by  combustion,  i.  125 

vitiated  by  respiration,  i.  123 

vitiated   by  respiration,  effects  of,  i. 
142 

vitiated  by  sewer-air.  i.  127 

vitiated  by  sewers,  effects  of,  i.  146 

vitiated  by  trades,  i.  130 

warming  of,  i.  177 

warming  or  cooling  of,  i.  168 

watery  vapor  in,  i.  200 

weight  of.  ii.  89 
Aitken  on  the  growth  of  the  recruit,  ii.  196 
Albumen,  i.  203 
Albuminates,  i.  204 

determine  absorption  of  oxygen,  i.  205 

quantity  in  diet,  i.  209,  213 
Albuminoid  ammonia  in  air,  i.  124,  199 

in  water,  i.  82,  92 
Alcock  on  frontier  ulcer  in  India,  i.  60 
Alcohol,  as  an  article  of  diet,  i.  307,  315 

as  preventive  of  disease,  i.  325 

destruction  of.  in  the  body,  i.  315 

dietetic  us-e  of,  i.  826 

in  bodily  labor,  i.  319 

in  deficiencj-  of  food.  i.  320 

influence  of,  on  organs,  i.  311 

in  great  cold,  i.  317 

in  great  heat,  i.  318 

in  mental  work,  i  320 

in  war,  i.   320 

per  cent.,  table  for  calculating,  i.  297 

remote  effects  of,  i.  314 

use  of,  under  certain  conditions,  i.  317 
Alcoholic  rations,  ii.  228 
Aldridge's  closet,  ii.  45 
Aleppo  evil,  or  Damascus  ulcer,  1.  60 
Alga;  in  water,  i.  41,  70 
Alimentary  mucous  membrane,  effects  of 

impure  water  on,  i.  42 
Aliments,  nitrogenous,  i.  204 
Alkalies  in  food,  i.  208 
Alkaline  solution,  standard,  for  acidities, 

ii.  383 
Alluvial  soils,  i.  861 
Alluvial  waters,  i.  26 
Altitude,  correction  for,  ii   108 
Alum,    effects   of,    in   stopping    diarrhoea 
caused  by  impure  water,  i   30 

in  beer,  i.  299 

in  bread  and  flour,  i.  264,  266 

in  wine,  L  306 
Aluminous  salts,  for  water  purification,  i. 

30 
American  stations,  ii.  317 

tube  weUs,  Norton's,  i.  8 


Ammonia,  albuminoid,  in  air,  i.  124,  199 

determination  of,  in  water,  i.  92 

free,  in  air,  i.  199 

in  water,  determination  of,  i.  92 , 

in  water,  i.  77 

in  water,  inferences  from,  i.  80 
Amraoniacal  vapors,  i.  141 
Ammonium  chloride,  standard  solution,  ii. 
381 

sulphide  in  air,  i.  141 

sulphide,  test  for  lead  and  copper  in 
water,  i.  78 
Amoebas  in  water,  i.  72 
Anchylostomum  duodenale.  i.  64 
Anemometer,  Casella's,  i.  193 

Neumann's,  i.  193 

Osier's,  ii.  116 

Robinson's,  ii.  116 
Aneurism  among  f  oldiers,  ii.  279 

causes  of,  ii.  281 
Angell  and  Hehner  on  butter  analysis,  i 

287,  288 
Anguillula  aceti,  i.  337 
Anguillula3  in  water,  i.  73 
Angus  Smith  on  ammonia  in  air,  i.  200 

on  estimation  of  CO2,  i.  197 
Animal  charcoal  as  a  filter,  i.  34 

matter  in  water,  i.  41 

organic  matter  in  water,  dissolved,  i 
43 
Animals,  age  of,  i.  226 

air  required  for,  i.  162 

for  food,  weight  of,  L  326 

inspection  of,  i.  226 

supply  of  water  for,  i.  6 
Ansted  on  the  drainage  of  wells,  i.  29 
Anthrax,  i.  228 
Antozone,  ii.  117 
Apjohn's  formula,  ii.  104 
Appendix,  ii.  380 

Approximate  mean  temperature,  ii  99 
Aphtha  epizootica,  i.  228 
Aqueducts,  i.  14 
Arched  basements,  ii.  212 
Arctic  expedition,    work  done  by  sledge 

parties,  ii.  72 
Area  drained  by  wells,  1.  29 

sectional,  in  ventilation,  i.  175 
"  Argo,"  case  of,  i.  48 
Ari.stotle  on  impure  drinking  water,  i.  61 
Army   Hospital   Corps,   weight   of   equip- 
ments, ii.  247 

regulations,  on  water,  i.  1 

statistics,  ii.  191 
Armstrong  on  lime-juice,  i.  343 
Aruott,  plans  of  ventilation,  i.  171 
Arnott's  pump  for  ventilation,  i.  189  ;  ii. 

214,  215 
Arrangement  of  barracks,  ii.  203,  205,  212 
Arrowroots,  i.  272 
Arsenic  in  water,  tests  for,  i.  79 

poisoning  through  water,  i.  65 
Artesian  wells,  i.  8 

well-water,  i.  27 
Arum  arrowroot,  i.  373 


LNDEX. 


531 


Ascaris  lumbricoides,  i.  63 
Ashanti  campaign,  alcohol  in,  i.  323 

tube  wells  in,  i.  8 

purification  of  water,  i.  33 
Aspergillus  glaucus,  i.  289 
Aspirators  for  measuring  air,  i.  196 

description  of,  i.  197 
Assimilation  of  food,  i.  223 
Atmidometer,  Babington's,  ii.  114 
Atmometer,  Leslie's,  ii.  114 
Austrian  soldier,  rations  of,  ii.  223 
Averages  or  means,  calculation  of,  ii.  186 

Bacillus,  i.  71 

malarife,  i.  136  ;  ii.  129,  164 

of  phthisis,  i.  121 
Bacilli,  ii.  164 
Bacteria,  action  in  water,  i.  80 

and  ribriones,  signification  of,  i.  71 

conditions  favorable  for,  in  water,  i. 
71 

in  air,  i.  120 

in  disease,  ii.  164 

temperature  that  kills  (Sanderson),  i. 
30 
Bacteridia  in  water,  i.  71 
Bacteriforin  puncta  in  water,  i.  70 
Bacteroids  in  water,  i.  70 
Bsedeker  on  copper  poisoning  from  water, 

i.  45 
Bahamas,  ii.  316 
Bajra  (miUeti,  i.  270 
Bakewell  on  smallpox  matter  in  air,  i.  121, 

187 
Bak  ng,  te=t  for  flour,  i.  244 
Baillarger  on  goitre,  i.  61 
Balfour  on  diet  of  Duke  of  York's  School, 
i.  207 

on  army  statistics,  ii.  191,  193 
Balloon  ascents,  ii.  101 

effects  on  pulse,  ii.  89 
Ballot  on  cholera,  i.  54 
Ball  traps,  ii.  24 
Bally  and  Coindet  on  artificial  production 

of  goitre,  i.  61 
Banner's  ventilator,  ii.  44 
Banting  system,  success  of,  explained,  i. 

207 
Barbadoes,  ii.  312 

leg,  pachj^dermia  or  elephantiasis,  i. 
60  ;  ii.  312 
Barff's  process  for  coating  iron,  i.  13 
Barium  chloride  as  test  for  sulphuric  acid, 
i.  77 

nitrate  solution  for  soap  test,  ii.  380 
Barker,  Herbert,  on  preservation  of  dead 

bodies,  ii.  125 
Barley,  i.  268 

structure  of.  i.  250,  252 
Barometer,  ii.  106 

corrections  for.  ii.  107 

reading  of.  ii.  106 

scales,  ii.  387 
Barrack  Commission's  filter,  i.  11,  VZ 
Barracks,  ii.  201 


Barracks,  cavalry,  ii.  208 

cooling  of.  ii.  214 

infantry,  ii.  203 

in  forts  and  citadels,  ii.  210 

in  hot  climates,  ii.  210 

on  home  service,  ii.  203 

reports  upon,  li.  206 

ventilation  of,  i.  183 

warming  of,  ii.  200 
Barrels  for  storing  water,  i.  14 
Baryta  water  as  a  test  for  COo.  i.  198 
Bastian  on  bacteria  and  vibriones,  ii.  166 
Bathing,  good  effects  of,  ii.  121 
Batho  on  Bilharzia,  i.  64 
Baths,  amount  of  water  required  for,  i  4,  5 
Bean  and  pea,  i.  251,  271 
Beans,  Indian,  i.  271 
Bean  starch,  drawing  of.  i.  254 
Beatson  on  prison  diet  in  India,  i,  216 
Beaufort  scale  for  force  of  wind,  ii.  116 
Beaumont  on  digestion,  i.  219.  220 
Becher  on  body  temperature,  ii.  84 
Bedding,  purification  of,  ii.  166 
Beef,  fre.-h,  composition  of,  i.  212.  215,  225 

salt,  composition  of,  i.  212,  215 
Beer,  i.  294 

ad  n  Iterations,  i.  298 

alcohol  in,  i.  294,  296 

as  an  article  of  diet,  i.  294 

examination  of,  i.  295 

physiological  action  of,  i.  295 

quality  of,  i.  295 
Bell  on  specific  gravity  of  butter  fat,  1  287 
Bellamy's  process  for  water  purification, 

i.  30 
Bell  tent,  cubic  space  of.  i.  192 
Berlin,    water  of,  contaminated  by  coal- 
gas,  i.  29 
Bermuda,  ii.  316 

i  Bert  on  effects  of  increased  pressure  of  air, 
!      ii.  92 

Berthe  on  absorption  of  fat,  i.  219 
Berthollet  on  water  purification,  i.  32 
Bettington  on  fever  produced   by  marsh 

water  at  Tulliwaree,  i.  47 
Beverages  and  condiments,  i.  294 
Beverages,  non-alcoholic,  i.  327 
Bhisties,  Avater-carriers  of  Bengal,  i.  29 
Bilharzia  hsematobia,  i.  64 

embryos  of,  in  water,  i.  73 
Bilious  remittent  fevers,  ii.  142 
Bird's  plan  of  purifying  water,  i.  30 
Biscuit,  i.  260 
Biscuits,  meat.  i.  293 
Bituminous  lining  for  lead  pipes  (M'Dou- 

gaU's).  i.  19 
Blackley  on  hay  fever,  i.  136 
i  on  spores  in  hair,  i.  118 

i  Blagden  and  Fordyce   on  temperature  in 

ovens,  ii.  85 
Blake  on  treatment  of   phthisis  in   open 

air,  ii.  91 
Blanc'on  cholera  at  Yerrauda,  i.  56 

on  fever  from  water  in  Abvssi.uia,  i, 
48 


532 


INDEX. 


Block- tin  pipes,  i.  18 

acted  on  by  water  containing  nitrates, 
i.  19 
Board  of  Trade,  minute  on  water- fittings, 

i.  IG 
Boat-race,  work  during,  ii.  73 
Boiling  of  meat,  i.  238 

of  water,  to  purify,  i.  30 
Boils,  endemic  of,  at  Frankfort,  from  im- 
pure water,  i.  59 
Bond's  terebene  preparations,  ii.  183 
Bone-burners,  i.  156 
Boots  and  shofs,  ii.  241 
Bothriocephalus  latus  from  water,  i.   63, 

73 
Bottles,  shaking,  for  soap-test,  L  86 
Boudet  on  Paris  water,  i.  40 
Boudin  on  case  of  "  Argo,"  i.  48 
on  impure  water  at  Oran,  i.  44 
on  yellow  fever  from  water,  i.  59 
Boutron  and   Boudet,    method  with   the 

soap-test,  i.  88 
Bowditch  on  effects  of  drying  soil,  i.  351 
Bowels,  condition  of,  ii.  121 
Boyd  on  the  recruit,  ii.  197 
Boyle's  ventilator,  i.  183 
Brackish  water,  effects  of,  i.  44,  45 
Braxy  in  sheep,  i.  228,  236 
Bread,  i.  260 

acid,  i.  262.  263 
alum  in,  i.  264,  265 
chemical  examination  of,  L  263 
dried,  i.  292 
examination  of,  i.  263 
loss  of  weight  in,  i.  262 
making  of.  i.  260,  261 
microscopical  examination  of,  i.  266 
Breadth  of  houses  in  India,  ii.  212 
Brickfields  and  cement  works,  air  of,  i. 

155 
Brine,  juice  of  meat  in,  i.  214 
British  Guiana,  ii.  314 
British  or  potato  arrowroot,  i.  272 
Brittan  and    Swayne  on  bodies  in  air  of 

cholera  ward,  i.  120 
Bromus  serrafalcus,  i.  250 
Bronchitis  from  impure  water,  i.  46 
Brucine  solution,  preparation  of,  ii.  384 
Brunei,  huts  designed  by,  ii.  216 
Brushwood,  effects  of,  i.  356 
Brydens  tables  of  mortality  in  India,  ii. 

349,  350 
Buckwheat,  i.  270 

structure  of,  1.  255,  258 
Buchanan  on  cause  of  typhoid  fever,  i. 
353 
on  effects  of  drying  soil,  i.  351 
on  health  of  towns,  ii.  41 
water-poisoning:  at  Caius  College,  i.  29 
Budd  on  enteric  fever,  i.  50 
Buhl  on  ground  water  and  fever,  1.  352 
Bulama,  diarrhoea  from  impure  water  at, 

i.  43 
Burdon- Sanderson  on  bacteria  in  water,  i. 
71 


Burettes,  size  of,  i.  86 
Burnett's  fluid,  ii.  181 
Burning  of  the  dead,  ii.  126 
Butter,  i.  285 

adulterations  of,  i.  288 

examination  of,  i.  285,  287 

fat  of,  i.  286 

melting,  sinking,  and  floating  points 
of,  i.  287 

proportion  of  fixed  and  volatile  acids 
in,  i.  287 

preservation  of,  1.  288 
Butterine,  i.  288 

Butyrate  of  lime  causing  diarrhoea,  i.  44 
Butyric  acid,  presence  of,  in  water,  i.  72 
Byrne  on  filtration,  i.  34 

Cabb.\6E,  composition  of,  i.  213 

Cactus  as  an  antiscorbutic,  i.  276 

Cajanus  indicus.  i.  271 

Calamus  aromaticus,  i.  306 

Calandra  granaria.  i.  249 

Calcium   carbonate   in  water,  importance 

of,  i.  80 
Calculation  of  velocity  of  air  currents,  i. 

195 
Calculi,  effects  of  water  in  producing,  i. 

60 
Calcutta,  water  supply,  i.  3,  7 
Calorigen,  George's,  ii.  57 
Calvert  on  tin-lined  pipes,  i.  18 
Calvert's  carbolic  acid  powder,  ii.  49 
Camellia  .sasanqua.  i.  234 
Camels,  water  required  for,  1.  6 
Camps,  ii.  222 

compressed,  ii.  223 

con.servancy  of,  ii.  224 

hospital,  ii.  226 

order  of,  ii.  222 
Canada,  ii.  317 
Canal  de  I'Ourcq,   as  source  of  water  in 

Paris,  i.  40 
Canna  arrowroot,  i.  272 
Cape-Coast  Castle,  ii.  324 

frontier,  impure  water  at,  i.  44 

of  Good  Hope,  ii.  325 
Carbide,  magnetic,  as  filter,  i.  36 
Carbo-hydrates,  i.  204 
Carbo-hydrates  in  articles  of  diet,  i.  212, 

213 
Carbolic  acid  as  air  purifier,  ii.  173 

acid  or  phenol,  ii.  181 

powders,  ii.  183 
Carbon  dioxide.     See  Carbonic  acid. 
Carbon  disulphide  in  air,  ii.  130 
Carbon  in  articles  of  diet.  i.  215 
Carbon  monoxide.     See  Carbonic  oxide. 
Carbonates  in  water,  action  on  lead,  i.  17 

Mohr's  process  for.  i.  98 
Carbonic  acid,  behavior  with  soap,  i.  86 

calculation  of,  in  air,  i.  198 

eflfectsof,  i.  139 

elimination  of.  during  exercise,  ii.  61 
Carbonic  acid,  tree,  in  water,  by  soap-test, 
i.  899 


INDEX. 


533 


Carbonic  acid,  given  off  in  respiration,  i. 
122 

in  air,  i.  113 

in  a  r,  estimation  of,  i.  197 

in  soil-air,  i.  346 

in  solids  of  water,  i.  84 

in  water,  i.  86,  87 

in  water,  action  on  lead,  i.  17 

oxide,  effects  of,  i.  139 

oxide  from  stove-s,  ii.  58 
Carbonization  of  sewage,  ii.  50 
Carburetted  hydrogen  in  air,  i.  141 

in  water,  i.  76  , 

Carferal,  filtering  medium,  i.  35 
Carpenter  on  enteric  fever  at  Croydon,  i. 

50 
Carriage  of  necessaries  and  armament,  ii. 

249 
Carrots,  composition  of,  i.  213 
Casein,  i.  204,  281 
Casella's  air  meter,  i.  193 
Casks  for  storing  water,  i.  14 
Cassava,  i.  272 
Cast-iron  water  pipes,  i.  19 
Caterhara,  enteric  fever  at,  i.  52 
Cattell  on  cholera  at  Devna,  i.  56 
Cattle  plague,  i.  228,  236 
Causus  or  heat  fever,  ii.  84 
Cavalry  barracks,  ii.  208 
Cells,  ii.  207 
Celsus  aud  Hippocrates  on  variety  of  diet 

and  temperance,  ii.  120 
Cement,  sewage,  ii.  36 

works,  i.  lo5 
Centigrade  scale,  ii.  102,  386 
Cerealin,  i.  241 

Cerebro-spinal  meningitis,  ii.  143 
Cesspools,  air  of,  i.  127 
Ceylon,  ii.  330 
Chad  wick's  system  of  cottage  warming,  ii. 

58 
Chalk  waters,  i.  25 
Chalvet   on   air  of   Hopital  St.    Louis,  i. 

120 
Champouillon  on  dysentery  from  water  of 

Canal  de  I'Ourcq,  i.  46 
Chapman  on  ammonia  in  air,  i.   199 
Charcoal,  animal,  as  a  filter,  i.  34 

for  purifying  water,  i.  34 

plan  of  sewage  removal,  ii.  34,  36 

sea- weed,  as  filter,  i.  35 

vegetable  and  peat,  i.  35 

wood,  as  filter,  i.  35 
Charqui,  i.  291 

Charrinar  casks,  for  purifying  water,  i.  33 
Cheese,!.  289 
Chemical  agents,  effects  en  low  forms  of 

life,  ii.  169 
Chemical  characters  of  drinking  water,  i. 

102,  106 
Chemical  examination  of  the  sediment  of 

water,  i.  74 
Cheminee  d'appel,  i.  185 
Chenopodium  album,  i.  276 

Quinoa,  i.  258 


Chester,  loss  of  water  on  constant  supply, 

i.  15 
Chevers  on  impure  water  at  Calcutta,  i. 
46 

on  water  plants  in  tanks,  i.  13 
Chicory,  i.  331 

Children,  supply  of  water  for,  i.  4 
Chimneys,  currents  in,  i.  183,  184 
China,  ii.  358 

Chloranthus  inconspicuus,  i.  234 
Chloride  of  sodium  in  air,  i.  113,  116 
Chlorides  in  water,  action  on  lead,  i.  17 

determination,  i.  85 
Chlorine  as  air-purifier,  ii.  171 

as  disinfectant,  ii.  176 

determination  of,  i.  85 

in  food,  i.  208 

in  water,  i.  77 

in  water,  inference  from,  i.  79,  81 
Chlorosis,  Egyptian,  caused  by  Dochmius 

duodenalis,  i.  64 
Cholera  absent  in  towns  with  pure  v  ater 
supply,  i.  57 

action  of  sewers  in,  ii.  133 

and  ground  water,  i.  354 

at  Gibraltar,  ii.  296 

at  Hurdwar,  i.  55 

at  Malta,  ii.  301 

at  Theydon-Bois,  i.  54 

at  Yerrauda,  i.  56 

belts,  ii.  237 

diminished   by  pure  water  supply  at 
Calcutta,  i.  58 

at  Hurda,  i.  58 

disinfection  in,  ii.  177 

from  drinking  water  at  Broad  Street, 
i.  54 

from  water  in  India,  i.  55,  56 

in  Baden,  i.  55 

in  Berlin,  i.  57 

in  Breslau,  i.  57 

in  Copenhagen,  i.  57 

in  East  London,  i.  54 

in  Holland,  i.  54 

in  Haarlem,  i.  57 

in  Horsleydown,  i.  53 

in  Konigsberg,  i.  57 

in  Lambeth,  i.  57 

in  Munich,  i.  55 

in  Newcastle-on-Tyne,  i.  54 

in  Russia,  in  winter,  i.  58 

in  Saxony,  i,  55 

in  Silesia,  i.  57 

in  Southamptom,  i.  54 

in  Southwark,  i.  57 

in  sugar  factory,  Richter,  i.  55 

in  the  Bengal  Presidency,  ii.  351 

in  Vienna,  i.  55 

internal  causes  of,  ii.  138 

,T.  M.  Cunningham  on,  ii.  134 

localization  of,  ii.  138 

Pettenkofer  on,  ii.  138 

Macnamara  on,  ii.  135 

measures  to   be   adopted  against,  ii. 
353,  354 


534 


INDEX. 


Cholera,  prevention  of,  ii.  134 

Crerar,  on  sulphur  fires  for,  ii.  137 

propagated  by  water,  i.  53 

prophylactic  measures  in,  ii.  139 

portability  of,  ii.  134 

quarantine  in,  ii.  134 

Fauvel  on  quarantine  in,  ii.  135 

tables  of  mortality  from,  ii.  352,  353 

transmission  through  air,  ii.  136 

transmission  through  food,  ii.  137 

transmission  through  water,  ii.  137 

use  of  tents  in,  ii.  138 
Cholum,  a  kind  of  millet,  i.  270 
Chowne's  siphon  ventilator,  i.  181 
Chromate  of  potassium,  use  of,  i.  85 
Cicer  arietinum,  i.  271 
Cihated  infusoria  in  water,  i.  71,  72 
Circle,  area  of,  i.  192 
Cirro-cumulo- stratus,  or  nimbus,  ii.  117 
Cirro-cumulus,  ii.  116 
Cirro-stratus,  ii.  117 
Cirrus,  ii.  116 
Cisterns,  cleaning  of,  i.  11,  12 

materials  of,  i.  13 

overflow  pipes  of,  should  not  pass  into 
sewers,  i.  13 

protection  of,  i.  13 

storage  of  water  in,  i.  12 
Citric  acid  in  scurvy,  ii,  150 
Citrus  acida,  i.  343 

limetta,  i.  343 

limonum,  i.  343 
Claremont,  lead  poisoning  at,  i.  IS 
Clarke,   Dr.   Robert,   on  Hygiene  on  the 

West  Coast,  ii.  324 
Clarke's  method  of  purifying  water,  i.  81 

soap  test  for  water,  i.  b^i 
Classification,  hygienic,  of  drinkiug-waters, 
i.  103,  106 

by  Rivers  Pollution  Commission,  i.  23 
Clavelee  in  sheep,  i.  228 
Clay-slate,  water  from,  i.  25 
Clay  waters,  i.  26 

Cleanliness  as  affecting  health,  ii.  121 
Cleansing  of  filters,  i.  37 
Clement  on  endemic  of  boils  at  Frankfort, 

i.  59 
Climate,  ii.  80 

influence  of,  on  diet.  i.  211 

of  West  Indies,  ii.  234 
Clothes,  purification  of,  ii.  166 
Clothing,  ii.  74 

articles  of,  for  soldiers,  ii.  235,  237 

chemical  reaction  of  fabrics,  ii.  74 

general  conclusions  on,  iL  79 

materials,  conducting  power  of.  ii.  75 

materials  of,  ii.  74 

of  the  soldier,  ii   234 
Cloud,  estimation  of  amount  of.  ii.  117 
Clouds,  ii.  116 

Clouston  on  dysentery  from  sewage  irriga- 
tion, ii.  40 
Coal-gas,  air  required  for  combustion,  i. 
126 

composition  of,  i.  126 


Coal-gas,  in  water,  i.  29 

products  of  combustion,  i.  126 
Cobbold  on  entozoa  through  water,  i.  64 
Cocculus  indicus  in  beer,  i.  300 
Cochineal  as  a  test  for  acidity,  i.  98 

solution,  preparation  of,  ii.  384 
Cocoa,  i.  336 

action  of,  i.  208 

adulterations  of,  i.  337 

as  an  article  of  diet,  i.  386 

structure,  i.  337 
Co-efficients  of  traction,  ii.  71 
Coffee,  i.  327 

action  of,  i.  208 

adulterations  of,  i.  330 

as  an  article  of  diet,  i.  328 

making  of,  i.  328 

structure  of,  i.  330 
Coleps  hirtus,  i.  72 

Cohn  on  bacteria  in  vaccine  lymph,  ii.  164 
Colchicin  in  beer,  i.  3(.-0 
Colin  on  effect  of  marsh  water,  i.  49 
Collection  of  water,  i.  8 
Colostrum  in  milk,  i.  281 
Coloring  matters  in  wine,  i  305 
Combes'  air  meter,  i.  193 
Combined  carbonic  acid,  restoration  of,  to 

solids  in  water,  i.  84 
Combustion,  effects  of  breathing  air  ren- 
dered impure  by,  i.  145 

vitiation  of  air  by,  i.  125 
Composition  of  drinking-water,  i.  19 
Condiments,  i.  337 
Conduction,  ii.  55,  56 
Conduits,  open,  impurities  of,  i.  27 
Condy's  fluid,  for  cleansing  filters,  i.  38 

for  purifying  water,  i.  HI 
Cone,  cubic  content  of,  i.  193 
Cones  flour,  i.  259 
ConfervcB  in  water,  i.  72 
Confinement  to  barracks  in   the   tropics, 

evil  effects  of,  ii.  343 
Conservancy  of  camps,  ii.  224 
Constipation,  ii.  121 
Contagia,  Beale  on,  ii    162 

effects  of  chemical  agents  on,  ii.  169 

Hallier  on,  ii.  163 

nature  of,  ii.  162 

propagation  of,  in  air,  i.  137,  138 

Richardson  on,  ii.  163 

spread  of,  ii.  162 
Contagions,  spread  of,  iu  air,  i.  119,  130 
Contagious   Diseases  Acts,   effects  of,    ii. 

159 
Convection,  ii.  55,  56 
Cooked  meat,  analysis  of,  i.  213 
Cooking  of  meat.  i.  238 

of  peas  and  be.-ins,  i.  271 
Cooling  of  air,  ii.  214 
Copper  in  bread,  i.  265 

in  water,  miners  of  Attacama,  i.  45 

tests  for,  i.  7S 

poisoning  from  water,  i.  45,  65 

solution  for  glucose  and  lactin,  ii.  383 

tinned  water  pipes,  i.  19 


INDEX. 


535 


Correction  for  temperature  in  CO2,  esti- 
mation, i.  199 
Cotton  as  an  article  of  dress,  ii.  75 

fibre,  ii.  75 

soil  ("  regur  ")  of  India,  ii.  334 
Coventry,  effects  of  impure  water  in,  i.  43 
Cowls,  plans  of,  i.  171,  175 
Creain,  quantity  in  milk,  i.  279 
Crease's  filters  (figs.  9  and  10),  i.  109,  110 

ship  filters,  i.  39 

patent  cement,  i.  13 
Cremation  of  the  dead,  ii.  136 
Cresylic  acid  or  cresol,  ii.  173 
Cretinism,  i.  61,  63 
Crooke's  tests  for  carbolic  acid,  ii.  183 
Croydon,  enteric  fever  at,  i.  50 

water,  effects  of,  i.  43 
Cubic  space,  amount  necessary,  i.  164 

cannot  take  the  place  of  change  of  air, 
i.  167 

measurement  of,  i.  191 
Cullen  on  diminution  of  cholera  at  Hurda, 

i.  58 
Cultivated  lands,  water  from,  i.  26 
Cumboo,  a  kind  of  millet,  i.  370 
Cumulo-stratus,  ii.  117 
Cumulus,  ii.  116 

Cuningham,  J.  M. ,  on  cholera,  i.  55 
Cunningham  and  Lewis  on  Delhi  boil,  i.  60 

D.  D. ,  on  bacteria  in  air,  i.  118 
Cupralum,  ii.  184 
Curcuma  ;irrowroot,  i.  373 
Cycas  circinalis,  i.  373 
Cyclops  quadricornis  in  water  (fig.  3),  i. 

73 
Cyprus,  ii.  303 
Cysticercus  cellulosse,  i.  329,  337 

tenuicoUis,  i.  331 

D-TRAP,  bad  form,  ii.  35 

Damper,  Australian,  i.  359 

Dancer  on  spores  in  air,  i.  118 

Danson's  tables,  ii.  197 

Daphnia  pulex  in  water,  (fig.  3),  i.  73 

D'Arcet's  ventilation  plans,  i.   187 

Darnel  grass,  i.  357 

Davis  on  dysentery  from  impure  water  at 

Tortola,  i.  45 
Davy,  John,  on  body  temperature,  ii.  84 
Deacon  on  the  waste  of  water  in  towns,  i. 

15 
Dead,  burial  of,  at  sea,  ii.  136 

burial  of,  on  land,  ii.  135 

cremation  of,  ii.  136 

disposal  of,  in  war,  ii.  136,  137 

disposal  of  the,  ii.  134 
Dean's  gully  trap,  ii.  37 
Death  and  invaliding  at  home,  ii.  271 

rate  of  European  armies,  ii.  373 
De  Chaumont,  experiments  on  air,  i.  159 

his  formulae  for  size  of  inlets  and  out-, 
lets,  i.  176 

his   formulae   for  ventilation   calcula- 
tions, i.  100,  161 

on  air  of  hospitals,  i.  163 


De  Chaumont  on  carbonic  acid  in  air  of 
barracks,  hospitals,  and  prisons,  i. 
133,  133 

on  enteric  fever  from  water-poisoning, 
i.  13 

on  humidity  of  air,  i.  163 

on  smell  as  a  test  of  purity  in  air,  i. 
159,  195 

on  taste  of  constituents  in  water,  i.  68 

on  the  effect  of  heat  on  fabrics,  ii.  I(i8 

on  theory  of  ventilation,  i.  158,  163 
Delhi  boil,  effects  of  impure  water,  i.  60 
Demerara,  ii.  314 
Dengue,  ii.  133 

in  Jamaica,  ii.  307 
Deodorization  of  sewage,  ii.  179 
De  Renzy  on   enteric   fever  in   Millbank 

Prison,  i.  51 
Desaguliers'  wheel,  i.  188  ;  ii.  314 
Desmids  in  water,  i.  73 
Devna,  cholera  at,  i.  56 
Dew,  as  source  of  water  supply,  i.  21 

point,  ii.  103 
Dextrin,  i.  304 
Dholl,  a  kind  of  vetch,  i.  371 
Dhurmsala,   hill  diarrhoea,  cause  of,  i.  42 
Dhurra,  a  kind  of  millet,  i.  870 
Diarrhoea  caused  by  bracldsh  water,  i.  44 

caused    by  dissolved   animal   organic 
matter  in  water,  i.  43 

caused  by  nitrates  and  butyrates,  i.  44 

diminution  of,  by  efficient  sewerage, 
ii.  42 

from     dissolved    mineral    matter    in 
water,  i.  44 

from  fetid  gases  in  water,  i.  44 

from  impure  water,  i.  43 

hill,  of  India,  cau?e  of,  i.  43. 

prevention  of,  ii.  144 
Diatoms  in  water,  i.  73,  74 
Diet  for  laborious  labor,  i.  311 

for  men  at  rest,  i.  309 

for  ordinary  labor,  i.  210 

for  soldiers  in  the  field,  i.  211 

general  principles  of,  i.  203 

Moleschott  on,  i.  210 

of  prisoners,  i.  310 

Pettenkofer  and  Voit  on,  i.  310 

Playfair  on,  i.  309 

Ranke  on.  i.  210 

standard  for  adult,  i.  210 

standard,  proportions  of  constituents, 
i.  314 

Wilson  on,  i.  316 
Diets,  table  for  calculating,  i,  313 
Dinger  on  cholera  from  water,  i.  55 
Diphtheria  from,  impure  water,  i.  59 
Dip-trap,  or  mason's  trap,  bad  form,  ii.  25 
Disconnection  of  pipes  and  sewers,  ii.  35,  36 
Disease,  prevention  of,  ii.  138 
Diseases  arising  from  altered   quality  of 
meat,  i.  233 

attributed  to  telluric  effluvia,  i.  348 

connected  with  moisture  and  ground 
water,  i.  350 


530 


INDEX. 


Diseases  connected  with  the  quality  of  Hour 
and  bread,  i.  2()(j 
non-specific  prevention  of,  ii.  144 
wasting  of  animals,  i.  235 
Disinfecting  chambers,  ii.  107 
Disinfection  and  deodorization,  ii.  161 
in  bubo  plague,  ii.  177 
in  cattle  plague,  ii.  179 
in  cholera,  ii   177 
in  dysentery,  ii.  178 
in  enteric  fever,  ii.  177 
in  exanthemata,  ii.  176 
in  measles,  ii.  176 
in  small-pox,  ii.  176 
in  typhus,  ii.  176 
in  yellow  fever,  ii.  178 
Dissolved  animal  organic  matter  in  water, 
i.  43 
solids  in  water,  i.  176 
Distilled  and  ice-water  may  contain  bac- 
teridia,  i.  71 
water,  aeration  of,  i.  28 
water,  action  on  lead,  i.  17 
water,  impurities  in,  i.  23 
water,  preparation  of,  i.  23 
water,  pure,  i.  87 
Distoma  hepaticum,  i.  63,  228 
Distribution  of  water,  i.  14 
Dobrudscha,  cholera  in,  i.  56 
Dochmius  duodenalis.  i.  64,  73 
Dome,  cubic  contents  of,  i.  192 
"Double,"  ii.  259 
Dracunculus,  ii.  313,  324 
Drainage  of  soU,   effects  of,  on  health,  i. 

3.")3 
Drain  pipes,  fall  of,  ii.  24,  28 
Drains,  laying  of,  ii.  23,  28 

materials  for,  ii.  22 
Drills  and  marches,  ii.  258 
Drink,  evil  effects  of,  ii.  290 
Drinking  water,  composition  of,  i.  19 
water,  impurities  of  source,  i.  24 
water,  quality  of,  i.  19 
water,  impurities  in.  their  origin,  i.  24 
Druitt   on   absorption  of   sewer  gases  by 

water,  i.  28 
Dry  air,  effects  of,  in  arresting  disease,  ii. 

88 
Dry  closets,  arrangement  of,  ii.  49 

plans  of  sewage  removal,  ii.  45,  46 
Drysdale  and  Hayward,  sj'stem  of  heating, 

ii.  59 
Dublin,  experiments  on  water  at.  i.  5 
Dundas  Thomson  on  air  of  cholera  wards, 

i.  120 
Dupre  and  Wanklyn  on  process  for  alum 
in  bread,  i.  264 
on  ethers  in  wine.  i.  302 
Dust  and  sand  showers,  i.  116 
Dysentery  at  Cape  Coast  Castle,  i.  45 

at  Guadaloupe   from  impure  water,  i. 

45 
at  Prague  from  impure  water,  i.  45 
at  Walcheren,  i.  45 
disinfection  in,  ii.  178 


Dysentery  from  impure  water,  i.  45 

from  impure  w  uter  at  Calcutta,  i.  46 

from  impure  water  at  Niirnberg,  i.  46 

in  Barbadoes,  ii.  312 

in  Peninsula  from  impure  water,  i.  46 

in  West  Indies,  ii.  304 

on  the  West  Coast  of  Africa,  ii.  322 

prevention  of,  ii.  144,  145 
Dyspepsia  from  impure  water,  i.  43 
Dytiscus,  larv^  of,  in  water,  i.  74 

Earth  closets,  Moule's.  ii.  47 
Eassie  on  cremation,  ii.  127 

on  sanitary  examination  of  a  dwelling, 
ii.  3-5 
Echinococcus,  i.  238 
Eczema  epizootica,  i.  228,  284 
Edinburgh,  sewage  irrigation  at,  ii.  40 

water  of,  lead  in,  i.  18 
Edmond's  method  of  ventilation,  i.  185 
Edward's  desiccated  soup.  i.  292 
Effluent  water  of  sewage,  conditions  of, 

ii.  39 
Effluvia  from  decomposing  animals,  i.  155 
Eggs,  i.  289 

dried,  i.  293 

of  worms  in  water,  i.  73 
Elastic  tension  (or  force)  of  vapor,  ii.  105 
Ehrenberg  on  dust  showers,  i.  116 
Electrical  conditions,  ii.  95 
Electricity,  modes  of  estimating,  ii.  118 
Elephantiasis  of  the  Arabs,  i.  60 
Elephants,  water  required  for,  i.  6 
Eleusine  corocana  (millet),  i.  271 
Elevation,    as   preventive    of    paioxysmal 
fever,  ii.  129 

effect  of,  in  yellow  fever,  ii.  132 
Eliott,  Sir  George,  on  alcohol  at  siege  of 

Gibraltar,  i.  323 
Ellipse,  area  of,  i.  192 
Emanations  from  streams  polluted  by  I'ffical 

matter,  i.  152 
Energy  obtainable  from  food,  i.  216-218 

potential  or  latent,  i.  204,  205 

whence  derivable,  i.  205,  206 
Enteric  fever  and  ground  water,  i.  252 

at  Bedford,  i.  51 

at  Caius  College,  Cambridge,  i.  51 

at  Cowbridge,  i.  52 

at  Garnkirk,  Glasgow,  i.  51 

fever  at  Gibraltar,  ii.  296 

fever  at  Halle,  i.  52 

at  Malta,  ii.  300,  301 

at  Munich,  i.  51 

at  Nunney,  i.  53 

at  Katho,  i.  51 

at  Sedgley  Park  School,  i.  53 

at  Sydenham,  i.  51 

Buchanan  on.  i.  51 

Budd  on,  i.  50,  52 

Carpenter  on,  i.  50 

carried  by  milk,  i.  284.  285 

connection  of,  with  soil,  i.  348,  352 

disinfection  in,  ii.  177 

Flint  on,  i.  50 


INDEX. 


537 


Enteric  fever  from  water-poisoning,  i  13, 
47,  51 

from  water  (Walz  on),  i.  50 

in  Millbank  PnsoD,  i.  51 

in  European  armies,  iL  273 

Jenner  on,  i.  52 

Miiller  on,  i.  50 

or  typhoid  fever,  prevention  of,  ii.  141 

and  cholera,  reduction  of,  by  efficient 
sewerage,  ii.  41,  43 

Eichter  on,  i.  50 

Eouth  on,  i.  50 

Schmitt  on,  i.  51     » 

Simon  on,  i.  52 

spread  of,  from  deficient  water-supply, 
i.  39 
Entomostraca  in  water,  i.  73 
Entozoa,  danger  from   sewage   irrigation, 

ii.  40 
Ephestia  elutella,  or  cocoa-beetle,  i.  249 
Epithelium  in  air,  i.  119,  121 

in  water,  i.  70 
Equipment,  ii.  243 

new  infantry,  ii.  251 

of  European   armies,  average  weight 
of,  ii.  249 
Ergot  in  flour,  test  for,  i.  244 
Ergotism,  i.  269 
Error,  mean,  ii.  188 

of  mean  square,  ii.  188 

probable,  ii.  188 
Eruptive  fevers,  ii.  142 
Erysipelas,  prevention  of,  ii.  143 

from  impure  water,  i.  50 
Eskimos,  food  of,  L  206 
Essentia  bina,  i.  299 
Euchlorine  as  disinfectant,  ii.  176 
Euglente  in  water,'  i.  73 
Englena  pyrum,  i.  72 

viridis,  i.  72 
Evaporation,  ii.  114 

from  skin  and  lungs,  ii.  61-63 

from  tropical  seas,  ii.  115 
Exanthemata,  disinfection  in,  ii.  175 
Excreta,  amount  of,  ii.  16 

deodorizing  powders  for,  ii.  46,  47,  179 

methods  of  removal  of,  ii.  18,  45,  46 

pail  systems,  ii.  46 

removal  of,  ii.  16 

removal  of,  by  dry  methods,  ii.  45 

removal  of,  by  water,  ii.  20 

solids  and  fluid,  amount  of,  ii.  16 
Exercise,  ii.  60 

amount  which  ought  to  be  taken,  ii.  70 

and   rest,  absorption  and  elimination 
during,  ii.  61 

as  affecting  health,  ii.  122 

changes  in  the  Tuuscles  during,  ii.  66 

general  effect  of,  ii.  69 

effects  of,  ii.  60 

effects  of,  on  generative  organs  and 
kidneys,  ii.  64 

effects  of,  on  heart  and  vessels,  ii.  63 

effects  of,  on  respiration,  ii.  60 

effects  of,  on  the  bowels,  ii.  65 


Exercise,  effects  of,  on  the  digestive  sys- 
tem, ii.  64 

effects  of,  on  the  elimination  of  nitro- 
gen, ii  65 

effects  of,  on  the  nervous  system,  ii.  63 

effects  of,  on  the  skin,  ii.  63 

effects  of,  on  temperature  of  the  body, 
ii.  66 

on  the  voluntary  muscles,  ii.  63 
Extract  of  meat,  value  and  use  of,  ii.  228 
Extraction  of  air  by  fan  or  screw,  i.  188 

of  air  by  heat,  objections  to,  i.  187 

of  air  by  heat,  i  183 

of  air  by  steam-jets.  i.  187 
Extractum  carnis,  Liebig's,  i.  291 
Eyre,  General  H.,  his  committee,  ii.  351 

Fabrics,  effect  of  heat  on,  ii.  167,  168 

Factor  for  chlorine,  i.  85 

Factories,  air  of,  i.  131 

Factors  for  soap  measures,  i.  86,  87 

Glaisher's,  ii.  104 
Fffical  matter,  effects  of  emanations  from, 

i.  153 
Fagopyrum  esculentum.  buckwheat,  i.  255 
Falk  and  Scheffer.  experiments  on  animals, 

i.  40 
Farms,  sewage-,  ii.  40 
Farnham  waters,  i.  25 
Farr  on  cholera  outbreaks,  1.  54 
Fasciola  hepatica,  liver  fluke,  i.  63 
Fats,  i.  204 

absorption  of,  i.  219 

amount  of,  in  diets,  i.  310 

and  carbohydrates,  relations  of,  i.  306 

furnished  by  nitrogenous  substances, 
i.  305 

in  articles  of  diet,  i.  811 

in  milk,  by  Vogel's  method,  table,  i. 
380 
Faught  on  ague  from  water  at   Tilbury 

Fort,  i.  49 
Faure  on  the  water  of  the  Landes,  i.  48 
Fauvel  on  quarantine,  ii.  135 
Fehling's  solution,  ii.  383 
Ferguson  on  goitre  in  Baree  Doab,  i.  63 
Ferguson,  William,  on  alcohol,  i.  334 

on  the  life  of  the  soldier,  ii.  391 
Ferralum,  ii.  184 
Ferric  salts,  tests  for,  i.  78 
Ferrous  salts,  tests  for,  i.  78 
Fever  at  the  Mauritius,  ii.  338 

bilious  remittent,  ii.  143 

bilious  remittent  at  Malta,  ii.  300 

continued,  cause  of,  ii.  384 

eruptive,  ii.  143 

in  Ceylon,  ii.  333 

produced  by  marsh  water  at  Bedford, 
i.  48 

produced  by  marsh  water  at  Sheernesa, 
i.  48 

produced  by  marsh  water  at  Tilbury 
Fort,  i.  49 

produced  by  marsh  water  at  Versailles, 
i.  48 


538 


INDEX. 


Fever,  produced  by  marsh  water  on  board 
Argo,  i.  4S 

paroxysmal,  in  Jamaica,  ii.  309 

relapsing,  ii.  141 

typhoid  or  enteric,  ii.  141 

typhus,  ii.  140 

yellow,  prevention  of,  ii.  130 
Fibrin,  i.  204 

Fick  and  Wislicenus  on  elimination  of  ni- 
trogen, ii.  C!o 

on  muscular  action,  L  205 
Field's  flush-tank.  ii.  23 

manhole,  ii.  27 
Filaria  dracunculus,  Guinea-worm,  i.  64,  78 

sangninis  horaiuis  (Lewis),  i.  64,  73 
Filter,  animal  charcoal,  i.  37 

Barrack  Commissions,  i.  11,  12 

beds,  composition  of,  i.  32,  33 

Chanoit,  i.  36 

Fonvielle's,  i.  36 

Maignen's,  i.  36 

magnetic  carbide,  i.  38 

pocket,  i.  108 

sea-weed  charcoal,  i.  3.5 

spongy  iron,  i.  38 

vegetable  and  peat  charcoal,  i.  35 
Filters,  cleansing  of,  i.  37 

Crease's,  i.  39 

domestic,  i.  35  ' 

pipe,  i.  38 

simple  forms  (Figs.  5-8),  i.  109 

ship.  i.  39 

Souchon,  i.  36 

cistern,  bad,  i.  38 
Filtration  of  sewage,  ii.  36 

of  water,  i.  32 

Byrne  on,  i.  34 

experiments  on,  i.  33,  34 

Notter  on,  i.  34 

on  the  march,  i.  108 

Shield  on,  i.  33 

single  filter,  i.  11,  13 

Witt  on,  i.  33 

through  sand  and  gravel,  1.  32,  34 
Finke   on   marsh    water  in    Holland   and 

Hungary,  i.  49 
Fixed  solids  in  water,  i.  85 
Flap-traps,  ii.  24 

Fleck  on  arsenious  acid  in  air,  i.  119 
Fleming  on  Delhi  boil,  i.  60 
Flesh  of  diseased  animals,  effects  of,  L  234, 

235 
Floors  of  barracks,  iL  213 
Flour,  i.  243 

adulteration  of,  i.  249 

cooking  of,  i.  259 

diseases  of,  i.  248 

examination  of,  i.  242 

microscopical  examination  of,  i.  244 

of  meat,  i.  290 

Peligot's  analysis,  i.  242 

puccinia  in,  i.  248 
Fluctuations  of  temperature,  ii.  82 
Fliigge  on  foods,  i.  221 
Flush-tank,  Field's,  ii.  23 


Fodor  on  soil  air,  i.  346 
Foetid  gases  in  water,  i.  44 
Food,  i.  203 

amount  of,  in  good  diet,  i.  210 
concentrated  and  preserved,  i.  290 
deficiency  of,  i.  222 
digestibility  of.  i.  219 
diseases  connected  with,  L  221 
energy  obtainable  from,  i.  318 
excess  of,  i.  221,  222 
of  the  soldier,  ii.  226 
of  the  soldier  in  India,  ii.  345 
quality  of,  i.  225 

quantity  of  proximate  aliment  neces- 
sary, i.  209 
salts  in,  i.  209 
varietv  necessary,  i.  220 
Foot  and  mouth  disease,  i.  228,  236 
"  Foots,"  i.  299 

Foot-tons,  amount  of,  in  exercise,  ii  70 
Forage-cap,  ii.  238 
Force  regulators,  i.  208 
Foreign  service,  ii.  293 
Forster  on  cholera  in  Silesia,  i.  57 
Forts  and  citadels,  ii.  210 
Fox,  Cornelius,  on  ozone,  ii.  93,  117 
Francis  :  weight  of  lungs  in  tropics,  ii.  86 
Frankland's  experiments  on  scattering  of 
solid  and  liquid  matters  in  sewer[air. 
i.  129 
method  for  organic  matter  in  water, 

i.  82 
on  fungi  in  water,  i.  72 
on  potential  energy,  i.  217,  218 
on  previous  sewage  contamination,  i. 

80 
on  purification  of  water  in  streams,  i. 

28 
on    temperature   of    evaporation   for 

solids  ot  water,  i.  84 
on  the  water  of  the  Irwell,  i.  28 
Free  carbonic  acid  in  water  determined  by 

soap-test,  i.  89 
Freezing-mixture    for    arresting    organic 

matter  in  air,  i.  197 
French   or  metrical   weights,   equivalents 
of,  in  English  weights,  i.  83,  and  Ap- 
pendix B,  ii.  385 
soldier,  equipment  of,  ii.  248 
soldier,  rations  of,  ii.  230 
soldier,  steps  in  marching,  length  of, 
ii.  259 
Friction  of  air  in  tubes,  losses  by,  i.  173 
Fumigation,  ii.  169 
Fungi  in  air.  i.  117,  120 
,  in  flour,  i.  248 

in  water,  i.  41,  71,  73,  74 

Galen's  division  of  life.  iL  123 
Galton's  stoves,  i.  182  ;  ii.  57,  58 
Gambia,  ii.  323 
Gamgee,  Professor,  on  "  braxy,"  i.  228 

on  calculi  in  sheep  from  water,  i.  61 
Ganges,  effects  of  water  of  the,  i.  42 
I  Gangrene,  hospital,  ii.  143 


INDEX. 


539 


Gas,  combustion  of,  effects  on  health,   i. 

126 
G-aseous  substances  in  air,  i.  121 
Gases  in  water,  i.  75,  76 

in  water,  effects  of  organic  matter  on, 

i.  75 
in    water,     Frankland's     method    of 

analysis,  i.  76 
in    water,    Macnamara's    method    of 

analysis,  i.  76 
in  water,  reasons  for  suspicion,  i.  81 
Gauge,  rain,  ii.  112 
Gelatin  and  chondrin,  i.  208,  212,  217 

value  as  food,  i.  212,  217 
General  diseases,  ii.  288 
Geological    formation,     influence    of,    on 

drinking-water,  i.  24 
Geological  terms,  i.  365 
Gerardin  on  lustre  of  water,  i.  67 
German  soldier,  equipment  of,  ii.  248 
soldier,  rations  of,  ii.  231 
soldier,  steps  in  marching,  length  of, 
ii.  260 
Gibb  on  effects  of  sewage -poisoned  water, 

i.  43 
Gibraltar,  ii.  293 

water  supply,  i.  12 
"Gid,"  -'sturdy,"  or  "turnsick,"  i.  228 
Glaisher's  factors,  ii.  104 
Glanders  and  farcy  in  horses,  i.  238 
Glasgow,  Leech  on  hard  water  in,  i.  42 
Glengarry  cap,  ii.  238 
Globulin,  i.  208 

Glutin  in  flour,  determination  of,  i.  243 
Godwin  on  diet  of  Hindu,  ii.  234 

on  Indian  flour,  i.  263 
Goitre,  i.  61 

in  France  and  Italy,  i.  61 
in  India,  i.  61 
in  Switzerland,  i.  62 
Gold  chloride  as  a  test  for  organic  matter 

in  water,  i.  78 
Gonorrhoea,  see  Venereal  Diseases. 
Gore  on  diarrhoea  at  Bulama,  i.  43 
Gouldsbury,  Surg.-Major  V.,  C.M.G. ,  puri- 
fication of  water  in  Ashanti,  i.  32 
Goux  system  of  sewage,  ii.  46 
Graham  on  lead-poisoning,  i.  18 

on   protective   influence   of   carbonic 
acid  in  water  against  lead,  i.  18 
Grains  in  order  of  richness,  i.  270 
"  Grains  of  paradise,"  i.  299 
Gram  (kind  of  pea),  i.  271 
Grammes   per    litre,    conversion  .of,    into 
grains  per  gallon,    i.    83 ;     and  Appen- 
dix B,  ii.  386 
Grange  on  goitre,  i.  61 
Granite,  disintegrated  or  "weathered,"  ef- 
fects of,  i.  359 
Granitic  water,  i.  25 
Graphic  representation,  ii.  190 
Gravel  strata,  water  from,  i.  25 
Graves,  disinfection  of,  ii.  126 
Graveyards,  air  of,  effects  of,  i.  154 
water  from,  i.  27 


Great-coat  and  cloak,  ii.  242 

Greenhow  on  diseases  of  operatives,  i.  134 

on  sewer  gases  in  water,  i.  44 
Grenelle,  well  of,  i.  27 
Griesinger  on  bilharzia,  i.  64 
Griess's  test  for  nitrous  acid,  i.  93 
Ground-water,  i.  349,  350 

and  cholera,  i.  353,  354 

and  enteric  fever,  i.  352 

measurement  of,  i.  354 
Grosz  on  marsh-water  in  Hungary,  i.  49 
Grouven's  experiments  on  cattle,  i.  206 
Guard-room,  ii.  207 
Guinea-worm,  i.  64 

at  Cape  Coast  Castle,  ii.  324 

in  water,  i.  73 
Gully  trap,  ii.  26 

Giiuther  on  cholera  in  Saxony,  i.  55 
Gutta-percha  pipes,  i.  19 
Gymnasium,  duties  of  medical  ofi&cer  in. 

ii.  256 
Gymnastic  exercises,  ii.  254 

Habitations,  ii.  1 

conditions  for  insuring  healthy,  ii.  2 
dryness  of,  essential,  ii.  2,  3 
Haemoptysis  simulated  by  leeches  in  the 

pharynx,  i.  64 
Haine's  patent  tin-lined  pipe,  i.  18 
Hair  dyes,  effects  of,  ii.  121 
Hales'  bellows  for  ventilation,  i.  189 
Hall,  Sir  John,  on  alcohol,  i.  321 
Halliday,  Sir  A.,  on  dysentery  in  Barba- 

does,  ii.  313 
HaUier,  Professor,  his  views  on  fungi  in 

air,  i.  137 
Hardness  of  water,  fixed,  i.  87 
of  water,  total,  i.  86 
of  water  stated  in  metrical  degrees, 

i.  87 
of  water  sufficient  to  affect  some  per- 
sons, i.  42 
Hard  water,  effects  on  horses,  i.  42 
Harley,  J. ,  on  bilharzia,  i.  64 
Harmattan  wind,  effect  on  small-pox,  iL 

88 
Hart,  Ernest,  on  milk  epidemics,  i.  285 
Harvey  on  coal  gas  in  water,  i.  29 
Hassall  on  paramecia  in   Thames  water, 
i.  72 
on  Thames  water,  i.  70 
Haughton  on  calculation  of  work,  ii.  70 
71,  72 
on  muscular  action,  i.  205 
Hay  fever,  cause  of.  i.  13J 
Head  dress  of  the  soldier,  ii.  238 
Health   of   towns,    commission   on   water 

supply,  i.  39 
Heart  and  vessels,  diseases  of,  ii.  279 
effect  of  alcohol  on,  i.  312 
effect  of  exercise  on,  ii.  63 
Heart,  work  of,  ii.  71 
Heat,  absorption  of,  by  soil,  i.  357 
convection  of,  ii.  56 
effects  of,  on  digestion,  ii.  86 


540 


INDEX. 


Heat,  effects  of,  on  heart's  action,  ii.  86 

effects  of,  on  nervous  system,  ii.  8G 

effects  of,  on  respiration,  ii.  85 

effects  of,  on  skin,  ii.  8(i 

effects  of,  on  urine,  ii.  86 

in  shade,  ii.  84 
Heating  by  hot-water  pipes,  ii.  57 

by  steam,  ii.  57 
Height,  approximate,  by  barometer  table, 

ii.  110 
Heights,  measurement  of,  ii.  108,  109 
Heisch  on  fungi  in  water,  i.  72 
Helmets  of  cavalry,  ii.  239 

of  infantry,  ii.  238 

wicker,  etc.,  for  India,  ii.  239 
Hepatic  disease  at  Jamaica,  ii.  809 

at  Malta,  ii.  301 

disease  at  the  Mauritius,  ii.  327 

disease  in  India,  ii.  146 
Herbage,  effects  of,  i.  350 
HerscheFs   formuliB   for    mean   tempera- 
tures, ii.  100 
HiU  climates  of  India  for  phthisis,  ii.  356 

stations  in  India,  ii.  339 
Hille's  process  for  sewage,  ii.  180 
Hills  in  India,  advantages  of,  for  troops, 

ii.  339 
Hippocrates  on  effects  of  marsh-water,  i. 
47 

on  impure  drinking-water,  i.  61 

on  moderation,  ii.  120 
Hirt  on  diseases  of  workmen,  i.  133 
Hof  mann  on  carbonic  acid  in  water  as  pro- 
tection against  lead,  i.  18 
Holden  on  ague  on  board  .'^hip,  i.  364     " 
Home,  Sir  A.  D.,  on  Crease's  filters,  i.  39 
Honduras,  ii.  316 
Hong-Kong  and  Cowloon,  ii.  359 
Hood  on  hot-water  heating,  ii.  57 
Hooghly  water,   difficulties  in  filtering,  i. 

33 
Hoppe-Seyler  on  casein,  i.  278 
Horses,  effects  of  hard  water  on,  i.  42 

water  required  for,  i.6 
Hospital  furniture  to  be  reduced  to  a  mini- 
mum, ii.  9 

gangrene  through  impure  air,  i.  138 

marquee,  cubic  space  of,  i.  193 

ships,  ii.  362 

tents,  ii.  218,  375 

ventilation,  Dr.  Parkes'  plan,  ii.  11 

walls  to  be  impermeable,  ii.  9 

wards,  plans  of,  ii.  10 
Hospitals,  ii.  6 

arrangement  of  water-closets  in,  ii.  10 

contamination  of  air  of,  ii.  6 

essentials  for  medical  treatment,  ii.  10 

field,  ii.  373,  374 

for  infectious  diseases,  ii.  14 

general,  ii.  373 

intermediate,  ii.  374 

in  the  tropics,  iL  14 

memorandum  on,  from  Privy  Council, 
ii.  15 

in  war,  ii.  373 


Hospitals,  in  war,  materials  and  construc- 
tion of,  ii.  375 

in  war,  position  of,  ii.  375 

military,  parts  of,  ii.  375 

ventilation  of,  ii.  15 

pavilion,  plans  of,  ii.  13,  14 

water  supply  for,  i.  7 
House,  method  of  examining,  ii.  3 

pipes  and  drains,  ii.  22 
Houses,  warming  of,  ii.  54 
Howard's  nomenclature  of  clouds,  ii.  116 
Humidity,  ii.  S7,  103 

amount  most  agreeable,  ii.  88 

in  India,  ii.  336 

of  air,  i.  163  ;  ii.  103-105 
Hurdwar,  outbreak  of  cholera  at,  i.  55 
Huts,  war,  ii.  216 

wattle,  ii.  224 

wooden,  ii.  216 

wooden,  causes  of  unhealthiness   in, 
ii.  217 
Huxley  on  the  chocolate  moth,  i.  249 
Huyshe  on  alcohol,  i   322 
Hydrochloric  acid  vapors,  i.  141 
Hydrogen  in  articles  of  diet,  i.  215 

sulphide,  effects  of,  in  air,  i.  139 

sulphide,  in  air,  i.  200 

sulphide,  in  soil  air,  i.  346 

sulphide,  in  water,  causing  diarrhoea, 
i.  43,  44 

sulphide,  tests  for,  i.  70 
Hydrometers,  i.  275 
Hydrozoa  in  water,  i.  73 
Hygienic  classification  of  drinking-waters, 
i.  103-106 

management,  individual,  ii.  120 
Hygrometer,  Daniell's,  ii.  lOS 

Dines',  ii.  103 

Mason's,  ii.  103 

Reguault's,  ii.  103 

Saussure's.  ii.  103 

Wolpert's,  ii.  103 
Hygrometers,  ii.  103 
Hypocaust,  ii.  59 

Ic  E  and  snow,  as  source  of  water,  i.  21 
Impure  water,  chief  ingredients,  i.  41 
Impurities,  origin  of,  in  drinking-water,  i. 

23 
Ilex  paragnayeusis,  i.  327 
India,  ii.  332 

causes  of  mortality  in.  ii.  347 

diseases  of  natives,  ii.  842 

effects  of  climate  of,  ii.  .338 

effects  of  marsh  water  in,  i.  47 

ground  water  in,  i.  350 

habits  and  customs  of  the  troops  in, 
ii.  343 

health  of  the  troops  in,  ii.  346 

invaliding  in.  ii.  356 

loss  of  service  in.  ii.  356 

mortality  according  to  service  in,  ii. 
349 

mortality  compared  with  home,  ii.  348 

mortality  in,  ii.  346 


I2^DEX. 


541 


India,  mortality  of  native  troops,  ii.  358 

mortality  of  officers  in.  ii.  o48 

soldiers'  rations  in,  ii.  8M 

use  of  alcotLol  in,  ii.  346 

barracks,  ii.  210 

corn  flour,  I  2o0,  269 

Sanitary    Commission,    recommenda- 
tions of,  ii  211 

statistics,  ii.  346 
Individual  hy^enic  management,  ii.  120   • 
Infantry  barracks,  ii.  203 

kit,  weight  of,  ii.  246 
Infectious  diseases,  hospitals  for,  ii.  14 
Infusoria  in  water,  i.  41 
Inlets  and  outlets  for  air,  position  of,  i.  177 

size  of,  i.  177 
Insolation,  ii.  148 

prevention  of,  ii.  148 
Insufficient  supply  of  water,  i.  41 
Intemperance,  Xeison's  statistics  of,  i.  307 
Invaliding  in  the  army,  ii.  285 
Iodide  of  potassium  and  starch  as  a  test 
for  nitrous  acid.  i.  77 

of  potassium  and  starch,  preparation 
of,  ii.  384 
Iodine  as  an  air  purifier,  ii.  171 
Iron  barracks,  unsuitable  for  tropics,  ii.  212 

cisterns,  i.  13 

in  water,  i.  78 

in  water,  determination,  i.  98 

in  water,  effects  of,  i.  42 

perchloride  used  for  sewage,  ii.  35 

spongy,  as  a  filter,  i.  35,  38 

sulphate  as  a  test  for  nitric  acid,  i.  77 
Irrigation  with  sewage  water,  ii.  37 
Irvine  on  effects  of  Lathyrus  sativus.  i.  271 
Isocheimonal  lines,  rarely  used,  ii.  102 
Isotheral  lines,  rarely  used,  ii.  102 
Isothermal  hues,  ii.  102 

Jagek  on  cholera  from  water  in  HoUand, 

i.  54,  55 
Jamaica,  ii.  307 

dysentery  in,  from  impure  water,  i.  45 
Jatropha  manihot,  i.  272 
Jenning's  air-brick,  ii.  3 
Johnston  on  ciu'e  of  goitre  in  Durham  jail 

by  a  pure  water  supply,  i.  61 
Jourdanet  on  effect  of  altitudes  on  phthi- 
sis, ii.  91 
on  Mexico,  ii.  90 
Jowree,  a  kind  of  millet,  i.  270 
Jute,  ii.  77 

Kala  kangni,  a  kind  of  millet,  i.  270 
Kansas,  effects  of  water  of  the,  i.  42 
Kassaree-dholl,  a  poisonous  vetch,  i.  267, 

271 
Keratin  or  elastin,  i.  234,  208 
Kerona,  i.  72 
Kingston,  Canada,  ii.  318 
Kit,  articles  of,  for  infantry,  ii.  236 

issued  in  hot  and  cold  climates,  ii.  236, 
237 

issued  on  active  service,  ii.  236 


Kit,  cavalry,  ii.  244 
service,  ii.  245 
surplus,  ii.  245 

Kitchens,  ii.  207 

Klebs  and  Tommasi-Crudeli  on  the  cause 
of  ague,  ii.  129 

Knapsack  abolished,  ii.  252 

Kolpoda,  i.  72 

Konig,  analyses  of  foods,  i.  213 

Koumiss,  i.  277 

Kumaon,  goitre  in,  i.  62 

Kurrachee,  fever  in,  from  excessive  rain- 
fall, i.  351.  352 

Kuskus  tatties,  ii.  215 

Lactic  acid  in  beer,  i.  294,  296 

acid  formed  in  milk,  i.  278 
Lactin.  i.  204,  209.  277,  278.  281 
Lactoprotein.  3Iilton  on,  i.  277 
Lancisi  on  marsh  water,  i.  47 
'■  Lamb's  quarter,"  i.  276 
Landes,  water  of,  i.  25 

water  of,  producing  fever,  i.  48 
Leplace's  formula  for  heights,  ii.  109 
Lariboisiere  hospital,  ventilation  of,  i.  186 
Larrey,  Baron  H. ,  on  military  hospitals,  ii. 

376 
Lathyrus    sativus   and    cicera,   poisonous 

vetches,  i.  267.  271 
Latitude,  correction  for,  ii.  Ill 
Latrines,  ii  208 

water,  i.  5 
Lauder  Lindsay,  action  of  hard  water  on 

lead,  i  18 
Laundry,  establishment  in  war  hospitals, 

ii'377 
Laurier  rose,  for  purifying  water,  i.  32 
Laws  and  Gilbert  on  origin  of  fat.  i,  206 
Lawson's  table  of  diseases  of  the  circula- 

latory  organs,  ii.  280 
Lead   acted   on   by   galvanic   currents   in 
presence  of  other  metals,  i.  17,  18 

amount  of,  that  will  poison,  i.  18 

action  of  water  on,  i.  17 

action  on,  by   various   substances   in 
water,  i.  18 

as  a  test  for  SH-;,  i.  78 

in  flour,  i.  267 

in  water,  i.  17-19 

tests  for.  i.  78 

nitrate,  ii.  181 

pipes,  protection  of.  i.  17 

poisoning  through  water,  i.  65 

salts  as  tests  for  SHo,  in  water,  i  78 

sulphide      lining      for      lead      pipes 
(Schwartz's),  i.  19 
Leaden  cisterns,  bad.  i  13 
Leather,  choice  of.  ii.  78 
Ledoyen's  fluid,  ii  181 
Leeches  in  water,  i  64,  73 
Leech  on  hard  water  in  Glasgow,  i.  42 
Leggings  and  gaiters,  ii.  241 
Leguminos^.  i.  271 
Lemaire  on  minute  cells  in  air,  i.  117 
Lemna  in  water,  i  12 


542 


INDEX. 


Lemou  and  lime  juice,  i.  342 
Lemon  juice,  factitious,  i.  344 

juice,  substitutes  for,  i.  344 

juice,  use  of,  i.  344 
Lempriere    on    dysentery    from     impure 

water,  i.  45 
Letheby  on  air  of  sewers,  i.  128 

on  cholera  outbreaks,  i.  54 

on  sulphur  fumigation,  ii.  174 

on  typhoid  fever  from  sewer  irriga- 
tion, ii.  40 
Leuckart  on  ascarides'  eggs  in  water,  i.  G3 
Lewis  and  Cunningham  on  ground  water 
and  cholera  in  Calcutta,  i.  354 

on  soil  air,  i.  346 
Lex  on  bacteria  in  water,  i.  71 
Lias  clays,  water  from,  i.  25 
Liebig's  extractum  carnis,  i.  291 
Liebig  on  salt  meat,  i.  214 
Liernur's  pneumatic  system  of  sewerage, 

ii.  51 
Light,  effects  of,  ii.  95 
Lights,  amount  of  air  required  for,  i.  162 
Liharzik  on  the  recruit,  ii.  197 
Lime,  determination  of,  by  soap-test,  i.  88 

by  weight,  in  water,  i.  89 

in  water,  i.  77 

in  water,  inferences  from,  i.  80 

Bulphate  in  water,  effects  of,  i.  44 

water  as  a  test  for  COo,  i.  198 

water,  causticity  of,  i.  198 

water,  for  purifying  water,  i.  31 
Lime  juice,  i.  342 

examination  of,  i.  343 
Limestone  waters,  i.  26 
Lind  on  purification  of  water,  i.  30 
Linen,  characters  of,  ii.  75 
Lining  of  wells,  i.  13 
Linseed,  detection  of,  i.  255 
Lister's  method,  advantages  of,  ii.  163 
Litmus  as  a  reagent,  i.  77 
Liver  diseases,  prevention  of,  ii.  146 
Liverpool,  effects  of  hard  water  in,  i.  42 
Local  diseases,  ii.  295 
Locality,  examination  of,  for  military  pur- 
poses, i.  367 
Lodging-houses,  model,  water  used  in,  i.4 
Lolium  temulentum.  darnel  grass,  i.  257 
London  Water  Companies'  filtration,    i.  33 
Longmore,  Professor,  on  war  hospitals,  ii. 
373 

on  insolation,  ii.  66 
Loose  sand,  water  from,  i.  25 
Loss   of  strength  per  1,000   in   army   at 

home,  ii.  271 
Lowe's  ozone  papers,  ii.  117 
Ludwig  on  effects  of  heat,  ii.  85 
Lueder  and  Leidloff's  powder,  ii.  181 
Lumbricus  from  water,  i.  63 
Lung  diseases,  produced  by  impure  air,  i. 

142 
Lungs,  effect  of  exercise  on,  ii.  60 

weight  of,  in  Europeans  in  India,  ii.  86 

Maas,  effects  of  water  of  the,  i.  43 


Macadam,  Stevenson,  on  influence  of  im- 
pure water,  i.  55 
Macaroni,  i.  260 

M'CleJlan  on  goitre  in  Kumaon,  i.  61,  62 
Macdonald,  J.  D. ,  on  structure  of  tea-leaf, 
i.  334 

on  microscopic  examination  of  water, 
i.  69 

plate  of  suspended  matters  in  air,  i. 
118,  120 

table  of  starches,  i.  273,  274 
M'Dougall's  carbolic  acid  powder,  ii.  49 
Macfarlane's  latrine,  ii.  45 
M'Grigor,  Sir  James,  on  dysentery  in  Pe- 
ninsula, i.  46 

on  alcohol  in  war,  i.  320 
M'Kinnell's  ventilator,  i.  181 
Maclaren  on  gymnastics,  ii.  255 
Maclean,  Professor,  on  insolation,  ii.  148 
Macnamara  on  cholera  in  India,  i.  56,  58 

his   scheme    for  analysis   of    potable 
water,  i.  76 
Macpherson's  table  of  bill  stations,  ii.  341 
Maddox  on  spores  in  air,  i.  117 
Madras  water  supply,  i.  7 
"Magazine  accoutrements,"  ii.  253 
Magnesia,  determination  of,  by  soap-test, 
i.  88 

forming  double  salts  with  soap,  i.  86 

in  water,  by  weight,  i.  89 

tests  for,  i.  79 

producing  goitre,  i.  61 

required  in  food,  i.  207,  209 
Magnesian  limestone  waters,  i.  26 

salts,  effects  of,  in  water,  i.  42 
Magnesium  chloride,  effects  of,  i.  43 

sulphate  in  water,  effects  of,  i.  43 
Magnetic  carbide  filter,  i.  36 

declination,  ii.  115 
Maha  murree,  or  Pali  plague,  ii.  140,  342 
Maida  ( flour  i.  i.  262 
Main  pipes  for  water,  i.  15 
Maize,  or  Indian  corn,  i.  250,  269 
Malaria,  ii.  94 

effects  of  elevation  on,  ii.  130,  340 

effects  of  vertical  ascent  in  avoiding, 
ii.  94 

range  of  horizontal  spread,  ii.  94 

spread  over  water,  ii.  95 
Malarious  fevers,  from  water,  i.  21,  47 

soils,  i.  362 
Malic  acid  in  scurvy,  ii.  150 
Malignant  pustule  in  animals,  i.  228,  235 
Malta,  ii.  29S. 

water  supply  in,  i.  12 
Manihot  arrowroot,  i.  272 
Mann,  Dr. ,  on  alcohol,  i.  321 
Manometer,  Fletcher's,  i.  195 

Peclet's  and  Sanderson's,  i.  195 
Manure  manufactories,  effects  of,  L  153 
Maranta  arundinacea,  i.  272 
March,  order  of,  ii.  264 
Marches,  ii.  2.")8 

conditions  adding  to  fatigue  of,  ii.  261 

during  war,  ii.  261 


INDEX. 


543 


Marches,  duties  of  medical  officers  during, 
ii.  266 

effects  of,  ii.  264 

length  of,  ii.  261 

supply  of  water  during,  i.  108 
Marching  in  Canada,  ii.  269 

in  India,  ii.  268 

length  of  step  in,  ii.  259 
Marcker  on  the  amount  of  air  required  for 

animals,  i.  162 
Marquee,  hospital,  ii.  219 

cubic  contents  of,  i.  193 

officers',  ii.  219 
Married  soldiers'  quarters,  ii.  206 
Marsh  water,  i.  26 

apparently  harmless  in  Holland,  i.  49 

in  Hungary,  i.  49 

effects  of.  at  Tilbury  Fort,  i.  49 
Marshall,  John,  on  cholera  from  drinking 

water,  i.  54 
Marshall  on  views  of  Singalese  on  marsh 

water,  i,  47 
Marshes,  i.  362 

air  of,  i.  131 

salt,  i.  26 
Martin,  Sir  Ranald,  on  iron  soils,  i.  363 
Materials  for  building,  ii.  212 
Mauritius,  ii.  327 

and  Jamaica  contrasted,  ii.  337-330 
Maury  on  effects  of  evaporation,  ii.  115 
Mean,  arithmetical,  ii.  188 

duration  of  illness,  ii.  287 

temperature,  Mr.  Glaisher's  tables  for, 
ii.  100 
Mean  Meer,  causes  of  its  unhealthiness,  ii. 

354 
Means,  successive,  ii.  188 
Measle  in  pigs,  i.  229,  237 
Measles,  disinfection  in,  ii.  176 

Dr.  Salisbury's  statements,  i.  136 
Measures  of  soap  solution,  i.  86 
Meat,  analysis  of,  i.  212,  213,  225 

biscuits,  i.  292 

cooking  of,  i.  238 

dead,  inspection  of,  i.  229 

decomposing,   poisonous  effects  of,  i. 
233,  234 

diseases  arising  from,  i.  233 

dried,  M'<:airs,  i.  290 

flour  of.  Hassairs,  i.  290 

from  inflammatory  disease,  i.  234 

preservation  of,  i.  240 
Medicines,  effects  of,  in  flesh  of  animals, 

i.  238 
Mediterranean  stations,  ii.  293 

stations,  ventilation  of  barracks  in,  i. 
183 
Medlock  on  the  action  of  water  on  lead,  i. 
17 

on  water  purification,  i.  32 
Mege  Nouries,  plan  for  utilizing  bran,  i. 

243 
Meinert  on  food,  i.  221 
Melampyrum  arvense,  1.  256 
Mental  work,  amount  of,  ii.  133 


Merchant  Shipping  Act,  i.  343 
Mercury  poisoning  through  water,  i.  65 
Merthyr  Tydvil,  sewage  tiltration  at,  ii.  36 
Metals  in  water,  cause   for   condemning 

water,  i.  101 
Metallic  impregnation  of  water,  i.  45 
Metamorphic  strata,  water  from,  i.  25 
Meteorological  instruments,  reading  of,  ii. 
96 

observations,  official  instructions  for 
taking.  iL  96 
Meteorology,  ii.  96 
Metropolis  Water  Act,  1871,  i.  15 
Mexican  war,  effects  of  im^jure  water  in, 

i44 
Mica,  scales  of,  in  water,  causing  diarrhoea, 

i.  43 
Microphytes  in  air  of  marshes,  1.  132 
Microscopic  plants  in  rain  water,  i.  21 
Microscopical  characters  of  drinking  wal  er, 

i.  69,  70,  10^-106 
Microzyme  test  for  water,  i.  71 
Microzymes  in  air,  i.  116-118 

in  water,  i.  41 
Middleton  on  effects  of  drying  soil,  i.  351 
Midfeather  traps,  ii.  24 
Military  service,  effects  of,  ii  270 
Milk,  adulterations  of,  i.  283 

alterations  in,  i.  378 

as  a  diet,  i.  377 

as  a  vehicle  of  disease,  i.  284,  285 

ass's,  i.  277 

bad  effects  of,  i.  383 

blue,  i.  284 

chemical  analysis  of,  i.  279 

composition  of,  i  213 

concentrated,  i.  293 

cow's,  i.  377 

dried,  i.  293 

examination  of,  i.  279 

from  diseased  cows,  i.  278 

preservation  of,  i.  283 

microscopical  examination  of,  i.  281 

sickness,  i.  285 

specific  gravity  of,  i.  379 
Millbank  Prison,  fever  in,  i.  51 
MiUer  on  carbonic  acid  in  water  as  protec- 
tion against  lead,  i.  18 

on  gases  in  water,  i.  75 
Millet,  i.  256,  270 
Millstone  grit,  water  from,  i.  25 
Mineral  matters  dissolved  in  water,  i.  44 
Mineral  matter  of  water  sediment,  deter« 
mination  of,  i.  74 

substances  in  water,  i.  41 
Miner's  phthisis,  i.  133,  134 
Mines,  air  from,  i.  133 

ventilation  of,  i.  184  . 
Mississippi,  effects  of  water  of  the,  1.  42 
Missouri,  effects  of  water  of  the.  i.  42 
Model  lodging-houses,  water  used  in,  i.  4 
Moffat  on  ozone,  ii.  93 
Moffat's  ozone  papers,  ii.  117 
Mohr's  process  for  carbonates,  i.  98 
Moina  in  water,  i.  73 


544 


INDEX. 


Moleschott  on  diet,  i.  210 

Molybdate  of  ammonium  as  test  for  phoB- 

phoric  acid  in  water,  i.  71),  97 
Monads  in  air,  i.  IIG 

in  water,  i.  71 
"  Monkey  "  for  tube-well,  i.  8 
Montgolfier's    formula,    table    calculated 
from,  i.  194 
rule  of.  i.  172 
Montreal,  ii.  318 
Moor  water,  1.  26 
Moore  on  marsh  water,  i.  47 
Morgan,  Professor,  method  of  salting  meat, 

i.  22G 
Morin,  General,  on  quantity  of  fresh  air 
required,  i.  158 
on  ventilation,  i.  186 
Mortality,  causes  of,  ii.  273 
influence  of  age  on,  ii.  274 
of  army,  compared  with  civil  popula- 
tion, ii.  274 
to  sickness,  ii.  287 
Mortar,  for  cisterns,  etc.,  should  be  hy- 
draulic, 1.  13 
Moscati,  his  examination  of  air,  i.  20 
Mo.sler  on  ascarides'  eggs  in  water,  i.  63 
on  effects  of  deficient  water  supply,  i. 
40 
Moss,  his  examination  of  air,  1.  124 
Mouat  on  purification  of  water,  i.  32 
Moule's  earth  closets,  ii.  47 
Mud,  Thames,  action  of,  on  lead,  i.  17 
Mules,  water  required  for,  1.  6 
Miiller  on  enteric  fever  from  water,  i.  50 
Miiller  on  trimethylamine  in  well  water,  i. 

28 
Miiller- Schiir  deodorant,  ii.  49,  183 
Munro,  Donald,  on  dysentery  from  impure 

water,  i.  45 
Murchison  on  enteric  fever  among  sewer 

mpn,  i.  150 
Murha  or  Maud,  kind  of  millet,  i.  270 
Murray  on  water  of  Newcastle  and  calculi, 

i.  60 
Muscles,  changes  of,  during   exercise,  ii. 
66 
exhaustion  of,  during  exercise,  ii.  68 
Muscular  action,  i.  205 
Mustard,  i.  339 
Myosin,  i.  204,  208 

Neill  on  alcohol  in  New  Zealand  war,  i. 

322 
Nerium  olean  er  for  purifying  water,  i.  32 
Nervous  diseases,  ii.  282 
Nessler's  solution  as  a  test  for  ammonia,  i. 
77,  91 
preparation  of,  ii.  881 
Nesslerizing,  i.  91 
Netley  Abbey,  water  from,  !.  25 
Neva,  effects  of  water  of  the,  i.  43 
Newera  Ellia.  ii.  331 
Nichols  on  soil  air,  i.  346 
Nicholson's  soap  solution,  i.  86  ;  ii.  380' 
Nightingale,  Miss,  notes  on  hospitals,  ii.  6 


Nimbus  or  rain  cloud,  ii.  117 
Nitrate  of  lime  causing  diarrhoea,  i.  44 
Nitrates  and  nitrites  in  water,  inferences 
from,  i.  80 
effects  of,  on  metals,  i.  45 
in  water,  action  on  lead.  i.  17 
Nitre  soils,  water  from,  i.  28 
Nitric  acid  in  water,  i.  77 
determination,  i.  93 
inferences  from,  i.  80 
Nitrites  in  water,  action  on  lead,  i.  17 
Nitrogen,  amount  of,  in  food,  i.  215,  216 
in  articles  of  diet,  i.  215 
in  meat,  analysis,  i.  215 
gas,  in  water,  i.  75 
organic,  in  water,  i.  82 
percentage  of,  in  nitrogenous  aliments, 

i.  204 
the    elimination    of,    during   exercise 
and  rest,  ii.  65 
Nitrogenous     and     non-nitrogenous     sub- 
stances, distinction  between,  i.  204 
matter  in  air,  determination  of,  i.  199 
Nitro-prusside  of  sodium  as  test  for  soluble 

sulphides,  i.  78 
Nitrous  acid  as  air  purifier,  ii.  171 

in  solids  of  water,  determination  of,  i. 

93,  94 
in  water,  i.  7/ 

in  water,  inferences  from,  i.  79 
Normandy's  apparatus  for  distilling  water, 

i.  23 
Norton's  tube-wells,  i.  8,  107 
Notonecta  glauea  in  water,  i.  74 
Notter  on  filtration,  i.  34 
Nutrition  of   body,  circumstances   affect- 
ing, ii.  120 

Oakes  on  dysentery  at  Cape  Coast  Castle, 

i.  45 
Oats,  drawings  of,  i.  255 

as  a  food,  i.  268 
Obernier  on  heatstroke,  ii.  85 
Occupation  for  soldiers,  advantages  of,  ii. 

291,  292 
Odling  on  ozone,  ii.  93 
Oidium  aarantiacum,  ii.  166 

lactis,  i.  281 
Oil,  air  required  for  its  combustion,  i.  1C2 
Oliver's    "Magazine   Accoutrements,"   ii. 

253 
Onobrychis  sativa,  i.  257 
Oolite,  water  from.  i.  25 
Open  conduits  for  water,  i.  28 
Operatives,  diseases  of,  i.  133-136 
Ophthalmia,    military,  prevention  of,    ii. 

153 
Ordinates,  ii.  189 

Organic  carbon  in  water,  i.  82,  83,  96 
matter  in  air,  i.  119 
matter,  dissolved,  in  water,  i.  43 
matter  in  water,  143 
matter  in  water,  Frankland's  method, 

i.  82 
matter  in  water,  inferences  from,  i.  80 


INDEX. 


545 


Organic  matter  in  water,  plans  for  its  de- 
termination, i.  82 
matter  in  water,  Wanklyn's  method, 

i.  82,  83,  91,  92 
matter  of  sediment  of  water,  deter- 
mination of,  i.  74 
matter,  oxidizable,  in  water,  tests  for 

i.  78 
nitrogen  in  water,  i.  83 
Organisms  in  air,  i.  116,  117,  118,  119, 120, 

121 
Organisms  in  water,  i.  70-74 
Orizaba,  impure  water  at,  i.  44 
Orsborn,  Dr..  cases    of   zinc-poisoning,    i. 

13 
O'Shaughnessy  on  Strychnos  potatorum,  i. 

32 
Outlets  for  air,  position  of,  i.  177 
for  air,  plans  of  shafts,  i.  178 
for  air,    with    and   without    artificial 
heat,  i.  178,  179 
Overflow  pipes  of  cisterns,  i.  13 
Oxalate  of  ammoaium  as  a  test  for  lime, 

i.  77 
Oxalic  acid  as  a  test  for  lime  water,  i.  198 

solutions,  preparation  of,  ii.  383 
Oxen,  water  required  for,  i.  6 
Oxford  boat-race,  work  done  in,  ii.  73 
Oxidizable  matter  in  air,  i.  200 
in  water,  i.  41 

in  water,  determination,  i.  94 
Oxygen,  absorption  of,  during  exercise,  ii. 
61 
diminution  of,  at  altitudes,  ii.  90 
in  soil  air,  i.  346 
in  water,  i.  75 
Oxytricha  lingua,  i.  72 
Ozone,  ii.  93,  117 

as  air  purifier,  ii.  170 
effects  of,  ii.  93 

modes  of  estimating,  ii.  117,  118 
observations,  fallacies   attending,    ii. 
118 

"  Patn  biscuite,"  i.  263 

"  Pain  de  munition,"  i.  263 

Pali  plague,  ii.  140 

Palmer  on  river  water  in  India,  i.  28 

Panicum  miliaceum  (millet),  i.  270 

Paramecia  in  water,  Hassall  on,  i.  72 

Paramecium,  i.  72 

Parent-Duchatelet  on  Paris  water,  i.  40 

on  sewer  air,  i.  147 
Parkes'  measurements  of  water,  i.  4 

on  asoaris  at  Moulmein,  i.   83 

on  cholera  at  Southampton,  i.  54 
Paroxysmal  fever,  prevention  of,  ii.  129 

fever,  effects  of  soil  water  on,  i.  351 
Passions,  regulation  of,  ii.  122 
Pasteur's  fluid,  i.  71 
Pattison  Muir  on  the  action  of  water  on 

lead,  i.  18 
Pavy  on  effects  of  exercise,  ii.  64 
Payne   on  diminution  of  cholera  at  Cal- 
cutta, i.  58 

Vol.  II.— 35 


Pea  and  bean,  i.  251 

drawings  of,  i.  254 
Pea  sausage,  i.  292 
Peas,  i.  213,  271 

India,  i.  271 
Peat  charcoal  as  filter,  i.  35 
Pectin,  i.  204 
Pellagra,  i.  269 
Pellischek  on  darnel,  i.  258 
Pemmican,  i.  291 

analysis  of,  i.  213 
Penicillaria  spicata,  1.  370 

glaucum,  ii.  166 

lactis,  i.  284 
Pentonville  Prison,  air  of  i.  123,  165 
Pepper,  i.  341 

drawings  of,  i.  341,  342 
Perchloride  of  iron  for  purifying  water,  i. 

31 
Perkin's  system  of  heating,  ii.  57 
Permanganate  of  potassium  for  cleansing 
filters,  i.  38 

for  purifying  water,  i.  31 

method  for  organic  matter,  i.  82,  83 

standard  solution,  ii.  381 

with  alkali,  Schultze  and  Lex,  i.  97 
Pettenkofer  and  Voit  on  diet,  i.  205 

on  effects  of  exercise,  ii.  61 
Pettenkofer  on  COj  exhaled  by  men,  i.  158 

on  cholera  at  Munich,  i.  55 

on  ground  water,  i.  350 

on  ground  water  as  a  cause  of  typhoid 
fever  and  cholera,  i.  352,  353 

on  effects  of  subsoil  drainage,  i.  352 

on  measurement  of  ground  water,  i. 
354 

on  measurement  of  soil  air,  i.  347 

his  method  for  carbonic  acid,  i.  197 
Phosphate  of  calcium,  Weiske  on,  i.  207 

of  sodium,  as  a  test  for  magnesia,  i. 
79 
Phosphates  in  water,  action  on  lead,  i.  17 
Phosphoric  acid  in  water,  inferences  from 
i.  80 

in  water,  test  for.  i.  79 
Phthisis  at  Gibraltar,  ii.  296 

at  Malta,  ii.  301 

causes  of,  ii.  279 

diminished  by  drying  of  soil,  i.  35 

effect  of  altitude  upon,  ii.  91 

from  vitiated  air,  i.  142,  144 

in  India,  ii.  354 

in  European  armies,  ii.  272 

mortality  compared  with  civil  life,  ii. 
277 

pulmonalis,  prevention  of,  ii.  148 
Physical  characters  of  drinking  water,  i. 

24,  67 
Pimlico  depot  for  clothing,  ii.  235 
Pipe  filters,  i.  38 
Pipes  and  drains,  cleansing  of,  ii.  23 

and  drains,  examination  of,  ii.  27 

for  water,  i.  13 

junctions  of,  ii.  24 

water,  main-pipe,  1.  15 


546 


INDEX. 


Pipes  and  drains,  subinain,  L  15 

service,  i.  15 

materials  of,  i.  17 
Pistia  in  water,  i.  12 
Plague  arrested  by  dryness  of  air,  ii.  88 
Plague  at  Gibraltar,  ii.  295 

at  Malta,  ii.  300 

bubo,   or  oriental,  prevention  of,   ii. 
140 
Playfair  on  diet,  i.  209 

on  potential  energy,  i   217 
Pleuro-pneumonia  of  cattle,  i.  227.  235 
Plutarch  on  regulation  of  mental  work,  ii. 

122 
Pneumatic  plan  of  sewerage,  Liemur's,  ii. 

51 
Pneumonia  and  acute  bronchitis,  ii.  283 
Pneumonia  from  sewer  air,  i.   148 
Pocket  filter,  i.  108 
Poisonous  fish.  i.  233 

meat,  i.  234 
Poisson's  formula,  ii.  187 
Pole,  Dr..  on  water-supply,  i.  3 
Poles  of  heat  and  cold.  ii.  102 
Pollen  in  air,  i.  118,  136 
Polygonum  fagopyrum,  buckwheat,  i.  255 
Polyphemus  in  water,  i.  73 
Polyps  in  water,  i.  73 
Poncet  on  impure  water  in  Mexican  war. 

i.  44 
Ponies,  water  required  for.  i.  6 
Poor,  amount  of  water  used  by,  i.  4 
Portland  cement  for  cisterns,  i.  13 
Potassium  permanganate,  examination  of 
air  by,  i.  200 

examination  of  water  by.  1.  82,  94 
Potatoes,  i.  275 

cooking  of.  i.  275 

dried,  i.  292 

preservntion  of,  i.  276 

solids  of.  i.  275 

specific  gravity  of,  i.  275 
Potato  starch,  detection  of,  i.  250 
Pouchet's  aeroscope,  L  196 
Poudrette.  ii.  46 

Prague,  effects  of  impure  water  in,  i.  43 
Precipitants  of  sewage,  ii.  34 
Pressure  of  air.  increase  of,  ii.  91 

lessening  of,  ii.  89 
Previous  sewage  contamination  of  water, 

i.  80 
Prevention  of  disease,  ii.  128 
Price's  fumigating  lamp.  ii.  174 
Pringle  on  dysenteiy  from  impure  water, 

i.  45 
Prison,  amount  of  water  used  in,  i.  4 

diets.  Indian,  i.  234 

military,  sickness  in,  ii.  289 
Proof  spirit,  i.  298  ;  iL  385 
Protococci  in  water,  i.  72 
Protococcus  pluvialis,  i.  12 
Protozoa  in  water,  i.  71 
Prout  on  principles  of  diet.  i.  203 
Prussiate  of  potash  as  a  test  for  iron,  i;  77 
Psorospermia,  Rainey's  capsules,  i.  231 


Psychrometer,  iL  1C3 
PuccLnia  in  wheat,  i.  241 

in  Hour,  i.  248 
Pnebla  and  Mexico,  dryness  of  air,  ii.  90 
Pulmonary  disease  of  miners,  i.  134 
Punkahs,  i.  189  ;  ii.  214 
Pupa  forms  of  insects  m  water,  i.  74 
Purification  of  air.  ii.  169 

of  rooms,  etc.,  ii.  173 

of  water,  i.  30 
Pus  globules  in  air,  i.  121 
Pyrolusite,  used  in  filtration,  i.  35 

Qualitative    chemical    examination    of 
water,  i.  76 
tests  of  water,  inferences  from,  i.  79 
for  water,  Kubel  and  Tiemann  on,  i. 
79 
Quality  of  drinking  water,  i.  19 
Quantitative  examination  of  solids  in  wa- 
ter, i.  81  > 
te-sts  for  water,  inferences  from,  i.  98 
Quarantine  in  cholera,  ii.  134 
Quebec,  ii.  318 
Quetelet's  tables,  ii.  197 

Rabies,  meat  from  animals  with,  i.  237 

Radcliffe  on  cholera  outbreaks,  i.  54 

Radiant  heat,  ii.  56 

Radiation  from  ground,  effect  of,  ii.  83 

Radiating  grates,  ii.  56 

Rasrgy,  a  kind  of  millet,  i.  270 

Rain,  ii.  112 

calculation  of,  for  water  supply,  i.  8  ; 
ii.  387 

cloud,  ii.  117 

fall,  cause  of,  ii.  114 

excessive,  producing  fever,  i.  351 

in  different  places,  ii.  114 

in  England,  mean,  i.  9 

in  India,  ii.  336 

gauges,  ii.  103 

water  as  a  source  of  supply,  i.  21 

collection  of,  i.  8 

composition  of,  i.  20 

contamination  of.  i.  27 

impurities  in,  i.  20 
Rainey's  capsules,  Psorospermia,  i.  231 
Rainy  on  air  of  cholera  wards,  i.  120 
Ranke  on  diet.  i.  210 

on  nutrition,  i.  205 

on  quantity  of  air  required,  i.  161 
Ransom  on  heat  as  a  disinfectant,  ii.  168 
Rations  of  foreign  armies,  iL  230 

soldiers',  nutritive  value,  ii.  226 

war,  ii.  227 
Rattray  on  body  temperature,  ii.  84 

on    effects    of    heat    on   weight    and 
height,  ii.  87 
Rawlinson  on  sewer  ventilation,  ii.  31 

on  water  pipes,  i.  19 
Reaction  of  water,  i.  77 
Reaumur  scale,  ii.  U2,  386 
Recruit,  age  of.  ii.  195,  197 

height  of,  ii.  195,  197 


INDEX. 


547 


Recruit,  the,  ii.  195 

training    of,    physical,    mental,    and 
moral,  ii.   195 

weight  of,  ii.  197 
Recruits,  effects  of  gymnastic  training  on, 
ii.  257 

sickness  and  mortality  among,  ii.  200 
Red  River  Expedition,  alcohol  not  used  in, 

i.  322 
Regulations,  army,  on  water,  i.  1 

army,  on  ventilation,  i.  182 

sanitary,  i.  1 
Reid's  method  of  ventilation,  i,  185 
Relapsing  fever,  ii.  141- 
Renkioi  hut  hospital,  ii.  21G 
Reservoirs,  cleansing  of,  i.  11,  12 

materials  of,  i.  13 

for  water,  i.  12 
Resistance,  coefficient  of,  in  air  shafts,  i. 
185 

coefficient  of,  in  exercise,  ii.  72 
Respiration,  air  of,  i.  122 

air  of,  effects  of,  i.  142 

in  the  tropics,  ii.  85 
Results  of  water  analysis,  statement  of,  i. 

83,  102 
Reynolds'  manhole  and  trap,  ii.  26 
Rhamnus  theezans,  i.  333 
Rhazes  on  marsh  water,  i.  47 
Rhinanthus  major,  i.  236 
Rhizopoda  in  water,  i.  72 
Rhus  toxicodendron  gives  rise  to  poison- 
ous milk,  i.  285 
Rice,  i.  269 

fields,  effects  of,  i.  361 

structure  of,  i.  253,  255,  256 
Richardson  on  effects  of  water  in  Norfolk, 

i.  60 
Richter  on  cholera  from  water,  i.  55 

on  enteric  fever  from  water,  i.  50 
Rinderpest,  i.  228,  236 
Rio  Grande,  effects  of  water  of  the,  i.  42 
Ritchie,  plan  of  ventilation,  i.  170 
River  water,  composition  of,  i.  21 
Rivers,  i.   9 

calculation  of  yield,  1.  10 

in  India  purer  than  tanks,  i.  28 

Pollution  Act,  ii.   19 

on  results  of  irrigation,  ii.  37,  38 

on  sewer- water,  ii.  19 

report  of,  i.  3,  4 
Roasting  of  meat,  i^  239 
Robinson's  anemometer,  ii.  115 
Roll-cumulus,  ii.  117 
Roofs  of  barracks,  ii.  213 
Rooms,  purification  of,  ii.  173 
Roscoe  on  air  of  schools,  i.  122 

on  air  of  towns,  i.  130 
Rossignol  on   effects  of   calcium  salts  in 

water,  i.  60 
Roth  and  Lex  on  arsenic-poisoning  through 
water,  i.  65 

on  quantity  of  air  required,  i.  161 
Rotheln,  ii.  175 
Rotif era  (wheel  animalcules)  in  water,  i.  72 


Routh  on  cholera  in  Rupsia  in  winter,  i.  58 
on  fecal  fermentation,  i.  221 

Round-worms,  i.  63 

Rules  for  improving  healthiness  of  site,  i. 
368 
for  mensuration,  i.  192 

Russi  n  soldier,  rations  of,  ii.  233 

Rye  as  a  food,  i.  209 

detection  of,  in  flour,  i.  254 

Saddleky,  weight  of,  ii.  245 

Sago,  as  a  food,  i.  273 

Sagus  farinifera,  i.  273 

Saint-Lager  on  goitre,  i.  61 

Sainfoin,  in  flour  as  adulteration,  i.  257 

Salt,  i.  342 

Salt  beef,  analysis  of  (Girardin),  i.  212 

nutritive  value  of,  i.  214 

inspection  of,  233 
Salting  of  meat,  i.  225,  232 
Salts,  in  food,  i.  203,  204 

essential  for  food,  i.  207 

in  articles  of  diet,  i.  212,  215 

in  diets,  i.  209,  215 

of  vegetable  acids,  i.  208 
Sandals,  ii.  242 

Sanderson  on  death-point  of  bacteria,  i.  30 
Sand  filters,  i.  33 
Sand-rock,  water  from,  i.  25 
Sanitary  officer's  duties  in  war,  it  372 

regulations  on  water,  i.  1 
Sarcina  botulina,  i.  234 
Sausage,  pea,  i.  292 
Sausage-poisoning,  i.  234 
Savory  on  the  food  of  the  dog  and  the  rat, 

i.  205 
Sawee  Chennawaree,  kind  of  millet,  i.  270 
Scarlet  fever  carried  by  milk,  i.  285 

disinfection  in,  ii.  217 
Schizomycetes,  Njigeli  on,  ii.  163 
Schlesinger  on  chemical  reaction  of  fab- 
rics, ii.  74 
Schonbein  on  ozone,  ii.  93,  117 
Schonbein's  ozone  paper,  ii.  117 
Schiibler  on  retention  of  heat  in  soils,  i. 

357 
Schumacher's  formula  for  barometers,  ii. 

107 
Sclerostoma  duodenale,  i.  64 
Scolecidffi  in  water,  i.  73 
Scott  on  mean  temperature,  ii.  99 
Scott's  instructions,  ii.  108 
Scurvy,  danger  of,  in  India,  ii.  346 

grass,  i.  276 

in  war,  its  great  danger,  ii.  371,  872 

prevention  of,  ii.  150 
Sea-level,  correction  for,  ii.  108 
Sea-weed  charcoal  as  filter,  i.  35 
Sediment  of  water,  chemical  examination 

of,  i.  74 
Sedimentous  water,  means  of  purifying, 

i.  30 
Segment  of  circle,  area  of,  i.  192 
Seidel  on  probable  connection  of  fever  with 
level  of  ground  water,  i.  352 


548 


INDEX. 


Selenitic  waters,  i.  26 
Sepoy  diet.  ii.  234 
Serge  frock,  ii.  240 
Service  of  the  soldier,  ii.  195 

on  board  ship,  ii.  361 

pipes  for  water,  i.  13-15 
Setaria  Germanica,  a  kind  of  millet,  i.  270 

Italica,  a  kind  of  millet,  i.  270 
Sewage,  ABC  process  (Sillar's)  for,  ii.  35 

carbonization  of,  ii.  5U 

cement  (Scott's),  ii.  36 

comparison   of  different  methods  of 
removal  of,  ii.  53 

deodorization  of,  ii.  179 

dry  methods  of  removal  of,  ii.  45 

farms,  ii.  40 

filtration  at  Merthyr  Tydvil,  ii.  36 

filtration,  Dyke  on,  ii.  36 

Fryer's  process  of  dealing  with,  ii.  50 

interception  system  of,  ii.  43 

irrigation,  ii.  37 

irrigation,  effects  on  health,  ii.  40 

Liernur's  pneumatic  system,  ii.  51 

matter,  decomposition  of,  ii.  17 

vitiation  of  air  by,  i.  127 

precipitants,  ii.  34 

the  separate  system  of,  ii.  42 
Sewer.    See  under  Sewage  and  Sewers. 
Sewer-air,  effects  of  breathing,  i.  146 
Sewer,     emanations    from    fecal     matter 
thrown  on  the  ground,  effects  of,  i. 
152 

gases  in  water,  causing  diarrhoea,  i. 
44 

reflux  of,  prevented  by  constant  water 
supply,  i.  15 

men,  health  of,  i.  147,  148 
Sewers,  ii.  18 

access  to,  ii.  29 

air  of,  i.  127 

amount  of  water  required  for,  i.  5  ;  ii. 
21 

construction  of,  ii.  21 

discharge  from  calculation,  ii.  29 

flushing  of,  ii.  32 

influence  of,  on  health  and  death-rate, 
ii.  41 

producing  typhoid  fever,  i.  148 

inspection  of,  ii.  31 

main,  ii.  28 

objections  to,  ii.  41 

ventilation  of,  ii.  30 
Sewer-slime,  ii.  32 
Sewer- water,  composition  of,  ii.  19 

discharge    into   running    water    pro- 
hibited, ii.  33 

discharge  into  the  sea,  ii.  33 

disposal  of,  ii.  32 

microscopic  examination  of,  ii.  19 

precipitation,  ii.  34 

storage  in  tank,  with  overflow,  ii.  38 
Seymour  Haden  on  peri-shable  coffins,  ii. 

126 
Shaking-bottles  for  soap-test,  i.  86 
Shako,  ii.  238 


Shell-jacket  abolished,  ii.  240 

Shepherd,  analysis  of  Delhi  waters,  i.  60 

Sheringham  valve,  i.  180.  182 

Shield's  experiments  on  filtration,  i.  33 

Ship  filters,  i.  39 

Ships,  air  in  holds  of,  i.  132 

Shoddy,  how  recognized,  ii.  78 

Shoeburyness  water,  i.  27 

Shoes  and  boots,  u.  241 

Sick,  aggregation  of,  risks,  ii.  6 

amount  of  ar  required  for,  i.  163 

men,  water  supply  for,  i.  7 

necessity  for  distribution  of,  ii.  7 

in  war,  division  of,  ii.  374 

rooms,  air  of,  i.  120 
Sickness,  cause  of,  ii.  288 

loss  of  service  from,  ii.  286 
Sida  in  water,  i.  73 
Sieges,  sanitary  duties  during,  ii.  379 
Sierra  Leone,  ii.  322 
Silica  in  water,  determination  of,  i  98 
Silicic  acid  in  water,  test  for,  i.  79 
Silver,  nitrate  of,  as  test  for  chlorine,  i.  77 

solution,  standard,  preparation  of,  ii 
380 
Simon  on  effects  of  impure  water,  i.  40 
Siphon  traps,  ii.  24 

clo.'^et-basiu,  ii.  25 
Sirocco,  effects  of,  ii.  88 
Site,  preparation  of,  for  military  purposes, 

i.  368 
Size  of  barracks,  ii.  211 
Skin  diseases  from  impure  water,  i.  59 
"Skip-jack"     or     "water-boatman"     in 

water,  i.  74 
Slate  for  cisterns,  best,  i.  13 
Sluice,  discharge  ot  water  through,  i.  10 
Small-pox,  discharges  from,  in  air,  i.  121, 
138 

disinfection  in,  ii.  176 

in  sheep,  i.  228,  236 

prevention  of,  ii.  142 
Smart  on  mountain  fever  and  malarious 

water,  i.  21 
Smith,  Angus,  on   composition  of   air,  i. 
113 

on  lead  poisoning,  i.  18 

on  rain  water,  i.  20 

resi-arches  on  air,  i.  113,  116,  127, 132, 
139 
Smith,  Edward,  on  diet,  i.  216 

on  exercise,  ii.  60. 

on  muscular  action,  i.  205 
Snellen  on  cholera  in  Utrecht,  i.  54 
Snow-line,  height  of.  ii.  102 
Snow  on  cholera  from  drinking-water,  i. 
54 

on    specific    diseases   propagated    by 
water,  i.  46,  47 
Snow-water,  causes  of  unwholesoraeness 

of,  i.  21 
Soap  solution,  graduation  of,  ii.  380 

preparation  of,  ii.  380 
Soap  test,  rationale  of,  i.  86 

for  hardness  of  water,  L  86 


INDEX. 


549 


Sodium  carbonate,  for  purifying  water,  i. 

ui 

chloride,  in  water,  i.  19 

chloride,  for  graduating  standard  sU- 
Ter  nitrate  solution,  ii.  380 
Sodium  salts  in  air,  i  113 
Soil,  air  in,  i.  346 

chemical  esamination  of,  i.  364 

conformation  and  elevation  of,  1.  355 

examination  of.  i.  3C4 

from  West  Coast  of  Africa,  i.  363 

mechanical  condition  of,  i.  364 

method  of  rendering  drier,  i.  355 

moisture  of.  i.  349  - 

solid  constituents  of,  i.  355 

temperature  of,  i.  364 

water  in,  i.  348,  351 
Soils,  i.  346 

absorption  of  heat,  i.  357 

alluvial,  i.  361 

animal  matter  in,  i.  359 

chemical  composition  of  solids  in,  i. 
358 

cultivated,  i.  361 

different  kinds  of,  i.  359,  360 

iron,  as  cause  of  fever,  i.  363 

made,  i.  361 

malarious,  i.  362 

mineral  constituents  of,  1  359 

of  India,  ii.  333 

vegetable  matter  in,  i.  358 
SoO.  water,   fever  produced   by  impeded 

outflow  of.  i  351 
Souchon  filters,  i.  36 
Solanum  tuberosum,  1  275 
Soldier,  clothing  of,  ii.  234 

f o  :'d  of.  ii.  226 

service  of,  ii.  195 
Soldierly  qualities,  ii.  290 
Soldiers,  supply  of  water  to,  i.  8 
Solids,  fixed,  in  -water,  i.  84,  85 

in  water,  dissolved,  i.  76 

quantitative  esamination  of,  i.  81 

tocal.  in  water,  i  83 

volatile,  in  water,  i.  84,  85 
Somerset  patent  trap.  ii.  26 
Sore  feet.  ii.  267,  268 

Sorghum  (or  panicum)  vulgare  (millet',  1 
270 

saccharatum  (miUetj,  i    270 
Soojie.  flour,  i  262 
Soxhlet's  apparatus  for  fat,  i.  280 
Specific  diseases,  prevention  of.  il  129 
Specific  diseases  propagated  by  water,  i.  46 
Sphere,  cubic  contents  of,  i.  193 
Spirillum  in  water,  i.  71 
Spirits,  i.  306 

composition  of.  i.  307 

used  in  different  countries,  i.  306 
Splenic  apoplexy  in  sheep,  i.  228,  236 
Sponge  as  a  filtering  medium,  i.  34 
Spongj'  iron  as  a  filter,  i.  35,  38 
Spongy   iron    does   not   favor   growth    of 
fungi,  i.  72 

filter,  figure  of,  fig.  11,  1.  110 


Sporendonema  casei,  i.  289 
Spotted  typhus,  ii.  140 
Sprengel  pump,  use  of.  i.  76 
Spring  water,  composition  of,  i.  23 
Springs,  calctilaiion  of  yield,  i.  9,  10 
Stables,  ii.  209 

air  of,  i.  123 

ventilation  of,  i.  167 
Standard  barium  nitrate  solution  for  soap 
test,  ii   380 

nitrate  of  silver  solution,  ii.  380 

soap  solution,  ii.  380 

solution  of  ammonium  chloride,  ii.  381 

solution   of   permanganate   of  potas- 
sium, ii.  381 

sulphuric  acid  solution  for  carbonates, 
ii.  383 
Starch-grains  of  arrowroot,  i.  273-274 

of  barley,  i.  252 

of  beans,  i.  254 

of  maize,  i.  253 

of  oat,  i.  255 

of  pea,  i.  354 

of  potato,  i.  353 

of  rice,  i.  255 

of  rye,  i.  256 

of  wheat,  i.  247 
Starches  and  sugars,  i.  273 
Starches,  tabular  synopsis  of  characters,  i. 
373,  274 
I  Starchy  substances,  1  204 
Stations,  dressing,  ii  373 

regimental,  ii.  373 
Statistics,  ii.  185 

in  war,  ii.  194 
Steam  pipes  for  warming,  ii.  57 
Stentor,  i  72 

Stephanurus  dentatus,  i.  228,  231 
Stevenson's  thermometer  screen  or  stand, 

ii.  119 
Stewing  of  meat,  i.  339 
St.  Helena,  ii.  321 
St.  Lucia,  ii.  314 
Stoddart  on  lime  juice,  L  343 
Stomach,  affections  of,  from  impure  water, 

i.  42 
Storage,  calculation  of,  L  11 

of  water,  i.  11 
Stoves,  cast-iron,  dangers  of,  ii.  58 
Stratus,  ii  116 

Streams  polluted  by  fecal  matter,  i.  158 
Stromeyer   on   military   conjimctivitis,   L 

138 
Strongylus  dnodenalis,  i.  64 

filaria,  i.  228 
Strychnos  potatorum  for  purifying  water, 

i.  31 
Stylonichia,  i.  73 
Sub-mains  for  water,  i.  15 
Sub-soil  water,  i.  26,  349 
Sugar,  i.  313,  274 
Sugars,  i.  204 

Sulphates  in  water,  action  on  lead,  1.  17 
.  Sulphates,  effects  of.  i  44 
i  Sulphides,  metallic,  as  cause  of  goitre,  i.  63 


550 


INDEX. 


Sulphides  in  water,  tests  for,  i.  77 
Sulphur  dioxide.     See  Sulphurous  acid. 
Sulphur,  quantity  required  for  fumigation, 

ii.  172 
Sulphuretted    hydrogen.     See    Hydrogen 

sulphide. 
Sulphuric  acid  in  water,  determination  of, 
by  soap  test,  i.  90 

acid  by  weight,  i.  90 

acid  solution  for  carbonates,  ii.  383 
Sulphurous  acid  as  air  purifier,  ii.  172 

acid  for  preserving  meat,  i.  240 

acid  gas,  effects  of,  i,  141 

acid  in  wnter,  effects  of,  i.  60 
Sun's  rays,  effects  of  direct,  ii.  83 
Sunstroke,  rarity  of,  in  mid-ocean,  ii.  84 

prevention  of,  ii.  148 
Supply  of  water,  constant  and   intermit- 
tent, i.  14-16 
Surface  water,  i.  8,  26 
Suspended  matters  in  air,  i.  115 

matters  in  enclosed  spaces,  i.  119 
Sutherland  on  hard  water,  i.  42 
Sutton's  method  of  ventilation,  i.  185 
Savern  deodorant,  ii.   41),  183 
Swansea,    sulphurous    acid    from   copper 

works,  i.  60 
Sweet  potato,  i.  276 
Sylvester's  plan  of  ventilation,  i.  170 
Syntonin,  i   204,  208 

Syphilis,  effects   of,    in   producing   aneu- 
rism, ii.  281 
Syphilis.     See  Venereal  Diseases. 

Table  of  useful  measures,  i.  83,  and  Ap- 
pendix B,  ii.  385 

to  show  discharge  of  air,  i.  194 
Tabular  view  of  qualitative  tests  in  wa- 
ter, i.  77 

of  inferences  from  do.,  i.  81 

of  classes  of  drinking  water,  i.  103- 
106 
Tacca  or  Otaheiti  arrowroot,  i.  272 
Taenia,  i.  63 

marginata,  i.  231 

mediocanellata,  i.  228,  231,  237 
Tallow-makers  and  bone-burners,  i.  156 
Tanks,  cleaning  of,  i.  12 

for  water,  i.  12 

materials  of,  i.  13 
Tank-worms  in  India,  i.  73 
Tannin  for  purifying  water,  i.  32 
Tape -worm,  i.  63 
Tapioca,  i.  272 
Taps,  screw,  required  for  constant  water 

supply,  i.  15 
Tartaric  acid  in  wine,  i.  303 

acid  in  scurvy,  ii.  151 
Tasajos  (dried  meat),  i.  291 
Taylor,  Inspector-General  J.  R. ,  on  order 

of  march,  ii.  2(58 
Tea,  action  of,  i.  208 

advalterations  of.  i.  334 

as  an  article  of  diet,  i.  338 

composition  of,  i.  333 


Tea,  examination  of,  i.  335 

for  purifying  water,  i.  32 

leaf,  structure  of,  i.  333 
Telluric  effluvia,  diseases  attributed  to,  i 

348 
Temperature,     conditions     affecting,     ii. 
101 

corrections  for,  for  heights,  ii.  Ill 

corrections  for,  ii.  107 

effects  of  elevation  on,  ii.  336 

effects  of  land  and  water  on,  ii.  101 

effects  of,  on  health,  ii.   82 

effects  of  rapid  changes  of,  ii.  87 

in  India,  ii.  334 

mean,  ways  of  obtaining,  ii.  99 

of  the  air,  recording,  ii.  97 

of  the  body,  ii.  84 

periodic  changes  of,  ii.  100 

range  of,  ii.  99 

required  for  evaporation  of  water  in 
analysis,  i.  84 

variations  of  climate  due  to,  ii.  82 
Tenay  (millet),  i.  270 
Tent,  bell,  ii.  18 

bell,  cubic  contents  of,  i.  192 

circular,  ii.  219 

marquee,  ii.  219 

shelter,  ii.  219 
Tente  d'abri,  ii.  220 
Tents,  American,  ii.  220 

and  camps,  ii.  218 

Edgington's,  ii.  221 

French,  ii.  220 

hospital,  ii.  375 

Indian,  ii.  219 

officers',  ii.  219 

Prussian,  ii.  220 

Rhodes',  ii.  221 

Russian,  ii.  220 

Turner's,  ii.  221 

ventilation  of,  ii.  218 
"  Terai,"  unhealthy  region,  i.  363 
Terebene,  Bond's,  ii.  183,  184 
Terrestrial  radiation  thermometer,  ii.  98 
Tliackrah  on  diseases  of  workmen,  i.  133 
Thames  water,  objects  of  (Plates  II.  and 
III.),i.  74 

water,  substances  in,  i.  72 
Thermantidote,  ii.  214 
Thermometer,  common,  ii.  98 

scales,  ii.  386 

relations  of,  ii.  102 

stand,  War  Office,  ii.  118 

stand,  Stevenson's,  ii.  119 
Thermometers,  maximum,  ii.  97 

minimum,  ii.  98 

reading  of,  ii.  98,  99 

spirit,  ii.  98 

wet  and  dry,  ii.  103 
Threadworms,  i.  73 
Throat  ulcer  from  impure  water,  i.  59 
Thudichum  and  Dupre  on  the  albuminoid 

ammonia  method,  i.  82 
Tichborne  on  street  dust,  i.  118 
Tidal  river,  influence  on  wells,  i.  27 


INDEX. 


551 


Tidy,    process   for   oxidizable   matter    in 

water,  i.  95 
Tiemann  on  carburetted  hydrogen  in  wa- 
ter, i.  76 
Tilbury  Fort,  cases  of  ague  at,  i.  49 

marsh  poisoning  through  water,  i.  28 

objects  in  water  from  (Plate  IV.),  i. 
74 
Tilbury  Fox  on  Trichophyton  in  air,  i.  120 
Tin  lining  for  lead  pipes,  i.  18 

water  pipes,  i.  18 
Toronto,  ii.  318 

Tortola,  impure  water  of,  causing  dysen- 
tery, i.  45 
Total  solids  in  water,  i.  84 
"  Tous-les-mois,"  i.  272 
Town  wells,  water  fro^i,  i.  26 
Towns,  air  of,  i.   130 
Townsend  on  cholera  in  India,  i.  56 

on  fever  from  marsh  water  in  India, 
i.  47 
Towns,  supply  of  water  to,  i.  3 
Trades,  dust  produced  in,  and  effects,  i.  33 

vitiation  of  air  by,  i.  30 
Training,  ii.  73 
Transports,  amount  of  water  allowed  in,  i.  4 

for  healthy  troops,  ii.  361 

for  sick  troops,  ii.  361 
Traps  (for  drains,  etc.),  ii.  24r-26 

efficiency  of,  ii.  25 
Trap  rock,  water  from,  i.  25 
Trautman  on  minute  cells  in  air,  i.  117 

on  putrefaction  cells,  ii.  172 
"  Trembles,"  i.  285 
Trees,  eflEect  of,  on  soU,  i.  356 

evaporation  from,  i.  356 
Triangle,  area  of,  i.  192 
Trichina  spiralis,   i.   229,  230,   231,   237, 

338 
Trifolium  arvense,  i.  256 
Trinidad,  ii.  310 
Tropical  climates,  causes  of  unheal thiness, 

ii.  80 
Tropics,  water  supply  in,  i.  7 
Troubridge,  Sir  T.,  his  yoke  valise,  ii.  252 
Trousers,  ii.  240 
Tubercular  diseases,  ii.  275 
Tubes,  vertical,  Tobin's  and  others,  i.  178 
Tunic,  ii.  239 
Turbidity  of  water,  i.  41 
Turkish  or  Roman  bath,  ii.  84,  121 
Turmeric,  as  reagent,  i.  77 
Turner  on  butter  analysis,  i.  287 
Tyndall  on  bacteria,  i.  71 

on  influence  of  humidity  on  climate, 
ii.  87 

on  suspended  matters  in  air.  i.  117 
Typhoid  fever.     See  Enteric  fever. 
Typhus,  cessation  of,  due  in  part  to  more 
abundant  water  supply,  i.  39 

disinfection  in,  ii.  176 
Typhus  exanthevQaticus,  ii.  140 

in  war,  great  danger,  ii.  371,  373 

propagated  through  air,  i.  145 


Uhlk  on  effects  of  ozone  on  malaria,  iL 

93 
Underclothing,  ii.  237 
Universal  disinfecting  powder,  ii.  181 
Uredo  in  wheat,  i.  241 
Urea,   elimination  of,   during  exercise,  ii. 

61' 
Urinals,  ii.  208 
Utrecht,  cholera  in,  i.  54 

Valise  equipment,  ii.  253 

Vallin  on  the  effect  of  heat  on  fabrics,  ii. 

168 
Van  Hecke,  plan  of  ventilation,  i.  170, 188, 
189 

ventilation  plans,  i.  170 
Vanne,  as  source  of  water  in  Paris,  i.  40 
Vapor,  weight  of  cubic  foot  of,  ii.  105 
Varagoo  (millet),  i.  270 
Vauvray  on  dengue,  ii.  1 33 
Vegetable  acids,  salts  of,  i.  208 

and  peat  charcoal  as  filter,  i.  35 

growths  in  tanks,  etc.,  i.  12 

matter,  dead,  in  water,  i.  12 

suspended  matter  in  water,  i.  43,  43 
Vegetables,  dried,  i.  293 

dried,  as  antiscorbutics,  i.  276 ;  ii.  153 

succulent,  i.  274,  276 
Vegetation,  effects  on  soil,  i.  356 
Velocity  of  air  currents  in   chimneys,   i. 
184,  185 

of  work,  effect  of,  ii.  72 
Venerea]  diseases,  ii.  155,  288 

at  Gibraltar,  ii.  297 

in  Jamaica,  ii.  310 

at  Malta,  ii.  301 

at  the  Cape,  ii.  327 

in  India,  ii.  356 

prevention  of,  ii.  155 

statistics  of,  ii.  159 
Ventilating  traps  for  drains,  ii.  26 
Ventilation,  i.  157 

area,  amount  allowed  in  barracks,  1. 
182 

by  action  of  winds,  i.  169 

by  diffusion,  i.  169 

by  extraction,  i.  183 

by  propulsion,  i.  188 

experiments,    apparatus   required,    i. 
201 

improved,  good  effects  of,  in  cavalry 
stables,  i.  112 

mechanical,  i.  164 

natural,  i.  165,  168 

natural   and   artificial,  relative  value 
of,  i.  189 

of  Indian  barracks,  ii.  214 

of  sewers,  ii.  25,  30 

openings,  size  of,  i.  175 

practical   applications   of  theoretical 
statements,  i.  174 

Sylvester's  plan,  i.  170 

system  adopted  in  the  army,  i.  182 
Ventilator,  M-Kinnell's,  i.  181 
Ventilators,  Watson's,  Muir's,  i.  180 


yoi 


INDEX. 


"Verderame"  or  "Verdet"  of  maize,  i.  | 

269 
Vernier  scale,  ii.  207 
Vibriones  in  air,  i.  116 

in  Hour,  i.  249 
Vierordt  on  effects  of  heat,  ii.  85 
Vienna  Congress  on  ozone  observations,  ii. 

118 
Vinegar,  i.  337 

adulterations  of,  i.  339 

and  ammonia,  as  air  purifiers,  ii.  173 

a  preventive  of  scurvy,  ii.  151 

examination  of,  i.  337 
Virchow  on  ground  water,  i.  353 
Vitreous  glaze  (D.  Lavenant's),  for  pipes, 

i.  17 
Voelcker  on  water  from  the  Lias,  i.  25 
Vogel's  lactoscope,  1.  280 
Voit's  experiments  on  food,  i.  205 
Volatile  solids  in  water,  i.  84 
Volga,  effects  of  water  of  the,  i.  43 
Volumetric    analysis,    standard    solutions 

for,  ii.  380 

Walcheren,  dysentery  at,  i.  45 

Waldie,  Mr.  D. ,  on  filtration  of  Hooghly 

water,  i.  33,  34 
Walking,  work  done  in.  ii.  71 
Walls  of  barracks,  ii.  213 

passage  of  air  through,  Pettenkofer's 
experiments,  i.  1G9 
Wo.lz  on  enteric  fever  from  water,  i.  50 
Wanklyn,  miniature  gallon,  i.  83 

on  composition  of  milk,  i.  277 

on  tests  for  metals  in  water,  i.  78 

simple  form  of  steam  bath,  i.  84 

method  for  organic  matter  in  water, 
i.  91 
War,  ii.  305 

amount   of    hospital  accommodation 
during,  ii.  378 

causes  of  sickness  and  mortality  in, 
ii.  371 

cleanliness  in,  ii.  368 

cooking  of  food  in,  ii.  367 

entry  on,  ii.  3G9 

equipment,  ii.  237 

food  in,  ii.  227-229,  872,  378 

hospitals,  ii.  373 

sanitary  duties  connected  with,  ii.  372, 
373,  378 

inspection  of  meat  during,  i.  238 

marches  during,  ii.  261 

preparation  for,  ii.  366 

sanitary  regulations  for,  ii.  370 

sickness  during,  ii.  371 

statistics  in,  ii.  194 

Office  experiments  on  water,  1.  4 
Warm-water  pipes,  ii.  57 
Warmth,  degree  of,  for  houses,  ii.  54 

required  in  disease,  ii.  55 

different  kinds  of,  ii.  55 
Warming  of  houses,  ii.  54 
Warning  pipe,  for  constant  water  supply, 
i.  16 


Waste  preventers,  water,  i.  5 
Water,  i.  1 

action  on  lead,  i.  17 
albuminoid  ammonia  in,  i.  92 
amount  allowed  in  transiiorts,  i.  4 
amount  for  domestic  purposts,  i.  3 
amount  for  water-clo.'-ets.  i.  5 
amount  required  for  adults,  i.  4 
amount  for  women,  i.  4 
amount  for  children,  i.  4 
amount  for  animals,  i.  6 
amount  for  baths,  i.  5 
amount  required  for  the  sick,  i.  7 
amount  supplied  to  soldiers,  i.  3 
amount  used  by  poor  families,  i.  4 
amount  used  in  model  lodging- houses, 
.     i-4 
amount  used  in  prisons,  i.  4 
analy.sis,  form  of  report,  i.  102 
animal  matters  in,  i.  41,  70,  72 
army  regulations  on  the  subject  of, 

i.  1 
bacteria,  vibriones,  or  microzymes  in, 

i.  70 
brackish,  effects  of,  i.  44 
chemical    examination    of     dissolved 

solids,  i.  76 
chief  ingredients  of  impure,  i.  41 
chlorine  in,  determination,  i.  85 
classification  of,  i.  24,  103-106 
collection  of,  i.  8 

collection  of,  for  examination,  i.  66 
collection  of  sediment,  i.  67 
color  and  transparency  of,  i.  67 
composition  of,  i.  19 
concentrated,  examination  of,  i.  79 
constant  supply,  i.  3,  16 
containing  iron,  effects  of,  i.  42 
contamination,  of,  by  coal  gas,  i.  29 
contamination    of,     by    cholera    and 

typhoid  discharges,  i.  50,  51,  53 
contamination  of.  through  pipes,  i.  29 
deficiency  of,  effects  of,  i.  39 
dissolved  animal  organic  matter  in,  i. 

43 
dissolved  mineral  matters  in,  i.  44 
dissolved  solids  in,  i.  76,  83 
dissolved  vegetable  matter  in,  i.  43 
distilled,  action  on  lead,  i.  18 
distilled,  pure,  ii   382 
distribution  in  India,  i.  29 
distribution  of,  i.  14 
distribution  to  every  floor  of  house,  i. 

17 
effects  of  impure,  general  conclusions, 

i.  65 
effects    of,    in    producing  calculi   in 

China,  i.  61 
effects   of  suspended   vegetable  sub- 
stances in,  i.  43 
epithelium  in,  i.  70 
examination  of  dissolved  matters  in,  i. 

71,  72 
examination  of,  for  hygienic  purposes, 

i.  65 


INDEX. 


553 


Water,  filtration,  i.  32 

filtration  of,  in  reservoir,  i.  11,  12 
fittings,  Board  of  Trade  minute  on,  i. 

16 
fixed  solids  in,  i.  84 
foetid  gases  in,  i.  44 
free  ammonia  in,  i.  90,  91 
from  granite  strata,  i.  25 
from  marshes,  i.  26 
from  town  wells,  i.  29 
from  wells  near  the  sea,  i.  27 
fungi  in,  i.  71 
gases  in,  i.  75,  76 
good,  i.  103 

hard,  effects  on  horses,  i.  42 
hard,  Leech  on,  i.  42 
hard,  Sutherland  on,  i.  42 
hardness  of,  determination,  1.  86 
hardness  of,  sufficient  to  affect  some 

persons,  i.  99 
Impure,  i.   24,  106 
impure,  at    Gibraltar   during  yellow 

fever  epidemic,  i.  59 
impure,  causing  boils,  i.  59 
impure,  causing  diarrhoea,  i.  42,  43 
impure,  causing  diseases  of  the  bones, 

i.  60 
impure,  causing  dysentery,  i.  45 
impure,  causing  dyspepsia,  i.  4"3 
impure,  causing  erysipelas  and  throat 

ulcer,  diphtheria,  i.  59 
impure,  causing  skin  diseases,  i.  59 
impure,  effects  of,  on  pulmonary  and 

urinary  raucous  membranes,  i.  46 
impure,  effects  of,  Simon  on,  i.  40 
impure,  eff^-cts  on  alimentary  mucous 

memlarane,  i.  42 
impure,  effects  on  stomach,  i.  42 
impure,  producing  goitre,  i.  61 
impure,  propagating  cholera,  i.  53 
impure,  propagating  typhoid  fever,  i. 

50 
impure,  supply,  i.  40 
Impurities  of  distribution,  i.  29 
impurities  of  source,  i.  24 
impurities  of  storage,  i.  28 
impurities  of  transit,  i.  27 
impurities  from  manufactures,  i.  27 
impurities  from  sewage,  i.  27 
in  China,  purification  of,  i.  32 
in  soils,  i.  348 
insufficient  supply,  i.  39 
intermittent  supply,  i.  3 
iron  in,  taste  of,  i.  68 
living  animals  in,  i.  72 
limits  of  taste  in,  i.  68 
lustre  of,  i.  67 
measurements  of  streams  and  springs, 

i.  9,  10 
measurements  by  Dr.  Paikes,  i.  4 
metallic  impregnation  of,  i.  45 
microscopic  examination  of,  i.  69 
microzymes,  algse,  fungi,  infusoria  in, 

i.  41,70,  72 
mineral  particles  in,  L  70 


Water,  mineral  substances  in,  i,  44 

nature  of  suspended  matter  in,  i.  69 
not  concentrated,  examination  of,  i. 

77,  78 
organic  impurities,  i.  28 
organic  matter  in,  i.  40,  43 
oxidizable  matter  in,  i.  41,  94 
physical  characters  of,  i.  67 
precautions    in    estimating   dissolved 

solids,  i.  81 
producing  cholera  in  Holland,  i.  54 
propagating  entozoa,  i.  63 
propagating  malar- ous  fevers,  i.  47 
propagating  specific  diseases,  i.  46 
propagating  yellow  fever,  i.  59 
pure  and  wholesome,  i.  24,  103 
purification  of,  i.  30 
purification  of,  in  open  channels,  i.  28 
qualitative  chemical  examination  of, 

i.  76 
quality  of,  i.  19 
quantity  of,  i.  2 

quantity  necessary  for  analysis,  i.  66 
rain,  i.  8,  9 
restriction  of,  by  trainers,  wrong,  ii. 

68 
search  after,  i.  107 
sediment  of,  inanimate  substances  in, 

i.  70 
sediment  of,  chemical  examination  of, 

i.  74 
smell  and  taste  of,  i.  68 
solids  in,  i.  81 
storage  of.  i.  11 
supply  of,  i.  2,  3 
supply  of,  to  soldiers,  i.  107 
supply  of,  to  towns,  i.  3 
Bu>pended  animal  substances,  effects 

of,  i.  43 
suspended  fecal  matter  in,  effects  of, 

i.  42 
suspended  matters,  examination  of,  i. 

69 
suspended     mineral     substances     in, 

effects  of,  i.  42 
suspicious,  i.  24,  99 
taste  due  to  gases,  i.  68 
total  amount  required  per  head,  i.  4, 

5,  6,  7 
troughs,  ii.  43 
turbidity  of,  i.  41 
usable  i.  24,  104 
veget:ible  matters  in,  i.  70 
volatile  solids  in,  i.  84 
War  Office  experiments  on,  i.  4 
waste  preventers,  i.  5 
waste  of,  in  towns,  i.  15,  16 
Water-boatman  or  skipjack  in  water,  i,  74 
Water-bottle,  soldiers',,  i.  108 ;  ii.  246,  247 
carts  and  water-sacks,  i.  108 
cisterns  and  reservoirs,  i.  11,  12 
courses,  measurement  of  flow,  i.  10 
closets  and  water-troughs,  ii.  43 
closets,  water  required  for,  i.  4,  5 
fleas  in  water,  i.  73 


554 


INDEX. 


Water-gnat,  larvje  of.  in,  i.  74 

latrines,  water  for.  i.  5 

pipes,  i.  13.  IT.  IS 
Waterproof  clothing,  11.  79,  237 

courses,  ii.  2 
Waterproofing  of  boots,  11.  243 

of  cloth,  ii.  243 
Water  supply  for  hospitals,  1.  7 

supply  for  the  sick,  1.  7 

supply  in  India.  1.  7 

supply,  permanence  of,  i.  11 

supply  in  transports,  1.  107 
Water-tanks  in  India,  impurities  of,  i.  29 
Watery  vapor  in  air.  i.  2(J0 
Watson  on  air  of  phthisical  wards,  i.  120 

on  suspended  matter  in  air,  1.  197 
Weather,  Beaufort  notation  for  registering, 
ii.  11!J 

in  connection  with  disease,  ii.  119 
Weber    Brothers,    their    calculations    on 

length  of  step,  ii.  200 
Webb,  H.,  on  overcrowding  in  Indian  bar- 
racks, ii.  211 
Weber,  Hermann,  on  Alpine  climates,  iL  90 
Weber  on  hydrogen  sulphide  In  water,  1. 

44 
Weedon,  water  from,  i.  25 
Weevil  in  flour,  i.  249 
Weight  of  cubic  foot  of  air,  il.  103 

of  the  air,  ii.  112 
Weights  and  measures,  metrical,  ii.  385 

of  articles  of  dress  and  of  accoutre- 
ments, ii.  243 

modes  of  carrying,  ii.  249 
Weirs,  used  for  measuring  water  supply, 

i.  10 
WeU-water,  objects  in  (Plate  I.),  L  74 

composition  of,  L  21,  22 
Wells.  Artesian,  i.   8 

calculation  of  yield  of,  1.  11 

effect  of  tide  on,  i.  27 

near  the  sea.  water  from,  i.  27 

Norton's  American  tube,  L  8 

protection  of,  i.  13 
West  Coast  of  Africa,  ii.  327 
West  Indian  stations,    effects   of   impure 

water  in,  1.  45 
West  Indies,  ii.  303 

Wet-  and  dry-bulb  thermometers.  U.  103 
Wheat,  1.  241 

grain,  structure  of.  i.  245 

envelopes  of.  i.  245-247 

starch,  grains  of.  i.  247 

flour,  adulteration  of,  L  249 

diseases  of,  1.  248 

grains,  examination  of,  1.  245 
Wheel  animalcules  in  water,  i.  72,  73 
Whitvvell  on  hill  diarrhcea  of  India,  1.  42 


Wlldenstein's  method  for  sulphuric  acid  in 

water,  i.  90 
Wilson,  Dr.  G. .  on  amount  of  water  used 
in  Portsmouth  Prison,  1.  4 

on  air  in  prisons,  i.  122 

on  prison  diet.  i.  216 
Wind,  direction  of.  ii.  115 

force  of,  calculation,  iL  116 

velocity  of,  ii.  115 
Winds,  summary  of  direction,  ii.  115 
Windward  and  Leeward  Islandi!,  ii.  306 
Wine,  acids  in,  1.  303 

adulterations  of,  1.  305 

coloring  matters  in,  i.  305 

composition  of.  i.  301 

dietetic  value  of,  i.  326 

ethers  in,  1.  302 

examination  of,  i.  303 
Witt's  experiments  on  filtration,  i.  33 
Wolseley,  Lord,  on  alcohol,  i.  323 

on  wooden  huts,  ii.  225 
Women,  supply  of  water  for,  1.  4 
Wood  on  thermic  fever,  ii.  S5 
Wood,  products  of  combustion  of,  i.  125 
Wool,  ii.  77 

Woollen  underclothing,  ii.  237 
Worms  in  water,  i.  73 
Work  done,  calculation  of,  11.  70 
Work  of  the  soldier,  il.  72,  253 

Yam,  1.  276 

Yaws,  ii.  313 

Yeast,  examination  of,  1.  261 

Yellow  fever  a  fecal  disease,  11.  131 

communicability  of,  ii.  131 

fumigation  as  a  preventive,  U.  132 

at  Gibraltar,  ii.  295 

at  Malta,  ii.  300 

In  Barbadoes,  ii.  313 

in  Bermuda,  ii.  316 

in  Jamaica,  il.  307 

Incubative  period  of,  11.  132 

localization  of,  ii.  131 

on  the  West  Coast  of  Africa,  11.  322 

prevention  of,  ii.  132 

quarantine  in,  ii.  132 

water  propagating.  1.  59 

remittent,  different  from  true  yellow 
fever,  il  132 
Yerrauda,  cholera  at,  1.  56 

Zmc  cisterns,  1.  13 

chloride,  il.   181 

pipes  containing  lead  yield  It  to  water, 
L  17 

poisoning  through  water,  i.  13,  53,  54 

tests  for,  in  water,  1.  78 
Zoogloea  in  water,  1.  71 


INDEX. 


555 


INDEX   TO   AMERICAN   APPENDIX. 


Adulteration  of  coffee  and  tea,  511 

food,  legislation  on,  508 

milk,  509 
Agents  of  decomposition  in  water,  400 
Air,  cooling  of,  for  buildings,  474 
American  Public  Health  Association,  395 
Analyses  of  impure  water,  432 
Analysis,  sampling,  for  water,  422 

water,  interpretatic)n  of  results,  422 
Analyses  of  well  waters,  416 
Apparatus,  hot-water,  for  buildings,  466 
Artificial  soils,  441 
Associations,  sanitary,  B95 

Boards  of  health,  municipal,  398 
Board  of  health,  national  391 
Boards  of  health,  State,  394 
Bread  adulteration,  512 
Buildings,  ventilation  of,  special,  469 
Butter  adulteration,  512 

Canned  foods,  adulteration  of,  513 
Cesspool,  testing  connection  between  well 

and,  434 
Cheese,  adulteration  of,  513 
Chemical  examination  of  water,  423 

methods  for  purifying  air,  518 
Cisterns,    impurities  in  water  caused  by, 

405 
Classification  of  waters,  415 
Climatology,  443 
Coffee,  adulteration  of,  511 
Combination  of  sewage  and  surface  water, 

480 
Composition  of  sewage,  415 
Consumption  and  soil,  394 
Consumption  of  water  in  American  cities, 

483 
Contagious  diseases,  control  of,  396 
Conventions,  sanitary,  396 
Cooling  of  air  for  buildings,  474 

Defects  in  plumbing.  527 
Diseases,  control  of  contagious,  396 
Disconnection  of  house  drains  from  sew- 
ers, 488 
Disinfection  and  deodorization,  518 
Disinfectants,  use  of,  520 
Distufection  in  various  diseases,  520 
Disposal  of  sewage,  479 
Drinking-water  and  disease,  403 
Drug  and  food  adulteration,  397 
laws  in  New  York,  515 

Electricity  affecting  climate,  454 
Experiments  on  the  efficiency  of  traps,  490 

Factory  inspection,  399 

Filters,  420 

Filtration,  419 

Flour  and  bread  adulteration,  512 


Flow,  purification  of  streams  by,  411 
Food  adulteration,  legislation  on,  503 
laws  in  New  York,  515 

Grates,  stoves  and,  as  ventilators,  467 
Grease  interceptors,  500 

Health  resorts,  American,  446 
Hot-air  furnaces,  465 
Hot-water  apparatus,  466 
House  drains,  disconnection  of,  from  sew- 
ers, 488 
ventilation  of,  489 
House-waste,  removal  of,  397 

Ice,  434 

Impure  water,  analysis  of,  433 

Impurities  in  water  caused  by  cisterns,  405 

rain  water,  404 

water,  400 

wells,  412 
Indigenous  soils,  442 
Inspection  of  factories,  399 
Interceptors,  grease,  500 
Interpretation  of  results  of  water  analysis, 

423 
Irrigation,  sub- surface,  484  *^ 

Lactometer,  use  of,  510 
Lard  adulteration,  513 
Laws  of  New  York,  food  and  drug  adul- 
teration, 515 
Laws,  the  New  York  plumbing,  398 
Legislation  on  food  adulteration,  503 
Literature  on  food  adulteration,  514 

Marsh  soils,  440 

Measuring  rainfall,  460 

Meteorology,  457 

Milk  adulteration,  509 

Mineralogical  composition  of  soils,  437 

Moisture    and    temperature    in   buidings, 

468 
Municipal  boards  of  health,  398 

Necessity  for  water,  400 
New   York  food    and  drug    adulteration 
laws,  515 

Origin  of  soils,  435 
Ozone  and  rainfall,  453 

Peppermint  test  for  defects  in  plumb« 

ing,  527 
Plans,  prizes  for  tenement  house,  398 
Plumbing,  defects  in,  537 
Plumbing  law,  the  New  York,  398 
Pollution  of  streams,  397 
Ponds  and  streams,  water  of,  409 
Public  Health  Association,  American,  395 
schools,  397 


556 


INDEX. 


Purification  of  water,  41G 

by  flow,  411 
Purifying  air,  chemical  methods  for,  518 

rooms  after  infectious  diseases,  519 
Purity  of  water,  standards  of,  i'dO 

Rainfall  and  ozone,  452 

measuring  of,  4G0 
Rain-water,  403 

impurities  in,  404 
Removal  of  house -waste,  397 
Resorts,  health.  440 

Rooms,    purification   of,  after    infections 
diseases,  519 

Sampling  water  for  analysis,  423 
Sanitary  associations,  395 

conventions,  39G 

inspection,  534 
Schools,  public,  397 
Sewage,  composition  of,  415 

disposal  of,  479 

and    surface-water,    combination   of, 
480 
Sewers,    disconnection    of,    from    house 

drains,  488 
Simplicity,  importance  of,  in  plumbing, 

500 
Snow,  407 

Soil  and  consumption,  394 
Soils,  artificial,  441 

indigenous,  443 

mineralogical  composition  of,  437 

origin  of,  435 

transported,  438 
Sources  of  water,  400 
Springs,  surface  water,  407 
Standards  of  purity  of  water,  430 
State  boards  of  health,  394 
Statistics,  vital,  394,  533 
Stoves  and  grates,  ventilating,  467 


Streams  and  ponds,  water  of,  409 

Sub-surface  irrigation.  484 

Surface  water  and   sewage,  combination 

of,  480 
Systems  of  sewerage,  397 

Tea,  adulteration  of,  511 

Temperature  and  moisture  in  buildings, 

408 
Tenement  house,  prize  plans,  398 
Transported  soils,  438 
Traps,  experiments  on  efiBciency  of,  490 

Use  of  disinfectants,  520 

Vaccination,  396 

Ventilating  stoves  and  grates,  467 

Ventilation  of  house  drains,  489 

special  buildings,  409 
Vital  statistics,  394,  522 

Water,  agents  of  decomposition  in,  400 

analysis  of  impure,  433 

chemical  examination  of,  423 

consumption    of,  in  American  cities, 
483 

drinking,  nnd  disease,  403 

hot,  apparatus  for  buildings,  466 

impurities  in,  400 

necessity  for,  400 

of  ponds  and  streams,  409 

purification  of,  410 

rain,  403 

sources  of,  400 

standards  of  purity  of,  430 
Waters,  classification,  415 
Well,  testing  connection  between  cesspool 
and,  434 

waters,  analyses  of,  416 
Wells,  413 

impurities  in,  413 


Pi2. 


QL^e--  ^ 


